ISSUE 8 | AUGUST 2022

MENTAL HEALTH
ADVISER
HELPING YOU PROTECT YOUR EMPLOYEES’ MENTAL HEALTH & WELLBEING

Your Guide to Managing an Employee Who’s

Absent Due to Mental Ill-health
Find out how to support the person off work sick and how to
manage the wider impact on the team.
SEE PAGE 3 >>

How to Support an Employee

with an Eating Disorder
Discover the main types of eating disorder, the
warning signs to watch out for and a strategy
to help your employee.
SEE PAGE 7 >>

Return to Work Interviews:

Do Yours Cover the Causes
of Work-related Stress?
Use our checklist if you suspect work-related
mental health problems are an underlying
cause of staff absence.
SEE PAGE 11 >>
Say Hello to ‘Life-work Inside this Issue:
Balance’
Your Guide to Dealing with Staff Absence
Dear Reader,
Due to Mental Ill Health
We all understand the importance of work-life SEE PAGE 3 >>
balance. However, some organisations don’t believe
this concept goes far enough and are switching
to a new term: ‘life-work balance’. It’s a subtle Practical Ways to Support an Employee
change of wording but a significant shift in priorities,
acknowledging that it’s life which comes first for your with an Eating Disorder
employees and work second. SEE PAGE 7 >>
Of course, replacing one term with the other in your
written and verbal communications with employees
won’t, on its own, make the slightest difference to their Case Study: Talking Therapy
day-to-day lives. To be able to use the phrase ‘life-work
balance’ without your employees raising a cynical SEE PAGE 8 >>
eyebrow, you must practise what you preach.
Do you support employees’ physical and mental
wellbeing? Do you ensure they don’t work excessive How to Run Mental Health First Aid
hours? Do you offer flexible and, where possible, Successfully in Your Business
remote working? Are your holiday entitlements and SEE PAGE 9 >>
leave for parents generous? Provided that you have the
right culture and policies in place, it may be time to say
goodbye to mere ‘work-life balance’ and start extolling
the virtues of ‘life-work balance’ to your employees. Return to Work Interviews: Do Yours Cover
Work-related Stress Absence?
Yours Sincerely,
SEE PAGE 11 >>

Online Resource Centre

You can download and customise all of the tools
found in this issue at:
www.mentalhealthadviser.co.uk/resources
Access hundreds of checklists, policies, letters and staff
training presentations covering the core areas of mental health
and wellbeing. You can download these immediately, edit and
customise these to your organisation’s needs.
Jackie Le Poidevin & Carolyn Dukes CMIOSH Go to: www.mentalhealthadviser.co.uk/resources and enter your
Editors-in-Chief, Mental Health Adviser personal password. Or, if you have not yet created a password, simply
follow the instructions on screen.

About the Editors

Jackie Le Poidevin specialises in HR and
employment law and has written extensively for Ask the Experts Email Helpdesk
business and legal publications over 20 years. Get free personal, 1:1 advice from our team of experts,
Jackie’s goal is to keep you up to date with key including the Mental Health Adviser Editors-in-Chief,
changes affecting mental health and provide Jackie Le Poidevin and Carolyn Dukes, our Health &
practical guidance in plain English. Safety Adviser and Risk Assessment & Compliance
Carolyn Dukes is a registered OSHCR consultant. Editors, Carolyn Dukes, Ian Bollans and Linda Crossland-Mead and
Her occupational health and safety management our Pay & Benefits Adviser Editor, Sarah Bradford. Just email your
experience is wide-ranging and includes time spent query to [email protected] on any mental health
working in the education sector, healthcare and and wellbeing issue you are facing and you will receive an answer
law enforcement. within 48 hours.

2 www.mentalhealthadviser.co.uk/resources
 KEY TOPIC

Your Guide to Dealing with Staff Absence Due to

Mental Ill Health

O
ne in four people will be affected by mental health issues in their lifetime and, given that we will spend
an estimated 1,795 hours per year working (over 84,365 hours in a lifetime, according to Understanding
ModernGov), it is unsurprising that mental health can be a major cause of long-term absence in the
workplace. So how can you manage staff during a mental health absence, assist them to return to work and set
a standard of support for the wider team?
Danny Clarke CMIOSH, Founder, Simply-People, Liverpool

Why You Need an Absence Agree the Rules on Communication

Management Procedure When an employee has a mental health condition, you may need to
agree on adjustments to your rules on keeping in touch during their
The purpose of an absence management procedure is to support
employees’ health needs and provide clear, consistent guidance to absence. For example, someone experiencing anxiety might feel more
avoid further unauthorised or inappropriate absences. Failing to act comfortable texting rather than phoning in, getting a family member
reasonably when managing the absence could even result in an to call in or having an alternative point of contact. It may also be
employment tribunal finding any subsequent ill-health dismissal to helpful to give them a bit of space so you don’t exacerbate their
be unfair (if the employee has worked for you for 2 or more years). If condition, rather than frequently checking up on them and asking
the mental health condition amounts to a disability, there’s also the when they’ll be back.
risk of a disability discrimination claim. This doesn’t require any Additionally, it would be advisable to ask the employee what they
minimum length of service and there’s no upper limit on awards. are comfortable with regarding information around their absence
Your Legal Duties Under the Equality Act 2010 being passed on to colleagues, and if they are comfortable with
colleagues contacting them. This ensures that confidentiality is
The Equality Act defines disability as a physical or mental respected and the employee can disclose as much information as
impairment which has a substantial and long-term adverse
they are willing to with their colleagues.
effect on the person’s ability to carry out normal day-to-day
activities. Substantial means, for example, that it takes much Holding an informal discussion with the employee about their
longer than normal to complete regular day-to-day tasks. Long return to work is also important. Line managers can welcome back
term means lasting, or likely to last, 12 months or more. employees during their return to work and discuss the employee’s
If an employee qualifies as disabled, you have a legal duty health and feelings around returning to work. After updating them
to make reasonable adjustments for them. It is best practice, on any developments that may have occurred during their absence,
however, to make adjustments where possible to help all staff, reasonable adjustments can be discussed alongside any additional
regardless of a formal diagnosis. support the employee may need.

