Happiness at Work

The key to tackling mental health problems?

The equation seems simple; a healthy workforce equates to a happy workforce which results in a more productive and successful organisation. This is good for society and the country’s economy. However in reality the picture is bleak, suggesting that this formulae is neither being understood nor utilised.

Unfortunately, poor mental health is not uncommon in today’s society. In Britain, one in four adults will experience a diagnosable mental health problem in any one year, despite the UK being one of the richest countries in the developed world. Whilst wealth does not necessarily lead to happiness, having a good standard of living, access to free healthcare, can certainly improve a society’s wellbeing. However, not so surprisingly, 80 percent of people with a mental health problem believe that their condition is associated to work related problems. Does this imply that employers do not understand the equation mentioned above? Or are they so intent on achieving their outcomes that they choose to ignore it, not realising that the long term affects of poor mental health can be catastrophic for society. 

With one in six working Britons experiencing a mental health issue at any one time, including depression, anxiety or stress - more needs to be done to address these unsettling statistics.

In the run up to Mental Health Awareness Week (12^th – 18^th May) two significant, and timely, documents have been published; a survey by Depression Alliance revealing that a third of people struggle to cope at work due to stress/exhaustion, and a report entitled “Depression in the Workplace in Europe: new insights from business leaders", which makes the argument that employers need to be more responsible for the wellbeing of their employees and the benefits this has on the country’s economy and society as a whole.

At any one time in Britain one worker in six will be experiencing depression, anxiety or problems relating to stress. Among people who describe their mental health as poor, 80% say this is at least in part a result of problems at work

The report, which was published at the end of April, suggests that mental health problems are the leading cause of disability worldwide, affecting 350 million people. More over, depression disproportionally affects adults of working ages and the financial impact on business and the economy is profound. Recent figures, from the London Schools of Economics and Political Science and King’s College London, shows that the annual cost of depression to European businesses is a staggering £77 billion. This is directly a result of lost productivity.

Presenteeism, as identified in the report, can be as detrimental to the organisation and the individual, as much as absenteeism, if not more. In the UK, it is believed that 1.5 times as much work is lost through presenteeism as absenteeism for mental health conditions. This can be attributed to two reasons; firstly, employees with depression also experience cognitive symptoms (difficulty concentrating, indecisiveness and forgetfulness) up to 94% of the time, hindering their performance in the workplace. Secondly, employees are reluctant to take time off work, even when they need to, due to fear of losing their job or demotion, which could compromise their finances. This therefore fuels their stress and can augment and prolong existing mental health conditions. 

In the UK it is argued that 1.5 times as much work is lost through presenteeism as absenteeism for mental health conditions

Time off work or reduced productivity at work can 

affect finances and push people into debt

Having a mental health problem can impact all aspects of our every day life including our relationships with family, friends and colleagues. The Depression Alliance survey which involved 1,200 people, found that 83 percent affected by a mental health problem at work also experienced isolation or loneliness. However, only half of those feeling depressed or lonely confided in a colleague, yet a large proportion who did, reported to have felt better.

Mental health problems can affect any of us, however, in spite of this, there is a widespread lack of awareness, especially in the workplace, of how to recognise the signs and support people. Colleagues and managers may not know how, or feel confident, in supporting someone with a mental health condition, and moreover may not be aware what, if any, the companies policy is on mental health. The report stated that the majority of workplaces (78% in the UK), do not have a formal mental health policy in place and would most likely benefit from reviewing how they deal with depression. Not surprisingly, many employees are reluctant to inform their managers if they know that they have a problem due to fear of facing prejudice or stigmatisation. This of course can escalate feelings of isolation.

Chief Executive of Depression Alliance, Emer O'Neill says, "Depression is the biggest mental health challenge among working-age people and often leads to considerable loneliness and isolation at work. However, many companies aren't properly equipped to manage employees who suffer from depression so providing support to these individuals in the workplace is essential”.

Who’s responsibility is it anyway?

