Manager’s desk guide
Manager’s desk guide for workplace mental wellbeing
for workplace mental wellbeing
Helping people make the most of their lives Produced by Suffolk Mental Health Partnership NHS Trust
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If you are concerned about a colleague in distress… Samaritans: 0845 790 9090 A 24-hour confidential telephone service http://www.samaritans.org.uk/ MindinfoLine: 0845 766 0163 Monday to Friday 9.00am - 5.00pm http://www.mind.org.uk/ NHS Direct: 0845 4647 24hr National helpline providing medical advice. http://www.nhsdirect.nhs.uk/ Saneline: 0845 767 8000 Out of hours telephone help line. Opening hours: 12noon to 2am http://www.sane.org.uk/
Suffolk Business Minded would like to thank the following for all their support and contributions to the ‘Suffolk Business Minded Initiative’ and ‘Manager’s Desk Guide’: Suffolk and Bury Chambers of Commerce Nigel George - George & Co. Solicitors Judith Howard-Rees - Gipping Occupational Health Clare Whight & Sharon Foster - SOS HR Valerie Beresford - Workwise Lesley Bailey - InterAct Kent Austin - Copywriter Robert Nesbitt - SMHPT Gabriel Tamaya - SMHPT
Every effort has been made to ensure the accuracy of this guide, but it is not a substitute for professional advice and no responsibility can be taken for any errors.
1 A good manager’s guide We’ve got a problem I need more information
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Who is this guide for? The Manager’s Desk Guide is designed to be used by line managers, team leaders and anyone who manages staff. For new managers, we hope this book will help you make a good start in supporting your team to achieve greater productivity. Your team look to you to set the culture of ‘the way we do things round here’. This isn’t about having big ideas. It’s about the hundreds of small things you do every day that set the right culture – giving people honest feedback, praise, thanks, and setting a good example by the courtesy you show to customers and colleagues. For experienced managers, we hope the guide will provide a useful refresher. The law and business practice have changed significantly in the last decade. This guide may help you to stay on top.
How to use this guide There are three sections each with a different purpose.
1. A good manager’s guide. Day to day tips and guidance to manage stress in your workplace.
2. We’ve got a problem A go-to guide for when you need help now.
3. I need some more information. Facts and resources at your fingertips.
A good
manager’s
guide 1
Day to day tips and guidance to manage stress in your workplace.
In this section… 1.1
Right person – right job
1.2
Right culture
1.3
Right side of the law
1.4
Right approach to managing sickness
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1.1 Right person – Right job It sounds obvious, but if you recruit the wrong person for any job you’re going to have a big problem further down the line. So is the employee who you have put in that position. But when managers are under pressure they sometimes cut corners on planning – and this includes planning job design and recruitment. This is a false economy. The first step to designing stress out of your job is to plan recruitment properly.
1.1.1 The Job Description and Person Specification Janet was great. In the end she almost ran the entire office! No wonder she left... We just need to find another Janet. I’ll put an advert in the paper next week....
Start with the Job Description [JD] as this sets out what the job is there to do. Then work on the Person Specification [PS] as this describes the minimum knowledge and skills of the person who can do that job. • Jobs change over time. Reviewing the JD and PS is an opportunity to be creative and to make your team more efficient. • Ask for input from your team – they know what works and what doesn’t. • Distinguish between essential and desirable requirements for the job. Focus on what needs to be achieved. • Ensure that you identify the mental or emotional elements specific to the job, and outline the abilities necessary to meet set work schedules and targets.
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• Enable adjustments to be made to accommodate people with a mental health problem or any disability. • Plan ahead. If your PS needs someone who can type, then you may want to put some time into the interview schedule for a typing test. • Do a reality check. It can be very tempting to put everything into a JD that other people don’t want to do, or no-one can do well. Have you ended up with a JD for someone with super-human powers?! Does the PS match the JD? Why does the receptionist need to have a PhD?
1.1.2 Short-listing applications Bear in mind that you might need your paperwork later to show that you followed a fair process if you are challenged. Keeping good recruitment records is a basic management competency. It’s surprising how often it is overlooked even by experienced managers. Toolkit – Short-listing
Do
Don’t
Ideally use two people when short-listing
Don’t discriminate on grounds of sex, age, religion, race, gender, sexual orientation or disability
Include and train line managers Use a simple scoring system independently of one another Short-list against the criteria on the person specification Finalise the short list by comparing and discussing results
Only use information the candidate has given on their application form Don’t take up references prior to interview If the candidate is known to you, don’t go on previous knowledge, hearsay or recommendation from colleagues – make your own judgment
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1.1.3 The interview You want the best person for the job, so you need each candidate to be able to give their best performance at interview. Try to create the right atmosphere from the start so that candidates feel they can talk openly; you will then be in a better position to assess their skills. Remember, every candidate will talk about you and your company afterwards to their colleagues and friends. They’re doing your marketing for you. So what do you want them to say?
“I really hope I get this job – they’re friendly, very well-organised and really seem to want their staff to do well. Even if I don’t get this job I’ll try again. It’s a great company.”
Or ntact. If that’s y didn’t make eye co the d an ce on ile sm stomers? If I do “They didn’t do they treat their cu w ho ff, sta ir the at see how they tre desperate, and then take it because I’m get the offer I’ll only for.” what else I can go
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Toolkit – Interview
Do
Don’t
Consider any reasonable adjustments, e.g. venue, access, time, equipment
Talk too much or over the candidate
Give the candidates as much notice as possible
Make the candidate feel intimidated or uncomfortable Ask closed/leading questions
Provide any details of tests or presentations in advance
Ask personal questions which are not relevant to the role
Ask all candidates the same questions, which should be relevant to the job
Allow yourself to be interrupted during the interview
Agree the questions before interviewing commences
Write inappropriate comments on the scoring sheet
Make notes about the candidate’s responses Score each person individually based upon the selection criteria Let the candidate do around 80% of the talking If possible, include the line manager of the post and an HR practitioner. An ideal panel size is 2-3 people
Promise something you can’t deliver
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1.2 Right culture Culture is one of those elusive things... you can spot a good working environment within hours or even minutes of being in the team, but there is no single recipe for creating a healthy, productive and rewarding work environment. There is, however, a lot that you can do as a manager to make a difference. Successful organisations have low sickness rates, high productivity, and staff members who feel that they make a difference and matter. Failing organisations have stressed out staff, poor morale, and high sickness and turnover. Where would you prefer to work? It makes good business sense to promote mental well-being. “A Policy on Positive Mental Health and Wellbeing is a priority... All Employers have both a legal responsibility and a duty of care to look after and safeguard the health, safety and welfare of their employees. SOS-HR recommend all employers to have a robust Health, Safety and Welfare Policy which will include looking after the mental health and well-being issues whilst they are at work. This policy should provide a working environment where hazards to health are identified, assessed and removed or reduced and will ensure that staff who have, or have had, symptoms of mental ill health are treated responsibly and in an understanding manner.”
