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How Are You, Really?

Business owners and managers need to be aware of their employees’ mental health.

If someone was struggling with their mental health at your place of work, would you be able to spot the signs? Would you know how to help? As a business owner and/or manager, are you aware of your responsibilities? Our sister publication, AV Technology Europe, examined the very real issues around mental health in business, and we see it as important issue for our industry to reprint the story here. Some of the facts have been switched to U.S. statistics, but otherwise the message is the same — do not ignore the mental health of your employees.

There are many different levels of mental health ranging from good — where everything is fine — to more serious conditions, such as stress, anxiety, and depression. As human beings, we all fit into one or more of those categories at some point in our life — some short term, while some may impact us for the rest of life. How we manage our mental health, or respond to those suffering with theirs, is vitally important — and potentially even life-saving.

According to the National Institute of Mental Health, nearly one in every five adults living in the U.S. lives with a mental illness. The reasons can be wide and varied, and are always unique to an individual. These may cause, for example, a lack of sleep or panic attacks, difficulty in concentrating, and low confidence. In England, figures show that one in six people now experience a common mental health problem (such as anxiety and depression) in any given week.

The implications of mental health issues for businesses are significant. It’s estimated that 15 in every 100 people have an existing mental health condition at work (take a look around). Research from Mental Health America found that workplace stress contributed to higher rates of absenteeism in the workplace — with 33 percent of survey respondents stating they missed work because of stress. Depression and anxiety disorders alone cost the global economy $1 trillion each year in lost productivity, according to World Health Organization (WHO).

In recent years, the discussion around mental health has become less taboo. Celebrities, high-profile business execs, and numerous national campaigns spearheaded by leading health organizations have all contributed in taking the subject out of the dark and into the public light, and helping to erode the perceived or assumed stigma surrounding it along the way.

However, while attitudes are improving, there still remains some way to go, particularly in business.

“Mental health is still the elephant in the room in most workplaces,” says Emma Mamo, head of workplace wellbeing at Mind.

Perhaps most tellingly, Gillian Connor, from the national mental health charity Rethink Mental Illness, adds: “Mental health can affect all of us at any given time. Mental health is not selective. It doesn’t target a specific gender, people with a specific job title, or how much they earn. There is no standard fit or model to work off. We are all individual human beings. We all come with our own context and look at life through a different lens and we all have our own triggers.”

Life Outside of Work
Connor has urged employers to help support their employers for matters related not just to things in work, but also out of it.

Employers are obligated to ensure their employees should not leave work in worse health than when they arrived based on their own obligations — however, for many people, a mental health condition is an extension of what’s happening in their personal life.

Discussing how an employer can help provide additional support, such as flexible working hours or even time off, could benefit everyone.

“Good employers recognize the value of their staff and will try to accommodate their staff when they’re trying to juggle things outside of work,” says Connor.

“If somebody had a bereavement, companies have a policy around compassionate leave. So therefore, if somebody is going through a breakup, why wouldn’t you recognize or have that discussion that they’re probably not going to be able to work at 100 percent?

“Having said that, it’s also about not making an assumption because for some people, work can be a relief or they might want to carry on as normal. It goes back to the conversation.”

Spotting the Signs
Addressing the issues around mental health can (crudely) be of tremendous benefit, helping not only to enhance reputation (see sidebar) but also financially.

A recent WHO-led study estimated that “for every one dollar put into scaled-up treatment for common mental disorders, there is a return of four dollars in improved health and productivity.” By contrast, a study measuring mental-health related productivity estimated that untreated mental illnesses can cost companies over $1600 per year per person.

“By looking after employees’ mental wellbeing, staff morale and loyalty, innovation, productivity, and profits will rise,” Deloitte wrote in a recent report.

There are numerous ways in which employers and employees can help support their colleagues, the majority of which require minimal (if any) investment, and do not force staff to play the role of a mental health professional.

According to figures published in the Thriving at Work Report — commissioned by the U.K. prime-minister — only 11 percent of employees discussed a recent mental health problem with their manager in 2017, while half of employees say they would not discuss mental health with their manager. Eight in 10 employers report no cases of employees disclosing a mental health condition.

