We need to talk – businesses need to tackle emotional wellbeing

Brendan Street, Professional Head of Emotional Wellbeing at Nuffield Health; Alaana Linney, Director of Business Development


One in four people in the UK will experience a mental health problem this year. For many of them, it will affect their performance at work. In fact, it is likely to cost employers between £33billion and £42billion according to the 2017 report Thriving At Work, developed for the Prime Minister by Stevenson and Farmer. This amounts to a cost per employee of between £1,205 and £1,560 per year – a cost for all employees, not just those who are ill.

The one-in-four statistic is useful in terms of indicating how common mental health problems are.  However, Nuffield Health takes the view that all employees have emotional wellbeing needs, in the same way that they have physical health needs.

Employers can take steps to support their staff and cut the costs of mental health problems. Interventions from awareness campaigns, on-site clinics offering psychological interventions, mental health first aiders through to access to a nationwide network of therapists can reduce the burden. In fact, Deloitte calculated the return on investment of interventions as between £1.40 and £9.40 for every £1 invested.

Many employers might not be aware of the true scale of these conditions, though, as many employees will carry on coming into work but will operate less efficiently. So it might not show up as sick leave or even staff turnover, but instead as poor concentration, tearfulness, short temper or changes in personal appearance. This is often referred to as “presenteeism”. Presenteeism alone is estimated to cost employers in the UK between £17billion and £26billion.

We all have emotional wellbeing needs and these needs vary, day to day, week to week, year to year, depending on what is going on in our lives, says Brendan Street, professional head of emotional wellbeing at the corporate wellbeing provider Nuffield Health. Just as people have physical health needs that can change over time, so too do our emotional wellbeing needs. And emotional wellbeing is more than the absence of mental ill health.

Last year Nuffield Health helped more than 100 ScotRail employees cope with significant emotional challenge and return to good health. It provided emotional wellbeing support for ScotRail train drivers who had suffered traumatic experiences at work. These can lead to drivers developing long-term problems including post-traumatic stress disorder.

Help starts with a call to an emotional wellbeing therapist, and can lead to a course of therapy such as cognitive behaviour therapy. All therapies are evidence-based and endorsed by the National Institute for Health and Care Excellence (NICE). With therapists across the country, the therapy sessions can take place face-to-face or over the phone.

The approach proved so successfulwas opened up to all colleagues across the company.

Street recommends businesses should tailor the services they offer to the unique needs of their organisation and employees. In some businesses, having mental health champions – employees who raise awareness of emotional wellbeing – can make a big difference. It changes the culture, improving understanding and making it okay to talk about emotional wellbeing.

Theresa May has publicly backed the importance of transforming mental health in the workplace. Businesses need to tackle the challenge. The message that the employer values the emotional wellbeing of its employees and expects a dialogue about it needs to be delivered via training, communication and leadership. Employers that get it right will not just be doing the right thing, they will have an edge against competitors by reducing costs and retaining the best people.


Get in touch to discover how you can implement a health and wellbeing strategy.


Video Transcript:

Welcome to Business Reporter's Workplace Sustainability Campaign. I'm Rachel Hicks. Mental health is becoming more and more of a hot topic within the news agenda, particularly the impact these conditions have on the economy. And it's reported that approximately one in four people in the UK will experience a mental health problem each year. And one in six people in England report experiencing a common mental health problem, such as anxiety or depression, in any given week.

In 2017, findings from the Thriving at Work report showed the UK is facing a significant mental health challenge at work, with an annual cost to the UK economy reported to be 99 billion pounds and a cost of 42 billion pounds to employers. So how can organisations look after their employees and offer the most appropriate support? This is what we're going to find out from the experts of Nuffield Health.

Good morning. Thank you for joining us here, Alaana Linney and Brendan Street from Nuffield Health. Now, I know that you would like employers to care more about the well-being of their employees. But before we discuss that, can we look at the epidemic state of health issues facing employers, stakeholders, and the boardroom at the moment?

Sure, so I think there's probably two major issues in terms of health and well-being and the workforce. One is musculoskeletal issues-- so things like back, knee, hip pain, et cetera-- stopping people from being able to perform at their optimum. And the second is mental health issues. And when we think about physical health conditions, there's a lot of access to information and support for those employees. But what we're seeing is there's not the same prevalence of support with mental health issues.

I think also, interestingly, that the two are intrinsically linked. So if you've got a mental health condition, you're more likely to have a physical health condition. If you've got a physical health condition, you're three times more likely to have a mental health condition. And I think added to that, if you've got a mental health condition, you're less likely to do well with your physical health condition.

OK, so if we look a little bit more at mental health, it's difficult to see it, isn't it? It's very nebulous. It's not like a physical ailment, like obesity. So what sort of health problems should we be looking out for and that exist out there?

I think maybe initially, in terms of your point about it being nebulous, it's probably nebulous because of the words we've got to describe it and that people don't understand those words. So terms like depression and anxiety are not commonly known by people. People don't know what that means, and that's why it's maybe a nebulous term. The moment you start to drill down into terms of, what are the symptoms?

So patients that I see on a day-to-day basis, a patient that I saw recently in terms of depression. He was experiencing behavioural signs of depression. So he'd stopped seeing his friends and family. He'd started drinking more than he was drinking previously. In terms of physical symptoms, he wasn't sleeping well, and he was fatigued all the time. In terms of emotional symptoms, he was tearful all the time. He felt agitated all the time. So a range of different symptoms. So it's more than just the words. It's actual personal experience.