Clare Whight, Director of SOS HR
A healthy workforce is a productive workforce. Healthy working environments reduce employee absence through sickness and stress, and help attract and retain the best people. The CBI estimates that in 2008 175 million working days were lost, at a cost of £13 billion. Simple measures to prevent and manage ill-health can reduce absenteeism and make a significant impact on productivity and competitive edge. Employees who feel cared for are more satisfied and perform better, thereby reducing staff turnover and increasing productivity. Being known as an organisation that cares about staff enhances your reputation and can help attract staff and customers.
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Conversely, failure to invest in health and mental wellbeing of workers is proven to have a widespread detrimental effect on a business’s ability to compete.
Signs and symptoms in your team
Bad for business... and bad for your reputation as an effective manager
• Low staff morale and job satisfaction • High levels of staff sickness absence • High staff turnover
• • • • • •
Poor financial performance Loss of productivity Drop in sales Decreased customer satisfaction Low client retention High level of litigation
1.2.1 “Let’s talk about... stress” Stress has been talked about so much that the word has almost lost any meaning. Getting the right culture doesn’t mean eliminating stress. We need some stress and at the right levels it can be motivating and even exhilarating. But organisations, teams, and people with chronic out-of-control stress are headed for failure. So, it’s important for all managers to understand this much misunderstood and over-used word. And if you feel yourself glazing-over at this point, remember that ignoring stress is one of the causes of the problem!
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1.2.2 Recognising ‘bad’ stress It can be easy to assume that your colleague is simply an aggressive, bad-tempered control freak. Perhaps they are. But perhaps they are reacting to stress at home, or at work. One in six people report ‘very high’ or ‘extremely high’ levels of stress at work. Yet stress can be easily reduced by making straightforward adjustments in management practice.
Looking at possible symptoms... • • • • • • • • • •
Irritability Frustration Aggression Poor concentration Inability to make decisions Tearfulness Frequent absence Working excessive hours Excessive tiredness and insomnia Loss of appetite and eating disorders
• Headaches, aching limbs, abdominal pains, raised blood pressure, etc • Loss of control and self-determination • Psychological distress, including panic attacks, irritability, poor concentration, mood swings, etc • Behaviours which are ‘out of character’. For
example, poor work performance, emotional outbursts, disputes with work colleagues and family, selfmedicating with alcohol or drugs • Poor insight: denial of a problem, avoiding issues, ‘bottling-up’ feelings, reluctance to seek help
If you identify the symptoms of stress in an employee, it is important that you take action to address the cause. Find out about your legal responsibilities in 1.3.
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Many of the symptoms are similar to those that people experience when they are under normal levels of pressure. The principal difference is in the severity and duration of the symptoms and the impact they have on an employee’s everyday life. Excessive levels of stress can lead to other mental health problems such as anxiety and depression.
“Exposure to prolonged stress will increase the risk of serious mental health problems, including depression and disablin g anxiety conditions, as well as alcohol misuse.” Dr. Penny Gray, The Mental Health Foundation
1.2.3 Policy into practice A policy won’t create a culture, but it’s more difficult to create the right culture without good policies. If your firm is too small to have an HR department, consider buying-in HR expertise to help you design your policies, train your staff and plan your future. Successful organisations see HR as part of organisational development, not as a break-down recovery vehicle. It is important to consider health when drafting all employment-related policies. Good policies, well-implemented, can help reduce the risks of illness and promote a speedy return to work after illness. They protect you as a manager and they protect staff. In addition to policies, overleaf are some tried and tested tips from experienced managers.
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Toolkit – Stress-busting
Do
Don’t
Make it your habit to always acknowledge an individual’s contribution
Tolerate bullying. It is your responsibility to ensure that staff are not bullied or harassed on any account.
Communicate with employees to make them aware of the issues that might have an impact on their well-being Train your managers to be confident in dealing with sickness absence and return to work planning Support staff to remain in or quickly return to work when they develop health problems or disabilities. e.g. by changing working patterns or making workplace adjustments Provide adequate training and support and ensure that employees aren’t working excessive hours Invest in improving the health and well-being of your staff - e.g. good occupational health support, promote healthy living - this doesn’t need to be costly Review and implement health, well-being and sickness absence policies and practices on a regular basis
Encourage a negative or ‘blame’ culture in order to drive people to perform Make employees feel afraid to ask for help if they have any questions or problems Allow staff to stagnate in a repetitive job role - encourage them to learn a new skill. Boredom and difficult working relationships can lead to harmful stress levels Overwork staff or expect them to work unreasonably long shifts – encourage regular breaks Operate rigid working hours flexible working hours enable employees to balance the demands of home life with work, and are proven to improve staff retention and productivity
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Tell an employee, kitchen” heat get out of the “If you can’t stand the port of call is your employee’s first Don’t be surprised if ors. a solicitor. George and Co. Solicit or of – Nigel George, Direct
Employers and managers should be able to recognise and understand when a person is feeling unwell or needing additional emotional support. Early intervention is crucial, and there are legal implications if the appropriate actions are not taken. It is therefore important that you have in place a Human Resource Management Policy which incorporates training programmes to cover health, safety and first aid.
1.2.4 Occupational health practitioners – practical help for managers The role of occupational health practitioners (OH practitioners) is to assist the employer and support workers with health issues, including mental health.
“Your employees are yo greatest asset – select theur m
carefully, look after the m well and working for yo u and your business wil l be mutually beneficial an d within the law.”
They are qualified to make an assessment of risks and needs and provide advice to Judith Howard-Rees, the employer on how best to support a Director of Gipping worker who is experiencing health Occuptional Health problems. This may include adjustments to a job role, working hours, time off to access NHS support services or engaging peer support, etc.
An occupational health assessment explores, in confidence, the issues that are concerning the employee, while taking into account any concerns which the employer may have about health, behaviour, attendance and safe performance.
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OH practitioners are also able to deliver personal advice to employees about accessing NHS community care services and, if necessary, the OH Practitioner can liaise with the person’s GP.
An OH practitioner can assist and advise your business in the following areas: Prevention and removal of health risks • Risk assessments - including workplace risk assessment and for display screen equipment/computer users to help you meet your legislative requirements • Immunisation against work-related infectious diseases, e.g. hepatitis B
Screening and surveillance • Pre-employment health screening • Health screening for specific job roles, including food handlers, drivers and night workers • Workplace protection screening - e.g. lead, asbestos and vibrating tools • Health screening programmes to help you meet your legislative responsibilities – e.g. noise, fumes, dust, etc.
