A guide for employers.

To promote mental health

in the workplace.

www.enwhp.org
 Colofon brochure work in tune with life
A guide to promoting mental health in the workplace

Published by:
TNO
P.O. Box 718 / 2130 AS Hoofddorp/ The Netherlands
T. 088 866 6100
www.tno.nl

Authors:
Lee Knifton, Verona Watson (Mental Health Foundation, Scotland)
Rob Gründemann, Anja Dijkman, Heleen den Besten, Kristin ten Have (TNO)

Editor: Arborignals, Amsterdam

Graphic design: Meesters Ontwerpers, Amsterdam

Full descriptions of all Workplace Mental health Good practices are available at www.enwhp.org

March, 2011
 Table of contents

1. Introduction Page 04

2. Why is mental health important

for a successful business? Page 06

3. What employers can do to promote

mental health and prevent stress Page 08

4. What employers can do to support, retain and

employ people with mental health problems Page 12

5. How to create a mentally healthy workplace –

A plan of action in 7 steps Page 14

The Edinburgh Declaration on the Promotion of

Workplace Mental Health and Wellbeing Page 18

3
1. Introduction

Mental health is important for business. In the The World Health Organization defines positive
21st century the mental health and well-being of mental health as “a state of well-being in which every
your employees is crucial to the success of your individual realizes his or her own potential, can cope
organisation. But, how should you as an employer with the normal stresses of life, can work productively
start to address mental health issues in your and fruitfully, and is able to make a contribution to
workplace? And what activities and policies do her or his community. Employees with good mental
you need to set in place? In a European campaign health will perform better in their work.”
work. in tune with life. move europe, the European Equally, mental health problems can affect anyone,
Network for Workplace Health Promotion (ENWHP) of any age and background. However with support
has taken the initiative to help promote mental most people can and do recover. By making
health in workplaces. changes to your workplace environment, and
offering support to employees, you can reduce the
This mental health promotion campaign aims to duration and severity of mental health issues and
raise awareness amongst both employers and enhance recovery.
employees. This resource is written for employers and
managers. It offers practical advice on managing
This guide explains why and how to: and supporting people who are experiencing stress,
• promote positive mental health in the workplace distress and mental health problems. It is designed
• understand and prevent issues that cause to be used as a source of practical help alongside
stress and mental health problems the work. in tune with life. move europe campaign
• support employees who develop mental health tools and the accompanying website: www.enwhp.
problems org. Here we also provide advice and information
• develop effective policies to reintegrate and for employees and how to assess the costs relating
employ people who have experienced mental to mental health in your company.
health problems.

4
 Introduction | 1

Comprehensive resource packs

• S
 cottish Centre for Healthy Working Lives,
www.healthyworkinglives.com or call 0800
0192211. They have an excellent guide to
develop a workplace policy www.healthywor-
kinglives.com/uploads/documents/8524-47679_
MENTALHEALTH.pdf and can guide you to
relevant training courses such as Mentally
Healthy Workplace and Mental Health First Aid
• www.tacklementalhealth.org.uk - Shaw Trust
resource “Managing mental health at work”
• www.mindfulemployer.net - Resources by
employers, for employers.
• www.mentalhealth.org.uk - The Mental Health
Foundation have a wealth of downloadable
research, publications and resources about
workplace mental health promotion, prevention
and support.
• www.shift.org.uk/employers - Shift are a De-
partment of Health Initiative that have a range
of line manager tools and guides
• www.bhf.org.uk – The British Heart Foundation
within its Think Fit! Think Well! publications of-
fers both a comprehensive guide to developing
a workplace mental wellbeing programme and
a simple guide to mental wellbeing for employ-
ees
• www.beyondblue.org.au – beyondblue is an
initiative of the Australian State and Territory
Governments with the key goals of raising
awareness about depression and reducing
stigma associated with the illness. It offers a
wide range of information and resources for
practitioners and experts.