We are all susceptible to experiencing a mental health problem. Research suggests that around 50 percent of our mental health can be attributed to our genetics and environment, but the remaining can be altered by our activities and steps we take in life to protect our mental health. With such a high percentage of mental health problems related to work (it is where we spend the majority of our adult life) more needs to done to protect the mental health and wellbeing of employees. Employers therefore should create a supportive environment that reduces the taboo around mental health, but also implement strategic health and wellbeing plans with the sole intention of protecting their workforce and providing managers and colleagues with the knowledge and tools to deal with mental health appropriately and effectively.   

The Royal Society for Public Health (RSPH) is a strong advocate of improving the health and mental wellbeing of the population, through the creation of health champions and workplace health and wellbeing champions. Our new national Level 2 Award in Mental Wellbeing qualification, seeks to equip people with practical skills they can incorporate in their every day lives to improve and protect mental health. When people have good mental health, they can lead more fulfilling lives, can solve problems and are more productive.

For more information, on the Mental Wellbeing qualification and how it can be adapted for your organisation, please contact Gina Mohajer gmohajer@rsph.org.uk.

Useful Links:

NHS Choices Helpline

http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/mental-health-helplines.aspx

Depression in the Workplace: A report featuring new insights from business leaders

http://targetdepressiondotcom.files.wordpress.com/2014/04/target-report_final.pdf

Mental Health Foundation

http://www.mentalhealth.org.uk/

Photo by Sina Bahrami

Suicide rates – a Public Health issue

On the 18^th February, the Office for National Statistics (ONS) published a report on suicide rates in the UK for 2012. The report highlighted that although the overall rates for people committing suicide had dropped since 1981, they had actually risen over the last five years. The report also identified the growing concern of high suicide rates for men compared with women for the same period.

The ONS Key Findings

• In 2012, there were 5,981 suicides in people aged 15 and over in the UK – of which 4,590 were males and 1,391 were females 
• In 1981 there 6,595 recorded suicide rates of which 4,129 were male and 2,466 were female
• The highest suicide rate was among men aged between 40 and 44 (25.0 deaths per 100,000 population) and the lowest rate was among men aged 15 to 19 at 6.4 deaths per 100,000 population
• In 2012 in England, the suicide rate was highest in the North West at 12.4 deaths per 100,000 population and lowest in London at 8.7 per 100,000 population

In 2012, the male suicide rate was more than three times the rate for females

The difference between men and women, socio-economic affects

The high suicide rate is undoubtedly a huge cause for concern despite the fact they have fallen over the past thirty years. However, it is the disparity between the rates of men and women that needs to be considered. With males three times more likely to commit suicide than their female counterparts, one needs to question why?

A recent report published by the Samaritans “Men, Suicide and Society” suggested that social and cultural changes, (rising female employment, increases in solo living), could be having significant impacts on the lives of men who are now in mid-life. In addition, the report made clear that men from low socio-economic backgrounds are also particularly at risk of committing suicide. This may be attributed to the arguments that people who live in disadvantaged communities, may have fewer prospects, less support networks leading to feelings of isolation, are more likely to be unemployed – augmenting feelings of low self worth and feeling they have nothing to live for. As a result they are more likely to engage in high health risk behaviour (smoke, drink, take drugs) as a form of escapism/way to deal with their stress.  

Nonetheless, women and young people are not immune to these problems described above. The evidence clearly states that people who live is in poorer communities, are more likely to experience greater physical and mental health problems, are more likely to do less exercise and have poorer diets – both of which have been indentified as improving ones overall wellbeing.   

 As with men, suicide is the leading cause of death among women aged between 20 and 34 years of age

The ONS report states that that people with mental illness have a higher suicide risk than the general population. Therefore, we need to help improve, protect and support people who are at risk of developing mental problems, as  well as targeting the younger population to build mental resilience. 

What is to be done?

