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NICE guidance on promoting mental wellbeing at work

There are several recent research studies I've come across that highlight the need for better working conditions.  Magnusson Hanson & colleagues' research on "Psychosocial working conditions and depressive symptoms among Swedish employees" shows clear links between decision authority, conflict & support and the development of subsequent depressive symptoms, while Nyberg et al's paper "Managerial leadership and ischaemic heart disease (IHD) among employees: the Swedish WOLF study" states "The dose-response association between perceived leadership behaviours (e.g. consideration for individual employees, promotion of employee participation and control, etc) and IHD was also evident ... with ... acute myocardial infarction and cardiac death as the outcome."  Thirdly Leineweber et al's "Covert coping with unfair treatment at work and risk of incident myocardial infarction and cardiac death among men: Prospective cohort study" strongly suggests that it's important to challenge unfairness if possible, as just putting up with it can literally kill you.

These kinds of issues are addressed in last month's NICE publication "Guidance for employers on promoting mental wellbeing through productive and healthy working conditions".  In the summary statement, it's stated: "The guidance is for those who have a direct or indirect role in, and responsibility for, promoting mental wellbeing at work. This includes all employers and their representatives, irrespective of the size of the business or organisation and whether they are in the public, private, or voluntary sectors. It may also be of interest to professionals working in human resources or occupational health, employees, trade unions representatives and members of the public.  It focuses on interventions to promote mental wellbeing through productive and healthy working conditions.  Mental wellbeing at work is determined by the interaction between the working environment, the nature of the work and the individual.  The five recommendations cover: strategy, assessing opportunities for promoting mental wellbeing and managing risk, flexible working, the role of line managers, and supporting micro, small and medium-sized businesses. They include: * Promoting a culture of participation, equality and fairness that is based on open communication and inclusion.  * Using frameworks such as Health and Safety Executive management standards for work-related stress to promote and protect employee mental wellbeing.  * Consider particular models of flexible working that recognise the distinct characteristics of micro, small and medium-sized businesses and organisations."

The guidance discusses "Why work is important to employees' mental wellbeing", commenting: "The following definition of mental wellbeing is used in this guidance: ‘Mental wellbeing is a dynamic state in which the individual is able to develop their potential, work productively and creatively, build strong and positive relationships with others and contribute to their community. It is enhanced when an individual is able to fulfil their personal and social goals and achieve a sense of purpose in society.' Mental wellbeing at work is determined by the interaction between the working environment, the nature of the work and the individual. Work has an important role in promoting mental wellbeing. It is an important determinant of self-esteem and identity. It can provide a sense of fulfilment and opportunities for social interaction. For most people, work provides their main source of income. Work can also have negative effects on mental health, particularly in the form of stress. Work-related stress is defined as ‘the adverse reaction people have to excessive pressure or other types of demand placed upon them'. Although pressure can motivate employees and encourage enhanced performance, when pressure exceeds an employee's ability to cope, it becomes a negative force in the form of stress. Working environments that pose risks for mental wellbeing put high demands on a person without giving them sufficient control and support to manage those demands. A perceived imbalance between the effort required and the rewards of the job can lead to stress. A sense of injustice and unfairness arising from management processes or personal relationships can also increase stress and risks to mental health. Other stressful conditions include physical factors such as material hazards, noise, dust and dirt. Stress is not a medical condition, but research shows that prolonged stress is linked to psychological conditions such as anxiety and depression as well as physical conditions such as heart disease, back pain and headache."

The guidance goes on to look at why "Why employees' mental wellbeing is important to organisations' productivity and performance", highlighting that:  "Promoting the mental wellbeing of employees can yield economic benefits for the business or organisation, in terms of increased commitment and job satisfaction, staff retention, improved productivity and performance, and reduced staff absenteeism ... The costs associated with employees' mental health problems are significant for businesses and other organisations. These costs are associated with loss in productivity because of sickness absence, early retirement, and increased staff turnover, recruitment and training. Evidence also shows that productivity can be reduced through the lower level of performance of employees who are at work but experiencing stress or mental health problems. This is known as ‘presenteeism'. A recent report estimated that impaired work efficiency associated with mental heath problems costs £15.1 billion a year, which is almost twice the estimated annual cost of absenteeism (£8.4 billion)."

Click for the 41 page Full Guidance and here for the 8 page Quick Reference Guide.  There are also several additional documents available including Promoting Wellbeing at Work: Business Case with its sections on "estimated costs and savings for an individual organization" and a "costing tool".  There is also a 2 page Promoting Wellbeing at Work: Advice for Small and Medium-Sized Businesses.  Good stuff!


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