According to Mind, 1:4 of people in the UK will encounter a mental health problem in the UK, each year. Although awareness of mental health as a physical illness is starting to increase, many organisations are still unaware of the impact such illnesses can have on the individual, and the devastating effect poor management practices can have on colleagues in certain situations. Such ignorance is concerning – in far too many cases, anxiety, depression and other conditions are treated with ‘lip service’ at best; or as taboo at worst. This session will try and tackle some of the main, down-to-earth matters surrounding mental health in Higher Education Institutions. Sometimes, performance is affected, and this can have a serious adverse effect on the morale and performance of a team or department at large. How straightforward is it to identify and help people who might be struggling? How is it best to tackle poor performance while, at the same time, help an individual or individuals cope with mental health difficulties? Should HEIs introduce transparent strategic mental health awareness policies at the very top? How would one do that? How might it be possible to change an institutional or departmental climate for the better, with other positive knock-on effects this could have on welfare, happiness and performance? How would it be possible to transform understanding and practice at a local and institutional level? Following a brief presentation, this session will be an open forum for the sharing of experiences, suggestions and best practice.

1. AUA Manchester 2017
Session 214
Transforming Mental Health
James Craig FAUA
(Ex-University of Leeds)
Retired – Writer/ Campaigner

2. Chatham House Rules
• Any personal mental health issues we share
with others, must be strictly “within these
four walls.”
• Ditto if referring to colleagues when talking
to others.
• Purpose, though, is to talk, listen, and share
best practice to take back to our Institutions

3. Effects on People/ Stigma
• Mental health can impact considerably on work,
relationships and quality of life generally.
• Everyone’s experience is different. (Two people
with the same condition may have entirely
different symptoms and coping mechanisms)
• We are all individuals (no “one size fits all”)
• There does remain a stigma (reluctance to
disclose/ shame/ fear/ scepticism)
• “Elephant in the Room”

4. Equality Act 2010
• A mental health condition is considered a disability if it has a long-
term effect on your normal day-to-day activity. This is defined
under the Equality Act 2010.
• Your condition is ‘long term’ if it lasts, or is likely to last, 12 months.
• ‘Normal day-to-day activity’ is defined as something you do
regularly in a normal day. This includes things like using a
computer, working set times or interacting with people.
• If your mental health condition means you are disabled, you can
get support at work from your employer.
• There are many different types of mental health condition which
can lead to a disability (see later slide).
https://www.gov.uk/when-mental-health-condition-becomes-disability
-Updated 5th April 2017

5. Non-discrimination
• If you’re in employment and become disabled,
your employer can’t discriminate against you
because of your disability - you’re protected
by the Equality Act 2010.
• They must also keep your job open for you
and can’t put pressure on you to resign just
because you’ve become disabled.
https://www.gov.uk/if-you-become-disabled/if-youre-in-employment-and-
become-disabled

6. ‘Reasonable Adjustments’
Your employer must make ‘reasonable adjustments’ for you so
that you’re not disadvantaged compared to non-disabled
people.
This could include:
• a phased return to work – eg working flexible hours or part-
time
• time off for medical treatment or counselling
• giving another employee tasks you can’t easily do
• providing practical aids and technical equipment for you
https://www.gov.uk/if-you-become-disabled/if-youre-in-employment-and-
become-disabled

7. Dismissal and Redundancy
• Your employer can’t dismiss you just because
you’ve become disabled.
• You can be dismissed if your disability means
you can’t do your job even with reasonable
adjustments.
• You can’t be selected for redundancy just
because you’re disabled.
https://www.gov.uk/if-you-become-disabled/if-youre-in-employment-and-
become-disabled

8. Mental Health Conditions
– Excessive and prolonged stress, is very common in the HE sector.
– Various other factors and causes can come into play too.
– Emphasise (again) that we are all different - no one size fits all.
• Depression
• Anxiety
• Panic attacks
• Obsessive-compulsive disorder (OCD)
• Phobias
• Bipolar disorder (“manic depression”)
• Schizophrenia
• Borderline Personality Disorder (BPD)
• Psychosis
• Dementia

9. Concerning Statistics
• Mental health problems account for 25% of
the burden of disease in the UK, but they only
receive 10% of NHS funding (Kings Fund).
• ¾ of adults with a common mental health
problem, are not in receipt of treatment (ie
medication and/ or psychotherapy.
• Each case of stress/ anxiety/ depression leads
to an average of 30 days lost.

