Directorate of Health Promotion

Mental Health Policy

Background

This policy has been developed to enable the Directorate to carry out its organisational responsibilities in relation to promoting the emotional wellbeing of staff, and the implementation of the Employment and Mental Health Standards which were adopted by North Stoke PCT on 26 January 2005.

It is part of a raft of policies that have been developed over the past few years and should not therefore be viewed as a stand alone piece of work. In particular the Work Related Stress policy agreed by all North Staff NHS Trusts already sets out the organisational response to the HSE Management Standards in relation to tackling stress at work. Therefore this subject is not covered by this policy.

A comprehensive list of the other relevant policies and plans is as follows.

  • Bullying and Harassment
  • Work related Stress
  • Disciplinary and Grievance procedures
  • Occupational Health
  • Equality and Diversity
  • Lone Worker Policy
  • Work –Life Balance/flexible working
  • Staff survey action plans
  • Safe Working Protocol for Stress

Please note that the suggestions for tackling work-related stress contained n this policy in no way contradict, supercede or replace any of these policies and plans.

In particular the suggestion to consider changing your job, if you are finding that stress is injuring your health even though you feel you have done everything you can to relieve it, is based on HSE guidelines and would not compromise any subsequent dispute between employee and the organisation in relation to workplace stress.

Introduction

Mental health problems account for the loss of over 91 million working days per year. Stress related absence costs an estimated £4 billion annually. Mental health problems have many causes, including factors at work, as well as in the outside world. The workplace can have a positive and a negative effect on an employee’s mental health.

It is the responsibility of North Stoke Primary Care Trust to prevent, as far as possible, risks to mental health arising in the workplace, and to provide a supportive working environment to those experiencing or recovering from mental distress.

Remit

This policy is primarily concerned with implementation of the Employment and Mental Health Standards, through the following key pieces of work.

1.Asserting a management culture in which good mental health is valued and promoted, and which is open and understanding about mental health issues, so that staff feel comfortable in discussing these issues.

2.Raising the general level of awareness for all staff about mental health

problems – identifying and addressing them, and tackling the associated stigma and discrimination.

3.Enabling line managers to identify possible mental health problems early on, to know how to intervene effectively, and support staff.

4.Encouraging a positive organisational response to the issue of recruiting and retaining staff who have long-term mental health problems.

Actions

1.Asserting a management culture in which good mental health is valued and promoted, and which is open and understanding

about mental health issues, so that staff feel comfortable in discussing these issues

1.1The principles against which people are expected to perform (previously agreed) are included in induction of all new employees into the Directorate.

1.2 Offer all staff training that helps them to act on these principles, eg using solution focussed/constructive approaches to resolving difficult issues (eg STEPS, Solution Focussed Approaches).

1.2 Incorporate Safe Working Protocol for Stress into existing health and safety procedures

1.3 Ensure all staff complete mandatory training on Equality and Diversity, Bullying and Harassment and Conflict Resolution.

1.4 Ensure all managers are aware of the of NHS professional behaviour standards

1.5Ensure effective and respectful communication throughout the organisation in all media.

1.6Ensure feedback received through exit interviews is picked up and acted on if necessary, in line with the PCT policy.

  1. Raising the general level of awareness for all staff about mental

healthproblems – identifying and addressing them, and tackling the associated stigma and discrimination

2.1Ensure all staff attend training in Mental Health Awareness

2.2Ensure all staff know how to promote mental health, and prevent mental health problems in the workplace, by including training based on the Safe Working Protocol for Stress in the Mental Health Awareness training.

3.Enabling line managers to identify possible mental health problems early on, know how to intervene effectively, and support staff

3.1Ensure all line managers have their line management training needs identified and addressed (through KSF). Includes awareness of Work Life Balance and flexi time.

3.2Ensure all line managers are familiar with the Line Manager’s Toolkit.

3.3Introduce peer support into the workplace for early detection of problems and for support when a problem has been identified, peers being volunteers who have attended training provided by the Staff Counselling Service.

3.4 Ensure all staff are aware of the range of services offered by the Staff Counselling Service.

4. Encouraging a positive organisational response to the issue of recruiting and retaining staff who have long-term mental health problems

4.1Review and amend recruiting material in line with good practice, eg include life experience in person specifications and a statement positively welcoming applications from people with experience of mental distress, for all posts.

4.2Ensure line managers are aware of reasonable adjustments that can be made to support people with mental health needs.

5.Monitoring

5.1Possible indicators for measuring the effectiveness of this policy include:

  • Staff sickness levels
  • Feedback from staff survey and action plan arising from it
  • Accidents
  • Staff turnover
  • Use of staff support services and occupational health
  • Working hours and patterns
  • Complaints
  • Early retirement through ill-health
  • Exit interviews
  • Feedback from staff at annual review

5.2Policy should be reviewed annually.