Independent and professional advice on staff unable to work due to health reasons • Referral to specialist nurses and doctors to assess the health of your staff following illness • Written health reports following referral to help you manage absent staff, including advice relating to rehabilitation and adjustments to the job or workplace to help staff return to work
Lifestyle and wellbeing • Well-person health screening and other work-related health promotion initiatives – e.g. diet, exercise, mental health, etc. • Counselling support for staff experiencing work-related or personal difficulties
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1.3 Right side of the law All companies have a duty in law to ensure that their employees’ health is not adversely affected by their work. Failure to assess the risk of stress and mental health problems and to take steps to alleviate them could leave you open to costly compensation claims.
“To succeed in busines s you must not only manage your own stress but that of your employees as well.” Nigel George,
Director of George&Co. As a manager, it is important that you solicitors have an awareness of employment law and how it works in practice. This will enable you to identify potential problems before they become unmanageable, implement good employment practices and reduce the incidence of employment tribunal claims.
Fortunately, most problems can be solved easily and inexpensively by good management practice, and will ultimately be of wider benefit for the business as a whole.
1.3.1 It’s the law The main areas of legislation that apply to stress and mental health problems in the workplace are: • The Health and Safety at Work Act 1974 This act imposes a duty on every employer to ensure, as far as reasonably practicable, the health, safety and welfare at work of all their employees. This includes mental health. • Management of Health and Safety at Work Regulations (1999) Employers have a duty to make a suitable and sufficient assessment of the risks to health and safety of employees and others affected by their work,
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and to determine what measures should be taken to comply with HSW regulations. This may include psychological risks and putting in place preventative steps where a risk is known. • Disability Discrimination Act 1995 & 2005 (DDA) The Disability Discrimination Act (DDA) generally defines a person as disabled if they have a physical or mental impairment that has a substantial and long-term adverse effect on a person’s ability to carry out normal day-today activities. • Human Rights Act 1998 (HRA) Don’t believe everything you hear in the pub about the Human Rights Act! A full description is outside the scope of this guide, but there is a lot of easily accessible information online: www.justice.org.uk
1.3.2 Practical steps for obeying the law Toolkit – Law
Do
Don’t
Treat employees and jobseekers with mental health problems fairly and equally
Discriminate against an employee on grounds of mental health. (For scenarios, go to the end of this section.)
Protect employees from victimisation and harassment Make reasonable adjustments to accommodate a return to work or an ongoing illness. For examples of reasonable adjustments, go to 1.4.4
Allow employees who have been diagnosed with conditions, such as schizophrenia, depression, etc, to suffer harassment or ridicule Place any restrictions (however informally) on employing someone with a particular disability
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1.3.3 More you need to know about the DDA The Disability Discrimination Act (DDA) generally defines a person as disabled if they have a physical or mental impairment that has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities. ‘Normal’ means things that people do on a regular or daily basis, such as reading, writing, using the telephone, having a conversation and travelling by public transport. ‘Long-term’ usually means the impairment should have lasted or be expected to last at least a year. ‘Substantial’ means not minor or trivial. However, a mental disability may not always be obvious. The key thing is not the impairment but its effect on an employee’s ability to do the job.
What are "normal day-to-day activities"? At least one of these areas must be substantially affected: 1. 2. 3. 4. 5. 6. 7.
Mobility Manual dexterity Physical co-ordination Continence Ability to lift, carry or move everyday objects Speech, hearing or eyesight Memory or ability to concentrate
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1.3.4 Legal pitfalls that you can easily avoid
A colleague of an employee with mental health problems has attended a tribunal hearing to give evidence, in good faith, to support a disability discrimination claim. After the hearing, the employer brands the colleague ‘a troublemaker’ for giving evidence against the employer and withholds his bonus. This is likely to be viewed as VICTIMISATION. An employee who has been diagnosed with schizophrenia has been jokingly referred to by a colleague as being ‘a bit off the wall’. Whilst the colleague claims they intended no offence, the disabled person feels that his remarks made her feel nervous about her work environment. The conduct of the disabled person’s colleague is likely to amount to HARASSMENT. One of your key employees has been off on long term sick leave, and is not showing signs of returning in the near future. You need someone functioning in the role full time and your business workload is increasing. You re-advertise the post of the absent employee with a view to placing them in a different role as and when they make a return to work. Your actions are likely to amount to DISABILITY DISCRIMINATION.
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1.4 Right approach to managing sickness absence At some point in your career as a manager an employee will call in to say that they’ve been signed off by the GP for stress or depression or some other mental health problem. This is one of those occasions where you can set the culture of your team – where you can help create a productive, healthy, environment where staff feel valued and want to do a good job. Alternatively, if you handle it badly you could have the opposite effect. This section is intended to help you minimize the problems and maximize the opportunities.
1.4.1 How to manage persistent absenteeism If you are going to raise the issue of absence in a constructive way, an employee needs to be able to trust you. So your first task is to reassure them that your intention is not to reprimand but to seek positive ways of getting them back into healthy working. If an employee is taking frequent short periods of sickness leave without any obvious reason, there may be an underlying mental health problem that should be discussed.
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Toolkit – Persistent sickness
Do
Don’t
Monitor any patterns of absence
Ignore the issue
Raise the issue as soon as possible
Be judgemental
Be positive and supportive
Jump to conclusions before you have the facts
Remain in regular contact with absent employees at agreed intervals Check how they are, by having an informal chat when they return to work Ask questions in an open and exploratory way Conduct a ‘return to work’ interview when someone returns
1.4.2 How to manage longer-term sickness absence Many managers are reluctant to contact an employee who is off sick in case it is perceived as harassment. However, the evidence suggests that people who have experienced mental distress view appropriate contact as a positive experience. This is a view supported by organisations that have pioneered active absence management programmes. Team members may want to send a ‘get well soon’ card. Ask your staff member what they want the rest of the team to be told and respect their privacy, but also try to convey the message that there is no shame in mental ill-health. The very act of staying in touch at an early stage can be more important than anything that is actually said, as it allows an employee to know they have not been forgotten, and that their problem isn’t in any way shameful.
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A lack of communication can cause an employee to feel that they are not missed or valued. Regular contact reassures a person that they are still part of the team and that their job is secure. It also gives the employee the opportunity to update you on what is happening.
Toolkit – Longer term sickness
Do
Don’t
Communicate in an honest, matter-of-fact way, in the same way you would deal with someone with a physical health problem
Delegate any call from an employee calling in sick.
Agree with the employee when and how you will stay in touch Inform the employee that they too have a responsibility to keep in contact Consider a phased return to work, such as working half days for an agreed period Review the employee’s job description Make any necessary ‘reasonable adjustments’ to the employee’s job description
Pressurise an employee into divulging personal or medical information. It is up to the individual whether or not they decide to enter into detail Force the employee to set a date for returning to work Don’t make contact with the employee’s GP unless an employee gives their explicit permission. Under no circumstances should you seek to contact their GP for help or advice Send visitors, get-well cards, flowers, etc, without asking the employee first
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Best practice If your organisation has a formal absence policy, you will be able to agree with the employee how often contact should be made. The employee then has a right to expect that frequency of contact. You should inform the employee that they too have a responsibility to keep in contact. If the employee does not contact you in the agreed way, you are within your rights under employment law to take the initiative and make contact with them. Never pressurise an employee to set a date for returning to work. When someone is in distress it may be difficult for them to know exactly how long recovery will take. Deadlines will only add to the pressure. In the event of long-term sickness absence, a phased return to work may be appropriate, such as working half days for an agreed period. As far as possible, someone with a mental health problem should be treated in exactly the same way as any other sickness absence. If your organisation employs occupational health professionals, it is their role, in normal circumstances, to deal with any health problems which may affect an employee’s ability to work, and to coordinate any reasonable job adjustments that may be required to address the problem.
