MANAGING MENTAL HEALTH

Tony Bough (CFIOSH, CMCIPD)Head of Health and Safety, RSA

CONTENTS

Intro to RSA – understand the context

What we think causes stress

Where we focussed investment

Overview of training

Metrics - if its not measured its not valued

Next steps

Example case study

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RSA – THE CONTEXT

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RSA – the context

With a 300-year heritage, RSA is one of the world’s leading multinational insurance groups. Today, we employ around 23,000 people, serving 17 million customers in over 140 countries.

Broad types of employees (UK).

•Call centre workers•Office workers (Insurance Claims/HR/Marketing/Executives/broker partners etc)•Engineers and Surveyors (visiting all conceivable workplaces)•Global consultants (Risk, H&S, etc)•Claims specialists (on the road/site visits)•Quality Repair Centre workers (vehicle workshops)•Homeworkers (encompassing Engineering, claims and general call centre work)

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Counselling / EAPCognitive behaviour therapy / including training for Leaders in understanding it.

Back Care / Physiotherapy / ergonomic solutions in the workplace /MSD management by OH professional.

Flu vaccinations Healthy catering / training on healthy eating

Private health insurance / Discounts on private healthcare

Flexible working, purchase additional holidaysDetailed job descriptions and performance appraisal system. Flexible benefitsOccupational HealthCampaigns on various wellbeing topics

Leaders trained to talk to employees on wellbeing prior to absence management issues occurring

Discounted gym membership / on-site facilities / promotion of exercise

Health Risk Assessments / Pre-employment health screening on common health issues

Promotion of Learning and Development

Focus on staff communication* Items marked in red are not provided by RSAhttp://www.bitc.org.uk/east/what-we-offer/business-action-public-health/employee-wellbeing-survey

What we already had in place

STRESS IN RSA

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• To be able to understand which department has the highest instances of stress we need to factor out the number of people in each department

• To do this we have taken the days lost due to stress in each department and divided it by headcount x days per month

• This gives us an incident rate of days lost due to stress per person per department and allows direct comparison

• UK Personal consulted on changing contracts in August which was implemented in October with further changes in Aug 14. There was also a back office review in September leading to redundancies in Manchester and wider changes in the department

WHAT CAUSES STRESS(OUR OPINION/EXPERIENCE)

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What causes stress resulting in absence or the need for assistance?

Combination of; work + Home + Individual susceptibility.

We started with a small and easily understood statement of what we wanted to achieve. With emphasis on the positives.

RSA values Employee Wellbeing. Employee wellbeing is a positive state in which the employee is able to function at or near their optimal level, which is defined and measured in terms of their physical, mental and emotional functioning within their team/role and has significant implications for our employee, their family, RSA and the experiences of our customers.

In managing Wellbeing RSA aims for;•A management style and organisational culture that promotes mutual trust and respect.•The Promotion and enabling of better communications and social cohesion to support good relationships in the workplace.•Support and interventions to manage health and wellbeing.•The promotion of a physically safe working environment.•The promotion of employee engagement and brand beliefs.

HOME STRESSORS

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Home stressors are influenced by an individuals life circumstances

Circumstances and therefore stressors differ between individual age groups as well as include issues such as relationship problems, money worries, health worries etc. Therefore the workplace interventions (preventative and reactive) need to be broad enough to consider this.

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The effects on the body

WORK STRESSORS

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Work stressors are as follows

Long hours

•unrealistic deadlines and expectations, often as a result of super achievement by the most talented

•technology overload

•unmanageable workloads

•under recruitment of staff for work already planned or in place

Job security, particularly in relation to terms of employment and stress levels

•How much change is the department / team going through?

•The experience of pressure is strongly linked to perceptions of control. Lack of influence and consultation in the way in which work is organized and performed, for example:

• lack of control over aspects of the job

• lack of involvement in decision making

• account not taken of staff ideas/suggestions about the job

• lack of influence over performance targets

• lack of time

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Work stressors are as follows

Work relationshipsMany roles demand regular contact with other people at work. Poor or unsupportive relationships with colleagues and/or supervisors can be a potential source of pressure. In addition, pressure can occur if individuals feel isolated or unfairly treated.