I think you can recognise them, as well, within a work environment. So people who are more quickly irritable, or that they look tearful, or they are struggling to manage conflict. So there are recognisable symptoms which I think employers and colleagues can look out for, which can actually start to help direct people who are experiencing mental health conditions.

Can you give us the numbers that this looks like? What kind of loss is that?

Yeah, so it's actually quite frighteningly large. So I think it's Thriving at Work report estimates between 33 billion and 42 billion per annum. And what that equates to is the cost per employee, so not just employees with ill health. It's per every employee.

Between 1,200 and 1,500 per employee, that's what it's costing employers. And that's for every employee, not just the ones that are ill. It's an interesting figure because that figure of 1,200 would be around about the amount that it would cost to provide one-to-one, face-to-face therapy-- an effective course of therapy to treat anxiety or depression. And you don't need to treat them all because they're not ill. So there's a cost saving there anyway.

And there's something that's affecting the workplace as well-- presenteeism. What is it, and what does it look like?

I mean, basically presenteeism is coming into work when you're ill. So feeling the pressure that, even though you're feeling below par and you're ill, that you still feel that you need to come into work.

It's kind of turning up, but not actually delivering on what you're supposed to be doing. And actually, there's a study which was by Britain's Healthiest Workplace which looks at workplace impairment, so that's both presenteeism and absence. And what they find is it's endemic. All organisations have got workplace impairment. And the average is around 30 days. So the larger the organisation, the bigger it is. But there's lots of things that you can do to really impact that. So making very small changes can have a dramatic impact in terms of presenteeism and workplace impairment.

This sounds great, but your definition implies that an employee is reliable and willing to work. Now, you could take a sceptical line manager who will say, well, your well-being policy is going to backfire. And actually, his employee isn't willing to work and isn't very reliable. And actually, we're just turning his workplace into a sort of social welfare hostel. What do you say to that?

It's pretty cynical. But yeah, I think there's two things here. One is that there are, obviously, performance management issues within a workplace, and actually having a mental health framework doesn't preclude the ability to manage someone's performance. But it gives you a safe environment in a safe framework in which you can support people to make those changes if it is mental health issues.

Supposing that the person is playing straight is a lot safer than trying to catch them out and look sceptically. Because if you do the sceptical side, then you don't have a safe framework, and then you--

You are opening yourself up to risk as an organisation.

Yeah, definitely. The Equalities Act, the Health and Safety at Work Act. So keep it simple, and suppose people are being honest with you.

OK, so let's say that the C-suite recognised the problem of mental health issues in the workplace, and they want to invest in it. What steps would they need to take?

So there's kind of two strands to this. One is that you need to look at it at an individual level, so that you can then build your global strategy on the back of that. So one way of doing that is serving a total population to really understand what the risks are within that business. And there'll be both vocational and non-vocational issues. And what we see is, actually, money should follow risk, and not everyone needs to have the same level of intervention within the business.

So either individual risk needs to be addressed, or we can put together strategies that help the organisation as a whole. And where we see this works really well is where organisations have the managing director or the CEO, and they're really being involved in that narrative and talking about personal experience, as well. Where we see it work not so well is where people say that it's really important, but then they have nothing there really from a senior leadership point of view.

You know, they're sending emails all over the weekend. They're being quite impactful in the way that they engage with their workforce. And actually, then it doesn't work, and it doesn't resonate because they're not actually living and breathing that strategy.

So it's a cultural change in recognition of symptoms and, of course, not being afraid to talk to people once we become familiar with recognising symptoms.

Yeah, and I think we've come a long way actually in the last five years. A lot of work is being done to really remove the stigma around mental health, but not a huge amount of work has been done to actually create cultures where people can thrive. So we're talking about it. It's good there's a budget. Often, it's recognisable. But actually doing the things to move the workforce forward-- that's where we are now. And it's really about investing in a strategy.

To give you an example, we work with a utilities company. And when we started working with them, they came to us because they wanted to provide physiotherapy to all of their employees, which is-- it's a great contract. It's fantastic, and it shows that they are investing in their people. But actually analysing their data-- and they had not brilliant but reasonable absence data-- what we could see was, actually, the issue that they had was-- there was a musculoskeletal issue because that is an endemic issue in all businesses.

There were specific areas of risk within their call centre environments, so we could see that actually there was mental health issues in specific call centres. So what we were able to do, then, is look at how we deliver resilience training for their leaders in those environments. We look at the job role, and we also put in place access to services, which means that we can then start to reduce that absence and ultimately achieve their long-term objective, which is to reduce the cost in terms of absence cost.

But it's a really good example of where money can follow risk. And actually, we are able to deliver physiotherapy services to those engineers that need it. But actually mental health services to those call centre handlers because that's what they need. And you don't have to have-- an equitable well-being solution isn't about doing the same thing for everyone. It's about giving people the provision that is appropriate for the risk that they're experiencing.

We've ranged over many topics and issues in our discussion today. What would you say are the main takeaway points?

I guess there's two for me. One is that there is-- you know, there is a financial and moral imperative to developing a mental health strategy. And the second is that actually you need to understand risk as both at an organisational level, but also at an individual level. And that individual understanding is going to help you build a global health care strategy. So it's really important to survey your people and develop a strategy on the back of that.

Yeah, I definitely agree with that. It's the right thing to do, and it's the right thing to do for the business and the individuals.

Brendan Street, Alaana Linney from Nuffield Health. Thank you so much for joining us today.

Thank you.