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1.4.3 Helping people with long term conditions stay at work People with mental health problems should be treated in exactly the same way as any other employee, unless they ask for support or demonstrate through their behaviour that they require help. In the event that someone needs support, managers and employees should work together to ensure that any reasonable long-term adjustments are flexible and meet the ongoing health needs of the employee. The majority of people with ongoing mental health problems can continue to work successfully without or with only minimal support. The evidence in the workplace suggests that employees who have developed a coping strategy for dealing with their illness are often better able to deal with pressure than people who have never experienced a mental health problem. Toolkit – Return to work
Do
Don’t
Arrange a return to work interview
Make assumptions about people’s capabilities on the basis of their illness, including their prospects for succession within the organisation and the duration of any sickness absence they are likely to need
Provide an opportunity for both you and the employee to agree on the best way to return to ‘business as usual’ Depending on the circumstances of the employee’s illness, you may also want to seek agreement on such factors as cutting down on work or social activities, drinking less alcohol, taking more exercise, eating a healthy diet and taking time to relax, etc.
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Best practice Review the employee’s performance, and agree on a plan which sets out the best way forward for their reintegration into the organisation. If appropriate, discuss a coping strategy for managing their ongoing illness, such as how you would deal with a possible relapse. What pre-emptive actions can you take to avoid it? In the event of a relapse, it is vital that you support the employee; minor and inexpensive adjustments at this first early warning stage will often prevent a more costly period of sickness absence. In some circumstances it is helpful to draw up an ‘advance statement’. This sets out how an employee wishes to be treated if they become unwell. It can cover practical arrangements such as details of relatives, friends or healthcare professionals who should be contacted, as well as any treatment preferences. An advance statement might also include information on how to recognise signs that the employee is becoming unwell.
1.4.4 Helping someone to return to work When planning the return to work, it is important to discuss with the employee any factors that contributed to their absence. Where appropriate, involve other sources of support such as the employee’s GP, occupational health or HR. Be aware that if the employee is on medication you will need to ensure that any side effects are considered in relation their job role. This is especially important where health and safety risks are involved. Support and monitoring at the early stages of return will maximise the chances of success. Agree on any reasonable adjustments that need to be made (in accordance with the Disability Discrimination Act (DDA)) and how progress will be measured. Equally, be honest and up front about any factors that you cannot change.
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Toolkit – Back at work
Do
Don’t
Brief the employee on what’s been happening within the organisation during their absence
Overwhelm the employee with an unrealistic workload. If a backlog of work has built up in the employee’s absence, make sure it is managed sensitively
Make sure you and the team make the employee feel welcomed back into the fold Set achievable goals to enable them to feel they are making progress Take the time to acknowledge their achievements and offer encouragement and feedback
Make them feel they are a special case; this can cause resentment, both with the individual and among their colleagues
If appropriate, make reasonable adjustments to an employee’s job role
Best practice Be mindful that your organisation has an investment in the employee, and in most cases a structured return to work is more cost effective than early retirement - success is in everybody’s interest.
Returning to work - adjustments Rarely is a person 100% fit when they return to work after an illness, whether physical or mental. In most cases, waiting for an employee to become fully fit before allowing them back is unrealistic; it artificially prolongs absences and may even compromise a person’s future employability.
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A more practical approach is to ease the individual back into productive employment by making adjustments. To promote full recovery after an extended period of absence, it can be in both parties’ interest to make reasonable adjustments to an employee’s job role. Most changes that need to be made are straightforward, inexpensive and need only be short term.
Some adjustments to consider • A phased return to work: perhaps starting part-time and building up. • Change aspects of the job that the employee finds especially stressful. • Review their job role, and if necessary rearrange responsibilities. • Identify any training and development needs that may be of benefit to the employee. • Consider specific job requirements such as communication skills, time management, etc. • Offer the option of working at home for part of the week. • As for all medical problems, time off should be allowed for attending therapeutic sessions. • Change shift patterns or consider different work options such as job-sharing. • Introduce flexible working based on agreed performance outputs. • Offer a later or earlier start to avoid rush hour travel. • Consider the employee’s physical environment and how it may be improved. • Create a quiet space where an employee can go if they are feeling anxious or stressed. • Provide support with childcare. “The majority of people with mental health problems make a successful return to work...”
We’ve
got a problem
A go-to guide for when you need help now.
2 In this section… 2.1
You think there’s an issue [but you’re not sure]
2.2
These things happen…
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It’s better to talk... This section provides advice on early-steps actions that should be taken if an employee experiences mental health problems. Early action in identifying and addressing mental health problems can help prevent the employee becoming more unwell. The longer you ignore someone who may be experiencing mental health difficulties, the harder it is to address, and it could even result in the person becoming more unwell.
Key points If an employee is off sick, your involvement and reassurance at an early stage will minimise the likelihood of their not returning to work or allowing the problem to escalate. Regular contact, including appraisals and informal chats about progress, provide neutral, non-judgmental opportunities to identify any problems an employee may be experiencing. Don’t jump the conclusion that the employee needs time off from work. They may – but work is good for people’s mental and physical health, so it could be that lighter duties or flexible hours will be a win-win for everyone. If you feel unable to cope with the situation alone, consider seeking additional support: for instance, from your occupational health or human resources department.
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2.1 I think there’s a problem… but I’m not sure As a manager, it’s part of your job to ask people how they are. Don’t shy away from it. The chances are that if you think one of your staff has a problem, then you’re probably right. Don’t ignore your gut feeling and ‘hope it will be ok’. Tackling issues early really is the best approach. If you’re wrong, then OK - it’s one less thing to worry about!
Pause for thought • • • •
What has changed? Has there been a change in behaviour or mood? Why is it a concern? When did it start?
2.1.1 Options to consider Do you take soundings from colleagues? This can seem like a tempting option - but beware. First of all, you don’t want to appear to talk behind people’s backs. Next, what will you do with the information you get uncover? If Mary says, “Well don’t say I said anything, but Dave is going through a terrible time with his partner – she sounds like an absolute nightmare… last weekend he came home early and found her...” What are you going to say to Dave? You might feel that you’re being sensitive to your team member’s feelings, but are you being genuinely sensitive or simply evading the issue?
