The pandemic's mental health crisis

The huge mental health consequences of the pandemic will continue to affect workplaces as we move into an endemic phase. How are organisations and OSH professionals tackling the mental health crisis?

It is no huge surprise that COVID-19 has affected the world’s mental health. Over the course of 2020, cases of depression and anxiety increased by more than 25% around the world (Santomauro et al, 2021). In Britain, the number of adults who reported experiencing some form of depression increased from 10% before the pandemic to 21% in early 2021, and then reduced slightly to 17% in summer 2021 (Office for National Statistics, 2021). Sixty-five per cent of 10,000 UK adults said their mental health had got worse since the first lockdown, and 26% said they had experienced mental distress for the first time (Mind, 2021).

The economic cost of poor mental health is also vast. Lost productivity caused by anxiety and depression costs the global economy $1tn a year, a figure predicted to rise to $6tn by 2030 (Lancet Global Health, 2020). The annual cost of poor mental health to UK employers was £45bn (Deloitte, 2020). These figures pre-date the pandemic, and a clear picture of how mental health impacts of the pandemic have affected global economies in monetary terms is still being formed. But the impact on the workplace is demonstrable.

Clash of consequences

Research from the Chartered Institute of Personnel and Development (CIPD) found that COVID-19 was among the main causes of stress at work: 31% of those surveyed attributed their stress to new work-related demands or challenges due to home-working, while 23% identified COVID-related anxiety as the main factor (CIPD, 2021). Mental ill health remains the most common cause of long- and short-term absence, with stress in particular leading to considerable sickness absence: 33% and 48% of respondents placed it among the top three causes of short- and long-term absence respectively (CIPD, 2021).

Eighty-four per cent of employers took additional measures to support employee health and wellbeing through an increased focus on mental health (CIPD, 2021).

‘Looking ahead, the upcoming publication of the UK government’s Living with COVID strategy will result in organisations’ wellbeing and absence practices being further scrutinised,’ says Rachel Suff, senior employment relations adviser at the CIPD. ‘We’ve seen many employers step up their efforts to support staff with their mental health and wellbeing over the past two years; these learnings need to be carried forward.’

Absence isn’t the only consequence for organisations. ‘Conversely, you might have presenteeism: dissatisfied, demotivated individuals,’ says Nick Wilson, director of health and safety services at consultancy WorkNest. ‘Those who work while sick take longer to recover and their lack of enthusiasm/continued illness can lower workplace morale. The result is dissatisfied, demotivated individuals and the next thing you know, one of your key metrics takes a hit with increased staff turnover. Poor organisational culture then becomes evident to somebody from the outside looking in.’

WorkNest has seen an increase in the number of companies asking for mental health advice and turning to OSH professionals for help on the risks connected to anxiety and stress. Nick says this may be exacerbated in those suddenly ‘catapulted into this existence where they no longer have daily face-to-face interaction with their managers and peers’. He adds: ‘The problem is we’re not medical practitioners, but we are often regarded as a sort of one-stop shop for anything that is health-related.’

Research from Nick’s company has found that 59% of business decision-makers say the pandemic has fundamentally changed how their organisation views workplace health and safety and that it will continue to be a priority in the future (WorkNest, 2021). But the survey also found that 36% of employees and 35% of decision-makers describe their organisation’s health and safety culture as ‘reactive’.

Sometimes, employers will contact WorkNest ‘once a situation with an individual has progressed to a point where it’s actually become a medical issue, at which point there’s very little that people can then do, other than to steer them towards some kind of medical professional’, Nick explains.

​Preventive measures

The GB Health and Safety Executive (HSE) launched the Working Minds campaign in November 2021 to encourage both recognition of the signs of stress and subsequent action to remove or reduce it, in a bid to make such considerations as routine as managing workplace safety risks. As well as publicising the ‘5 Rs’ to tackle mental ill health (see panel above), the campaign also features the launch of a new hub with tailored content for employers and employees, while the HSE has begun a series of blogs and developed a network of subscribers, champions and campaign partners.

‘The campaign will be delivered in phases to allow us to keep the messages relevant to the situation as things change – as people return to the workplace, as the “new normal” becomes established, and as the impact of work changes for people,’ Rob McGreal, policy adviser on the work-related stress and mental health team says, adding that next on the agenda are a mobile app, a new quiz designed to help employers understand the legal basics, and sector-specific research.

‘It’s too early to understand the full impact of the pandemic on workers’ mental health. Each and every business is affected – while some jobs have continued relatively unchanged, others have had to make significant adaptations,’ Rob says.

A proactive approach to psychosocial risk management that takes an overview of all work-related risks is crucial. Claire Dalton CMIOSH, owner of training company Live for Work, has adapted standard training courses to cover topics that include returning to work following time off due to mental ill health, and identifying the signs and symptoms of poor mental health early.

Business owners and managers need to consider the impact of home-working, hybrid working, and returning to the workplace full-time

‘Business owners and managers need to consider the impact of home-working, hybrid working and returning to the workplace full-time, and put support and training strategies in place,’ she says. ‘Consultation with employees and managers with regard to types of training and support provided will be most suitable; there is no “one size fits all” and it will be difficult to regulate. But it has been proven that many people are no longer willing to work in unsupportive environments that affect their mental and physical health, so many businesses will lose good workers if they don’t adapt.’

Line managers and OSH professionals alike need an awareness of how stress, anxiety, depression and other mental health issues manifest and present, Claire says. Good, consistent communication with teams and an open-door policy – virtual or real – are needed, as is ‘the understanding that poor mental health will affect the person’s whole being and can make someone very ill’.

Kevin Hithersay, a mental health first aid trainer who works with a range of sectors, including construction and the armed forces, says OSH professionals should look out for changes in behaviour and appearance, such as being absent from work or working more hours than usual.

‘It’s about approaching somebody at the right time, the right place and asking “Are you alright?”,’ he says. ‘If that person says “Yes, I’m fine”, you could say something along the lines of, “Well, I’m worried about you. If you want to come and have a chat, this is where I am.”’

He says the HSE’s management standards on stress, which cover six key areas of work design that if not properly managed are associated with poor health, are ‘absolutely pivotal to what directors and senior managers should be reaching and understanding, doing the policies, getting the risk assessments in place and listening to staff’.

​Three steps

Professor Neil Greenberg, a consultant occupational and forensic psychiatrist who was part of NHS England’s response to protect the mental health of NHS workers in 2020, says workplaces need a preventive medical approach to mental health, training both managers and ‘peer supporters’.

His team at King’s College London researched the delivery of a one-hour training package called REACT (Recognise, Engage, Actively listen, Check risk, Talk to them about specific actions) to NHS staff. This provides workers with a template for active listening and ‘psychologically savvy’ chat. ‘It’s an easy win,’ he says.

Many people with mental health problems remain suspicious that if they say something, it will impair their career or reputation

Neil also recommends an approach in which senior people in organisations talk about negative mental health experiences in a positive way. ‘Although it’s really useful to have education to talk to everybody and say, “We believe in mental health”, the fact is that many people with mental health problems remain suspicious that if they say something, it’s going to impair their career or reputation. What you really want within an organisation is to look for the people who have had difficulties in the past and who have come through them,’ he adds.

The third approach Neil recommends encourages organisations to talk openly (without giving individual details) about instances of things that have gone wrong and potentially contributed to employees’ poor mental health, and the ways in which they rectified matters. ‘Where something has changed, you need to make a song and a dance about it, about how things are different from the narrative that people generally have of that organisation,’ he says.

Unparalleled opportunity

Peter Jenkins, group health and safety manager at food company Dalziel, says OSH professionals have been exposed to more mental health needs than ever before and are rising to the challenge admirably. ‘The OSH profession has come together like in no other time against a common risk, COVID; the same opportunity exists for meeting mental health needs,’ he says.

‘At the very least, the pandemic has given all businesses an unparalleled opportunity to define their values-based actions and develop their management systems around human factors,’ he adds. ‘The impact of pandemic-rooted mental health needs on businesses has been felt across every scale and size of organisation.’

At the same time, the OSH profession is held in higher esteem than ever before. Forty-three per cent of IOSH members said they felt valued since COVID-19 struck and 63% say their role was highly regarded within the organisation. In addition, 72% said mental health and wellbeing in the workplace should be part of their role.

The initial mental health impact of the pandemic and its effect on work is broadly understood, and data is still being collected. As research continues and the daily impacts of COVID-19 change, we will begin to understand the medium- and long-term consequences for mental health. In the meantime, supporting people in the workplace with a preventive, psychosocial approach to managing risks associated with mental health remains crucial.

References:

CIPD. (2021) Health and wellbeing at work 2021. (accessed 14 March 2022). 

Deloitte. (2020) Mental health and employers: refreshing the case for investment. (accessed 14 March 2022). 

GoodShape. (2021) Poor mental health is UK's top reason for time off work in 2021. (accessed 14 March 2022). 

HSE. (2021) Health and safety at work: summary statistics for Great Britain 2021. (accessed 14 March 2022). 

Lancet Global Health. (2020) Mental health matters. Lancet Global Health 1(11): E1352. 

Mind. (2021) Coronavirus: the consequences for mental health. (accessed 14 March 2022). 

Mind. (2019) Mental health champions toolkit for the sport and physical activity sector. (accessed 14 March 2022). 

Mind. (2017) Mind survey finds men more likely to experience work-related mental health problems. (accessed 14 March 2022). 

Office for National Statistics. (2021) Coronavirus and depression in adults, Great Britain: July to August 2021. (accessed 14 March 2022). 

Santomauro DF, Herrera AMM, Shadid J et al. (2021) Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet 398(10312): 1700-12.

WorkNest. (2021) The relationship between employer and employee is under pressure. (accessed 14 March 2022). 

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