The figures highlight the sensitivity around the subject and the need and necessity for companies, particularly managers, to get to know their staff.

According to Connor — whose charity has seen a significant rise in providing organizations with mental health training and awareness courses, identifying possible concerns and intervention (if required) is key. The first and clearest sign to look out for, as simple as it may seem, is if someone is behaving in a way that’s not considered normal for that person.

“Acting differently is often a sign that they are struggling in some form,” explains Connor. “If they’re normally happy, bubbly, and talkative, but all of a sudden they seem quiet, distracted, or even withdrawn, then there’s clearly something that’s not right. Stress or anxiety is a reaction to feeling threatened or the perceived feeling of being threatened, and can have a major impact on someone’s well-being.

“For managers, the importance of getting to know your staff cannot be underestimated. When you ask someone how they are, actually mean it as a question and not an almost instinctive throw away acknowledgment. If you manage properly, then you’ll take notice of your staff and you should (but not always) be able to get to know them well enough to identify when something isn’t normal.”

Understanding these signs and learning to identify certain triggers from staff — triggers they may not even acknowledge themselves at the time — is also crucial to help alleviate a problem before it potentially spirals out of control.

“They know their triggers and how to rebalance themselves when they’re well, but when they’re unwell, it’s easy to lose sight of that,” continues, Connor. “Having other people around who know the signs and step in is hugely important. All companies are capable of embarking on that journey.”

A report from Mental Health America stated that, in “unhealthy workplaces,” seven percent of people “never get emotional support from at least one person in the office,” while in a “healthy workplace,” 65 percent of people receive emotional support from at least one person in the office.

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Achieving these levels of relationships center heavily around the culture and environment created at a workplace — one that encourages communication and provides an open and trusted space, where staff feel comfortable enough to speak up if they have a problem (such as pressures over workloads, bullying, or even something outside of work) that could be impacting their mental wellbeing and, by extension, their performance at work.

According to Mind, around 300,000 people lose their job each year due to a mental health problem — a figure which could have been significantly reduced if the correct framework was provided by employers.

The impact of encouraging staff to be honest and supporting the message of “it’s OK to not be OK” cannot be underestimated. A report from Workplace Strategies for Mental Health says that four out of five managers believe it is part of their job to intervene when an employee is showing signs of depression. Fifty-five percent of managers have reported intervening, but only one in three had the appropriate training to do so.

It’s currently estimated that as many as 95 percent of people who take time off work due to a stress-related health issue will lie to their employer and instead use a physical sickness condition as the reason for their absence. This is largely related to fears over not being taken seriously, a lack of support, or that it might be perceived as a weakness that may harm their immediate or and/or future career.

“It’s a visibility thing,” explains Connor. “It’s this notion that, if you’re feeling mentally unwell, not feeling good, overworked, stressed, and a bit overwhelmed, it’s some sort of weakness to say something. A fear that you may be judged or that it may harm your career. A good working environment can help to eliminate these concerns.” (See “6 Core Standards” sidebar for suggested measures.)

6 Core Standards
The U.K.’s Thriving at Work Report sets out what it calls six “mental health core standards,” a framework for a set of actions that it believes all organizations in the country are capable of implementing quickly. These include:

1. Produce, implement, and communicate a mental health at work plan.
2. Develop mental health awareness among employees.
3. Encourage open conversations about mental health and the support available when employees are struggling.
4. Provide your employees with good working conditions.
5. Promote effective people management.
6. Routinely monitor employee mental health and wellbeing.

In addition, there is also growing issue around presenteeism, where staff that are struggling with their health (both physical and mental) continue to go into work. This is heavily linked to an increase in stress, anxiety, and depression cases in the U.K. Again, something that could potentially be cut with the right framework.

According to the latest CIPD—the professional body for HR and people development—Health and Well-being at Work survey, the number of people working while ill is at a record high in the U.K., tripling since 2010. Of the 1000-plus employee respondents to the 2018 survey, 86 percent said they had observed presenteeism in their organization over the last 12 months, compared with 72 percent in 2016 and just 26 percent in 2010.