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2.1.2 One to one conversation When was the last time you had a one to one conversation with them and asked them how they are? Make some time to talk but spend a few minutes preparing your thoughts. Here are some tips: • • • • • • • • • •
Tell them that you’re concerned that they’re not themselves Be prepared for “I’m fine” as a first response to raising the issue Tell them exactly why you are concerned and ask their views Ask open questions. E.g. “What’s the most stressful part of the job?” not “Are you coping with the job?” Empathise and summarise Make a plan. Write it down with the employee Make a time to review Keep a record A one to one conversation is usually the best solution Don’t put it off!
2.2 These things happen… This guide is not intended to turn you into a therapist, a social worker or a psychologist. But we start from the position that we’re all human and even in the best run organisation, people experience distress. We can easily get embarrassed if someone bursts into tears, and if you have ever experienced a panic attack you will know that they can be frightening. For these times, when faced with an acute problem at work, this section will give you a starting place to gather your thoughts and to help to start to make things better.
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2.2.1 Acute emotional distress How to assess a situation where someone is in emotional distress Toolkit – Situation assessment
Do
Don’t
Be Cautious - Is the person in
Panic – attempt to remain
any immediate danger? Is anyone else in immediate danger? Evaluate - has something
happened to "trigger" distress or an emotional outburst? Take note of the person’s
appearance, behavior and conversation Take note of a person’s
arousal level: are they agitated, restless? Take note of behaviour. Are
they highly disturbed - e.g. bizarre or threatening? Establish whether thinking or
recognition is impaired. If a person is expressing unusual thoughts, appears to be unaware of their surroundings or self control is not evident then the situation is potentially high risk. Seek immediate support
calm. When you approach a distressed person, do so quietly and slowly Take risks - if you feel unsafe,
try talking calmly from a safe distance and summon help immediately
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How to help someone in a distressed condition Typical scenario One of your employees has been showing increasing levels of stress in the workplace, along with erratic behaviour and has just broken down in tears at their desk. What do you do?
Firstly, reassure them that it is OK to be upset and that you are listening. Very often the process of listening can provide an opportunity for both you and the employee to gain an insight into the problem and possible ways of dealing with it. Due to their distressed state, the employee may not be able to think clearly, so try to be sensitive to the level of information they can cope with at any one time. Most importantly, you should reassure them that you will do all that you can to help and support them. Let them know that you are happy to continue with any discussion at a time and place which suits them.
Communicating with a person who is distressed Key Points • Find out the cause of their distress. Is it an ongoing issue or has it been triggered by a recent event? • Ask open questions about the situation, for example: “How are you feeling?” “What can I do to help you?” “What is upsetting you?” “What can be done to put things right?” • Ask them if there any problems outside work that they might like to talk about, if it would be helpful.
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• If the employee is happy to talk about it, discover whether they have any ongoing mental health problems that it would be helpful for you to know about. How may you and the organisation support them? Have they any coping strategies? • If they have a medical condition, would it be helpful for you to know about? • If they are on prescribed medication, are there any side-effects that you should be made aware of? • Does the employee want to suggest any reasonable adjustments to their job role that may be helpful? • If your organisation is able to offer support, for example with an Employee Assistance Programme (EAP), occupational health, counselling, etc, let the employee know that the resource exists for their benefit. • Depending on the nature of their problem, ask them if they are aware of external sources of support such as counselling for relationships and bereavement, drugs, alcohol abuse, etc, or advice on legal or debt problems. (NB: a list of support organisations can be found at the end of this guide. Go to page 56). • Agree what will happen next with the employee and who will take what action. • Establish what the employee wishes their colleagues to be told and who will convey that information. Bear in mind that any inappropriate breach of confidentiality or misuse of this information might constitute discrimination under the Disability Discrimination Act (DDA).
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Toolkit – Acute distress
Do
Don’t
Introduce yourself and explain why you are present - speak calmly and clearly
Jump to conclusions
Remain courteous and nonthreatening. Adopt a positive and supportive approach, tell them you understand their perspective Attempt to find out the cause of the problem Listen to the person in a nonjudgemental way Clarify and address what the person sees as the major issues first Ask them what would be helpful to them right now Encourage / assist person to receive appropriate mental health help [GP etc.]. Ask if there are any problems outside work the employee might like to talk about Keep an accurate record of all conversations, not only to protect the employee and your organisation, but also to demonstrate that the appropriate actions have been carried out in full
Tell them what they are saying is right or wrong Demand information. Remember that you have no right to demand information, and you should never put pressure on a person to discuss their personal life Insist that the employee talks to you. Some people might find it easier to talk to someone other than their manager Feel under pressure to take action immediately. While it’s understandable, it is often better to take some time to reflect on the problem and consider your options Be insensitive to the employee’s immediate needs. If appropriate, ask them if they would like someone of their choice to sit with them Divulge sensitive personal information to other members of staff without the expressed permission of the employee
Consider effectssomeone of the 2.2.2 How the to help who is suffering from situation upon the rest of the acute anxiety team
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Anxiety Anxiety is a very common emotional state and may occur in a wide range of circumstances, including exposure to stressful situations. It arises when a person perceives that danger is imminent – whether real or perceived.
Acute anxiety – spotting the signs • • • • • •
Highly aroused, wide-eyed, agitated, tearful, wringing hands, pacing Hysterical, screaming, yelling, frightened, frantic Rapid breathing (hyperventilation) Sweatiness Rapid pulse Body tremors
Someone suffering from acute anxiety may also complain of feeling "on edge", restless, a sense of dread or foreboding, frightened, feeling insecure or unsafe, fear of losing control, inability to focus on one thing. These feelings are often accompanied by physical symptoms such as: sweating, frequent urination, diarrhoea, nausea, vomiting, rapid heartbeat, headache, chest or abdominal discomfort or pain.
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Panic attacks If a person complains of shortness of breath, dizziness, faintness, hot or cold flushes, blurred vision and/or tingling fingers/feet, their anxiety may have developed into a panic attack. Seek immediate medical assistance. Toolkit – Panic attack
Do
Don’t
Attempt to identify the
Leave the person alone. Once
perceived threat or danger Where possible and safe to do
so, remove the perceived threat or danger Ensure that the person feels
safe or protected from the perceived threat or danger Where appropriate to do so,
reassure the person that the danger has passed or is being dealt with Help the person to regain
control Encourage regular, even
breathing (12 breaths per minute) Once breathing is regulated,
encourage the person to relax and be calm Encourage them to sit down
with their back to a wall, and help them to maintain an even breathing pattern
the acute anxiety attack has passed, ensure they are supported by a family member or friend and have somewhere safe to go Dismiss an anxiety attack as an
isolated event. If an individual has experienced sudden onset of anxiety, a thorough medical assessment/ mental state evaluation is strongly recommended. Assist the individual to obtain medical attention as soon as practicable
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2.2.3 How to help someone who is experiencing depression Depression is a common mental health condition. It causes both physical and psychological symptoms and can have a profound effect on a person’s normal ability to function. The consequences of depression are often experienced by more people than just the sufferer. Families, friends and work colleagues can all be affected. The symptoms of depression can include feelings of worthlessness or guilt, loss of interest and motivation, helplessness, anxiety and difficulty concentrating. Physical symptoms can include insomnia and fluctuating appetite for food. In some cases the sense of bleakness can become so overwhelming that the sufferer feels suicidal.
Depression – spotting the signs • • • • • • • • • •
Generally lowered mood Decrease in usual activity or work performance Increase in absenteeism or lateness Not mixing - withdrawal from social life, staying at home, little or no contact with friends Seeking constant company - cannot bear to be alone Bleak or pessimistic view of the future Decreased energy - excessive tiredness Loss of concentration and forgetfulness Irritability - easily angered; anger excessive to situation Deteriorating personal self-care, looks dishevelled, poorly groomed, looks tired
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Toolkit – Depression
Do
Don’t
Tell the person you are
Tell them to "cheer up" or
worried about them and that you would like to be of help Encourage them to talk to
you, but don’t pester Listen empathetically Offer your support – "What
can I do to help you right now?" Ask if they feel safe. Do they
have suicidal feelings, thoughts of self harm or harm to others? If they do not feel safe, then remain with them and arrange for immediate assistance Be patient, stay with them a
while even if they do not feel like talking Tell them depression is
something which can get better with the right help. Instilling hopefulness and optimism is an important part of the healing process Encourage them to seek
relevant help through their GP
“snap out of it“ Leave someone to cope alone.
Offer positive encouragement and, where appropriate, provide information such as contact numbers for help lines and self-help organisations, counselling services and practical assistance Believe the myth that ‘people
who talk about suicide never do it’. Actually many people who commit suicide have spoken about it to someone beforehand.
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Best practice Depression is common, but it is also very easy to treat. Professional help is available with medication or counselling, together with a range of self-help techniques and support networks to successfully manage the illness. On occasions, a person experiencing feelings of hopelessness can become too pessimistic to believe that treatment will work and therefore refuse assistance or to seek treatment. Under these circumstances it may be necessary to be more assertive in your management of the situation, and insist that you will help them to get assistance.
2.2.4 How to help someone experiencing acute psychosis Acute psychosis is characterised by a person progressively losing touch with reality. It is important to be aware that psychoses form a group of disorders and can be due to factors other than mental illness. It can be hard to diagnose the cause, even for experienced professionals. A person who is experiencing psychosis perceives the world around them differently and responds accordingly. Their sight, hearing and thought processes may also be distorted or misleading – e.g. hallucinations or delusions. They will commonly behave out of character and are often unaware of any changes in the way they think, talk or behave. Consequently, they may not seek help or professional assistance. A full exploration of acute psychosis is beyond the scope of this guide, but if you think a work colleague is experiencing psychosis and they are at immediate risk to themselves or anyone else you should contact the police. If there is no immediate risk, alert their next of kin.
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People usually make a good recovery from acute psychosis. One of the main difficulties they face is the lack of understanding from those around them. You can find out more about psychosis by using the resources in Part 3 of this guide.
Best practice When a person is recovering from an acute psychotic episode, it is important to offer appropriate support, care and understanding. In planning a return to work, Occupational Health input will be important in helping get the right support and the right risk assessment. This will vary from job to job. A person will have varying degrees of recollection about what has happened to them, and they may well find it embarrassing or distressing. Allow them to talk about what they remember if they want to, but do not place pressure on them to do so. It is important they do not feel ridiculed or shamed by being reminded of their behavior.
2.2.4 How to help someone who is suffering from alcohol or drug abuse When used inappropriately, alcohol and drugs and can result in persistent and permanent problems for the user, their families, work colleagues and the community, particularly when use is out of control. This is commonly referred to as substance abuse and it can also be a sign of an underlying mental health problem. Your organisation may have a specific policy on substance misuse, particularly if intoxication at work presents safety risks, and you should consult your HR advisor or manager.
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Substance abuse - spotting the signs • Deterioration in work performance • Unexplained change of friends • Unusual or irregular behaviour • Mood swings • Reluctance to interact with work colleagues or take part in organised activities • Changes in personal habits (e.g. eating, sleeping, hygiene) • Valuable items or money missing
Toolkit – Substance abuse
Do
Don’t
Engage in an open, non-
Ignore the problem and hope
judgemental discussion Tell the person you are
worried about them and that you would like to be of help Express concerns about their
health and wellbeing Tell them why you are
worried, i.e. discuss what you have noticed in terms of the changes in their behaviour Encourage communication by
letting them talk about the reasons their behaviour has changed Listen empathetically Offer support – both
_
emotional and practical
it will go away. Attempt to deal with the
situation without seeking help. If you don’t know what to do, suggest making contact with someone who does. Don’t jump to conclusions. Is
this an isolated incident? Or is it symptomatic of a more serious problem?
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Best practice Check that the employee has support and encouragement of others in the next few weeks. If you know them well or work with them, encourage them to talk about how it is going. If they seem discouraged or feeling like the "going is tough", offer them your support and encouragement. Try to provide opportunities (if appropriate for you to do so) for alternative social or recreational activities where drugs and/or alcohol are not readily available or present. Excessive use and abuse of alcohol or drugs can lead to serious health problems. If you have reason to believe that an employee has a problem, it is important they receive a thorough health assessment. It is important to obtain as much information as possible about drug and / or alcohol intake, patterns of use, quantities and effects. Ensure that your approach is objective and non-judgemental in order to encourage open and honest communication.
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I need
more
information on mental health Facts and resources at your fingertips.
In this section‌ 3.1
What is stress
3.2
What is mental health
3.3
Conditions / illness
3.4
Being a Mindful Employer
3.5
Mental Health First Aid England
3.6
Organisations
3
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3.1 What is Stress? "The adverse reaction people have to excessive pressures or other types of demand placed on them at work." Health & Safety Executive
Stress is not an illness – it is a state. However, if stress becomes too excessive and prolonged, it will impact on an individuals’ mental health, and if not addressed could lead to a mental and / or physical illness developing.
“Stress is the root cause of a lot of mental ill health, esp ecially anxiety or depression.” Dr. Penny Gray, The Mental Health Foundation
Work is generally good for people if it is well designed, but it can also be a great source of pressure. There is a difference between pressure and stress. Pressure can be positive and a motivating factor, and is often essential in a job. It can help us achieve our goals and perform better. Stress occurs when this pressure becomes excessive. Stress is a natural reaction to too much pressure.
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3.2 What is Mental Health? “Mental health can be conceptualized as a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” World Health Organisation
We all experience varying levels of good and poor mental health throughout our lives. Our mental health is influenced by many factors including our outlook on the world, our life circumstances, our personality, our physical health and well being etc.
