Mental health and wellbeing at work is a priority for UK government. The government published a Green Paper on Work, Health and Disability in October and as recently as the 9th January, the Prime Minister spoke about the government’s pledge to overcome the stigma and barriers of mental health.
Here, Christopher Lorenz, Co-Founder and Head of Science at Soma Analytics, speaks with James Rogers and Jane Abraham from the government’s Work and Health Unit about; their vision on work, health and disability, their Green Paper, building the business case for employer action and the importance of all stakeholder groups taking responsibility – especially the employer.
James Rogers is the Head of Employers Policy in the Work and Health Unit, which is jointly sponsored by the Department for Work and Pensions and the Department of Health. They work to improve the health and employment outcomes of working-age people who have or may acquire a disability.
Jane Abraham is a Policy Fellow with the Employers Team – again within the Work & Health Unit. She looks at the evidence, based on what works at work, as well as policy development from an employer’s perspective.
Improving Lives: The Work, Health and Disability Green Paper
CHRISTOPHER: Welcome and we are pleased to have you here. You have brought us a gift. It’s right here. It’s the Green Paper. It’s called “Improving Lives: The Work Health and Disability Green Paper” and as you can see it’s quite heavy. James, how much work has gone into this brilliant piece of information?
JAMES: A lot of work. Importantly, it’s a joint publication by the Department for Work and Pensions and the Department of Health – reflecting on a new and ambitious approach to work and health. We want to work to join-up systems and to change attitudes across the welfare system, health system, employers and society in order to help disabled people and people with health conditions maximise their strengths and talents.
Within the Green Paper, we are proposing to take early action and to seek views across the wide range of people involved in this space: employers, the welfare system and our society. We want to keep questioning what it would take to transform the employment prospects of disabled people and people with long-term health conditions.
CHRISTOPHER: What would you say is the top headline or top ambition of the Green Paper?
JAMES: At the heart of the Green Paper is the government’s ambition is to halve the disability employment gap. That’s the difference between the employment rate of non-disabled people, at 80%, and disabled people, at 48%, – so a gap of 32%. It’s a significant inequality, an injustice that we can’t sustain, and tackling that is the key to the government’s commitment to building a country that works for everyone.
Despite the record-breaking labour market picture at the moment, there are still 4.6 million disabled people and people with health conditions that are out of work. We really want to get to grips with that challenge.
The Employment Gap – A Case for Action
CHRISTOPHER: Fantastic and very ambitious. If we now close in further, and into a bit more detail, what are some of the highlights within the Green Paper?
JAMES: We set out key evidence and analysis within the Green Paper, including the evidence that shows that good work, appropriate work, is good for our health. On the flip side, unemployment can drive poor health outcomes.
We talk about the disability employment gap – and tackling that isn’t just about getting people into work, it’s also about stopping people falling out of work. We know that as many as 150,000 disabled people leave employment between two-quarters in a year, so we really need to stop that from happening and that’s where we get into some of the health and wellbeing and prevention agenda.
This is also a growing issue. Disability has been rising and we have an ageing population. We need to take action now.
There are some really compelling stats within the employer space and a clear case for action. Long-term sickness absence and tackling that is a priority stated within the Green Paper. 1.8 million employees on average take a long-term absence of 4 weeks or more in a year. There are some big costs for the employers here, including £9 billion pounds a year for employee sickness absence.
CHRISTOPHER: I want to highlight and stress at this point, just how fantastic all of the work you’ve done in creating the infographic below and making it accessible as well. You can find all of this information online. You can find the Green Paper online. You can find different language versions. You can also find a YouTube video including sign language. There’s also an easy-read version online so it is not only rigorous in terms of the facts and the data but also very well presented and very well done.
Now, you mentioned that reducing long-term sickness absence is a priority. What does it also mean in terms of what the case is for employers, and also in terms of prevention?
JAMES: It’s a broad vision, so as well as employers creating jobs and helping to create a healthy and inclusive workplace, which I’ll talk more about in a second, there’s also a more effective health service contributing to this, as well as more effective employment support systems to provide integrated support at the right time to individuals.
Our vision is of a society that is more ambitious for disabled people. Where people can speak about their conditions at work and get the help they need. In terms of prevention and wellbeing, we’re really interested in how we build healthy workplaces that prevent people from becoming unwell in the first place. We also grapple in the employer section with challenges further down that journey, so when someone does develop sickness or a health condition and they are out of work, how do we help get them back to work quickly to prevent them from completely falling out of employment.
And how do we create the conditions for disabled people and people with health conditions to thrive and progress in work and realise their talents.
The Prime Minister’s Plan for Mental Health
CHRISTOPHER: Also, for Soma as a company it’s very interesting because we’re trying to tackle stress from a preventative angle as well. Let’s take one step back because when we’ve mentioned health we’ve both talked about physical health and mental health. Just recently the Prime Minister, Theresa May, spoke to the Charity Commission, she said,
“We must get over the stigma. We must ensure that we are providing the services for people with mental health issues.”
This is the view we are getting from Theresa May, from the government. I’m very pleased to have two insiders sit here today, so from your perspective, James and Jane, what is the significance of this announcement?
JAMES: It brings a really significant focus to the issue and injustice of mental health in society, and it demands that we have a new approach within government to tackle this.
The prime minister has set out a plan to transform the way we deal with mental health issues at all stages in a person’s life. Most relevantly, we are doing more to support mental wellbeing in the workplace and to enable employees who have mental health conditions to thrive at work.
As part of that, two reviews have been announced – one being led by Lord Stevenson, a long-time campaigner on these issues, and Paul Farmer, the CEO of Mind. They are going to work with employers and mental health groups to create a new partnership with industry.
They will look at issues like prevention and breaking the stigma as the top priority for employers and take a look at mental health in the workplace because we know that good mental wellbeing doesn’t just improve the health of an employee, it also improves motivation, increases productivity and reduces sickness absence.
The other part of the announcement with regards to reviews is looking at employment discrimination laws for employees and whether they are sufficient to protect people with mental health conditions.
JANE: Yes, and also we know that mental health, and particularly mild to moderate issues such as stress, anxiety and depression, is one of the primary reasons for long-term sickness absence for employers and their employees.
Employers can see it as a difficult condition to manage. It’s a fluctuating condition, we know that line managers need more support to be able to manage it effectively, and we know that many businesses and employers say that they are fearful of doing the wrong thing.
Also, we have an ageing population, the default retirement age has gone and we’re seeing people working for longer. We are also seeing younger people come into the labour market, admitting that they have mental health issues and they are actively seeking employers that are doing more in this space.
It’s something that’s building a momentum. It’s great that we’re talking about it now but we also need to do more to reduce that stigma.
Building Momentum Requires All of the Stakeholders to Take Responsibility – And Work Together
CHRISTOPHER: You mentioned that we’re building momentum. I think the recent announcements clearly mean that we can see an increase in priority and an influence on policy. So, a question I have which I believe is really important and often being asked is “What can government do, but also what can the government not do? Where are the boundaries for the government here?”
JAMES: That’s a good question. The government is absolutely committed to action in this space and has set out how much of a priority it is.
In the Green Paper we set out a number of areas where we’re working to improve support and do more. For example, we set out that we’re doubling the number of employment advisers in talking therapies for people with mental health conditions – helping people retain or return to employment as part of their pathway through that service.
We’re also increasing access to psychological therapies and we’re trying new ways of providing mental health and employment services that will support people to return to work.
So there is a lot that we are doing in this space. As you talked about earlier, the government can’t achieve all of the change that we want and need to happen alone, without wider society, employers, the health system, etc.
There are lots of other actors in the system and through the Green Paper we really want to start a debate and a conversation with these actors and work out how we can work together to make the change, and the scale of change that we want, happen.
JANE: We have a number of initiatives. We’ve held a number of stakeholder events with the Green Paper through the consultation. We’ve been talking about the support that is already in place: Fit for Work and Access to Work. We’ve also got the Disability Confident campaign which is a toolkit which helps employers to recruit with confidence and support through inclusive recruitment processes.
However, we do know that there is not enough awareness of the products and the initiatives that we are supporting. Today is Time to Talk day, from Time to Change, which is another government supported initiative but we know that we need to work with partners as well, people like the Health and Safety Executive, ACAS and Mind. They have been doing some fantastic work around mental health and we need to be working with them, and with employers, to learn how to best tackle this stigma and reduce mental ill-health at work.
Creating the Business Case for Employers
CHRISTOPHER: Absolutely, and this is my next question. You mentioned the different stakeholders. You mentioned the Government as one of the stakeholders, non-profit organisations and charities as another, but also employers. This is what I would like to talk about in a bit more detail because it’s especially relevant for our readers today.
Many of our readers are already taking action, and maybe even in a preventative way addressing the wellness and the wellbeing of their employees. However, one of the key questions they have is “How do I create a business case for investing in the wellness and wellbeing of employees? What is the return on investment? How do we go about showing the return on investment when investing in wellness and wellbeing?”
JANE: A lot of the work that I’ve been doing is looking at the business case, and traditionally most of my evidence comes from the US market where they can show a return on investment but it’s a very different labour market to ours because of the insurance industry and the way that their health service works. In 2008, Price Waterhouse Cooper published a paper around the business case stating that they estimate that for every £1 invested £6 is returned, but we do need to know more.
We do know that investing in workplace health and wellbeing proactively, and in terms of retention and reducing sickness absence, helps with productivity output and employee engagement.
In today’s climate, investment is really important for attracting and retaining talent too. As I’ve said, young people are coming into the labour market actively seeking employers that are doing something in this space.
It’s also good for the brand and particularly around inclusive employers who have a diverse workforce. We know that reflecting the customer base, particularly with the service-led industries that they are trying to reach out to, is actually good for the brand.
We know that many organisations have done some great work, but what we don’t really have is much evaluation that we can use that is robust. So, we are asking our audience today to share any good practice that they have with regards inclusive recruitment, worker retention, health promotion and improving health at work.
If you have any evidence or any evaluation that shows what you are doing, the effect that it is having, whether it is actually doing what you want it to do – please share that with us, we’ll be really interested to hear from you.
CHRISTOPHER: Oh absolutely. We’ll come back to this call to action later, but before that I’d like to ask you a follow-up question. The Green Paper mentions that almost one in three working-age people in the UK have a long-term health condition that could affect their participation in the workplace, and if we look at mental health conditions specifically it’s actually one in five of the working-age population. Do you think employers are aware of this?
JANE: I think there’s a growing awareness amongst employers of the issues. However, many people don’t disclose their mental health conditions at work because they are fearful of how that would be perceived and how that will reflect on them.
A part of what we’re trying to do is reduce the stigma and we are working towards that. I do think that there’s awareness about it, but as I said the business case needs developing. We think it is, but we need much more evidence to actually demonstrate that yes, this is a big issue, and this is what can actually make a difference. So, we really need to understand what works in a more robust way.
Call to Action: Join the Consultation
CHRISTOPHER: Absolutely, and this leads us to our call to action, you can join the consultation. You can get in the contact with the government. James, how should they should go about this?
JAMES: Yeah, absolutely. Whilst the consultation closed last week, we are still welcoming any queries, follow-ups or evidence to be sent in to the email@example.com email address.
We really do want to hear about what you are doing, what the barriers are to you doing more and what kind of support would make a difference here. So please get in touch.
JANE: If you are an employer and you’re doing some good work and you want to have discussions about either the evaluation of it or how you could go about evaluating what you do, just get in touch with us directly.
CHRISTOPHER: Brilliant. Thanks again for joining us and let me quickly recap what we have covered, which is a lot, actually.
We started with the green paper. You can find it online in different versions. It’s a fantastic piece of information and research – very, very rigorous, very detailed. There’s also an evidence pack containing data and online resources. It’s very well presented so check it out.
We talked about the Government’s vision to reduce the employment gap between disabled people and non-disabled people, the key areas, and especially what this means for employers. We talked about Theresa May’s speech and how she is listing mental health as a top government priority. We also talked about boundaries, and that it’s not only about the government, but that there are other stakeholders that have to be involved in this as well – one of which is employers.
We talked about the business case for employers and how to create this. Jane mentioned that we have to cover a lot of different bases. We have to think about engagement, motivation and long-term and short-term sickness absence. We have to work in a measurable way. Awareness of the key issues is increasing but there is still a lot to do. In fact, it might even be possible to generate a business case with customer satisfaction surveys – resulting in a healthier, and a more diverse, workforce.
Last but not least the call to action is to join the consultation. There are many ways to do this (see above), including feeding back directly to James and Jane and the team at the Work & Health Unit.
Thank you very much for being here today.