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Appendix 1

Core principles and values ofNorth Staffordshire Directorate of Health Promotion

1.We believe that health promotion is for everyone, and therefore our service is a universal service, which must meet the needs of every member of the community it serves.

2.We aspire to excellence in the quality of our service and in the way the service is delivered.

3.We recognise that all people are different and of equal worth. We understand that differences between people can mean that some people and communities encounter more barriers to promoting their health than others, which can lead to inequity. We are committed to reducing health inequalities that arise from this inequity.

4.We understand that the factors that influence health are many and varied, and that most of them are outside the control of individuals. We are therefore committed to challenging approaches to health promotion that focus solely on individual behaviour change. We aim to address the social, economic and environmental factors that influence health.

5.We know that factors that influence health are often outside the direct influence of the Directorate. We are therefore committed to working in partnership with other organisations and with communities, who have a more direct influence. In doing so we recognise the value and importance of shared learning gained through partnership working.

6.We know that we are accountable to the community we serve because we are a statutory organisation. We therefore have a duty to respond to the diversity of the community and to ensure that our service offers value for money.

7.As NHS employees we have a duty of care not only to the people who use our service but to our colleagues. We expect staff to treat each other with care and respect, irrespective of their position or role within the organisation.

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Appendix 1

Directorate of Health Promotion

Safe Working Protocol No 6 - Stress

1.Background

Work-related stress is a common and serious problem affecting approximately one in five people. Stress puts the physical and mental health of staff at risk and therefore must be taken seriously as a health and safety issue. The Health and Safety Executive (HSE) warns that employers that fail to do so leave themselves open to compensation claims from employees who experience ill health due to work-related stress. Although individuals can do a certain amount to reduce or manage the pressures they may experience at work, the key to preventing work-related stress lies with the organisation.

The purpose of this safe working protocol is to outline those aspects of good management that can help prevent and reduce work-related stress, and steps that individuals can take to protect their health. Some specific examples of potential causes of workplace stress in an organisation such as the Directorate, and possible remedial action, are also provided.

The Directorate’s Mental Health Policy and the organisation-wide approaches to promoting mental health at work it involves will provide important support to the application of this safe working protocol. The adoption of a work-related stress management policy is also to be recommended for the same reasons.

2.Legal requirements

It is an employer’s duty in law, under the Health and Safety at Work Act 1974, to ensure that employees are not made ill by their work. Although work-related stress is not recognised as an illness, if it is intense and prolonged, it can give rise to serious mental and physical illnesses such as depression, anxiety and heart disease.

The HSE has issued the following guidance to employers:

“Ill health resulting from stress caused at work has to be treated the same as ill health due to other, physical causes present in the workplace. This means that employers do have a legal duty to take reasonable care to ensure that health is not placed at risk through excessive and sustained levels of stress arising from the way work is organised, the way people deal with each other at their work or from the day-to-day demands placed on their workforce.”

(Stress at Work: A Guide to Employers, HSE, 1995)

Under Health and Safety Law, where stress caused or made worse by work could lead to ill health, a risk assessment must be conducted. In relation to this process, employees have a responsibility under the Management of Health and Safety at Work Regulations 1999, to notify their employer of any shortcomings in health and safety arrangements.

3.Definition

Stress is defined by the HSE as the adverse reaction people have to excessive pressure or other types of demand placed on them.

4.Guidance on Safe Working Practice

A wide range of factors can give rise to workplace stress. These can relate to the working environment, the nature of the job, and the culture of the organisation. The main sources of stress in the workplace are covered by the Health and Safety Executive’s Management Standards for Stress at Work. The Standards therefore offer a useful framework for including stress in the risk assessment process, at the hazard identification stage. The Standards can be found in Appendix 3 and further detail is available from

Good management is key to both preventing and reducing work-related stress. Managers can help to prevent stress from becoming a problem by doing the following:

  • Show that you take stress seriously, and be understanding towards people who admit to being under too much pressure.
  • Take an open and understanding attitude to what people say to you about the pressures of their work and look for signs of stress in your staff[1].
  • Ensure that staff have the skills, training and resources they need, so that they know what to do, are confident that they can do it and receive credit for it.
  • If possible, provide some scope for varying working conditions and flexibility, and for people to influence the way their jobs are done. Thiswill increase their interest and sense of ownership.
  • Ensure that people are treated fairly and consistently and that bullyingand harassment are not tolerated.
  • Ensure good two-way communication, especially at times of change. Don’t be afraid to listen.