Mental health is: “…the emotional and spi ritual resilience which allows us to enjoy life and survive pain, disappointment and sa dness. It is a positive sense of wellbeing and an underly ing lief in our own, and oth beers’ dignity and worth.”
The mental health of employees has Health Education Autho rity – a very real and direct impact on their mental health promotio n: a quality framework ability to function productively at work as well as in their everyday lives. As such it is in the employer’s best interest to have a degree of understanding around what constitutes good mental health and how it can be fostered within their organisation. Please note : Mental health is not the same as mental illness. Mental illness refers to clinically diagnosed conditions [some of which a listed below], however having poor mental health can lead to mental illness.
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Common types of mental illness / disorders:
• Anxiety is a feeling of unease, apprehension or worry. It may be associated with physical symptoms such as rapid heart beat, feeling faint and trembling. It can be a normal reaction to stress or worry or it can sometimes be part of a bigger problem. • Bipolar Disorder is a disorder in which a person can experience recurrent attacks of depression and mania or hypomania. It used to be called manic depression. • Depression is a common condition. The main symptoms are feeling low, sleep problems, loss of appetite, concentration and energy. There are a number of treatments that can help. • Obsessive Compulsive Disorder is a fairly common problem where people experience ‘obsessions’, recurring unwanted thoughts which are difficult to stop, and ‘compulsions’, rituals of checking behaviour or repetitive actions which are carried out in an attempt to relieve the thoughts. • Panic Attack is an intense and sudden feeling of fear and anxiety. It is associated with many physical symptoms such as rapid heart beat, trembling, rapid shallow breathing, pins and needles in the arms and feeling faint. Many people who have a panic attack fear that they will collapse or die. These attacks are not harmful and usually go away within 20-30 minutes. • Personality Disorder describes someone who has severe disturbances of their character and behaviour. Personality disorders usually appear in late childhood or adolescence and continue into adulthood. The thought patterns and behaviours cause distress to the person or to those around them.
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• Psychosis is a condition in which a person isn't in contact with reality. This can include: sensing things that aren't really there (hallucinations); having beliefs that aren't based on reality (delusions); problems in thinking clearly; and not realising that there is anything wrong with themselves (called ‘lack of insight’). • Schizophrenia is a mental illness. The main symptoms are hallucinations (hearing voices), delusions (a firm belief in something that isn’t true) and changes in outlook and personality. It does not mean split personality. • Seasonal Affective Disorder (SAD) is a form of depression or mood disorder with a seasonal pattern. The symptoms of SAD are most obvious during the winter months when the days are shortest. Symptoms of SAD tend to appear from around September each year, and reduce or disappear in the spring and summer months.
For further information on the above conditions and others please go to The Royal College of Psychiatrists website: www.rcpsych.ac.uk
3.3 MINDFUL EMPLOYER® Led and supported by employers, the MINDFUL EMPLOYER® initiative is aimed at increasing awareness of mental health at work and providing support for businesses in recruiting and retaining staff. The Charter is just one part of the MINDFUL EMPLOYER® initiative. It's a voluntary agreement seeking to support employers in working within the spirit of its positive approach. The Charter is about working towards
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the principles of it and not the immediate fulfilment of them – signing up is a step along a journey not the end of it.
Being a MINDFUL EMPLOYER® • • • • • • • •
Shows others and your own staff that you are a good employer Expresses your corporate social responsibility Reduces recruitment and training costs Helps towards complying with legislation (e.g. DDA & HSE) Reduces sickness levels Enhances customer service Improves productivity Makes you more attractive to people with mental health issues and others • Helps you retain staff who have experienced discrimination in the past • Makes yours a healthier workplace • For employers who are positive about mental health Suffolk Business Minded are signatories to the Mindful Employer Charter Suffolk Business Minded supports the charter as part of its drive to promote best practice around stress and mental health issues in the workplace.
www.mindfulemployer.net
“80 million work days are lost a year due to stress, depression and anxiety. It is estimated that about £9bn is lost a year through employers not addressing mental health issues at work...”
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3.4 Mental Health First Aid A recent training initiative has been developed and is being taken forward called ‘Mental Health First Aid [MHFA] England’. ENGLAND Mental Health First Aid (MHFA) is the help Mental Health First Aid provided to a person developing a mental health problem or experiencing a mental health crisis. Just as physical first aid is administered to an injured person before medical treatment can be obtained, mental health first aid is the initial help given to someone experiencing a mental health problem before professional help is obtained or until the crisis is resolved.
A mental health crisis may occur when a person feels suicidal, or is suffering an anxiety attack, or an acute stress reaction. In some cases they may appear to be out of touch with reality or in a distressed or psychotic state. Remember, if any incident you have had to deal with was traumatic for you, or if you feel anxious or distressed, do not hesitate to discuss these issues with a friend or seek professional help. To find out more about mental health first aid training please visit:
www.mhfa.org.uk
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3.5 Additional organisations and resources: If a colleague is in distress or you are concerned about someone‌ Advice and further resources may be obtained by contacting: Samaritans: 0845 790 9090 A 24-hour confidential telephone service http://www.samaritans.org.uk MindinfoLine: 0845 766 0163 Monday to Friday 9.00am - 5.00pm http://www.mind.org.uk NHS Direct: 0845 4647 24hr National helpline providing medical advice. http://www.nhsdirect.nhs.uk Saneline: 0845 767 8000 Out of hours telephone help line. Opening hours: 12noon to 2.00am http://www.sane.org.uk
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Employment Law – sources of additional information Website: www.hse.gov.uk/legislation/hswa.htm Information about the Human Rights Act 1998 can be found on the Ministry of Justice’s website. Website: www.justice.gov.uk Disability Discrimination Act 1995 & 2005 (DDA) Details of disability discrimination law, with case studies to help, are found in the “Disability Discrimination Act code of practice on employment and occupation”. The 1995 and 2005 Acts can be downloaded from the Directgov website. Your local Jobcentre Plus or the Equality and Human Rights Commission (EHRC) can tell you more. The EHRC has advice on what counts as a disability according to the law.
