We Need A Re-Brand Of Workplace Mental Health Initiatives
Sheila Mitchell, CBE, Former marketing director of Public Health England Senior advisor freuds, Health and Behaviour Change
How an organisation spends its communications budget is often a bellwether for its priorities.
Thirteen years ago, when I took up the helm as marketing director of Public Health England, the bulk of the Government’s budget for public health campaigns was spent on smoking cessation, then the largest modifiable driver of ill health, with alcohol next and obesity and drugs lower down the list; some years, risky sexual practices or teenage pregnancy also got a look-in, depending on the priorities or prejudices of whoever happened to be public health minister at the time. Not one penny was spent on mental health.
Gradually, however, this changed. Partly this was due to the commendable efforts of a highly committed charitable sector, backed by some high-profile individuals who had the courage to tell their stories, prompting conversations in the media, in our homes and (quietly perhaps) in our heads (“if it can happen to her/him, could it happen to me?”).
Within the public health and medical communities, a more sophisticated understanding of the relationship between mental and physical health also began to dawn; instead of seeing the brain as just another organ that could, like the lungs, the heart or the liver, “go wrong”, clinicians and policymakers started to recognise the relationship between mental and emotional distress and the other behaviours that put our health at risk. Perhaps people were smoking, drinking and taking drugs, overeating (and, who knows, even having unprotected sex) not because they enjoyed these things, but because they were trying to alleviate mental and emotional pain – to cope with stress, anxiety, low mood, loss, financial distress or boredom. As Jarvis Cocker put it, perhaps people really did “drink and smoke and screw because there’s nothing else to do.” If so, unfortunately, these are very short-term strategies. Cigarettes are a case in point. The reason nicotine addiction is so powerful is that withdrawal from it creates anxiety that a cigarette appears, temporarily, to alleviate. Tobacco, like alcohol, drugs and sugar, is a false friend.
Thankfully, people now have better options. Since the creation of the Improving Access to Psychological Therapies (IAPT), we have seen a surge in community-based talking therapy services. Increasingly help is available if people need – and are prepared to access – it. But, while society is changing, are workplaces being left behind? Most of us spend at least a third of our day, and half our waking hours, working. Indeed, since the pandemic, many of us find ourselves not so much “working from home” as “living at work”. It is unsurprising that what happens during our working day (or night) affects our private lives and vice versa. Mental health problems are costing UK PLC.
In January 2020, Deloitte estimated the annual cost to UK businesses from poor mental health (presenteeism, absenteeism and staff turnover) to be in the region of £42bn - £45bn (an increase of £6bn or 16% since 2017). Additionally, the cost to Government of poor workplace mental health (benefits, lost tax and NI and NHS burden) has been estimated at £24bn - £27bn. Therefore, the total estimated cost to the UK economy (from lost output, costs to employers and cost to the NHS) is between £74bn - £99bn per year.
Of course, enlightened employers already know this. Which is why, alongside the growth in communitybased IAPT services, there has been an increase in employee assistance programmes, as managers seek to reduce sickness absence, boost productivity and stem staff turnover. This investment is a good thing. However, buying services isn’t always the answer, or at least not the whole answer. For this solution to work, employees have to recognise that they can benefit from these programmes and feel inclined to use them. And, unfortunately, the evidence suggests that this is not yet the case.
“Employees have to recognise that they can benefit from these programmes and feel inclined to use them. And, unfortunately, the evidence suggests that this is not yet the case.”
Annual research undertaken by Business in the Community in 2019 found a disconnect between how well senior management felt their business was addressing staff mental health and the views of nonmanagement employees. The study found that only 44% of employees felt comfortable talking to their line manager about their own mental health and 27% were fearful of negative consequences for their career if they spoke about mental health issues. Crucially, only 13% of employees would use their Employee Assistance Programme for support with a mental health issue. Younger workers are particularly at risk. A recent survey by ERICA found that 60% of under 25’s would neglect their happiness and job satisfaction in order to remain in a job for fear of not getting another and 50% would hide mental health issues from their bosses for fear of being let go. Why is this? Partly it is driven by outmoded perceptions of mental health. Research for the Every Mind Matters programme, which I led at PHE, showed that people tended to hear the words “mental health” as “mental ill health”, that is as something that only needs to be thought about once there is already a problem. The “prevention is better than cure” adage, so resonant in physical health, has yet to be internalised in mental health. Further, for years the dominant discourse on mental illness was about severe mental health disorders. The phrase “mental patient” still conjures up an image of someone suffering from psychosis, not a person experiencing sadness or worry. We need to create a new discourse that recognises that some negative feelings are normal human reactions to the ups and downs of life, and that there is nothing unusual, weak or “mental” about someone who gets help to deal with them.
And this is where marketing comes in. As with so many things in life, how a solution is presented is half the battle. Four million families signed up to PHE’s Change4Life campaign. I doubt they would have been so keen to join the Childhood Obesity Programme. So, if the primary barrier to uptake of EAPs is a perception amongst employees that seeking help via a formal HR process will have a detrimental effect upon their future prospects, then there is a need to change perceptions amongst employees, so they feel safe asking for help. In my new role as a senior adviser at Freuds, we are looking for a group of visionary employers to work with us to apply marketing techniques, such as consumer insight, proposition development, customer journey mapping and, yes, brand development, to this issue.
Our aim is to inform, educate and reassure employees about mental wellbeing and the business’ attitude toward it, to drive a culture change in the way staff and management view and engage in this issue, making this a shared responsibility, in which everyone is invested.
It will be vital that we measure shifts in knowledge, attitudes, intention and behaviour, as well as in staff wellbeing, and, ultimately on the impact on instances of mental ill health and improved productivity. Because, as employers and employees recover from the trauma of the pandemic, we will need to use all the help and support available to us.