In September 2012 the Department of Health launched ‘Preventing Suicide in England’ which sought to reduce suicide rates and improve those affected by suicide. The new strategy outlines six areas for action including: reducing the risk of suicide in key high-risk groups (for example, people in the care of mental health services, people with a history of self-harm, people in contact with the criminal justice system, and men aged under 50) and reducing access to the means of suicide.

It is also essential that the government looks deeply at the root causes that can lead to poor mental health, such as, economic deprivation, isolation, community disengagement, as well as supporting individuals and communities to partake in activities that are recognised as improving mental wellbeing – this could help reduce suicide rates. 

The Royal Society for Public Health (RSPH) is passionate about supporting the public's health and advocates that increased health awareness, community engagement and training individuals can help eliminate many of the problems highlighted throughout this Blog. A clear example is our Well London Training Communities programme, information can be found here and here, which aims to equip volunteers living in hard to reach communities to increase wellbeing knowledge, confidence and skills to bring about positive lifestyle changes.

The RSPH has also developed a Level 2 Award in Mental Wellbeing qualification, which aims to provide evidence based, practical skills on how to improve and maintain good mental wellbeing. When we are positive and happier, we are more likely to feel we can tackle everyday issues and face what life throws at us.

For information on this training please contact Gina Mohajer gmohajer@rsph.org.uk.       

Suicide is the leading cause of death in England and Wales for men aged between 20 and 49 years

Support for people who have suicidal thoughts

The NHS Health Choices website provides helpful information for people who are considering taking their lives. If you have thoughts about taking your own life, it's important you ask someone for help.

·         speak to a friend, family member or someone you trust as they may be able to help you calm down and find some breathing space

·         call the Samaritans 24-hour support service on 08457 90 90 90

·         go to, or call, your nearest accident and emergency (A&E) department and tell the staff how you are feeling

·         contact NHS 111

·         make an urgent appointment to see your GP

Visit the NHS Health Choices website here

The Vicious Cycle Between Poor Mental Health and Unemployment

A recent report by the BBC titled “mentally ill people hit hard by recession” argued that between 2006 and 2010 unemployment rates for people with mental health problems rose significantly.

The news item was reporting on a research study which sought to discover whether people with mental ill health are more likely to be discriminated against both in the job market and in society.  

The study which was carried out by researchers from King’s College London, the London School of Economics and Political Science, and John Hopkins Bloomberg School of Public Health, looked at data on the rates of employment and mental health problems from 27 EU countries.

The researchers focused on data derived from 2006 (prior to the 2008 economic crisis) and 2010. From both years, a consistent pattern emerged that people with mental health problems were more likely to be unemployed. Interestingly however, the study found that by 2010 the gap in unemployment rates between people with and without mental health problems had increased.

The researchers proposed that people with a mental health condition suffered more by the economic recession of 2008, and will have been more vulnerable to discrimination and unemployment. Download the published report in the peer-reviewed open access medical journal PLOS One.

Taking a deeper look

The researchers used data from two surveys: The Eurobarometer Mental Wellbeing 2006 and the Eurobarometer Mental Health 2010 survey. 30,000 citizens from 27 EU countries took part in the survey and information was collected through face to face interview.

From the 2006 and 2010 surveys it was found that compared with the general population people with mental health problems were:

1.     More likely to be female

2.     Significantly older

3.     More likely to have finished education before 20 years of age or had no formal education

4.     More likely to be unemployed/retired and unable to work

5.     Less likely to be in paid employment

The study also revealed that although females were more likely to have a mental health problem, males were more likely than females to be unemployed. In 2010 22% of men with mental health problems were unemployed compared with 14% in 2006. For women these were 17% and 12% respectively.

Interestingly, the researchers also found that in 2010 (but not in 2006) people with mental health problems were more likely to be unemployed if they lived in countries where the majority of people agreed with the statement “people with mental health problems are a danger to others”.

The (vicious) cycle

People with mental health problems are less likely to be in employment. This can however perpetuate their condition by causing them to become further isolated and anxious about their financial circumstance.

