COVID-19 Webinar 13: Workplace Mental Health

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The Lancet Psychiatry, Mental Health Innovation Network, MHPSS.net and United for Global Mental Health organise a series of weekly webinars designed to provide policy makers and the wider health community with the latest evidence on the impact of COVID-19 on mental health and how to address it.

Chair:

Niall Boyce - Founding Editor at the Lancet Psychiatry

Speakers:  

Professor Sir Graham Thornicroft - British psychiatrist, researcher and professor of community psychiatry at King's College London

Enoch Li - Founder and Managing Director at Bearapy

Emma Codd - Global Inclusion Leader at Deloitte

Sapna Mahajan - Director, Centre of Expertise on Workplace Mental Health, Canada

Key messages:

Sir Graham Thornicroft (King’s College London: In workplaces it is important to create opportunities for safe disclosure [for people to share their concerns regarding mental health] so people can  go to their line manager, chat lines etc. In the UK the Royal family has demonstrated the importance of supporting different groups e.g. young men. 

Emma Codd (Deloitte): Culture and addressing stigma. Big thing for me. Everybody when asked are you OK, they feel able to be honest about it and those asking them can signpost them to help that is in place. 

Sapna  (Centre of Expertise on Workplace Mental Health, Canada): Genuine leadership, integration of health (physical and mental), people leaders create the space and environment where people can come forward

Enoch Li (Bearapy): Give people the real picture of what is like. Normalise the conversation and indicate where to look for support. Give people hope we can get through this. 

WHO: The WHO Considerations for public health and social measures in the workplace in the context of COVID-19 provides advice for workplaces that are not in the health sector on actions to take to assess, prevent and mitigate work-related exposure to COVID-19. 


Niall opened the webinar and thanked the organisers and the speakers. He noted the world of work is one of the most remarkable areas of change due to the pandemic and its effect on the nature of work. He introduced the speakers.

 

Niall Boyce

Why is the workplace an important environment to address mental health? 

Sir Graham Thornicroft (King’s College London)  

It is an important environment because of the implications of work and mental health problems -  the workplace can be the cause, context and/or the consequences. The scale of the challenge is huge. The impact of mental ill health on the global economy is projected to be about $2.5 billion p.a. and an estimated 12 billion days are lost due to mental ill health. We know we can intervene to improve mental health in the workplace effectively. The return on investment of improving mental health in the workplace is four times the cost.

Niall Boyce

What has been the impact of COVID-19 on workplace mental health and how can businesses best address this?

Sir Graham Thornicroft (King’s College London) 

The impact to date has been astonishing. For example the impact of remote working or no work (particularly for those in LMICS). Long term implications are more serious still - “recessions can hurt but austerity kills.” Recessions could have a catastrophic impact on mental health in countries around the world. 

Niall Boyce

What has been your experience of mental health in the workplace? 

Enoch Li (Bearapy)

Lots of intention but these intentions are misaligned. Find HR or management teams would like to do something but want to avoid difficult topics e.g. talk about stress management but not burnout or depressions. Employees tend to be curious about mental health conditions. Company culture doesn’t keep up with their needs. Employees don’t want just a mental health workshop. Companies need to look at targets and performance expectations. 

Niall Boyce

What are you hearing from other lived experience advocates and the organisations that you work with about what is needed in the time of COVID-19?

Enoch Li (Bearapy)

Give people the real sense of what [mental ill health] might feel like - e.g. to have a panic attack. Webinars on productivity are not sufficient and can increase the taboos [around mental health]. Need more peer support to encourage people to reach out and supportive colleagues when they do. 

Niall Boyce

Deloitte has launched some new research - can you tell us about it? 

Emma Codd (Deloitte)

It is an annual millennials survey - 18,000 in 43 countries around the world - research conducted pre-COVID (November/ December) and smaller pulse survey during COVID. The definition of millennials used is those born between January 1983 and December 1994 and the survey also includes Generation Z i.e. those born between January 1995 and Dec 2003. 

Niall Boyce

What does it show?

Emma Codd (Deloitte)

Pre-COVID results - almost 50% of Gen Z and 40% millennials feel anxious or stressed all of the time and rates are higher among women than men. Parents more stressed than the average particularly Gen Z parents (whose children are typically younger). 48% of Gen Z ranked mental health as first or second priority and only physical health greater priority. 45% millennials think they will be less happy than their parents. There is a clear stigma around mental health. Over 50% report feeling stress and anxiety but nearly half of those who had taken time off gave a completely different reason for taking time off to their supervisor. How can an employer calculate the cost if there isn't transparency?