How You Can Manage Short-term

Absence Policies ⇣
Absences Your organisation’s absence policy is likely to cover the number
of paid sick days that employees are entitled to, expectations of
To ensure that employees can return to work smoothly and quickly,
attendance, the procedure to notify the business of sick leave,
you must manage absence for mental health needs effectively and
fit note requirements, any trigger points for absence warnings
proactively. As part of your policy on sickness absence and returning
and reasonable adjustments.
to work, it is important to acknowledge that you will treat absences
for a physical or mental health problem equally. You can download our sample Short-term and Long-term
Sickness Absence Policies from your Online Resource
The policy will set out who the employee’s point of contact is (usually Centre at: www.mentalhealthadviser.co.uk/resources
their manager) and how often the employee should call in. Your
initial discussions about the absence should cover:
1 The reason for the absence. How You Can Manage Long-term
2 How long the absence is likely to last. Absences
3 Any work that other team members may need to pick up so If an employee has been absent for longer than 4 weeks without
they don’t need to worry about it while they’re away. a clear indication of a return to work, you should hold a formal
absence meeting.
If the employee has previously discussed or disclosed their mental
health issues with their line manager, then they may feel more The employee should be informed in writing of the meeting
comfortable being open about the reason for their absence. If they’re date at least 5 days prior to the meeting, and also informed of
reluctant to talk and it’s a short absence, you can explore the reasons their right to be accompanied by a trade union representative or
sensitively in a return-to-work interview. colleague.

www.mentalhealthadviser.co.uk/resources 3
KEY TOPIC

These meetings are best held in private spaces in the workplace, How Your Approach to Mental Health
though in some cases of long-term absence an alternative neutral
Absence Can Impact the Wider Team
venue (e.g. a café) could be considered, or even over the telephone.
Firstly, it’s important to note that the way an organisation manages
Generally, absence meetings are split into 3 formal stages: an absence – particularly an absence related to mental health –
1 Stage 1 outlines the sickness absence concerns that led to will send a message to all individuals within and outside the
the meeting, giving the employee the opportunity to explain workplace about your organisation’s values.
their absence and the expected duration, and measures (e.g. Secondly, the absence management process is not solely about
occupational health and reasonable adjustments) that can be the individual who is absent, as there are wider implications
taken to improve their attendance. In some cases, this meeting for the team in terms of both the absence itself and the way it is
may be postponed to give employees time to provide medical managed. For example, an organisation that has a strong support
evidence where applicable. system in place for employees taking a mental health absence will
2 If the employee still doesn’t return to work, Stage 2 absence also cultivate a strong sense of trust and loyalty and a smoother
meeting will be necessary. In this meeting, the ongoing transition back to work.
absence, unsuccessful return-to-work programme, and expected
When mental health absence is managed poorly, there is a strong
duration of the continuing absence will be discussed. There will
likelihood that the employee may choose not to return to work, which
then be an agreement relating to action that will be taken and
can have a significant impact on the wider team’s morale and a
a timescale for a review or further meetings.
breakdown of trust. So how can you manage an absence effectively
3 Continued absence after this will result in a Stage 3 absence for the wider team? Use our Dos and Don’t in the table below.
meeting. The letter informing the employee of the meeting
should warn them that the potential outcome and that the Tips to Manage the Impact on the Team
potential for the outcome of the meeting could be dismissal.
An overall review of previous meetings, a review of the history Do Don’t
of the employee’s absence and the likelihood of a return to Encourage colleagues to stay Wait to resolve any issues
work will be discussed, along with any additional mitigating in touch with the employee, regarding the absence or
circumstances or options for their return. if the individual has given delegated workload (e.g. if a
Once a Stage 3 meeting has occurred, it is then a matter of deciding permission for this to happen. colleague feels as though the
whether to go ahead with dismissing the employee, wait (if they are absent employee is to blame
likely to be able to return to work in the near future) or implement an for extra work).
alternative to dismissal (e.g. redeployment, ill-health retirement). Regularly communicate with Discourage employees from
occupational health and/or seeking additional support.
How to Manage the Return to Work HR for recommendations.
Although you might assume that a member of staff will eventually Make assumptions about
Clearly explain how you will
be able to return to their role and be back functioning at full delegate any additional an employee’s condition (e.g.
capacity, it is likely that their return to work could be difficult or workload. team members diagnosing an
result in further absences. This is why a phased return to work and individual who has tried to
reasonable adjustments are a necessary consideration. What’s seek help).
‘reasonable’ will vary depending on the workplace and the needs of
Challenge any comments Share sensitive information
the individual employee. Many adjustments are low cost and are best
about ‘special treatment’ of – confidentiality is paramount.
determined by collaborating with the employee and, if possible,
the employee due to their
an occupational health professional. mental ill health.
The return to work arrangements will also need to be regularly
reviewed with the employee and updated if the measures are What Managers Can Do to Reduce the
not working. Here are some examples of possible reasonable
adjustments:
Impact on their Team
When an employee is absent due to their mental health, it is
● 
Workplace adjustments: dividing screens in the workplace, essential to address two key areas of concern for the wider team –
providing a quiet room, more natural lighting. how will the additional workload be managed and how informed
● 
Changes to how the employee performs their role: flexible will they be about the absence?
working hours, remote working, adjusted break times, a phased For managers, delegating the additional workload equally and
return to work, flexible leave options to attend appointments (e.g. communicating the circumstances of the situation (without
therapy and counselling). breaching confidentiality) are integral to alleviating any potential
stress or uncertainty for the wider team.
● 
Help and support: line manager supervision (e.g. ensuring that
the employee’s workload is not excessive), mental health support It may be necessary to get a contractor or temp worker for prolonged
absences to avoid additional workload for the wider team in the
groups, occupational health support.
long term. Keeping the team up to date on when their colleague
● 
Changes to the job role: redeployment to a more suitable role, might return or how they are getting on will also dispel any potential
changes to the employee’s job description or duties, support for concerns and provide an opportunity to iron out any ‘unfair’ or
the employee to apply for vacancies in other departments. ‘special treatment’ grievances that might be raised.

