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Thriving at Work - The Stevenson/Farmer Review of mental health and employers 2017

Mind's Chief Executive Paul Farmer, together with Lord Dennis Stevenson, was asked in January 2017 by the government to carry out an independent review into how employers can better support individuals with mental health problems remain in and thrive in work. The result of the extensive review were published on 26 October 2017.

The review was supported by an independent study on the cost to employers of the mental health problems of staff which was carried out by Deloitte. This found:

  • There is an annual cost to employers of between £33 billion and £42 billion each year made up of the cost of presenteeism (when individuals attend work but are less productive because of their mental health problem), sickness absence and staff turnover
  • Poor mental health costs government between £24 billion and £27 billion in lost tax revenue, benefits and NHS cost each year
  • Poor mental health costs the UK economy as a whole between £74 billion and £99 billion per year
  • Around 300,000 with a long-term mental health condition lose their jobs each year.

These figures are shocking. They also make clear that it is massively in both employers' and the government's interest to invest more in improving the nation's mental health. Mind is more concerned about the human cost behind these numbers.

The vision

Thriving at Work sets out a vision as to how progress can be achieved. The report's authors envisage that in ten years' time a number of changes will have happened:-

  • Employees in all types of employment will have "good work" (consisting of autonomy, fair pay, work life balance, opportunities for progression and the absence of bullying and harassment)
  • All of us will have the knowledge, tools and confidence to look after our own mental health and those around us
  • All employers of all sizes will be:
    • Equipped with the awareness and tools to address and prevent mental ill-health caused or worsened by work
    • Equipped to support individuals with mental health problems to thrive within the organisation
    • Aware of how to access help to reduce sickness absence caused by mental ill-health
    • The numbers of people with mental health problems leaving employment each year will dramatically reduce.

How the vision can be achieved

Core standards

The report recommends that all employers adopt a set of "mental health core standards" which all employers should be capable of implementing. Employers should:

  • Produce and implement a mental health at work plan
  • Develop mental health awareness among its employees
  • Encourage open conversations about mental health and what support is available when people are struggling
  • Provide good working conditions
  • Promote effective people management
  • Routinely monitor employee mental health and wellbeing.

Enhanced standards

The report calls for public sector employers and private sector ones with more than 500 employees to deliver enhanced standard which should:

  • Increase transparency and accountability through internal and external report of the organisation's approach to mental health
  • Demonstrate accountability by nominating a health and wellbeing lead
  • Improve the process for employees disclosing mental health problems, making sure people know why information is needed and providing support for people
  • Ensure that tailored in-house mental health support is provided together with good signposting to clinical help.

External support for employers

Employers alone cannot the cultural change envisaged in the report, which sees a role for trade unions, industry groups, professional bodies and accrediting organisation to provide support. This can be by way of industry groups such as the Federation of Small Businesses providing guidance on how to implement the core standards, or professional bodies such as the Federation of Master Builders including mental health awareness in their training and accreditation programmes. These bodies can also advise employers on occupational health services and insurance products to help support the mental health of their staff.

The government

Predictably a substantial role in effecting change is envisaged for the government. It should:

  • Streamline the fragmented and confusing array of information available from the government, voluntary sector and private providers. The report recommend the creation of a single mental health online information platform to promote best practice and help employers implement the core standards
  • Streamline the fragmented practical support available to employers to an integrated support service for mental health (as well as other physical health conditions and disabilities)
  • Incentivise employers to adopt the core standards with tax incentives
  • Introduce supply chain initiatives to encourage suppliers to public bodies implement the core standards
  • Legislate to provide further protection for workers and clarity for employers. A more proactive monitoring and enforcement role for the Equality and Human Rights Commission is encouraged.
  • Responsibility for completing fit notes should be extended beyond doctors to other mental health professionals and there should be improved (but secure) data and information sharing between health professionals and employers.

Implementation and delivery

Thriving at Work presents an ambitious vision and one that will not be easy to achieve. It envisages that a ten years plan will be needed to achieve the levels of cultural changed needed amongst employers. Mental health campaigns including information and support for improving workplace mental health are needed, and particular support should be given to small and medium sized employers and to the self-employed. Crucially, more evidence about how workers' mental health and wellbeing can be best supported is needed and there should be further research and evidence building at the heart of the ten year plan.

As we write, the government has announced, but not fleshed out, a ten year strategy to help more disabled people into work.

The report can be found here.

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