During periods of economic hardship, this may become more apparent as people with mental health problems may be more susceptible to losing their job and are unable to find a new one in a competitive labour market.

Beth Murphy, head of information at mental health charity Mind, said the findings were worrying “Losing your job is a sudden change and there can also be financial implications through loss of income, which in itself can cause anxiety”

“Specifically redundancy is known to trigger depression and suicidal thoughts”.

Conclusion:

Undeniably, the research paints a very bleak picture of the reality of people who have poor mental health. Not only do they have to live with and tackle their own mental health condition, but their problems are further heightened by the fact that they are more likely to loose their job or be unemployed.

What we have to remember is that no one is exempt from experiencing a mental health problem - it can happen to anyone of us. Statistics reveal that at least one in four people will experience a mental health problem at some point in their life, therefore, it is essential that a) society does not stigmatise/discriminate against people with mental health conditions and b) that we learn techniques on how to protect ourselves and improve our mental health and wellbeing. 

It is imperative that Governments, Local Authorities and communities ensure that they promote social participation of individuals with mental health problems (particularly during recessions) and that efforts are made to target the most vulnerable people in society. Evidence reveals that participation in meaningful activity is associated with improved self esteem and good mental health. Having strong social relationships/networks can reduce isolation and help to improve mental health and recovery as well as preventing mental health problems.

We know that improved mental health and wellbeing is associated with a range of better outcomes, from physical health to higher education achievement. Thus in a strategic attempt to improve the whole population’s mental health and wellbeing the Five Ways to Wellbeing has been developed by nef (new economics foundation) which is a set of evidence based public health messages that can be utilised by everyone.

For more information on how you can get trained to improve and protect your mental health and the community you serve click here.

Let us know what simple things you do to help improve your mental health and wellbeing?

Men's Health Week 2013: breaking the mental health stigma  

This year Men’s Health Week, led by the Men’s Health Forum, aims to tackle the stigma attached to men’s mental health and encourage more men to seek professional help.

It is understood that although equivalent numbers of men and women suffer from mental ill health, men are far less likely to receive diagnosis and treatment, because of their reluctance/hesitance to seek professional health advice.  Statistics from the Men’s Health Forum highlighted that in the UK, three in four suicides are committed by men and that around 4,500 men kill themselves each year.

The distressing truth is that men are not as comfortable talking about their feelings and are even more ashamed to admit that they may be feeling depressed/stressed/anxious, in fear that they will appear weak amongst their peers. As a result, men often suffer alone or indulge in high risk behaviour such as drinking and drugs as a coping mechanism, which can be equally as detrimental to their health.

Martin Tod, CEO of the Men’s Health Forum said; “If all men could talk about how they were feeling with confidence, I don’t think we’d be looking at horrific figures like these. Whatever the problem, your GP has heard it before. Don’t bottle it up”.

Shirley Cramer CBE, Chief Executive RSPH, says “the messages being raised in Men’s Health Week are vital, mental health is too often seen as a taboo subject especially amongst men. Good mental health is more than just the absence of mental illness and in addition to preventing and treating mental illness we should be actively promoting positive mental health. A key aspect of this is individuals feeling they can discuss their feelings and can ask for help.”

At the RSPH we strongly advocate the importance of maintaining good mental health. In our Mental Health report, we outlined the many harmful affects that poor mental health can have on the individual, on their family and society as a whole. In order to understand the importance of good mental health and ways this can be achieved, we have developed a new qualification in Understanding Mental Health and Wellbeing Level 2 Award. The interactive training day promotes the positive impacts of good mental health, as well as providing practical skills and knowledge of the measures that can be taken to prevent and protect against mental ill health. For more information on our training programme, click here or contact Gina Mohajer gmohajer@rsph.org.uk.  

For more information on men's health week see the Men’s Health Forum and to view the statistics on men’s mental health click here.  

Can a stressful job be harmful to our health?