Stress For more advice and help on assessing and managing stress in employees, including using the Management Standards to tackle stress, see the HSE website: www.hse.gov.uk/stress
Occupational Health For information about health and safety contact HSE’s Infoline: Tel: 0845 345 0055 - e-mail: hse.infoline@natbrit.com Also visit: www.nhsplus.nhs.uk/business/index.asp Commercial Occupational Health Providers Association (COHPA) Tel. 01933 232 373 Website: www.cohpa.co.uk
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SHIFT – line managers resource: Shift's Line Managers' Resource is a practical guide for managing and supporting people with experience of mental health problems in the workplace. The website also gives extra information and links to other organisations and websites. Website: www.shift.org.uk/employers/
Alcohol and drug misuse www.nhs.uk/conditions/Drug-misuse/Pages/Introduction.aspx Alcohol Concern Alcohol Concern is the national agency on alcohol misuse, supplying information and details of local services. Based at: Waterbridge House, 32-36 Loman Street, London SE1 0EE. Tel. 020 7928 7377. Website: www.alcoholconcern.org.uk Alcoholics Anonymous Alcoholics Anonymous is a fellowship of men and women who share their experiences to stay sober and to help others recover from alcoholism. Contact via: P.O. Box 1, Stonebow House, Stonebow, York YO1 2NJ. Tel. 01904 644026 (office) Helpline: 0845 769 7555 (open 24 hours) Website: www.alcholics-anonymous.org.uk
Suicide intervention ASIST - For a more in-depth course on suicide intervention skills it is recommended to attend an ASIST (Applied Suicide Intervention Skills Training) course. For more information visit www.asist.org.uk
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British Association for Counselling and Psychotherapy The British Association for Counselling provides information and advice on counselling and counsellors in the UK. Based at: 35-37 Albert Street, Rugby, Warwickshire CV21 2SG. Tel. 0870 443 5252. Website: www.counselling.co.uk CRUSE Bereavement Care CRUSE is a national voluntary organisation offering bereavement counselling and advice to all bereaved people. Tel. 020 8939 9530. Website: www.crusebereavementcare.org.uk Depression Alliance The Depression Alliance provides information, support and advice for those who suffer from clinical depression and their carers; also a network of self-help groups. Tel. 020 7633 0557. Website: www.depressionalliance.org Employers’ Forum on Disability The Employers' Forum on Disability is the world’s leading employers' organisation focused on disability. Funded and managed by their members, it aims to make it easier to recruit and retain disabled employees and to serve disabled customers. Tel. 020 7403 3020. Minicom. 020 7403 3570. E-mail: efd@employers-forum.co.uk Website: www.employers-forum.co.uk Improving Access to Psychological Therapies [IAPT] The Improving Access to Psychological Therapies programme aims to improve access to evidence based talking therapies in the NHS through an expansion of the psychological therapy workforce and services Website: www.iapt.nhs.uk
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Manic Depression Fellowship (MDF) / The Bipolar Organisation MDF is a national charity established by and for people whose lives are affected by manic depression. MDF provides a specialist advisory and information service, and has a network of self-help groups throughout the country. Based at: 21 St George's Road, London SE1 6ES. Tel. 020 7793 2600. Website: www.mdf.org.uk Mental Health Foundation The Mental Health Foundation provides information and publications on a wide range of mental health issues and learning disabilities. Based at: 83 Victoria Street, London SW1H 0HW. Tel. 020 7802 0300. Website: www.mentalhealth.org.uk Mind (The National Association for Mental Health) Mind provides information and publications on mental health issues and services. Over 200 local Mind associations offer a range of day-care and other services. Listed in the local telephone directory, or contact via: Granta House, 15-19 Broadway, Stratford, London E15 4BQ. Tel. 020 8519 2122. Website: www.mind.org.uk NHS Stressline The NHS Stress Line is there to advise, support and signpost callers who may have worries about money, losing their home or their job and for whom such worries may have begun to affect their health and wellbeing. Tel. 0300 123 2000 Rethink (formerly National Schizophrenia Fellowship) Rethink provides information and services for people with a diagnosis of severe mental illness, especially schizophrenia, and their families and carers. Based at: 28 Castle Street, Kingston Upon Thames, Surrey KT1 1EY. Tel. 0845 456 0455. Website: www.rethink.org
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Relate Relate provides couples counselling for breakdown within relationships. Local branches throughout the UK. Based at: Herbert Gray College, Little Church Street, Rugby, Warwickshire CV21 3AP. Tel. 01788 573241. Website: www.relate.org.uk Turning Point Turning Point provides help and advice on problems with drink, drugs, mental health and learning disabilities. Tel. 020 7702 2300. Website: www.turning-point.co.uk
Government Support Services Disability employment helpline: 0800 528 0462 Health and Safety Executive Employment Medical Advisory Service (EMAS) EMAS is staffed by doctors and nurses with occupational health qualifications located at Health and Safety Executive offices throughout the country. EMAS provides free advice and support to employers and employees regarding work-related medical problems, including mental health problems. Tel. 01342 334200. Health and Safety Executive InfoLine: 08701 545500. Website: www.hse.gov.uk Health Development Agency The Health Development Agency offers a range of expertise on health issues, including mental health and well-being. Information on the NHS, small and medium-sized business enterprises, and the Health at Work Award. Tel. 020 7430 0850. Website: www.hda-online.org.uk
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Local Suffolk support services and organisations Suffolk Business Minded Support for local employers around mental health and wellbeing in the workplace. Website: www.ifyouknew.co.uk Suffolk Chamber of Commerce Suffolk Chamber of Commerce represents business from grassroots to Government, and has grown to become the largest independent private sector forum in the County. Suffolk Chamber works with leading organisations to deliver the very best services and advice for your business. Suffolk Chamber supports your business throughout its lifecycle from start-up, development, growth and beyond. Tel. 01473 680600 Website: www.suffolkchamber.co.uk Suffolk Drug and Alcohol Action Team Information on local help and treatment and alcohol problems. Website: www.suffolkdaat.org.uk Suffolk Family Carers Suffolk Family Carers was started in 1988 to help raise awareness of family carers, their issues and their needs. It recognises the important contribution family carers make, and support them to carry on caring so they would be less likely to need care themselves. Website: www.suffolk-carers.org.uk Suffolk Mental Health Partnership NHS Trust Suffolk Mental Health Partnership NHS Trust provides mental health, substance misuse, learning disability and eating disorder services across Suffolk and Thetford. Website: www.smhp.nhs.uk
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Suffolk Mind East Suffolk Mind and West Suffolk Mind are two separately registered charities but are both affiliated to Mind National and both work together under the banner of the Suffolk Mind Partnership. Both are committed to improving the lives of people with mental health issues. Tel. 01473 652847 Website: www.suffolkmind.org.uk/ SPACE The Suffolk Partnership for Addiction and Care Engagement is an organisation of men and women who have been, or are, successfully engaged with drug and alcohol treatment services in Suffolk. The partnership brings together these individuals and groups, to form one main body carrying a united voice for service users in Suffolk. Website: www.spaceusergroup.com Workwise Workwise is an emerging Social Firm with additional craft and training facilities, providing work-based rehabilitation for adults who are recovering from various forms of mental health problems. Tel. 01284 755 261 Website: www.workwisesuffolk.org.uk
Picture page 11 courtesy of freedigitalphotos.net Pictures page 16 & 52 courtesy of sxc.hu Pictures on front cover and page 40 courtesy of freefoto.com
Suffolk Business Minded Foundation Trust Office St Clements Foxhall Road Ipswich Suffolk IP3 8LS telephone: 01473 329000 email: gabriel.tamaya@smhp.nhs.uk web: www.ifyouknew.co.uk
Graphic design by Suffolk Support Services, SMHPT
Š 2010 SMHPT. Ref: Comms/0263.