4 www.mentalhealthadviser.co.uk/resources
 NEWS AND TRENDS

Why Loneliness is a Business Issue and How You

Can Tackle it

A
surprising statistic emerged during this year’s Mental Health Awareness Week in May, the theme of which
was loneliness: people are lonelier now than they were at the start of the Covid outbreak. After analysing
Office for National Statistics data, the Campaign to End Loneliness said that between December 2021
and February 2022, 3.3 million people in the UK were ‘chronically lonely’ (or felt lonely all the time). This is up
from 2.6 million adults (5% of people) in April and May 2020. Here, we look at why this is an issue of concern for
employers and give some tips for helping employees – who typically spend more time at work than on any other
daily activity – to reconnect with colleagues post-pandemic.

Business Case for Action Practical Tips to Address Loneliness

Last year, the Campaign to End Loneliness published a report on The guide, which draws on a consultation with a range of employers,
‘Employers and loneliness’ together with the Department for Digital, breaks down its advice into 4 areas:
Culture, Media and Sport. Although this was completed during the
1. Organisational Culture and Values
pandemic when many people were working remotely, it remains a
valuable guide to tackling workplace loneliness. Emphasising personal success through competition may, the report
warns, exacerbate loneliness. Instead, it recommends emphasising
The guide warns that as well as being an undesirable experience, co-operation and connectedness. Some practical steps you can
chronic loneliness increases mental and physical ill health and take are to:
premature mortality. It puts the cost to UK employers at £2.5
billion every year, due to increased staff turnover (£1.62 billion) ● 
Embed loneliness awareness and the importance of meaningful
lower wellbeing and productivity (£665 million), the impact of social connections at work into your wellbeing and mental health
caring responsibilities (£220 million) and sickness absence policies and practices.
(£20 million). ● 
Ask employees about loneliness in people surveys to help you
understand how much of an issue it is and show you recognise
In contrast, high quality, meaningful connections are associated
with a better standard of work and greater engagement. Workplaces the problem’s importance.
where employees have a strong sense of organisational identity ● 
Assess the risks to, and offer support to, those at a heightened
can also withstand the effects of recession better and maintain risk of loneliness, such as new starters, those with management
performance. responsibilities, bereaved employees, those who regularly work
Continued on Page 6 >>

Improvement Notice Reported for Work-related

Stress Management Breach

I
t was recently reported on the Times Higher Education website that a Health and Safety Executive (HSE)
Improvement Notice has been issued to the University of East London (UEL) following multiple cases
of work-related stress among academics. We summarise the background to this case, the status of HSE
Improvement Notices and examine the enforcement role of the HSE in work-related stress cases.

In this case, it is reported that the Improvement Notice was issued staff members had said they lacked agreed workloads and many
to UEL following complaints to the HSE from university trade union respondents indicated experience of work-related stress.
representatives. Following an investigation, the HSE inspector
UEL has appealed against the notice, challenging the evidence and
recorded that she had ‘identified contraventions of health and safety
citing that absence relating to work-related stress has almost halved
law’. She found that:
in 3 years.
● 
The university had not undertaken a suitable and sufficient
risk assessment for work-related stress for the purposes of Understand the Legal Basis for
controlling the risk to staff, although it had clear evidence of the Issuing the Improvement Notice
risk of stress-related ill health arising from their work activities. The Health and Safety at Work Act 1974, section 2(1), states
● 
The evidence referred to included an increase in sickness absence that it is ‘the duty of every employer to ensure, so far as is
data relating to mental ill health going back to 2017. In addition, reasonably practicable, the health, safety and welfare at work
in a staff survey conducted by the union UCU, many academic of all his employees.’ It is now widely accepted that this provision
Continued on Page 6 >>

www.mentalhealthadviser.co.uk/resources 5
NEWS AND TRENDS

Continued from Page 5 Why Loneliness is a Business Issue and How You Can Tackle it