The list below highlights some potential workplace stressors and specific action that managers can take to address them.

Culture
Possible stressors / What management can do
Lack of communication and consultation /
  • provide opportunities for staff to contribute ideas, especially in planning and organising their own jobs.
  • introduce clear business objectives, good communication, and close employee involvement, particularly during periods of change.

A culture of blame when things go wrong, denial of potential problems /
  • be honest with yourself, set a good example, and listen to and respect others.
  • be approachable – create an atmosphere in which people feel it is OK to talk to you about any problems they are having

An expectation that people will regularly work excessively long hours, or take work home /
  • avoid encouraging people to work excessively long hours.
  • consider leading by example.

Demands of the job
Possible stressors / What management can do
Too much to do, too little time /
  • prioritise tasks.
  • cut out unnecessary work.
  • try to give warning of urgent or important jobs.

Too little/too much training for the job /
  • make sure individuals are matched to jobs.
  • provide training for those who need more.
  • increase the scope of jobs for those who are over-trained.

Boring or repetitive work, or too little to do /
  • change the way jobs are done by moving people between jobs,
  • giving individuals more responsibility,
  • increasing the scope of the job,
  • increasing the variety of tasks,
  • giving a group of workers greater responsibility for effective performance of the group.

Working environment
Possible stressors / What management can do
Noise, temperature, poor lighting, badly maintained building, poor workplace layout, poor siting of equipment, insufficient or inadequate equipment /
  • ensure that environmental hazards are properly controlled.

Control
Possible stressors / What management can do
Lack of control over work activities /
  • give more control to staff by enabling them to plan their own work, make decisions about how that work should be completed and how problems should be tackled.

Relationships
Possible stressors / What management can do
Poor relationships with others /
  • provide training in interpersonal skills.

Bullying, racial or sexual harassment /
  • set up effective systems to prevent bullying and harassment.

Change
Possible stressors / What management can do
Uncertainty about what is happening /
  • ensure good communication between staff.

Fears about job insecurity /
  • provide effective support for staff throughout the process.

Role
Possible stressors / What management can do
Staff feeling that their job requires them to act in conflicting ways at the same time. /
  • talk to people regularly to make sure everyone is clear about what their job requires them to do.

Confusion about how everyone fits in /
  • make sure that everyone has clearly defined objectives and responsibilities linked to business objectives.
  • provide training on how everyone fits in.

Support and the individual
Possible stressors / What management can do
Lack of support from managers and co-workers /
  • support and encourage staff, even when things go wrong

Not being able to balance the demands of work and life outside work /
  • encourage a healthy work-life balance
  • see if there is scope for flexible work schedules (e.g. working from home, flexible working hours)
  • take into account that everyone is different, and try to allocate work so that everyone is working in the way that helps them work best

5.What can staff do?

If you are experiencing stress, you are certainly not alone. As many as one in five people feel very, or extremely stressed by their work. Remember that work-related stress is a symptom of an organisational problem, not a weakness on your part.

There are a number of things you as an individual can do however, that will help your manager to tackle stress at work.

  • Talk to your manager – if they don’t know that there’s a problem, they can’t help. If you don’t feel able to talk to your manager, try speaking to your Union representative (if you have one) or one of the identified mental health first aiders in the Directorate. Your Union rep will be able to advise you of formal actions you may wish to take. The mental health first aider will be able to help you identify whether or not you are experiencing stress, what the stressors are, and how you might be able to address them.
  • Support colleagues if they are experiencing work-related stress. Encourage them to talk to their manager, or their Union rep or mental health first aider as above.
  • Consider using the Staff Counselling Service. This service provides professional help for people who are experiencing problems at work and/or home. The service is strictly confidential and available free of charge to all staff.
  • Speak to your GP if you are concerned about your health.
  • Try to put your energy into problem-solving rather than worrying. Think about what might make you feel happier at work and discuss this with your manager.
  • If you feel you have done everything you can to reduce the stress of your job, but you are still experiencing stress that makes you feel ill, consider changing jobs. The PCT offers exit interviews which identify the reasons why people leave, and place a responsibility on the PCT to address any identified issues such as excessive stress, poor management, etc. Exit interviews are not conducted by the individual’s line manager.

6.Risk Assessment

The above should be helpful in risk assessing for stress, and for identifying possible remedial action when stress is identified as a hazard. As previously referenced, the Health and Safety Executive’s Management Standards for Stress at work will be a useful guide to addressing stress within the risk assessment process, both in terms of hazard identification (identifying possible stressors) and taking remedial action. The Standards can be found in Appendix 3, and more information is available from the HSE website: