HR · 14 May 2019

Mental health in the workplace: An SME employer’s guide

The SME Employer’s Guide to Mental Health

In this handy guide, we look at how SME employers can address mental health issues positively and inclusively.

Employees are three times more likely to discuss physical illness over mental health issues with their employers. But when you’re running a small business, an open channel of communication can mean the difference between happy employees and a revolving door of talent …and in some cases, even life and death.

This week is Mental Health Awareness Week (13-19 May 2019), a time for us to pause and think about the millions of people around the world who live with mental health issues every day. This guide will help SME employers support the underrepresented, stigmatised and often isolated workforce affected by these issues.

Mental health issues can wreak havoc on productivity

Distressed employees spend more than one-third of their time at work being unproductive and average one full day off sick per month. This revelation comes from LifeWorks by Morneau Shepell and the International Employee Assistance Professionals Association (EAPA) based on data from multiple employee assistance providers worldwide and over 23,000 employee use cases.

According to the research, employees struggling with mental health or other wellbeing issues are unable to concentrate on their job, a symptom known as “presenteeism,” for more than a third of the total scheduled work time (54.95 hours). This adds up to about eight total days per month, and more than twice as much as the typical “healthy” employee.

In addition, these employees are also absent from work for an average of 7.36 hours per month – almost one full working day and about 5% of all work time.

The most common clinical issues behind the reduced productivity were related to mental health, including depression and anxiety, personal stress, relationship problems of marriage or family life, work and occupational issues, and alcohol misuse and drug problems.

Thriving at work – a major report on mental health and employers, commissioned by Prime Minister Theresa May – quantifies the impact of mental ill health in the workplace. Poor mental health costs employers between £33bn and £42bn a year. This is in addition to an estimated £37bn to £52bn cost to the economy in lost output and £25bn cost to the government due to reduced tax intake, NHS treatment costs and poor health-related welfare payments.

The individual cost of poor mental health are also considerable – not only are people with long-term mental health disorders much less likely to find work, but an estimated 300,000 also lose their jobs every year. The problem is mounting – according to the UK Labour Force Survey, the number of sick days taken due to mental health problems increased from 13.0m days in 2010 to 15.8m days in 2016, making up nearly one in 8 of all workdays lost to ill health.

Why are mental health issues still stigmatised?

A OnePoll survey of 2,000 employed adults in the UK reveals that only one in 10 workers would feel comfortable speaking about self-harm, psychosis, eating disorders, postnatal depression or schizophrenia–all very real, and potentially debilitating issues. In comparison, 40% of the respondents would be comfortable talking about cancer than bipolar disorder, which reveals a lot about the stigma surrounding mental health issues in the workplace today.

We would rather talk about diarrhoea [29%] than depression [26%] with our manager.

The findings from the research commissioned by Mental Health First Aid (MHFA) England and Bauer Media UK, illustrate that there must be a fundamental change to ensure we treat mental and physical health equally in the workplace.

“Whilst many employers are claiming to take mental health more seriously, the feedback I’m getting on my travels around the UK is that many of them are paying it lip service,” says Natasha Devon MBE, campaigner and author close to the research.

Our research shows that people still feel the stigma of discussing mental health in the workplace, fearing they will be seen as ‘unprofessional’ if they do disclose a mental health issue. That’s why, one year on from when we called for a law change to make mental health first aid mandatory in the workplace, we have expanded the range of recommended actions employers can take.”

“We spend a third of our lives at work and we can’t leave our mental health at the door – it’s essential businesses get this right.” – Natasha Devon MBE

Mental health and employee wellbeing: What can you do?

We spoke to Dr Mark Winwood, director of psychological services for AXA PPP healthcare, to ask what he would recommend to employers to help them take active steps towards supporting the wellbeing of all of their staff.

“We see many people regretting the fact that they did not seek help with their mental ill health sooner. Most don’t want to admit to having a problem as they are concerned about how this would be received by colleagues and fearful it could affect their careers prospects. We want to help change this.” – Dr Mark Winwood, AXA PPP healthcare.

AXA research reveals that people who have experienced mental ill health want employers to offer free screening for depression in the workplace. If this were widely available, we might see more people seeking and receiving support for their mental health sooner – before reaching a crisis point, Winwood adds. “Employers who adopt this approach would also show employees that their psychological wellbeing really matters – something that should, in turn, help to break down the stigma of mental ill health at work”.

There’s a lot more to employee mental health issues than the pressures and problems caused by work. For employers, it’s crucial to remember that there are only a number of things in your control, or even your remit.

Employees are affected by a number of pressures and responsibilities, both in their personal lives and in their professional lives. When these pressures mount, it can lead to stress, anxiety or even depression.

What can you do as a business owner? Here’s where HR can swoop in to support, specifically to normalise mental health issues at work and create a safe space for employees to speak up about their issues.

To create that safe space, senior management buy-in is absolutely essential. Leading from the top means senior managers are role modelling behaviours that help make it okay to talk about mental health issues.

When leaders visibly demonstrate their commitment to creating a positive, supportive workplace culture, they automatically signal to managers and staff that good mental health is a business priority.

Managers throughout the business also need to be trained and supported so they are equipped to have those crucial conversations with employees about mental health issues. By setting the precedent from the top and creating an empathetic and supportive environment, employees affected by mental ill health will gain the confidence to speak openly about their situation or offer support to their peers with whom they recognise the symptoms.

A mental health checklist for SME employers

Supporting mental health in the workplace is a key part of your duty of care to your employees’ health and safety. In addition to this basic responsibility, this can lead to a significant commercial return.

In fact, the average return on investment of workplace mental health interventions is 4 to 1, which means that for every initiative put in place, the positive impact is fourfold.

Placing wellbeing at the core of your HR strategy is the first step to building a mentally healthy workplace. The following checklist can help you and your business to achieve this.

Workplace culture – Build an environment that is open, transparent and empathetic by allowing for flexible working, social outings and more. Openly acknowledge key resources out there such as those from charities including Mind, Rethink and Anxiety UK.

Role modelling – Normalise mental health issues by sharing personal stories, preferably from the top.

Work/life balance – Establish and enforce boundaries at work so your employees know that after work hours are theirs to unwind and disconnect from the daily grind.

Physical wellbeing – Whether by setting up cycle to work schemes in place or something as simple as a running club or meditation hour, try to introduce physical activities as part of your company’s work life. This will give your team the option to incorporate physical well-being into their lives as well.

Peer support and mentoring – It can be hard to open up to colleagues (or worse—your boss!), so by introducing peer counselling you could set the scene for your employees to connect with colleagues in a way that gives them permission to open up and connect over shared experiences. Mentoring programmes where senior members of staff take juniors under their wing could also help create rapport and start a dialogue where they can be their authentic selves at work.

Build strong communications platforms – Internal communication isn’t just a large company’s game. Even when running a startup you can keep the lines of communication open and transparent. Whether it’s through messaging channels like Slack or a weekly meeting, keep everyone on your team in the loop about major work changes to ease their transition. It’s also a great opportunity to praise employees and give kudos when deserved.

Monitor absences – Absences can be a dead giveaway that things may not be smooth sailing for your employees. If an employee is absent or late frequently, it should raise questions about their wellbeing. This could present the opportunity to start an open dialogue about what’s not working for them at work.

Seek employee feedback – Adopt frequent wellbeing checks through formal surveys or informal one-to-one meetings to keep the channel of communication open both ways. Using the data you gather can help you understand where your wellbeing strategy may have gaps from the perspective of your employees.

Review all of your policies at least once a year – Using feedback and monitoring progress of particularly vulnerable employees can help you stay accountable and reinforce your company’s commitment to mental wellbeing.

Summary of Checklist for SME Employers

Number Checklist item
1 Workplace culture
2 Role modelling
3 Work/life balance
4 Physical wellbeing
5 Peer support and mentoring
6 Build strong communications platforms
7 Monitor absences
8 Seek employee feedback
9 Review all of your policies at least once a year


Download the “Business Advice – mental health checklist for SME employers” as a handy pdf guide you can read anytime, by clicking the download link below.