alone or remotely and those returning from maternity leave or ● 

Provide communal spaces, together with opportunities for team
long-term sick leave (see also section 3 below). working and high-quality interactions.
● 
Have a trained wellbeing or loneliness ‘champion’, who can ● 
Set aside time in the working day for one-to-one interactions
provide confidential information and support for colleagues when people are encouraged not to talk about work.
without them having to rely on their line manager. ● 
Hold workshops, mentoring programmes and other social
2. Management events for staff.
Key measures include: ● 
Use a range of options to communicate with any employees
working from home or on their own, including video
● Training managers to handle emotional and difficult
conferencing, the telephone and chat functions, and scheduling
conversations.
time for informal and social interaction.
● 
Making managers aware of internal resources they can refer
employees to (such as a wellbeing champion or mental health Case Studies: How Employers are Supporting
first aiders, occupational health or an employee assistance At-risk Groups of Employees
programme) and external self-help resources. The Marmalade
Trust’s website has guidance for both managers and employees, Re-engage, an
●  organisation which develops social groups for
including advice on how to talk about loneliness, while Mind has older people who live alone, has a buddy system to support
tips to manage loneliness. new and existing staff, as well as interest groups on topics
such as physical activity, reading and gardening.
3. People and Networks
The
●  National Lottery Community Fund has a Wellbeing
To prevent employees feeling marginalised and disconnected, Choir which has weekly sessions and takes part in internal
you can set up networks or initiatives to bring them together and external events.
around shared interests or concerns. You could have groups for
employees most at risk of loneliness, including those with caring Zurich gives its retirees one paid half day off per week during
● 

responsibilities, new parents and employees approaching the last 6 months of their employment for volunteering,
retirement. enabling them to use their experience for the benefit of the
community while learning new skills. The programme helps
4. Work and Workplace Design them understand what activities might appeal to them in
To tackle loneliness, it is important to make the space, time and retirement so they can remain socially active.
opportunities for connection. For example, you might:

Continued from Page 5 Improvement Notice Reported for Work-related Stress Management Breach

includes mental health, although traditionally it has been applied The Improvement Notice:
predominantly to physical health. ● Formally states the inspector’s opinion of the contravention.
The Management of Health and Safety at Work Regulations ● Specifies the statutory provision, gives reasons (for example,
1999, Regulation 3(1), states that ‘every employer shall make a evidence seen).
suitable and sufficient assessment of the risks to the health ● Requires the person or organisation to remedy the
and safety of his employees to which they are exposed while they contravention.
are at work.’ ● Specifies the period for compliance with the notice which
must be realistic and not less than 21 days, during which period
Investigation and Enforcement of recipients can appeal the notice to an employment tribunal.
Work-related Stress Breaches
The HSE will discuss the notice with the recipient and explain how
The HSE will consider investigating concerns about work-related they can comply with its requirements. Failure to comply with
stress where: the requirements of the notice within the given time period can
● 
There is evidence that a number of staff are currently ultimately result in prosecution.
experiencing work-related stress or stress-related ill health (i.e. it
Your 3 Key Actions for Compliance
is not an individual case).
There are 3 simple actions you can take to support the mental health of
● 
An individual case of bullying or harassment is accompanied by
your employees and to reduce the likelihood of HSE enforcement action:
evidence of a wider organisational failing.
1 Complete a suitable and sufficient risk assessment for
● 
Concerns about work-related stress have been raised already employee work-related stress.
with the employer and it has been given sufficient time to
2 Consult your employees regularly on an individual and
respond accordingly.
collective basis about their experience and perception of stress
Understand HSE Improvement Notices caused, or made worse, by their work.
Section 21 of the Health and Safety at Work Act gives HSE inspectors 3 Take effective action where there is evidence of work-related
the power to issue Improvement Notices to duty holders when they stress in your organisation. Examples of this include sickness
are of the opinion that a statutory provision is being contravened. absence data and staff survey results.

6 www.mentalhealthadviser.co.uk/resources
 SPOTLIGHT ON: EATING DISORDERS

Practical Ways to Support an Employee with an

Eating Disorder

T
his month’s article on specific mental health conditions focuses on eating disorders. An eating disorder is
a medical diagnosis based on a person’s eating patterns. It is estimated that around 1.25 million people in
the UK have an eating disorder, but they are often not talked about. We outline the main types of eating
disorder, describe the warning signs to look out for and recommend a strategy to help support employees with
eating disorders in your workplace.

