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How do work patterns affect us?
What causes stress at work?
How can I tackle stress?
What if I do become distressed at work?
How can I keep my job after experiencing mental distress ir illness?
Should I tell my employer if I have a mental illness?
Useful organisations
Useful websites
Further reading
'In order that people may be happy in their work, these three things are needed: they must be fit for it; they must not do too much of it; and they must have a sense of success in it.' John Ruskin
Not all work is paid work. People work and gain skills in many ways: through bringing up children, caring for relatives, maintaining the home and garden, or doing voluntary work for the community. While these are all tremendously important, the focus of this booklet is on paid employment.
'When my wife left me I felt my whole world had collapsed. I couldn't sleep, spent a lot of time with whisky, and ate little. I tried to carry on. I didn't tell anyone at work for some time. I felt ashamed. I couldn't concentrate, was ratty with colleagues and unable to work properly. People were getting fed up with me. I was starting to wonder if I would lose my job as well. In the end my manager talked with me. I felt bad at first, but I opened up and we talked about time off for me to seek legal advice, get support for me and sort out practical arrangements for the children.' Gerald
Jobs often used to be for the best part of someone’s working life. They provided security, stability and structure. However, people can now expect many changes in the course of their working lives. These may include changing employer, re-training, periods of unemployment, and even complete changes of occupation. More and more, people have short or fixed-term contracts, or work on a self-employed basis, and have career breaks. Individuals usually have to construct their own career paths, which can lead to uncertainty about the future, as well as unrealistic workloads for some and no work for others. And while it's possible to embrace an alternative point of view, and thrive without paid employment, unemployment generally leads to poor physical health, poor mental health and poverty.
So being in paid employment is generally considered to be a good thing. It is no longer just a way of earning a living: it provides identity, contact and friendship with other people, a way of putting structure in your life and an opportunity to meet goals and to contribute.
Having said that, work stress is now more of an issue than ever: every year, millions of work days are lost because people experience illnesses caused or made worse by their work.
The Health and Safety Executive defines stress as 'The adverse reaction people have to excessive pressure or other types of demand placed on them.'
Some of the symptoms of stress are:
Job demands that can lead to stress include: having too much or too little to do; work that is too difficult or too easy; being under pressure to meet deadlines; shift work; and physically demanding work. People doing repetitive tasks, at a high pace, with little freedom to take decisions are especially at risk. Lack of control over the pace of the work or how to get the job done is one of the most common causes of work-related stress.
Poor working conditions, such as noise or bad lighting, poorly designed equipment, exposure to hazards or witnessing other people's suffering are all sources of stress. People who are simply in the wrong job for their skills, abilities and expectations are also likely to experience stress.
Problems can occur if people aren't clear about the scope or responsibilities of their job. Conflicting demands make them feel very torn; for example, the demands of quantity versus quality, or quantity versus safety, or being expected to do things against their beliefs or personal and professional standards. This is made worse if there is a lack of managerial or supervisory support. In turn, managers and supervisors can find that the responsibility to provide this support conflicts with other goals expected of them by the organisation; or they may not receive the training to enable them to offer effective support.
Feeling trapped in a dead-end job, or insecure, is also very undermining. This may be because there are only limited opportunities for promotion and training, a threat of redundancy through organisational restructuring, or because you are working on a fixed-term contract.
The relationships we have with our colleagues, can have an enormous effect on the quality of our working life, and can be significant sources of stress or support. Supportive relationships can give protection against other workplace pressures; stressful relationships can intensify them.
Working in isolation from others makes it more difficult to build supportive relationships; for example, for people who work at home or run their own small businesses. But isolation isn’t only physical – it may include being the only man or woman or person of an ethnic minority in a workplace.
Bullying is a major source of stress and is very destructive, to the person being subjected to it and to the organisation itself. (See Mind's booklet, How to deal with bullying at work.)
The operating style or 'culture' of an organisation may cause problems. It may include lack of communication, consultation or participation in decision making, and unjustified restrictions on behaviour. If there are no policies in place to cover these matters, there will be no clear standards for the behaviour that is expected, and no system for individuals to challenge racism, sexism or other discrimination or harassment. This promotes the attitude that people should just deal with it on their own. An organisation that runs on fear, or interprets stress as individuals not coping, will simply generate more stress.
What we bring with us to work can also contribute to stress. This may be the conflicting demands of managing home and work life; personal crises, such as illness or bereavement; financial worries; or the psychological factors that can drive us to unhealthy working patterns.