Attracting the Next Generation
Providing a support network for employers around mental health and wellbeing is becoming an increasingly key factor for millennials and the next generation on where people choose to work.

“The evidence tells us they are much more interested in the ethical side of an employer,” says Connor. “They want to know what support is available and ask questions about company and their views on wellbeing.”

Work and Life Balance
The survey also found that “leaveism,” which sees people working through their annual leave — for example, due to concerns around workloads — is also a growing problem, with more than two-thirds of respondents (69 percent) reporting incidents in their organization over the last year. Just a quarter of respondents that have experienced presenteeism (25 percent) say their organization has taken steps to discourage it.

Rachel Suff, senior employment relations adviser at the CIPD, says: “This survey shines a light on the shocking scale of presenteeism and leaveism we have in the U.K., as people feel under even more pressure at work. Increasingly the threats to well-being in the modern workplace are psychological rather than physical, and yet too few organizations are discouraging unhealthy workplace practices and tackling stress, which is strongly linked to health conditions such as anxiety and depression.”

According to a report by the Surgeon General on mental health, depression costs employers $44 billion in lost productivity — with more than 80 percent of that cost coming from presenteeism.

Suff continues: “In order to encourage a healthy workplace, organizations need to look beyond sickness absence rates alone and develop a solid, evidence-based understanding of the underlying causes of work-related stress and unhealthy behavior such as presenteeism.”

“If you feel you have to be at work when you’re not physically or mentally fit to do so, then that’s not a healthy culture and that’s not going to benefit the business in the long term,” Connor adds.

Stress cultivated by an unhealthy work environment spills into personal spaces, influencing personal relationship and causing issues both at work and at home. In a Work Health survey by Mental Health America, 81 percent of respondents said that “work stress affected their personal relationships” with 52 percent of those same people reporting that relationships with family and friends were “always or often affected by workplace stress.”

“The best companies are the ones that recognize we all have mental health and it isn’t something to be taken for granted,” says Connor. “Companies that tell their staff that it’s okay to have good days and to have bad days, for me, create the foundation for a good culture. It gives people permission to talk and permission to feel that it’s OK to talk about it when they’re struggling.”

Symptoms of Possible Poor Mental Health
• Difficulty sleeping
• Feeling sad
• Hallucinating
• Hearing voices
• Low self-esteem
• Mood swings
• Negative thinking
• Racing thoughts
• Self-harm
• Suicidal thoughts
• Weight loss

Proactive Not Reactive
According to the previously mentioned Deloitte At a Tipping Point, Workplace Mental Health and Wellbeing Report, it’s estimated that four in 10 organizations (39 percent) now have policies or systems in place to support employees with common mental health — although eight in 10 employers report no cases of employees disclosing a mental health condition.

However, while great news, Connor admits that for many of the clients that approach her and her team regarding training on mental health in the workplace, it’s sometimes following the loss of a colleague to suicide and learning what they could have perhaps done differently.

One of the most concerning statistics you’ll read in this article is that over one million people in the U.S. attempt to commit suicide each year, according to American Foundation for Suicide Prevention; suicide is the tenth leading cause of death in the U.S. and costs the U.S. $69 billion annually.

And while, again statistically, women in full-time employment are nearly twice as likely to have a common mental health problem as full-time employed men (19.8 percent versus 10.9 percent), it is widely held believed that men are more likely to suffer in silence.

“The different between men and women when it comes to mental health is a concern,” says Connor. “We think a big reason for that is because men don’t share. Why? We believe it’s because there is a perception or an expectation among men that they don’t have permission to talk about their feeling and that they need to be strong. We have men taking their own lives, and that needs to stop.

“Keeping things to yourself is the worst thing you can do, and for businesses to implement some sort of support network, no matter how small, it could be a lifeline for someone. A good business will look after its staff.”

Three Levels of Mental Health
1. Doing really well and feeling good.
2. Finding things hard.
3. Being ill and possibly having time off work.

If you are suffering and need someone to talk to, the National Suicide Hotline is available 24 hours every day at 1-800-273-8255. If you are not comfortable speaking, there is a chat version available at or you can text HOME to 741741 and text with a trained counselor from the Crisis Text Line.