Eating disorders are serious mental health illnesses that are about ● Poor body image.
the way a person treats food and their underlying thoughts and ● Irritability and mood swings.
feelings. They can harm the mental health not only of the person with ● Tiredness.
the disorder but also of those close to them.
● Social withdrawal.
The Different Types of Eating Disorders ● Feelings of shame, guilt, and anxiety.
There are 4 main types of eating disorders: ● Difficulty concentrating.
1 Bulimia: this accounts for 19% of diagnosed eating disorders ● 
Harmful effect on physical health, including digestive problems
and is also known as bulimia nervosa. People diagnosed with it and higher sickness absence.
typically experience a cycle of bingeing and purging where they eat
large amounts of food in one go and then act to get rid of the food How to Start a Conversation if You
they’ve eaten, by making themselves sick and/or taking laxatives. Suspect an Eating Disorder
2 Anorexia: this accounts for 8% of diagnosed eating disorders Concerns that an employee’s performance may be affected by an
and is also known as anorexia nervosa. People diagnosed with eating disorder should be addressed in the first instance either by
the condition do not eat enough food. They reduce their food their line manager or HR. Open up a conversation by focusing on
intake to a point where they are not getting the energy they performance, explore what can be done to improve it and address
need to stay healthy. The condition can be masked as slimming any underlying issues. Concerns should be highlighted supportively
or dieting, but its roots are often connected to low esteem, and sensitively and the employee encouraged to speak openly
negative self-image and feelings of intense distress. without fear of judgement. Aim to reassure the person and discuss
3 Binge-eating disorder: this accounts for 22% of diagnosed the support they require.
eating disorders and is sometimes referred to as ‘compulsive This approach can also be taken where an eating disorder is
eating’. People with the condition might feel unable to stop suspected but has not affected performance.
eating even if they want to. They may rely on food to make
them feel better and to hide difficult feelings. 5 Actions to Support Workers with
4 Other specified feeding and eating disorder (OSFED): Eating Disorders
this is an umbrella term for diagnosed eating disorders which 1 Formally recognise eating disorders as mental health conditions by
don’t meet all the criteria for anorexia, bulimia or binge-eating including them in your organisation’s mental health strategy.
disorder. They account for 47% of diagnosed eating
2 Make adjustments for staff with a diagnosed eating disorder.
disorders. Examples include:
These disorders may qualify as a disability under the Equality
n A
 typical anorexia: where someone has all the symptoms Act 2010 if they have a substantial long-term or recurring
to form an anorexia diagnosis except their weight remains effect on the person’s ability to carry out normal daily activities.
within a normal range. In this case, you have a legal duty to make reasonable
n  ulimia or binge-eating disorder but of low frequency
B adjustments to help the employee continue working. These
and/or limited duration. could include time off to attend appointments, adjusting
n P
 urging disorder: where someone purges by being sick working hours or providing separate eating facilities.
or using laxatives but this isn’t part of binge/purge cycles. 3 Train your managers to recognise the signs of someone who may
n N
 ight-eating syndrome: where someone repeatedly
have an eating disorder and support managers to develop the skills
eats at night, either after waking up during the night or by needed to open up mental health conversations with their staff.
eating a lot of food after their evening meal.
4 Destigmatise eating disorders by making information
Look Out for these Warning Signs available to staff and raising staff awareness.
The warning signs that a person may be experiencing an eating 5 Ensure your workplace culture is supportive. Social events
disorder include: can revolve around eating, so aim to provide alternatives.
● Overly focused on food and/or secretive behaviour around food. Discourage other staff from diet talk and body-shaming or
● Obsession with calorie counting or exercise. commenting on colleagues’ food choices. Also ask that they are
● Self-consciousness when eating in front of others. mindful of conversations around exercise, as this can be a trigger
● Low confidence and self-esteem. for some people with eating disorders.

www.mentalhealthadviser.co.uk/resources 7
CASE STUDY

Talking Therapy: How OH Nurse Helped

Healthcare Workers Cope During Covid

M
ental health issues were a concern before Covid-19 of course, but they have been
exacerbated as a consequence of both the personal and workplace psychosocial
stressors the pandemic created. We spoke to Occupational Health Advisor, Libby
Morley, about her experience of helping others with their mental health during such an Libby Morley, OH Nurse,
unprecedented time. Northampton.

Kellie Mundell, Case Study Editor

Libby originally trained as a general nurse for the NHS and after a through this too, but eventually I just wanted to tell them that they
6-year stint in Berlin, she decided to specialise in occupational health had no idea what we were going through.’
with a focus on mental fitness. ’I’ve always believed there’s a huge
Just before Debbie went on sickness leave there were some incidents
link between your emotional wellbeing and your physical health,’
that left her traumatised: ‘Patients were becoming aggressive, they
she says. Libby applied for a job with Network Rail, and her new
were self-harming in the department and staff were all feeling the
employer sponsored her in studying for a Diploma in Occupational
same burnout. I had reacted out of character to a patient, and this
Health at the prestigious Warwick University.
had left me feeling really ashamed to the point where I put my head
9 years later the pandemic hit. Living through lockdowns, not in my hands just thinking about it.’
being able to see people, missing important events and even losing
loved ones to the virus meant Libby knew that a mental ill health
The Solution
epidemic was on the horizon. With permission, one of her clients – a Debbie was scared by the depth of her feelings and totally
healthcare worker herself – has provided an account of how she was overwhelmed. She was referred to Libby and they initially began
supported by occupational health after her mental health took a dive. with phone calls. ‘I remember after listening to me, she said: ‘Debbie,
you are very sick’. I felt like a weight was lifted.’
The Problem
‘When I first spoke with Libby, I was dreading the call,’ says For Debbie, she’d finally found someone who wasn’t trying to negate
Debbie. ‘As someone who has come up against many well-meaning her feelings or just give her some well-meaning advice. ‘We finished the
healthcare professionals in the past, I was dreading another list of call with her telling me to rest and take care of myself and not to worry
things I was supposed to do.’ about letting colleagues down as I needed to be well to be able to help
others. I remember thinking that for once I had not been blamed for
Debbie was diagnosed with ADHD later in life, and it means even feeling the way I did, I felt that someone had given me permission to feel
though she can be an over-achiever, she sometimes can’t keep simple it without having to justify my feelings. I felt legitimised.’
things together. ‘I can take care of the seriously ill and manage their
care, but I seem unable to focus on my own needs or those of my ‘Counselling helped me to allow myself to be kind to me, to stop
family. I often tie my self-esteem to my job and so when I started to blaming myself for not being more resilient,’ Debbie adds. Instead,
struggle with my work, I became fearful and nervous.’ she looked for ways to build resilience again, to allow herself the
time to think and grow without worrying. ‘I truly believe that without
The pandemic started slowly changing how Debbie felt about people.
the support and guidance I would have floundered further into a
She was always trying to fix people. She’d arrive early and stay late
possibly life-changing disability,’ she says.
out of a desire to always give 100%. But then she caught Covid.
‘By that time I had to admit that I was not OK – I was tired,
The Outcome
emotionally distant and constantly angry. I’m sure anyone close to Debbie says she has learned to say ‘no’, that she doesn’t have
me was worried about my constant obsession with the Covid stats to be ‘extra’ just because she’s not neurotypical. So, how did Libby
and my inability to focus on anything positive. I wanted to shout change her thinking? ‘By being supportive, constructive, and honest,’
at patients who continued to come with their seemingly ridiculous I’m embracing my differences and learning to use my newfound
issues. I had constantly tried to understand that they were going strengths.’