Poor work relationships can be a result of:•aggressive management style•lack of support from others•isolation at work•aversive behaviour, e.g. bullying and harassment•lack of understanding and leadership•manager forever finding fault•others not pulling their weight•others take credit for personal achievements•poor relationships with colleagues

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Work stressors are as follows

Job security

This is the extent to which lack of job security and job changes are a source of pressure, for example:

•job insecurity

•lack of job permanence, e.g. temporary/fixed term contracts

•future job change

•fear of skill redundancy

Work-life balance

The demands of work have the potential to spill over and affect personal and home life and so put a strain on relationships outside work, for example:

•long hours: being expected to or having to work additional hours at home to the detriment of personal, partner and family relationships

•over-demanding and inflexible work schedules

•unsocial hours

•excessive travel time

•work interfering with home/personal life

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Work stressors are as follows

Resources and communication

To perform a job effectively, individuals need to feel that they have appropriate training, equipment and resources. They also need to feel that they are adequately informed and that they are valued. Stress may result from lack of:•information about what is going on in the organisation•feedback on performance•adequate training to do the job•equipment/resources to do the job

Aspects of the job

These are potential sources of stress that relate to the fundamental nature of the job itself. Factors such as the physical working conditions, type of tasks and the amount of satisfaction derived from the job.•fear of aggression from Leaders/colleagues•work performance closely monitored but not effectively managed •organisation changes for change's sake (employee perception due to lack of communication)•dull and repetitive work•dealing with difficult customers/clients constantly with no job rotation or alternative tasks•lack of enjoyment of job

WE SURVEYED THE WORKFORCE TO SEE WHAT THEY THOUGHT WAS NEEDED

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Survey results – Mental Health

Is there a difference between wellbeing resources and mental health resources

Additional resources required for mental health support / management

WHERE WE FOCUSSED INVESTMENT

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Work related stressors – how to tackle them on an organisational level

Recruitment and Selection• Are we getting the job design correct? • Are we looking for all of the right skills?• Are we advertising for these skills?

• Are our Leaders who are interviewing capable of identifying these skills in the interviewee? • Have Leaders been trained to interview?• Is the process fair (affecting internal morale)?

• Are we selecting the right people?• Are we keeping these people?• Are we promoting these people?

• Are we taking the opportunity that induction presents us with and giving individuals the right skills and the opportunity to join RSA effectively?

• Is the induction sufficient in length / content type?• How well are Leaders trained to understand the importance of induction?• Is it a secondary and delegated activity?• Is it consistent with RSA’s values?• Is it a consistent experience for all new starters?

Induction

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• Are we enabling our employees to understand what they have to do?• Do they understand the process?• Do they understand the technology/equipment?• Do they understand why we are doing what we do as a business, and as a team?• Is the training employees receiveve effective?• Have we measured how effective the training is?• Do employees understand the aspects of their jobs? Our products? Etc?

• Are we talking to the workforce?• Are we talking about the right things?• Are we being open and honest?

Training and communication

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• Is it effective?• How good are managers at passing on understanding?• How good are Leaders at having difficult conversations outside of this process but as a

means of assisting its fairness?• How bought into the process are Leaders and therefore how bought in are employees?• Are we consistent?• Are we fair?• Are Leaders providing consistent feedback outside of the Performance Management

Meetings to allow employees to get a temperature check on their performance so that the Leaders’ and employees perceptions of performance are not drastically different?

• Do our company policies take into account individual circumstances?• E.g. Pension/benefits flexible to suit those at different life stages

Performance Management and other policies

1. Respectful and responsible: Managing emotions and having integrity2. Managing and communicating existing and future work3. Managing the individual within the team4. Reasoning/Managing difficult situations, incl reasonable adjustment.5. Understanding company policies.6. Different ways of communicating with your employees.7. Having Difficult conversations

We put our time and money into training our LeadersAn MHFA course will teach you to:

Spot the early signs of a mental health problem

Feel confident helping someone experiencing a problem

Provide help on a first aid basis

Help prevent someone from hurting themselves or others

Help stop a mental illness from getting worse

Help someone recover faster

Guide someone towards the right support

Reduce the stigma of mental health problems

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Measuring our success

1. Better WorkCharacteristics A management style and organisational culture that promotes mutual trust

and respect, including;Employment SecurityTalent ManagementJob design: task and variety challenge.Autonomy, control and task discretion.Non monotonous and repetitive work.Employee voice.