One common pattern is when a person works harder and harder to close the gap between what they are achieving, and what they think they should be achieving. They stop taking breaks, lose touch with their own needs and sense of enjoyment, and feel guilty when they are not working. Working harder brings exhaustion, their performance deteriorates, and they become more and more anxious, because they aren't making real progress. It leads to loss of energy, emotional exhaustion, poor sleep, indecisiveness, and sometimes increased drinking, smoking, eating or spending. The person ends up feeling trapped, and can become depressed.
Preventing stress means achieving a balance between demands and the capacity to respond to them. Learn to recognise what you find stressful in the work environment and what helps you work well. Taking action, however small, can improve your life at work and stop you feeling trapped or the victim of people's demands. You may be free to do some things without reference to anyone else, but some things you will need to negotiate, formally or informally, with colleagues or managers. However, there are many things employees can do for themselves.
Note: even if you work for a small business, such as a local shop or tradesman, you should still be provided with a contract of employment that includes terms and conditions; and there should be basic policies in place for employees, that include health and safety, and working conditions.
Anyone can become upset and reveal to their workmates that they are human. People who use mental health services may have particular need for a safe space to express feelings. If someone is going through a mental health crisis or breakdown, whether or not it's caused by work stress, it will be experienced in their working life.
If you can learn to identify what triggers your stress, this will make it a lot easier to find the right coping strategy. If you do get distressed, keep a diary of what happened, how you felt and how you reacted, so that you can cope better the next time the same type of situation arises; or indeed to learn to avoid that type of situation if at all possible.
These are just some examples, and it may take a few tries at finding what works for you. But once you know what you are likely to need, you may be able to make or negotiate with your employer, in advance, the conditions that will allow you to help yourself feel better and get back to working.
If you are worried about your mental health, or other people are expressing concerns, you may want to get professional help. This is not giving in, it's taking action. If you work for a large organisation, they may have an occupational health service. Someone in the workplace is not only easier to access, but has the advantage of understanding the organisation and being a potential ally in dealing with your supervisor. However, if you do not feel secure enough in your job to approach them, or there is no service available, you may want to talk to your GP or a counsellor. You may need time off work; and sickness absence with mental health problems is just as valid as that for any physical health problems.
If you have to take time off from your job to improve your mental health, it can be quite daunting returning to work. But you don't have to apologise or justify being in mental distress, any more than you would if you were recovering from an accident or operation.
In the midst of a mental health crisis, people sometimes say or do things they wouldn't otherwise say or do. If this has happened, then you may feel the need to rebuild relationships. But, very often, other staff will just be glad to see you back at work, and you should try to accept that. People are able to empathise, and are more likely to have been busy with their own lives and work, rather than preoccupied with why you have been off sick or what led up to it.
However, there are some practical things you can do to ease things, before you return completely:
For many people, what matters is knowing that they don't have to hide distress and will be allowed to get on with their job without feeling pressurised to continue if they do in fact need to stop or slow down sometimes. If you need feedback from another person to help you recognise when you are overdoing it, you could discuss with a trusted colleague what they need to be aware of, and what kind of support you would welcome.
Many of the adjustments that can help with mental health are things you might expect an employer to adopt as a matter of ordinary good practice; some you may be able to organise for yourself; others would require action, or at least agreement, on the part of the employer. The key to negotiation with the employer is to think creatively about what will enable you to do your job effectively. Here are some examples:
You are probably the best judge of what would be most successful for you. If you want to think through some of the possibilities with another person, before negotiating with your employer, or have someone to back up your request, you could speak with someone involved with your care or treatment, a local supported employment organisation, or with a disability employment adviser (DEAs), who are part of Jobcentre Plus (see 'Useful organisations'). DEAs can give you advice and carry out an employment assessment to find out what assistance you may need. Via the Access to Work scheme, they may be able to help you get funding for changes to premises, equipment, personal support or assistance, or help with extra costs of getting to work.
The law says you have a right not to be discriminated against in employment on grounds of race, gender, age, religion or belief, sexual orientation, or disability. A person with a mental illness that has a substantial and long-term effect (12 months, or more) on their ability to carry out day-to-day activities is considered disabled. You would still be covered if these effects are controlled by treatment, if you have recurrent episodes, or if you have met the definition of 'disabled' in the past.