MENTAL HEALTH ADVISER

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8 www.mentalhealthadviser.co.uk/resources
 IN FOCUS: MENTAL HEALTH FIRST AID

How to Establish and Run Mental Health First

Aid Successfully in Your Business

I
n last month’s issue, we provided a guide to assessing your business need for mental health first aiders (or
MHFAs) as part of your business mental health strategy, and to recruiting and training volunteers. In this
article, we look at how you can establish an effective MHFA network in your organisation and support and
develop your MHFAs.

You have assessed the need for MHFAs, run a recruitment exercise 6. Provide the Right Facilities
and the successful applicants have returned from their accredited Make sure you have the right facilities for your MHFAs to use where
training raring to go! So, what happens next? Follow our action plan your staff will feel comfortable to talk about their mental health
to get started. issues in confidence and without interruption. This often means a
small meeting room which MHFAs can book for one-to-one meetings.
6 Actions to Promote Your MHFA
Network How to Support, Retain and Reward
1. Let Your Workers Know You have MHFAs Your MHFAs
Hold a launch day or event. It will be particularly effective if you As well as promoting your MHFA network, you also need to have
can link it with an external mental health awareness campaign such a robust framework in place to support and develop your newly
as Mental Health Awareness Week (usually mid-May), World Mental appointed MHFAs.
Health Day (10 October 2022) or National Stress Awareness Day (2
1 Set up an MHFA network for mutual support and sharing of
November 2022).
ideas or concerns. This should be organised and overseen by
2. Demonstrate Senior Management Support for the MHFA Role either the senior manager for MHFAs or someone from your HR
Ensure your business leaders visibly support the promotion of the or wellbeing team. The network should meet regularly and be
new network. This will help show their commitment to investing in supplemented with one-to-one buddying sessions as required.
the mental health of their workers. 2 Follow up with new MHFAs shortly after they complete their
3. Provide Clear Information About MHFAs’ Role training course to make sure they feel comfortable in their new
Ensure your promotional material is very clear about what the MHFA role and to explain how the scheme works in your organisation.
role does and doesn’t cover. Employees must be aware that MHFAs are Don’t forget to let them know where to go for support if they
an initial point of contact for simple advice and reassurance. They need it, particularly for the initial contacts they get.
are not able to provide ongoing or professional counselling support. 3 Support MHFA development by offering regular refresher or
other related training opportunities. MHFA England recommend
4. Explain How and When to Contact an MHFA
a half-day MHFA refresher course every 3 years to align with
Provide the names, contact details and job titles of MHFAs on
physical first aiders.
your promotional material. Some people may prefer to contact
an MHFA who they don’t know or don’t work with. Manage 4 Keep MHFA performance and numbers under review.
expectations about response times. For example, an MHFA may not Review how frequently staff access MHFA support and whether
be able to respond immediately, so they will arrange a mutually the number of MHFAs you have is sufficient to meet demand.
convenient time to call or meet up. Be clear that MHFAs are available Get feedback from the staff who have accessed MHFAs to
only during standard working hours. Provide alternative points assess how effective the intervention was and consider any
of contact for other times, for example, your external occupational suggestions for improving the scheme. As with physical first
health provider or relevant charities like the Samaritans. aiders, keep track of when people leave the organisation, to
ensure you maintain good availability in all areas.
5. Maintain the Profile of the MHFA Network
5 Reward your MHFAs. Being an MHFA is a voluntary role
Following the initial launch of your MHFA network, take the
and can be very demanding, so celebrate your volunteers’
following actions to keep the profile of your MHFAs high:
commitment. This doesn’t necessarily mean a financial reward
● 
Add MHFA details to your physical first aider posters displayed but consider actions such as a buffet lunch for MHFAs hosted by
around the workplace. the responsible senior manager and recognition as part of the
● Put MHFA details on your company intranet. MHFA’s occupational performance assessment.
Provide MHFAs with badges or lanyards advertising their role.
⇣
●
Download
● Suggest MHFAs add their role to their e-mail signature.
Use your Mental Health First Aid Checklist to check whether
● 
Include MHFA details and information on what the role entails in you have adequate mental health first aid provision in your
your induction training and pack for new starters. business. You can download it from your Online Resource
● 
Remind staff of MHFA availability as part of sickness absence Centre at: www.mentalhealthadviser.co.uk/resources
return-to-work interviews.

www.mentalhealthadviser.co.uk/resources 9
ASK THE EXPERTS

Each month, we bring you the best questions we’ve received from our readers via the Ask the Experts service – along with answers from
your expert Editors, Jackie Le Poidevin and Carolyn Dukes. Do you have a question you would like to ask? If so, please contact us by email at
[email protected] and you’ll receive a response within 48 hours.