10. Work and non-work causes
• Often a combination of work/ non-work
• 20% of respondents stated down to “non-work issues”
CIPD Employee Outlook, 2011
• 70% of employee mental health problems are either directly
caused by work, or by a combination of work and home
CIPD/ Mind, 2011

11. Yawning Gap
“In spite of the growing awareness of
health and wellbeing within organisations,
there remains a yawning gap of ignorance
regarding the impact of employees’
physical state on their performance”.
Concilio Health

12. Employer’s Responsibility
The cost to an organisation in terms of reduced
productivity as a result of employees with poor mental
health working sub-optimally, is estimated to be three
times the cost of mental health related sickness absence.
(Centre for Mental Health)
It is therefore in an organisation’s best interests (ie
improved performance), to work proactively in creating
conditions for employees to be in the right physical and
mental state at the outset, rather than trying to avoid
negative outcomes (Prevention better than cure).

13. Positive Employee Engagement
“It is…impossible to disentangle the impact of
various factors on mental health and so it is in
employers’ interests to actively support staff with
mental health problems, whatever the original
cause or trigger. The wider knock-on effects for the
employer are also significant, as positive employee
engagement means staff feel valued and are more
likely to go the extra mile for the organisation”
CIPD/ Mind, 2011

14. “Positive employee engagement……….”
What does that mean?
Does it mean…..

15. Support Structures (common)
• HR department / HR staff? Staff satisfaction
surveys?
• Occupational Health/ University Medical
Officers?
• Staff development unit (delivering, eg,
leadership and management programmes)?
• ‘Investors in People’ certification?
• Unions?

16. More Support Structures
• Professional counselling service
• Courses in, eg, mindfulness (becoming trendy)
• Formal mentoring and buddy scheme
• Staff benefit packages (eg salary sacrifice
schemes) to help improve wellbeing

17. Support Structures; or Lip Service?
• Good managers and well-run units exist even in
poorly-run large organisation.
• Stress/ pressures on HEIs from the external
environment….
• .…and from within: Academics vs Administrators
(Arsenal vs Bayern Munich?)
• Academics vs Academics
• Administrators vs Administrators
• What does all this ‘vs’ say about organisational
culture, and even about basic ethics?

18. Tackling the causes
• We do need the basic structures and expert
staff, but much else besides…
• “Effective managers help employees to
manage their workloads, create opportunities
for coaching and learning, and promote a
culture of open dialogue – all of which help to
boost staff mental wellbeing and employee
engagement levels.”
Mind

19. Three-pronged approach (Mind)
1. Promoting wellbeing for all staff
2. Tackling the causes of work-related mental
health problems
3. Supporting staff who are experiencing mental
health problems

20. 1. Promoting wellbeing
• Getting senior leaders on board (mental health issues
explicitly in the Institutional Strategy – wellbeing-
motivation/ performance)
• Raising awareness of mental health and wellbeing
(challenging the “elephant in the room” at every level)
• Induction; training; champions
• Involve staff in dialogue and decision-making
• Culture of openness / two-way communications
• Work/ Life Balance
• Peer support, buddies, mentoring
• Positive working relationships

21. 2. Tackling the Causes
• ‘Taking stock’ of your colleagues’ mental
wellbeing
• Embedding mental health explicitly into all
staff policies. Promote awareness.
• Training for line managers to include mental
health and stress management at the heart.
• Regular one-to-ones. Open management. Be
available.
• Treat people as people.

22. 3. Supporting staff who are
experiencing mental health problems
• Could there be a disconnect between
Occupational Health (a medical professional
who really does understand mental health),
and a poor (or more correctly maybe an
under-trained) line manager, who doesn’t?
• Pulling in different directions
• Disclosure…..