Businessadvice - A mental health checklist for SME employers

A mental health checklist for individuals

According to AXA PPP healthcare’s Dr Mark Winwood, if you’re experiencing stress in the workplace, there are steps you can take to help address it:

Basic wellness checks – Should you be doing more exercise, improving your diet, or getting more sleep?  Fairly simple changes in these three areas can improve your outlook and ability to cope with stressful situations at work.

Challenge your thinking – If you find yourself taking a negative perspective on work issues could there be a more balanced or alternative way of looking at things?  Write down what’s troubling you and challenge it. Take some time to focus on the positive– what are  your strengths and what have you achieved?

Make lists and plan workloads – By ticking off  jobs on your list you’ll start to recognise your accomplishments and feel more in control.

Find time to relax – Reset your mind, listen to your favourite music or take a walk for air. Whether it’s at home or on your lunch break, make time for you. Switching off will also improve your sleep health, allowing you to tackle tasks with a fresh head.

Be fair on yourself – Think about  what you have the power to change  in your current circumstances and prioritise these things, rather than worrying about areas you can’t control. Keep things in perspective. Ask yourself ‘What’s the worst that could happen?’ It’s probably not as bad as you imagine.

Try not to avoid – Whether it’s faking a sick day or putting something off, ignoring the source of your stress won’t make it disappear and may only add to your to-do list.

Identify the real problem – Are you afraid of failing? Sometimes we’re our own worst critics.  Think about what you’d say to a friend or a colleague in the same situation. Would you be as hard on them as you are on yourself?

Protect your work-life balance – Don’t abandon social plans for the sake of working late. Overtime can lead to diminishing returns on productivity. Making time to catch up with friends and family will boost your mood and take your mind off work pressures.

Avoid unhealthy habits – Excessive food or drink consumption may offer temporary relief but it won’t help in the long run. Explore good habits that can boost your mood and energy levels. Exercise releases a chemical in the brain called dopamine which gives you a healthy high.

Don’t bottle it up – It’s helpful to share your concerns, so speak to your manager or a supportive colleague.  A problem shared is a problem halved.

Summary of Checklist for Individuals

Number Checklist item
1 Basic wellness checks
2 Challenge your thinking
3 Make lists and plan workloads
4 Find time to relax
5 Be fair on yourself
6 Try not to avoid
7 Identify the real problem
8 Protect your work-life balance
9 Avoid unhealthy habits
10 Don’t bottle it up


Download the “Business Advice – mental health checklist for individuals” as a handy pdf guide you can read anytime, by clicking the download link below.




BA mental health checklist for individuals

The case for employee assistance programmes (EAP)

Nearly two-thirds of people say they’ve experienced a mental health problem. Among women, young adults and people living alone, the number rises to 7 in 10. That’s why many businesses invest in an employee assistance programme (EAP) which connects them with counsellors and experts to guide them through their issues.

Knowing there’s a problem is hard enough, and admitting you need help even more so. According to the Morneau Shepell and EAPA research, about eight out of every 10 cases for counselling are self-referrals. Only 5% of referrals come from supervisors, and 2% from HR or the employer.

In terms of a measurable and tangible return on investment, the data speaks for itself. Measured over a three-month period of distress, EAP counselling restored up to five days of productive work time for businesses. This result was worth an estimated US$1,731 per case.

EAP counselling reportedly reduced the risks associated with the following workplace problems:

  • Issues with work presenteeism reduced from 56% to 28% of all cases.
  • Issues with life satisfaction reduced from 38% to 17% of all cases.
  • Issues with work absenteeism reduced from 34% to 14% of all cases.
  • Issues with work engagement reduced from 31% to 21% of all cases.
  • Issues with workplace distress reduced from 22% to 13% of all cases.
What are some of the strategies you use in your business to support employee mental health? Share your experience with us.

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Praseeda Nair is the editorial director of Business Advice, and its sister publication for growing businesses, Real Business. She's an impassioned advocate for women in leadership, and likes to profile business owners, advisors and experts in the field of entrepreneurship and management.

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