How Do I Start a ’Mental Health Conversation’?

Question: I’ve just completed my line manager refresher training. 1 Choose a place which is private and quiet for the conversation.
One of the recurring themes of the course was that, as managers, 2 Avoid making assumptions and keep an open mind.
we are responsible for monitoring and supporting the mental health
3 Assure your team members of confidentiality and that they
of our team members. When a fellow student asked how we’re
have control over any disclosures.
meant to do that, the trainer said ‘talk to them about it of course’
and moved swiftly on. I’m now back in the office and scratching 4 Encourage people to talk by having an open dialogue when
my head about how I start that sort of conversation with my team discussing mental health.
without it being really awkward. Any pointers you can give me 5 Be flexible in your response, which will depend on individual
would be greatly appreciated! circumstances.
Andrew Smith, Head of Logistics, Leicester. 6 Be honest and clear about any performance concerns you have.

Answer: Your trainer was right to suggest that talking is a good 7 Develop a mutually agreed action plan.
way to build a positive mental health framework and, as a line 8 Encourage people to seek further support if they need it.
manager, you are in the best place to know your staff and also any 9 Reassure people that they won’t be disadvantaged by being
work-related stressors they may be exposed to. honest about their mental health.
A good place to start is with the CIPD People Managers Guide. It 10 Get further support and guidance yourself if you’re unsure what
provides the following advice: to do with the information disclosed during the conversation.

Please Help Me Manage My Emotionally

Unstable Team Member
Question: I have a staff member who has been diagnosed with Once the employee has completed this, you can talk through his
emotional unstable personality disorder. He is having cognitive answers with him (when he’s not feeling very high or low) and agree
behavioural therapy and dialectical behaviour therapy. However, at how you can support him and what he can do himself to manage
work he is very unstable and can go from low to high extremes at his condition. His answers will help you – and him – understand
any time. He has inappropriate behaviours and I need help with how and manage his triggers so that, hopefully, he doesn’t experience as
I should handle the individual. many of these dramatic mood swings or episodes of inappropriate
behaviour. When you or he notice his mood or behaviour is starting
Anna Kowalczyk, Department Head, Newport.
to change, you’ll have an agreed response.
Answer: Ask the employee to complete a wellness action plan. This Some other support measures that might be helpful would be giving
has been developed by Mind and there’s a free template available him access to a buddy or mentor – in other words, someone who
on its website. There are sections for the employee to fill in their isn’t his manager who he can talk to in confidence – and having
response to various questions, along with some suggestions for them a quiet space where he can take a break if necessary. Mind
to consider. Basically, it’s a way to encourage employees to identify recommends that employees review their wellness action plan
solutions to the issues they’re experiencing and to help you start a monthly. This can help them log any learning or helpful practices
conversation with them about ways to address these issues. from the previous month. It also helps them to build self-awareness,
keep on top of identifying what keeps them well and check that
These are some examples of the questions in the document and of
the support measures are working. You might therefore arrange a
the accompanying notes:
monthly one-to-one meeting with him to discuss how the plan is
● 
What helps you stay mentally healthy at work (e.g. getting going and whether you or he need to do anything different.
some exercise before or after work or in your lunch break)?
Ultimately, if there’s no improvement and you feel you need to take
● 
Are there any situations or behaviours that can trigger poor formal action against him, I would recommend going down the
mental health for you while working (e.g. conflict, tight performance management route rather than disciplining him for
deadlines, something not going to plan)? the inappropriate behaviour. Before contemplating dismissal, it would
● 
Are there any early warning signs that your manager or colleagues be important to get occupational health advice and make any
might notice when you are starting to experience poor mental health? reasonable adjustments that they suggest.

10 www.mentalhealthadviser.co.uk/resources
 CHECKLIST

Return to Work Interviews: Do Yours Cover the

Causes of Work-related Stress Absence?

T
he latest figures from the HSE show that 50% of work-related ill-health is attributable to stress, depression
and anxiety. And even that staggering figure is probably an underestimate as it’s based on self-reported
cases. Mental health problems can often be manifested in a physical health effect such as fatigue,
gastrointestinal conditions or musculoskeletal disorders reported as a cause of sickness absence. It’s important
therefore to maximise the opportunity provided by return-to-work interviews to include questions which help
reveal the underlying causes of an employee’s sickness absence which may be linked to work-related factors.

Use this checklist, based on the HSE management standards, if you know or suspect work-related mental health problems are an underlying cause for an
employee’s absence. You can download this from your Online Resource Centre at: www.mentalhealthadviser.co.uk/resources

Return-to-Work Interview Questionnaire Checklist Download ⇣

‘Red’ answers indicate you need to discuss that factor further to determine if it has had a negative impact on the Yes No
employee’s mental health and decide if corrective action is required.