The employment sections of the Disability Discrimination Act (DDA) apply to all employers, except the armed services. The Act requires employers not to treat disabled employees or applicants less favourably than other people, and public authorities have an additional duty to actively promote disability equality. Employers must make 'reasonable adjustments'; in other words take reasonable steps to change work environments or arrangements that put a disabled person at a substantial disadvantage. The law applies to training and promotion, as well as recruitment, and outlaws victimisation of people bringing complaints.
You can ask for adjustments, under the DDA, at the point when you need them, even if you did not volunteer information about mental health problems earlier. However, if you were asked directly about your health record when you applied for a job, concealing information could be grounds for dismissal. The DDA does not protect against this.
If you have a complaint under the DDA, or any other law related to employment, you can take it to an employment tribunal. Get advice from your trade union, local Citizens Advice or the Equality and Human Rights Commission. (See 'Useful organisations' for more information.)
Your employer also has a duty of care to you under 'health and safety' legislation. All workers have a right to work in places where risks to their health and safety are properly controlled, and the employer also has responsibilities to protect employees after returning to work from sickness absence if they have become more vulnerable to risk because of illness, injury or disability. The Health and Safety Executive can provide more information on workplace hazards, including stress. (See 'Useful organisations'.)
Some people say you should be open about mental illness. Others advise against it, where there is a choice. Some recommend waiting until the employer has formed an impression of you based on your abilities and character, not on their preconceptions. Some companies have positive policies on disability and equality at work, which ought to mean that being open about your mental health is less of a risk.
An employer only has to make adjustments for needs that they know about. Therefore, if you want the protection of the DDA, or simply want your employer to understand your needs, you will have to make sure that someone in a responsible position knows what they are. This could be your manager or the human resources (personnel) department.
If you do decide to tell, think about how and when to do it, how much information you want to give, what kind of information, and who to share it with. For example, the human resources department may know your diagnosis, but they don't have to tell your supervisor or workmates.
You don't have to go into personal details; focus on what you need for the job. Employers' concerns tend to arise out of assumptions about poor work performance. They want to know if you can do the job and will get along with the customers or clients and the rest of the team. If you can show that your objective is to get the job done, this should go a long way to reassuring them. Being straightforward and unembarrassed about your history will help them get it in to perspective.
The potential risks of disclosing something about your mental health history include:
The potential benefits of disclosure are:
The Andrea Adams Trust
helpline: 01273 704 900
web: www.andreaadamstrust.org
Charity tackling workplace bullying
Equality and Human Rights Commission
helpline England: 0845 604 6610, helpline Wales: 0845 604 8810
web: www.equalityhumanrights.com
Employment Tribunals
tel. 0845 795 9775, web: www.employmenttribunals.gov.uk
Gives guidance on the tribunal system
Health and Safety Executive Information Services
infoline: 0845 345 0055, web: www.hse.gov.uk
Public Concern at Work
tel. 020 7404 6609, web: www.pcaw.co.uk
Helps organisations and individuals create a culture where it is safe and accepted for staff to raise concerns about poor work practices
Trades Union Congress (TUC)
tel. 020 7636 4030, web: www.tuc.org.uk
Working Families
tel. 020 7253 7243, web: www.workingfamilies.org.uk
Promotes and campaigns for work-life balance
www.citizensadvice.org.uk
www.direct.gov.uk
Information about employment rights and services and career advice
www.jobcentreplus.gov.uk
www.nice.org.uk
Have produced guidance: Promoting wellbeing at work(Nov 2009)
Building solutions 1: improving office environments (Mind 2006)
How to assert yourself (Mind 2006)
How to deal with anger (Mind 2009)
How to deal with bullying at work (Mind 2008)
How to look after yourself (Mind 2006)
How to rebuild your life after breakdown (Mind 2009)
How to recognise the early signs of mental distress (Mind 2008)
How to stop worrying (Mind 2006)
Managing for mental health: the Mind employers' resource pack (Mind 2006)
The Mind guide to advocacy (Mind 2006)
The Mind guide to managing stress (Mind 2009)
The Mind guide to physical activity (Mind 2008)
The Mind guide to relaxation (Mind 2009)
Mind troubleshooters: panic attacks (Mind 2009)
Understanding anxiety (Mind 2009)
Understanding depression (Mind 2008)
Understanding mental illness (Mind 2009)
Understanding post-traumatic stress disorder (Mind 2009)
Understanding talking treatments (Mind 2009)
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This booklet was written by Alison Cobb and revised by Mind
First published by Mind 2000. Revised edition © Mind 2010
ISBN 978-1-874690-91-7
No reproduction without permission