Key Indicator / metrics

Organisations values communicated to all employees. Employees understand the organisational values Organisational values within Leaders and Employees is measured. The commitment to training demonstrated by RSA, e.g. time allocated per

person. Feedback from employees, e.g. engagement survey. Evidence of leadership development, e.g. the proportion of senior positions

(Level 3 and above) filled by internal applicants.

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2. Better relationship Characteristics The Promotion and enabling of better communications and social cohesion to

support good relationships in the workplace particularly among:LeaderTeamSupport networksRelationships outside work (family and friends) are also supported through flexible working practices and involvement in social initiatives.

Key Indicator / metrics

Metrics revolve around flexible workingFamily friendly policiesCSR / volunteering. The results of RSA week and the everyone fund.Grievances undertaken. Trend data relating to grievances.Coaching and mentoring schemes. Trend data/time per person received against that allocated.

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3. Better specialist supportCharacteristics Support and interventions to manage health and wellbeing which may be provided

by:Occupational HealthLeader CoachesEmployee assistance/counsellingTraining for Line Managers / especially in relation to managing areas such as mental health.

Key Indicator / metrics

Attendance management/absence data. Utilisation rate of the EAP Leader feedback / audit of the occupational health service. Leader feedback of the Leader coach service, utilisation/delivery rates etc. Data in relation to litigation, e.g. ET’s.

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4. Better physical and psychological healthCharacteristics The promotion of a physically safe working environment.

Promoting healthy behaviours such as emotional resilience which builds self-esteem, healthy eating, physical activity, smoking cessation, sensible drinking and avoidance of drug misuse.

Key Indicator / metrics H&S Risk register. Health and Safety legislative compliance (spreadsheet) Accident data/trend. Free Eye tests, utilisation rates Information relating to statutory health surveillance. Health and Wellbeing promotions and campaigns (on a site basis).

Measured by occurrence and take-up. Absence data examined based on health issues. EAP data giving trends on disorders, drug issues etc. Demographic data relating to health risks, such as age (will affect

decisions in relation to wellbeing topics)

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5. Working wellCharacteristics The promotion of employee engagement and brand beliefs.

Employees feel trusted and that their work is valued and makes a difference.Employees believe that their views are respected and considered.A proactive approach to employee physical and psychological and social wellbeing.A think customer attitude endemic within the business.Employee and company objectives are aligned

Key Indicator / metrics Diversity and inclusion present within the business. Voluntary staff turnover at the levels expected and required by the

business (including exit interview feedback). Business performance. Corporate/Leaders scorecard Clearly defined governance for engagement and wellbeing. Productivity data (as indicators of what facilitates/impairs

employee productivity).

NEXT STEPS

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• Survey employees again as part of an engagement survey.

• Form a Wellbeing forum as a means of giving this topic constant scrutiny on areas such as company policy, benefits, training, absence levels etc.

• Wider Mental Health training for the workforce. The attitude of colleagues to those with mental health issues effects the successful return to work of someone who has had a mental health condition. Improving all employees knowledge on this subject will help to break down prejudices and misunderstandings.

• Increased focus on health and wellbeing? Research shows that those with good physical health are generally more mentally resilient.

THE FOLLOWING SLIDES DETAIL AN INTERNAL CASE STUDY –

IT WAS PLACED ON OUR INTRANET ON A SOCIAL MEDIA TOOL WE USE CALLED YAMMER AND GIVEN TO LEADERS AS PART OF A TRAINING SESSION

IT WAS THE FIRST OF MANY CASE STUDIES WHICH EMPLOYEES GAVE TO US AND EMPLOYEES WERE THE ONES WHO ACTIVELY SOUGHT ME OUT TO SHARE THEIR EXPERIENCES WITH COLLEAGUES

HOW WE CAN HELPCOLLEAGUES WITH MENTAL HEALTH ISSUES

WE ALL HAVE A BREAKING POINT, BUT WE DON'T KNOW WHAT IT IS UNTIL WE START TO BREAK.

We should all take better care of ourselves!

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We visit to the doctor when we start to feel physically unwell, but mental health is not often looked upon with the same urgency. We ignore how stressed we are, or how 'fed up' we feel, attributing the increasingly fast pace of life, bigger workloads, difficult life events etc. as simply something to get on with.

We'll be OK if we just have a break, a holiday, and for some people, some of the time, this helps. But for others, it's not that simple.

I HAD TRIED TO KEEP GOING, NOT LETTING PEOPLE DOWN, BUT I HAD REACHED A POINT WHERE I KNEW I HAD TO ACT.

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What helped me to take the steps I needed to take?

In the past few years, I have experienced several traumatic life events. I was seriously ill, I lost my mother, then my step-father and there were other personal problems, all of which took their toll, though at the time I didn't realise the impact they were having on my resilience. I was on auto pilot just to get through, so when a further stressful event occurred recently, my brain decided it had enough.

WHAT WERE MY FIRST STEPS?

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I needed to explain how I felt as I was finding it impossible to function in the office. She listened carefully and with compassion to what I had to say, and after a while she sent me home. It was she who advised me to ring HM Assist, and that a visit to the doctor was advisable.

My first step was to speak to my line manager

HM ASSIST IS AVAILABLE FOR ALL EMPLOYEES

When I rang HM Assist and they very quickly arranged for a local counsellor to contact me and schedule some face-to-face sessions to discuss how I was feeling. Then a trip to my GP. She diagnosed severe anxiety, provided support in the form of anti-depressants and I was to be off work for a while to provide me with the time I needed to deal with what was happening to me. She also recommended I call MIND, as they ran Mindfulness courses in my area.

HM Assist can help

Employee Support Line0800 141 2784

MY EXPERIENCE WITH MY COUNSELLOR WAS QUITE LITERALLY LIFE CHANGING.

My Counsellor helped me

For anyone who has not seen a counsellor before, there is no couch, no note taking, it's simply a confidential discussion with someone who is trained to listen. They do not provide you with the answers, or tell you what to do, but they do establish the crux of the problem and then help you see through the fog. For me, he gave me back the confidence that I could provide my own solutions, and with his guidance, I realise I was capable of finding my path back to health.

My counsellor made me realise that by working out how I had reached the point I had, I had the power within myself to change, to be happier, stronger and more resilient simply by altering my thinking habits and thought processes.

THE MINDFULNESS COURSE HAS BEEN AN EXCELLENT COMPANION TO THE COUNSELLING.

Mindfulness

Mindfulness is a way of thinking you adopt to be more present in the moment, rather than worrying about the past or the future. You learn to be calm both in body and mind, through meditation and breathing exercises, by seeing the world we miss when we are rushing around and by appreciating the small, and often overlooked happy moments we each find in the day.

It is a group session, which may seem a little unnerving, but in truth, it's of more benefit. I've realised I'm not the only person feeling how I do, and my group have bonded to share experiences and provide practical and moral support to each other. We reassure each other, and it's very clear to see real progress in all of us.

MY LINE MANAGER STRUCK THE BALANCE OF BEING CONCERNED FOR MY WELFARE AND THE BUSINESS IMPACT PERFECTLY.

Leaders plays a part in helping us to return to work

In all, from the day my line manager insisted I leave the office, it took 5 weeks to get to the stage I could come back to work. I was anxious about it, that's to be expected, but my line manager has been incredibly supportive. We kept in touch, with regular though not invasive telephone calls, and she never once pressured me to come back before I was ready. She was genuinely interested in my progress, and she made me feel at ease from the beginning, so I was unafraid to be honest and open.

Once I felt ready to come back, we agreed a phased return over three weeks and that I could use leave time I had remaining to take a day off each week to attend my Mindfulness course.

MANAGERS AND STAFF NEED TO WORK IN COLLABORATION AT TIMES LIKE THESE.

There are some very specific things that Leaders can do to help

My workload has been adjusted in the short term, and I have weekly 'catch-ups' with my Leader to make sure I'm OK, and to assess my progress. It is a difficult situation to manage, but I consider the way she dealt with it to have been just as important to my recovery as anything else I have done.

I've had to manage a person who was off with stress in the past, so I've seen both sides of the situation, and I would recommend to any line manager that they make full use of HM Assist if they are at all unsure of the way to deal with it. They are there as much for the manager as the staff member involved.

I HAVE TO WORK AT WHAT I'VE LEARNT, CONSCIOUSLY, EVERYDAY.

Where are we now?

I didn't finish my counselling sessions and was suddenly fine, I know that once my Mindfulness course finishes I won't be there either, and I still have to come off my medication in the New Year, so another hurdle awaits. I am after all trying to change habits I've learned over a lifetime.

I don't feel good everyday, but the bad days are fast turning to bad moments, so I'm doing Ok. I get more out of life now, and I'm happier than I've been in a long time. It's hard work, but it's worth the effort.