1. Demands: includes workload, work patterns and work environment

Is your workload about right?
Are you able to take sufficient breaks at work to feel rested?
Do you feel pressured to work long hours?
Do you have to work to unrealistic deadlines?
2. Control: how much control a person has over the way they do their work
Do you have any control over where and when you work?
Can you decide when you need to take a break?
Do you have a choice in how you do your work?
Can you be flexible about your work to take account of other responsibilities?
3. Support: encouragement and resources provided by the organisation
Do you get enough encouragement and support from your employer?
Do you get enough encouragement and support from your manager?
Do you get enough encouragement and support from your colleagues?
Do you have someone at work you can go to if you have problems?
4. Relationships: with colleagues, managers and others at work
Do you have problems with your relationships with your manager or colleagues?
Are you bullied at work?
Is there friction or anger between colleagues you work with?
Is there a healthy, inclusive culture, free from harassment in your workplace?
5. Role: clarity about your role at work and any conflicting roles
Are you clear about your role and responsibilities at work?
Do you understand how your job fits with your colleagues’ jobs?
Do you ever have to work outside your role in a way which you find difficult?
Are you happy that your manager and colleagues fully understand your role?
6. Change: impact of organisational change (large or small)
Do you feel consulted about organisational changes at work?
Do you feel fully informed about and understand the changes at work?

www.mentalhealthadviser.co.uk/resources 11
Access 12 Mental
Health Management
Toolkits in Your
Online Resource
Centre Today!
Do you have an underperforming employee but
you’re not sure whether the problem is down to
capability or an underlying mental health issue?

Do you need to make the person redundant, but are worried of falling foul of
discrimination law?

Or do you have line managers new to the role who need support to manage their
team for good mental wellbeing?

Whatever the issue you’re facing right now, make full use of your Mental Health
Management Toolkits* which you can find on your Online Resource Centre at:
www.mentalhealthadviser.co.uk/resources

Each Toolkit is packed with checklists, forms, letters and other resources to help
you and your line managers support employees who are dealing with mental health
issues in the workplace.

Our most popular Toolkits include:

• Mental Health for Line Managers

• Stress Management
• Homeworking
• Mental Health First Aid
• Managing Sickness Absence
• Warnings and Dismissals
• Bullying and Harassment

Plus 5 more Toolkits!

MENTAL HEALTH
*Mental Health Management Toolkits are all part of
your existing Mental Health Adviser service.
ADVISER
Sign Up for Your Mental
Health Adviser Online
Workshop Today!
Join us for a series of monthly online events designed to help
you create a mentally healthy and happy workforce.

Hosted by your very own Jodie Hill, each 45-minute workshop covers a key mental health
and wellbeing topic, plus 15 minutes Q&A. Following the workshop, you’ll receive a link to the
recording, plus all related resources and presentation slides.

Your Presenter: Jodie Hill

Jodie is founder and Managing Partner of multi-award winning Thrive Law. Her campaign,
One Mind, to bring mental health to the top of business agendas, has been featured by Sky
News, BBC, The Times, The Law Society Gazette, Yorkshire Post and other key media.

Jodie founded Thrive Women, disrupting the world of employment law as a female
entrepreneur with her own firm before the age of 30. She was appointed to the Law Society’s
Employment Law Committee in 2020 and is frequently asked to comment in national media
on a range of employment law, mental health and diversity and inclusion issues.

2022 Workshop Topics

Jodie is looking forward to sharing her expert knowledge and experience with you throughout
2022. We have listed just a few of the key topics she’ll be covering:

• Training line managers to confidently deal with sensitive and difficult conversations.
• Creating a workplace culture which proactively supports men’s mental health.
• Making reasonable adjustments for mental health conditions.
• Supporting employees who are returning to work after a period of poor mental health.

And many more… For information on the full list of workshops, go to: tinyurl.com/mhw-2022

Sign Up Today!
Sign up to a single
workshop for £50 and enjoy a
20% subscriber discount using
code WORKSHOP20.
Just go to tinyurl.com/mhw-2022, MENTAL HEALTH
choose your workshop and enter ADVISER WORKSHOPS
your discount code at checkout.
 MENTAL HEALTH
ADVISER
About 4
Mental Health Adviser is a comprehensive specialist information service for HR Managers, Occupational
Health & Safety Managers, Managing Directors and anyone with responsibility for ensuring good mental
health and wellbeing within their organisation. It is the only service to help you meet your legal
duty of care to ensure good mental health in the workplace and to protect your workers from
psychological harm. It will help you manage employees’ complex and sensitive mental health issues
positively, improving staff engagement, productivity and happiness.

Online Resource Centre 4

You will find hundreds of actionable solutions
by way of checklists, policies, letters and staff
training presentations covering the core areas
of mental health and wellbeing.
Updated each month, the documents have all
been written by mental health, employment
law and occupational health and safety
experts, designed to help you manage workplace
mental health issues sensitively, and by the book.
You can download these immediately, edit and
customise these to your organisation’s needs.
Go to www.mentalhealthadviser.co.uk/resources and create your own personal account.

Ask the Experts Email Helpdesk 4

You will receive personal advice from your team of experts, including the Mental Health Adviser Editors-in-Chief,
Jackie Le Poidevin and Carolyn Dukes, our Health & Safety Adviser and Risk Assessment & Compliance Editors,
Carolyn Dukes, Ian Bollans and Linda Crossland-Mead and our Pay & Benefits Adviser Editor, Sarah Bradford.
Just email your query to [email protected] on any mental health and wellbeing issue you are
facing and you will receive an answer within 48 hours.

What’s in the Next Issue:

l Promote World Mental Health Day 2022 to Boost Your Organisational Wellbeing Strategy
l U
 se Wellness Action Plans to Help Staff Facilitate Mental Health Discussions
l Understand the Dangers of Self-harm and what You Can Do to Support Your Employee