A mental health check

With one in five Australian adults suffering a mental disorder each year, Domini Stuart says boards cannot afford to ignore mental health issues in the workplace.

If you would like your company to be more productive, your employees’ mental health would be a good place to start. "Organisations and businesses that promote good mental health in the workplace have higher levels of productivity, performance, creativity and staff retention and are more likely to be perceived as employers of choice," says Professor Allan Fels AO, Dean of the Australia and New Zealand School of Government (ANZSOG) and chairman of the National Mental Health Commission .

"Typically, organisations with strong organisational health – those that invest in quality people management – also exhibit better performance in terms of service delivery."

This translates into improved financial performance and also reduced costs.

"Looking at sharemarket performance from 1998 to 2006, the 100 companies on Fortune’s Best Places to Work list have outperformed the Standard & Poor’s top 500 by more than eight per cent," says Michael Hines, a psychologist and director of marketing and communications at the Positive Psychology Institute.

Meanwhile, mental disorders account for 
13.3 per cent of Australia’s total burden of disease and injury and are estimated to cost the economy $20 billion each year. When absenteeism, presenteeism – reduced productivity at work due to ill health – and staff turnover are taken into account, the cost to businesses for depression alone is about $12.3 billion a year. And, last year alone, stress-related Workers Compensation claims topped $10 billion.

"Not every stress claim is about depression or anxiety, but they’re all very much interrelated," says Kate Carnell AO, CEO of beyondblue.

Research carried out by beyondblue in association with Melbourne University found that about six million work days are lost each year to job-related depression. And, while presenteeism is harder to detect and quantify, the 2010 Medibank Private report Sick at Work estimated that in 2009-10, an average of 6.5 productive working days were lost per employee per year. More than a fifth of this loss was due to depression, the biggest contributing factor.

"Many workers who are chronically anxious or depressed don’t want to be perceived as being unwell so they don’t take time off from work, but they do perform poorly," says Professor Philip Morris, executive director of the Australian and New Zealand Mental Health Association. "They might be afraid of losing their jobs, or that their reputations and career prospects would be tarnished by a psychiatric diagnosis. Even companies that claim to have wonderful mental health policies can give out mixed messages in this regard. For instance, when people identify themselves as being unwell, their superiors might start to question whether promotion is a good idea – whether they could handle the stress of the next job up the ladder."

LEGAL OBLIGATIONS

Everyone has tough times in their lives and, in recent years, there has been a growing awareness of psychosocial hazards in the workplace itself.

"These hazards include bullying, discrimination, harassment, anger and fatigue, all of which can have a negative effect on employee mental health," says Hines.

Companies may choose to ignore the economic arguments for addressing these kinds of issues, but they could find they are breaking the law.

"Employers and directors are subject to a number of legislative obligations related to mental health in the workplace," says Claire Blundy, director of policy and development at SANE Australia. "These include work health and safety legislation requiring employers to ensure that workplaces are physically and mentally safe and healthy and do not cause mental ill-health or aggravate existing conditions. Employers also have an obligation to make reasonable workplace adjustments to accommodate the needs of workers with mental health conditions, as well as obligations arising from the relevant disability discrimination legislation. Under Commonwealth industrial laws, there is an obligation to ensure a workplace does not take any adverse action against a worker because of his or her mental health condition. Employers and directors also need to be mindful of the relevant Workers Compensation implications that could arise from these obligations."

The new harmonised work health and safety laws being embedded progressively across Australia impose greater demands on organisations to enact, adopt and maintain the new requirements.

"Directors and officers are having to come to grips with more onerous requirements and the associated penalties for non-compliance," says Hines. "For example, for Category 1 ‘Reckless Conduct’ offences, there are penalties of up to 
$3 million for corporations and $600,000 and/or five years’ imprisonment for individuals."

Employers also have a moral responsibility to protect and promote the mental health of their employees.

"For some organisations, it can be part of their corporate social responsibility to behave morally and ethically and contribute to the development of the community while improving the quality of life of their workforce and their families," says Blundy.

The board needs to know appropriate training, policies and procedures are directed to staff at all levels with a view to building everyone’s skills in relation to mental health.

"All of these policies should be reviewed and amended to reflect the ethos of a mentally healthy workplace," Blundy adds. "It’s not a question of having one stand-alone mental health policy but of ensuring all policies within the organisation take the mental and physical health of employees into account. This requires a clear commitment of resources to mental health in the workplace."

Across the organisation, a genuine understanding of mental illness, its signs and symptoms will help to address any stigma.