A certain amount of stress/pressure can “supposedly” be beneficial to us, by making us more productive. However, too much stress over a long period of time can have negative impacts on our health. A recent study from Spain sought to examine what these negative effects were and to what extent could stress increase the risk of developing cardiovascular diseases and coronary heart problems. 

The research was carried out by the insurance company Ibermutuamur, and two universities in Spain and the findings were published in the peer reviewed Scandinavian Journal of Public Health.

The purpose of the study was to determine whether a correlation exists between stress (from work) and abnormal levels of fat (lipids) in the blood. Worryingly, high levels of bad cholesterol known as LDL cholesterol – caused by fat in the blood - can block arteries which in turn may lead to coronary heart disease and other cardiovascular diseases.

Just over 90,000 people took part in the study which was conducted through questionnaires. Participants were asked questions relating to how they felt they coped in their job: “During the last year, have you frequently felt that you cannot cope with your usual job?". Participants who answered "yes" were considered to have job stress.

The questionnaire also included eleven questions relating to anxiety and depression symptoms, such as "Have you felt keyed up, on edge?" and "Have you had difficulty relaxing?” The researchers took fasting blood samples from participants measuring levels of total cholesterol, and then examined whether abnormal lipid levels were linked to job stress. The study did take into account age, sex, smoking, obesity, alcohol consumption and also type of job (blue or white collar occupation).

Results

Around 8,000 (9%) of participants are reported to have job stress; in addition these individuals also reported higher levels of anxiety and depression symptoms, and were found to have a 10% increase in abnormal lipid levels and higher levels of LDL cholesterol, than those who did not consider their job stressful.

Although these findings have been regarded as generally strong in understanding the relationship between stress and bad cholesterol, what the study did not take into account is that, individuals who suffer from stress or poor mental health, may indulge in high risk behaviour as a coping mechanism. This could increase their risk of developing higher levels of “bad” cholesterol as they may be more accustomed to unhealthier diets and/or consume higher levels of alcohol. Therefore, rather than the stress itself, these other “risky behaviours” may play a fundamental role in causing peoples “bad” cholesterol to rise.

Nonetheless, what this research highlights is that stress (too much of it) and poor mental health is detrimental for our wellbeing and for society as a whole. Whether it causes our cholesterol to rise or whether it causes us to indulge in health risk behaviour – the message remains clear that improving ones mental health should be paramount in order to tackle many of the other health related problems that exist in today’s society.

What can you do?

The RSPH believe that we all have a responsibility to ourselves and to others, to help prevent, protect and promote good mental health practices. As such a one day programme on Mental Health and Wellbeing has been developed, to provide people with practical skills and knowledge to understand the measures they can take to improve not only their own mental health, but also help the wider community. Click here to download the report on Mental Health in the New Public Health System and click here to find out more about our programme.   

Combating the myth that creativity 

is linked with mental illness!

The belief that creative people are more likely to suffer from mental illness, is an ancient notion that has transcended through the years and has long been part of our popular culture. The tortured artist or the visionary genius who succumbs to his/her own personal demons, is an image that is perhaps a little too familiar.   However, how legitimate is this concept ? Are creative people really prone to increased mental health issues? Or is being “creative” actually the coping mechanism to improve mental health?

Reverse the stigma

Previous studies, namely recognised as being poor and often subject to bias, have shown a link between creativity and mental illness. This could be a result of artists and writers who kill themselves often becoming high profile news items, and hence distorting the truth.  Artists and writers who live contented and well-balanced lifestyles are likely to attract less attention.

The study

Researchers from Gothenburg University and Uppsaala University in Sweden, sought to distinguish the association between creativity and mental disorder and whether in fact a correlation existed. The study used Swedish health records to identify more than a million people diagnosed with various mental illnesses. They compared the incidence of creative occupations among people with mental illness  against a matched sample of “healthy” people.