Niall Boyce

There is a sense of overwhelming anxiety. What is your company doing to respond to mental health at the time of COVID-19?

Emma Codd (Deloitte)

70% of the workforce fall into this age category [Gen Z or millennials]. We focus on stigma. Peer support is really helpful and we have mental health champions. It is to do with culture and addressing stigma and having our leaders speak about their mental health. 

Niall Boyce

How are you seeing workplaces prioritise mental health across Canada during COVID-19?

Sapna Mahajan (Centre of Expertise on Workplace Mental Health)

It has shone a light on accountability of workplaces - mental health as important as physical health. First response to COVID-19 was to physical health needs - but mental health will last longer than the pandemic. Need to equally address mental health and expand the notion of health and safety to include mental health.

Young people have less stigmatising views of mental health but haven't quite broken through yet [in terms of workplace culture]. Help by equipping and supporting managers - especially millennials and Gen X - give them the skills and competencies [on mental health] and give them value to lead with such skills. 

Niall Boyce

Can you explain a bit more about your recent project on workplace mental health for the Asia Pacific Economic Cooperation organisation

Sapna Mahajan (Centre of Expertise on Workplace Mental Health)

APEC has a workplace wellness and resilience group that Sapna co-chairs with Japan. Acknowledgement of the need to take action on mental health. The group shares practices and lessons learned. It has launched a new white paper. It talks about some of the best practices in the region and how to take action.

Niall Boyce

Graham, how do you recommend businesses and other employers address regional or country level differences in attitudes or funding for workplace mental health? 

Sir Graham Thornicroft (King’s College London)

There are activities to do at different levels - individuals, teams, and the organisation. There are things to do with everyone, and to do with specific groups such as those with mental health problems. The evidence of what works is mostly from HICs. Stigmatisation can form barriers for people seeking health. I work with a network of 40 countries around the world to understand, intervene and help reduce stigma. Have to adapt and contextualise. The evidence shows stigma reduction is best achieved by encouraging contact between those who have and have not experienced mental ill health. Evidence shows using videos to create that contact between people is as effective as in-person. Programmes lead from the top i.e. managerial level has a real impact. Managers need to talk seriously and have improving mental health as a long term proposition. 

 

Niall Boyce reminded participants to post questions using the hashtag #COVID19MH. He said he was struck by the importance of leadership from the top and by the point (in contrast) of mental health programmes as things imposed on people rather than respond to their needs. Understanding people from further down organisation need to have their voices heard, give us some idea on how to facilitate that.

 

Enoch Li (Bearapy)

Multinational organisations can enable groups to determine strategy in different regions and bring in country level employees. It is helpful to identify what are the points of stress that differ across regions - people bring these stresses into the workplace and they can affect the job. Instead of a workshop on stress management we have done workshops addressing other points of stress such as communicating in relationships, parenting etc. This helped people handle their own stresses and not bring these into the workplace. 

Niall Boyce 

Taking a specific focus on millennials. There is a high degree of anxiety and precariousness. To what extent can you tailor mental health interventions by generational concerns?

Emma Codd (Deloitte)

60-70% of Deloitte’s workforce in this demographic. But they are not the only ones to suffer from mental ill health. We work in 120 countries around the world so it is important to listen. There is a huge body of research [on mental health] from outside the organisation but we also listen to people within the organisation. Deloitte has done staff surveys before COVID and during. External surveys [like the research done by Deloitte] show stress levels have come down during COVID - maybe due to reducing commute etc. But on workplace mental health, the message is about how to lead and that affects all the workspace - not generational. Culture is so important. If leaders send you an email at 11pm then it undermines everything we do as an organisation on improving mental health. We need to tailor mental health from a geographical perspective. 

Niall Boyce 

How do we support people working at home?

Sapna Mahajan (Centre of Expertise on Workplace Mental Health)

Not just technology but how we communicate and bring people together. People leaders are really key - top management and managers at the frontlines. Business is not as usual and we need to manage expectations. Give people the tools and acknowledge it is different. 

Niall Boyce 

How can people get access to Deloitte research? 

Emma Codd (Deloitte)

www.deloitte.com - We are also about to publish a white paper on the mental health findings within the next 2 days.

Niall Boyce 

How to support people who are expected to come back to their offices?

Enoch Li (Bearapy)

Acknowledge varied experiences people have had [during COVID-19]. Some people want to move on and not talk about COVID-19 or mental health but the danger is that we sweep it under the carpet particularly in countries where people are less inclined to articulate how they feel. Workplaces need to create the space and psychological experience to share how people are feeling - and communicate, “we are here for you and with you.” 