Employees need to know who to speak to if they have a problem, how the matter will be handled and that privacy obligations will be taken into account. Directors should feel comfortable that workers with a mental illness are receiving appropriate care in the organisation and have access to suitable support.

"Managers must be trained to understand their obligations fully with respect to employees who may be demonstrating mental health problems, including how to have conversations, what to say and what workplace adjustments and practices can be put in place," says Blundy. "Appropriate work practices and adjustments need to be made available to employees who may have a mental illness, such as an opportunity to work part-time or flexible hours."

Morris believes a well-supported return-to-work policy is particularly important.

"Many medical people have the attitude that you should wait before going back to work until you’re completely better but, unfortunately, this leaves some patients doubting that they will ever be quite well enough," he says. "As a doctor, I believe the right workplace can be a very effective part of patients’ treatment or rehabilitation. But it must provide ways for them to go back at various stages of recovery and, perhaps, to perform different roles rather than sticking to a rigid ‘all or nothing’ approach."

CHANGING THE CULTURE

Putting the right policies and systems in place is neither difficult nor expensive. In fact, many resources are available for no or relatively little cost from organisations such as SANE and beyondblue. However, their effectiveness is predicated on strong leadership.

"The board and organisational leaders have a critical role to play in driving a long-term commitment to policies and practices that promote mental health in the workplace," says Fels. "They have the capacity to exert a positive influence on workplace culture, management practices and the experience of employees. Effective business owners and organisational leaders prioritise people management, involve their people in decision-making processes, are more responsive to customer and stakeholder needs, encourage a high degree of responsiveness to change and learning orientation and enable their staff to use their skills and abilities to the full at work."

"The challenge for us is helping people to understand that pulling your socks up and pushing on is not the answer," says Carnell. "Just as with a physical illness, you need appropriate treatment to recover as quickly as possible – and we really need directors to make it very clear that mental health will be treated in exactly the same way as physical health in the workplace."

The most recent Australian Bureau of Statistics’ National Survey of Mental Health and Wellbeing found almost half of the 16 million Australians aged between 16 and 85 years had a mental disorder at some point in their life. Over a year, the figure was one in five. It would be an unusual board where not one director could speak from experience.

"The ideal scenario would be having directors and managers who are prepared to talk about the fact that they, or someone they’re close to, has experienced depression or anxiety and that it has been treated successfully," says Carnell. "Unfortunately, there is still a great deal of stigma attached to standing up and being counted, particularly among men – and men still constitute the majority of our leaders."

Morris agrees that employees can benefit from hearing stories about people who have been unwell but are now able to get on with their lives.

"Attitudes are slow to change, but I believe much of the progress we have seen over the past 20 years has been the result of a number of high-profile individuals identifying themselves as suffering from a mental illness," he says.

"Boards shouldn’t be giving the impression they’re above all that, that they never get sick. They should be helping to reinforce that mental illness can happen to anyone, and that their employees can trust the company to respond to mental illness with understanding and support."

Depressing signs that more must done:

• A staggering 95 per cent of respondents in a SANE Australia study said employers and managers needed education on mental illness and training on how to manage its effects in the workplace.
• Most of the 520 respondents in another SANE Australia survey said no support had been provided to them at work when mentally unwell. In addition, less than half of managers (43 per cent) had an understanding of mental illness.

Mental health in the workplace: what directors need to know

• Does the board have a clear commitment to mental health in the workplace?
• Are appropriate training, policies and procedures in place?
• Are these policies regularly reviewed?
• Does the company promote a genuine understanding of mental illness?
• Is mental health treated in exactly the same way as physical health?
• Does the company have a well-promoted zero-tolerance approach to bullying and harassment?
• Are managers trained to respond appropriately to workers with mental health problems?
• Do you have a well-supported return-to-work policy?

The Mentally Healthy Workplace Alliance

The Mentally Healthy Workplace Alliance has been established by the National Mental Health Commission to bring together stakeholders who are committed to creating mentally healthy workplaces. Members include:

• Australian Chamber of Commerce and Industry
• beyondblue
• Business Council of Australia
• Comcare
• Council of Small Business of Australia
• Mental Health Council of Australia
• Safe Work Australia
• SANE Australia
• The Australian Psychological Society

Professor Allan Fels says the Alliance’s vision is to encourage all Australian workplaces to promote mental health and to give them an understanding of the benefits of this. The Alliance will provide the business sector with practical guidance on how to drive sustainable change in culture and practices.