23. Lack of Disclosure (1)
50% of staff and students in UK
universities with mental health
difficulties are not asking for the help
and support they may need out of
lack of information or fear of
receiving unfair treatment.
Equality Challenge Unit, 2015:
http://www.ecu.ac.uk/news/mental-health-staff-students-accessing-support/

24. Lack of Disclosure (2)
• Around 50% of staff respondents had not
officially spoken to anyone in their university
about getting support or adjustments.
• Higher numbers have disclosed to colleagues
informally.
• 62% of staff answering the survey had shared
their difficulties with their peers, with 84%
receiving supportive, or very supportive,
responses.
Equality Challenge Unit, 2015:
http://www.ecu.ac.uk/news/mental-health-staff-students-accessing-support/

25. Early Signs/ Encouraging Disclosure
• The situation of a colleague who has a mental health
issue and who is seriously under-performing, can have
serious consequences for the rest of the team.
• Early conversation – broaching the subject - can be
difficult.
• Reluctance to talk on the part of the person who is
depressed etc.
• Conversation skills in a neutral place: open questions;
non-judgmental; eye contact; calmness; empathy;
avoid making assumptions; follow up in writing.

26. Rehabilitation
• Mental Health Champions (eg Deloitte)
• Wellness Recovery Action Plans (WRAPS)
• ‘Reasonable Adjustments’ (Disability Act 2010)
- and more
• Return-to-work interviews

27. Mental Health Champions
• Deloitte
• A few company partners who have been
specially trained.
• Employees may approach these people
outside the line management structures
• Clear signal from the top, that employees can
be open

28. Wellness Recovery Action Plan (WRAP)
• Employee-driven
• Bespoke
• Practical, mutually-agreed steps
• Details the following: signs/ symptoms;
triggers for distress; what support can help;
emergency contact
• Packages - eg free access to University sports
facilities for a given period

29. ‘Reasonable Adjustments’
• Disability Act 2010 – legal compliance should be
the bare minimum
• “…if the cost of making adjustments is anything
up to the cost of recruiting and training a new
employee, this is reasonable” (Mind)
• Practical implications of any reasonable
adjustment request
• See what goes on, from both sides
• Bespoke/ apply to all staff, whether or not they
have had a formal diagnosis?

30. Return to Work Interviews
• Trust and engagement
• Role of Occupational Health
• Role of Unions (representative)
• Tell people how much you missed them!
• Open questions. Listen. Empathise
• Open up about feelings
• WRAP (see above)

31. Managing under-performance and
mental health issues concurrently
• Can be very tricky indeed
• Time and sensitivity
• Focus on the person; avoid making
assumptions (eg is sickness absence genuine?)
• Support & reasonable adjustment in place
• Invite third party representation (eg a Union
rep) at every stage

32. Suggestion for discussion (1)
Is there anything you have
experienced (whether yourself
personally with a mental health
difficulty, or knowing a colleague with
a mental health difficulty), that could
give cause to suggestions as to how
you or your HEI might have handled a
given situation, any better?

33. Suggestion for discussion (2)
Have you any tips for resolving
the tension between managing
under-performance, and
supporting a colleague during a
period of disability caused by
mental difficulty?

34. Suggestion for discussion (3)
How can top management in your HEI, be
persuaded to embrace practical, strategic
measures that might be necessary, to bring
into play some of the more ethical and
cultural transformational changes
described above? Or are they already
“there”? If so what steps did they take to
achieve those changes?

35. References (1)
Mind: Mental Health at Work – Numerous valuable resources (must-reads):
http://www.mind.org.uk/workplace/mental-health-at-work/
(Tip: Follow Mind on LinkedIn)
Mind/ CIPD – Managing and supporting mental health at work: disclosure
tools for managers (must-read):
https://www2.cipd.co.uk/publicpolicy/policy-reports/mental-health-work-
disclosure-tools.aspx
Concilio Health – Dr Sarah Hattam (GP) with a very strong focus on the need
to transform workplace health:
http://www.conciliohealth.com/about/

36. References (2)
NICE ‘Healthy workplaces: improving employee mental and physical health
and wellbeing’ (Quality Standard QS147):
https://www.nice.org.uk/guidance/qs147
Equality Challenge Unit: Mental Health in HE: Staff and Students not
accessing support: http://www.ecu.ac.uk/news/mental-health-staff-students-
accessing-support/
Centre for Mental Health (formerly the Sainsbury Centre for Mental Health)
https://www.centreformentalhealth.org.uk/
Deloitte – Mental Health Champions
http://www.deloitte.co.uk/impact/2012/case-studies/mental-health-
champions/