It is not business as usual - it is a changed environment.

Sir Graham Thornicroft (King’s College London)

Last 2-3 months so many people have said it is like a roller coaster. Normal emotional experience intensified. Many people have been working under unacceptably intense conditions for several months. Going back to the office may not feel like normality - particularly the relational part of work (gossip and chit chat). We cannot generalise. Some are feeling very worried about proximity and transmission of disease. Managers and Employee Assistance Programmes (EAPs) need to look at where people are and what they need. Some people experience fearfulness of being at home for long periods. 

Niall Boyce 

How flexible can employers be?

Emma Codd (Deloitte)

Deloittes is a client servicing organization that requires people to be on site. This will happen as long as people are comfortable. All we have are our people. I have spoken to teams who are likely to be working from home for the next 6 months. It is important for people to have the ability to work from home for another 6 months. We have talked about what that feels like. Each country has different requirements. The most important thing is for our people to voice where they have concerns. The biggest word heard most frequently is “scared”. Employers need to show responsibility and demonstrate they won’t jeopardize health. 

Niall Boyce

Is the world of work permanently changed, and if so, what are mental health consequences?

Sapna Mahajan (Centre of Expertise on Workplace Mental Health, Canada)

It will be changed. Positive pieces e.g. can do work remotely. It is not a return to work but a return to the workplace. The new workplace may not give benefits such as social interaction. Workplace has changed and as workplaces start thinking about guidelines they need to help people physically and mentally - they should do both.  

Enoch Li (Bearapy)

In Beijing and across China some companies have mandated employees to be in the office for 9 hours while others have trusted employees to determine themselves when they come into the workplace. There is a lot of work online and some offline events too. Organisations are actively approaching us for advice. There remain key differences globally on workplace mental health. 

Sapna Mahajan (Centre of Expertise on Workplace Mental Health, Canada)

Spend time to gather information to see what the issues are; measure interventions and see if they are working. COVID-19 is highlighting mental health needs but these are different around the world. The intention is there [to do more on mental health] but the role of the workplace differs on how much we can do and prioritise it. It is moving in the right direction but there are quite a bit of differences. There is the white paper from APEC. and we are developing international standards to try and leverage the differences and tailor accordingly. It would be nice if we were all approaching the issue in a similar way.

Niall Boyce 

What is your final take-away message?

Sir Graham Thornicroft (King’s College London

WHO will have evidence based guidance and are doing excellent work led by Ayisha Malik. Meanwhile in workplaces it is important to create opportunities for safe disclosure [for people to share their concerns regarding mental health] so people can  go to their line manager, chat lines etc. In the UK the Royal family has demonstrated the importance of supporting different groups e.g. young men. 

Emma Codd (Deloitte)

Culture and addressing stigma. Big thing for me. Everybody when asked are you OK, they feel able to be honest about it and those asking them can signpost them to help that is in place. 

Sapna  (Centre of Expertise on Workplace Mental Health, Canada)

Genuine leadership, integration of health (physical and mental), people leaders create the space and environment where people can come forward

Enoch Li (Bearapy)

Give people the real picture of what is like. Normalise the conversation and indicate where to look for support. Give people hope we can get through this. 

Niall thanked the panel and encouraged people to continue the conversation through the hashtag #COVID19MH. He announced that the webinars coming are on July 7th on addressing poverty as part of mental health programmes during COVID-19; and on July 14th - supporting parents and carers through different innovative approaches. 

 

Statement from WHO:

The WHO Considerations for public health and social measures in the workplace in the context of COVID-19 provides advice for workplaces that are not in the health sector on actions to take to assess, prevent and mitigate work-related exposure to COVID-19.  

The impact of COVID-19 and associated public health and social measures on workers’ mental health is fully acknowledged. Reduced or lost earnings and job insecurity are major causes of stress for both employers and employees. Fear of infection, particularly among those who have continued to work throughout the pandemic, is another. People who are tele-working, often for the first time, can feel isolated from colleagues. The return to the usual place of work, while a relief for some, can be a new source of stress for others.

Given the above sources of stress, WHO recommends that employers take action to assess, prevent and mitigate work-related risks to health, safety and well-being, including for mental health, as well as putting in place measures to prevent infection among their employees. As people adapt to new working circumstances, it is critical that they are aware of how and where to access support for their mental health.


Secretariat

United for Global Mental Health is the secretariat of the Global Mental Health Action Network.

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