It was the loss of a close friend that moved Katherine Compton to ask her employer, Heathrow Airport, formerly BAA, to support the creation of a role to oversee health and wellbeing, with a particular focus on mental health and occupational health at the aviation hub.
Compton, who was head of health and safety improvement at the business in 2016 when a health and wellbeing strategy was first raised, felt that health had become the 'neglected partner'.
"One person doing both aspects of this role was too much," she says. "It was too broad. We needed a strategy for health, which is why I created the role. I had the full support of the business, which recognised the importance of the health agenda. We look at proactive [interventions] rather than just preventive. Catching somebody before they fall is an important part for us."
Appointed as head of health and wellbeing transformation in February 2017, Compton has overseen the development of the strategy, which comprises multiple strands and has been rolled out in stages, the latest one on trauma landing last October.
Heathrow employs just over 6,500 colleagues from a diverse range of backgrounds. Roles are also varied, and include, for example, engineers, office workers, firefighters, security officers, airside operatives and project teams.
However, despite so many cultural differences and roles, some of which might appear high-risk, Compton says no single group stands out as needing particular mental health support or focus.
"Because mental health issues are not necessarily work-related and are so broad and non-discriminatory, they can affect anybody at any level of the organisation, which is how we shaped our health and wellbeing strategy -- we look at the whole person."
The challenge at the outset for Compton was how to bring together the different strands around mental health and physical health issues so that they fitted into a cohesive strategy that also reflected Heathrow's objectives.
"I was clear at the outset, that we are not just a wellbeing team," she says. "It is not about getting colleagues to become a bronzed god or goddess doing a yoga pose on a beach with a sunset behind them. To truly be beneficial and make a difference to the health profile of our colleagues, our engagement and education strategy has to appeal to everyone and be relatable -- there must be something for everyone." ]
Compton says the organisation's mental health strategy is not a silver bullet. "Although we would love to be in a position where no one suffers from a period of mental ill-health, sadly that doesn't reflect our current reality -- we need to be realistic about what we can do," she says.
"Ensuring our colleagues take accountability for their own health is important. We can provide them with education, empowerment and access to care pathways to help them make healthy choices and understand health risks. It was a bit of a deal: 'We'll do this; and you need to do this'," she says.
When they first started to create their mental health strategy, Compton's team had neither health data nor insights into whether colleagues were grappling with issues as varied as financial worries, stress and bereavement. So the first stage in the strategy's development was an exercise to glean the workforce's general health status.
On the physical health side, in early 2017 the team rolled out a 12-month calendar of initiatives and used each one to capture feedback. A physiologist carried out 20-minute health assessments from which they started to identify trends. A pop-up gym was installed and a room set aside where staff could relax. Compton admits, however, that on the mental health side it was "a bit of voyage into the unknown".
"We wanted to create a multi-layered approach to our mental health agenda that takes into account the whole person -- not just the work person -- and touches every layer of the organisation," she says.
"We wanted to start by encouraging people to talk, and not to feel alone, recognising that there may be stigma associated with reaching out for help. To launch our campaign, our executive signed the 'Time to Change' pledge, and we asked colleagues to be part of a DVD to share their story."
Compton was genuinely moved by the number of colleagues who came forward and wanted to share their stories to help others. The DVD included two members of the executive, which Compton says has been instrumental in changing perceptions of the business's culture.
The next step was leading people to support, she says. "Once you start people talking, [the next, and most important question] is 'where do you lead them to?'. You need them to have somewhere that they can go to get professional help and support."
To truly be beneficial and make a difference, our engagement and education strategy has to appeal to everyone and be relatable
However, colleagues can be uncomfortable about speaking frankly about their concerns to their line manager or human resources. So Compton's team worked with psychological health consultancy March on Stress to develop a bespoke, two-day course to equip selected volunteers -- known as sustaining resilience at work (StRaW) buddies -- with the tools to have a structured conversation about mental ill-health indicators. The individuals wear pin badges on their lanyards to identify themselves.
This was an improvement on the Mental Health First Aid approach, she says. "When looking for a product we wanted something that could equip managers with practical tools to have a conversation."
The StRaW buddy programme uses a red, amber and green approach to guide the volunteers to identify the best pathways for a colleague to be directed towards professional help.
"One of the differences in our product is that it has a structured recruitment process," Compton says. "If you compare us with other organisations, they might have 200-plus mental health first aiders, opening up training to anyone within the organisation. We have 23, who have been through a rigorous selection process. It is the quality not the quantity that is important."
She says this process is about identifying individuals who are good listeners, understand the importance of confidentiality and are in a 'good place' mentally to help others. She equates it to putting on an oxygen mask -- "you need to put yours on first before helping others, and we need to ensure that our buddies are in the right place to be able to help others".
Heathrow's product also differs in that the training does not cover mental health conditions. That's because "a little knowledge is sometimes dangerous", she notes. "The StRaW buddies," she adds, "are there not to diagnose, but to listen and signpost colleagues to the help and support that is appropriate to them."
After the StRaW buddies have completed the formal two-day training, they receive an extra half-day session hosted by a StRaW manager (who runs the overall programme) where they get to know each other better, to form a support network.
"We also reaffirm the business's expectations, for example, the importance of boundary-setting and confidentiality -- we ask them to sign a confidentiality agreement," says Compton.
"There is also a focus on looking after their own wellbeing, and on the importance of the structured governance for the programme, which includes their own check-ins and welfare calls."
The StRaW manager provides mandatory, annual refreshers for the volunteers, to ensure their skills remain fresh and relevant. "They have to complete an assessed role-play, which they must pass to remain as a StRaW buddy for the following year -- something other programmes don't do," Compton says.
"This rigour that we've put in place is important to safeguard the mental health of our volunteers and of those they are helping."
The buddy programme is continuously reviewed, to help Compton and her team to pick up on prevalent themes or trends across the business. They have recently created four 'lunch-and-learn and networking sessions' on key themes that are supported by local charities -- including cancers and domestic abuse.
"These sessions enable the volunteers to find out what the charity does and where it is located, and to build a rapport with it," she says. "If a colleague needs to be signposted for support, the buddy can feel confident in the referral routes and services that the colleague could reach out to."
An important feature of the programme is the opportunity for the volunteer to stand down from the role -- temporarily or permanently -- to respond to their own life events or challenges.
It is also noteworthy that the programme has full support from the unions, which helped to shape its development. "Our unions also look after colleagues, wellbeing, and it is important that we have a joined-up approach to mental health," Compton says.
Line managers matter
An important but missing piece of the jigsaw was the role of the line manager, who Compton says is arguably best placed to catch individuals before they 'fall'. She refers to findings from the Mental Health at Work Report 2017 (bit.ly/2lAXnJi) which noted that line managers know they have a duty of care to support employees on mental health issues, but aren't always sure how to discharge this duty effectively.
Compton could identify both extremes at Heathrow: there were line managers who failed to provide the required support and others who went too far -- for example, by taking phone calls outside work hours to support a colleague.
Drawing on industry best practice, together with coaching techniques and a Heathrow 'purpose and values' lens, her team devised a one-day, off-site course called 'Your Mind Matters' for line managers, which was launched in June 2018.
The first part of the course looks at the importance and role of the line manager in creating a positive psychological environment in which colleagues can thrive. In risk assessment language this entails the line manager eliminating workplace stress risk.
Compton says: "The line manager has a responsibility to create that environment but they also have a role, which is the second part they are taught on the course, in catching somebody before they fall -- spotting the early signs and symptoms.
"It's far easier to help someone recover more speedily if you catch them at an earlier stage."
The final stage of the course involves helping the individual back into work if they have been absent due to mental ill-health. Compton wanted to provide a suite of practical tools that line managers could take away from the course: aids that would give them the confidence to apply the practical measures while giving them the autonomy to manage the individual.
Two tools were created. The first is a personal plan for non-work-related issues. It comprises three simple prompts for the manager to shape a conversation with the colleague, including temporary adjustments.
The second is a workplace pressures assessment tool. Based on the UK Health and Safety Executive's stress risk assessment model, the tool has been adapted to reflect Heathrow's business climate.
Compton says that Heathrow made one simple yet significant change: the line manager, rather than occupational health, has responsibility for completing the workplace pressures assessment.
There is a two-step approach to this process. After the initial conversation, the employee is given a form to take home, where they can reflect on the issues they feel they are facing. The template requires them to consider the triggers at work that are causing them anxiety.
"If I came into a meeting with you right now and you said, 'Talk me through what's causing you stress', it would all come tumbling out, in any order," she says. "I am also not owning it. If I just blurt it out and gave it to you as a torrent of how I am feeling, you get the emotion, but also irrational and unlinked illogical thought patterns, which are commonly associated with stress or anxiety."
The act of asking employees to complete the form at home, with time to reflect, confers ownership of those thoughts on the person who has them, she says. "By writing it down, they are committing to the process, and forced to think about what the true triggers are.
"The second part of the [workplace pressures assessment] process is that they bring it back and talk to their line manager, who can help them put in place any adjustments that are required."
Again, boundary-setting is crucial, and something that is reinforced by Compton's team. She admits that, before the course, some managers were stepping too far outside their role.
"A manager is not there to be a friend. They are there to provide guidance, helping the employee to reach out for professional help, and providing structured support in the workplace," she says.
"Sometimes, when you are struggling, you need someone to break the problem down into manageable, bite-sized actions -- that is what the manager can do. Giving someone a routine is also important."
She has found the training has changed the mindset of some line managers, too. "[Before the training] some managers thought, if you are off with mental ill health, you get better outside work, as with a physical injury. They hadn't realised that coming back into the workplace is part of that whole recovery, and that they have a critical role to play." Assisting the employee back to work is the final stage of the whole process.
Compton says Heathrow has a commitment to train all its line managers within 18 months from the course launch. So far, just over 600 managers have been trained.
The feedback has been refreshing, she says, with all managers reporting that they would recommend the course to others.
Sometimes, when you are struggling, you need someone to break the problem down into manageable, bite-size actions -- that is what the manager can do
Learning from the army
Launched last October, Heathrow's trauma incident management system (TRiM) operates as a sister product to the StRaW programme, but is still very much in its infancy (see box, below.)
"TRiM is a widely used product in the army and blue-light services that we have learned a lot from," Compton says. "It is a structured risk-assessment process that provides support and interventions at key timed intervals."
As with the StRaW buddy course, Heathrow has provided bespoke training that fits the business's needs, again with an emphasis on boundary-setting.
The next project taxiing for take-off is the team's work on musculoskeletal disorders (MSDs).
"It's become easy to have a conversation about mental health issues, but MSDs is now sort of a poor relation," Compton admits.
"We've just started to shape our strategy this year by looking at what our data is showing us. What are the trends and risks? It's similar to mental health, in that most of our workplace absences are non-work-related," she says.
Compton's team received industry plaudits in July when Heathrow was among six shortlisted finalists in the Bupa Health and Wellbeing Award category at the Responsible Business Awards 2019.
"Being recognised for the award was an amazing recognition of how far we have come on our mental health agenda -- and I am incredibly proud. However, as with the safety agenda, I feel that there is still more to do and learn," she says.
"I don't think that there should be any boundaries to sharing best practice regarding the health agenda. We all have a social responsibility to care for one another -- why reinvent the wheel?."
Compton returns to her earlier point about encouraging a whole-person approach. "Normally, we find that work is a trigger, or contributor, but there are other underlying issues," she says.
"By supporting our colleagues to find the true trigger, it helps to make their recovery quicker, because they can get the right support. For me, that is huge."
Care for the first responders
Heathrow Airport recognises that trauma requires an entirely different skills set. Heathrow has a diverse risk-based profile and some environments are high-risk. There have been car crashes on the perimeter road, and passengers have had heart attacks after embarking planes.
"Our teams are trained to be first responders and deal with these," says Katherine Compton, head of health and wellbeing transformation.
"We therefore need to look after their mental health. We have a duty of care, as we are putting them in that position. The trauma part of the mental health agenda was huge for me -- how were we going to support them and what were we going to do differently?"
Heathrow's trauma incident management system (TRiM) has been applied to several incidents over the past year, most notably the arrival at the internal post-room of a Heathrow company building in March of a suspicious package, thought to have been sent by dissident Irish republicans.
The team has also applied TRiM to multi-agency terrorism-prevention exercises, which test the effectiveness of a joint response to a terrorist incident at Heathrow.
"We overlaid TRiM on that," Compton says. "This was our test bed to see whether it would work. Everybody said they felt there was a gap and wanted to pursue TRiM there, so we started to roll it out across the business."
Ultimately, she would like all the organisations working at Heathrow to embed this single product for trauma support.