The study identified that people in creative professions were significantly less likely than people in other professions, to be diagnosed with schizophrenia, schizoaffective disorder, depression, anxiety disorders, alcohol abuse, drug abuse, ADHD or to have committed suicide.  The only exception to this was writers.  It was found that people who wrote for a living were twice as likely to suffer from schizophrenia and bipolar disorder and more likely to experience depression and anxiety disorder.

The study was however unable to identify how or why, people with certain creative talents or dispositions would be more likely to experience mental health problems.  For example, does being a writer lead to psychiatric problems? Or, do mental health suffers turn to creative pursuits in order to express themselves?

Arts/Culture as a way to improve mental health

Over the past few decades, research has emerged around the positive impact that arts/culture can have on health, particularly mental health. One such cohort study by a Norwegian researcher, Koenraad Cuypers, performed statistical analysis on the health data of 50,797 Norwegians, as part of the Nord-Trodelag Health Study. The evidence derived from the study showed that participation in cultural/creative activities were significantly associated with good health, good satisfaction with life, low anxiety and depression.  Further information on arts and health studies can be found at The Arts Research Monitor by clicking here http://www.artsresearchmonitor.com/articles.php?catUID=6 

  

In the UK, health professionals and creative artists have worked together for over 25 years using the arts to support healthcare and health promotion. Thus, the importance of arts as a way of improving health must not be underestimated. Whether you are watching a concert, visiting an art gallery, painting, singing, dancing or reading – these creative activities have been recognised as effective ways to decrease stress, create community cohesion and improve social interaction as well as providing a sense of relief from everyday life.

Dr. James Aw, Medical Director of the Medcan Clinic Toronto stated that; “Hobbies and interests outside of work are important for health. New experiences and expanding social networks through art and culture is one piece of the armamentarium in achieving optimal health and living well.”

Early 2013 the RSPH will be holding a new programme, "New Horizons," to address an emerging and widening interest in how the arts can positively impact health and wellbeing.  For further information or to register your interest please contact Gina Mohajer.

To conclude

From the Swedish study, although cause and effect was not ascertained, it nevertheless, highlighted the importance of good mental health and ensuring that those who suffer from mental disorders have the appropriate support and information available to them.    

The RSPH has been involved in promoting the benefits of mental health and demonstrating how this can be achieved. Good mental health is integral for all parts of life, not only for the individual but also for the affects it has on family, relationships, work and society as a whole. Thus, it is imperative for mental health to remain at the top of National and Local Government agenda and policy.

To read RSPH full report on Mental Health please click here.

Why talking is good for our well-being

I'm sure we are all familiar with the expression “a problem shared is a problem halved”.  Now recent research affirms that communicating our thoughts and experiences to others, actually stimulates cognitive and neural mechanisms associated with reward and hence makes us feel better.   

The study, “Disclosing information about the self is intrinsically rewarding” was carried out by Harvard neuroscientist Diana Tamir and Harvard colleague Jason Mitchell and focused primarily on brain functionality associated with talking about oneself.  The evidence demonstrated that self disclosure was strongly linked with increased activation in brain regions that form what is known as the mesolimbic dopamine system. 

This system is recognised as the pathway in which dopamine is carried from one area of the brain to another and is responsible for controlling the brain’s pleasure and reward centers.  It is also associated with the functions of movement, preservation and compulsion. 

An MRI scanner was used to monitor the subjects’ brain by picking up changes in neurons activity as well as blood flow.  As a result, the scientists were able to distinguish the part of the brain that was responding to what the subject was talking about.  The experiment found that when people talked about themselves, which included beliefs and opinions, blood flow to region became significantly prominent. 

The study highlights that humans have a tendency to convey information about personal experience, because of the intrinsic value associated with self disclosure.  Whenever we face a problem, sometimes sharing our concerns or just simply relaying a fond memory to someone, can make us feel better and hence have a positive impact on our mental well-being and health.  Moreover, Tamir points out that by openly discussing our beliefs and opinions with others, has the added value of building social bonds and social alliances between people.

Perhaps we shouldn't underestimate the power of a conversation and the benefits of simply taking the time to listen and talk to someone.