5
2. “Why is mental health important for a
successful business?”
There are many reasons why employers should workplace a healthy workplace; physical, mental
make mental health promotion in the workplace and social!
a priority. The mental health of employees is an
important health determinant. In today‘s global Facts and figures of the impact of mental
economy it is an important driver for successful health in workplaces
business. More and more companies realise that • 25 percent of European citizens will experience
the commitment of employees is crucial for the a mental health problem during their life time
success of the organisation.
• 27 percent of the adult population in Europe is
affected by mental health problems, that is 93
The costs of work related mental ill health
million people
The economic business case for mental health is
compelling. For example in the UK, studies show • The World Health Organization estimates that
that common mental health problems such as stress, by 2020 depression will become the second
anxiety and depression account for 60 million lost most important cause of disability in the
working days each year. The cost to the employer world
through loss of productivity due to mental problems • Total costs of mental health disorders in
is higher than that caused by most other health Europe are estimated to be 240 billion Euro per
problems and much higher than in working days year. Direct costs such as medical treatment
lost to industrial disputes for example. Mental health account for less than half of this sum. The
promotion can reduce the costs of absenteeism and larger amount of 136 billion Euro is due to lost
associated management time. productivity including sick leave absenteeism
• Across Europe the levels of absenteeism,
In recent decades the increasingly global nature unemployment and long term disability claims
of our economies, and the advances in workplace due to work related stress and mental health
technology, mean that the nature of work is changing problems have been increasing. For example:
rapidly. This affects the content, organisation and Around 10 percent of long-term health
intensity of people‘s work, which increasingly problems and disabilities can be ascribed to
requires more skills and competences in terms of mental and emotional disorders
innovation, communication and social intelligence.
• There are 58.000 suicides per year in EU. In
These rapid changes in the nature of work can be
comparison: 50.700 deaths are caused by
rewarding for employees, however, they can mean
traffic accidents.
that employees may experience more pressure
and demands upon their cognitive, social and
psychological skills. Mental health is crucial: both Productivity and performance
for the formation of these skills and their effective Mental health promotion can also boost productivity
use in the workplace. and performance. A good working environment
can help to increase morale, teamwork and
However, across European countries and communication. Staff turnover is lower and so are
workplaces, poor mental health is significant and the associated costs of recruitment and training.
increasing. The workplace can provide a healthy A healthy workplace can help people to cope
culture and environment that is psychologically with change and difficult circumstances, which
supportive to the workforce. It is a challenge to is particularly important in challenging economic
employers as well as to employees to make the conditions.
6
 “Why is mental health important for a successful business?” | 2

Reputation Legal requirements and insurance

By developing mental health promotion programmes requirements
and policies, you can enhance the public reputation Last but not least there are laws to be considered
of your organisation. This can improve your business governing workplace stress and mental health,
reputation amongst potential future recruits, and such as the EU Framework Directive on Health and
it may increase your chances of gaining public Safety at Work of 1989. However, they do vary in
contracts. It can also improve your reputation the different countries.
amongst the wider public and customers as an
organisation that demonstrates corporate social Background and business case
responsibility. Good organisational reputation
will be associated with a healthy and stimulating • w ww.who.int/mental_health/policy/services/
workplace where personal development is part of essentialpackage1v13/en/index.html for WHO
the organization learning culture. resource with overview of mental health and
workplaces.
• www.workingforhealth.gov.uk - UK Government
Deakon, a service organisation in Austria has business case, health-check and evidence based
achieved significant results with their (mental) approaches.
health policy and workplace mental health • w ww.scmh.org.uk/pdfs/mental_health_at_
promotion activities. The attention for the motivation work.pdf - The business case developed by The
and well-being of the employees has led to a Sainsbury Centre for Mental Health
prospering enterprise and satisfied customers. The • w ww.scotland.gov.uk/Publications/2009/02/
organization has a very good image, high regards 16100540/0 - Scottish Government, It Pays to
of customers and suppliers, and appreciation of Look After Your Workforce – Employers
the local environment. They also have very low • www.enwhp.org – work. in tune with life. move
absenteeism figures. europe campaign tool: Guide to the business
case for mental health

No health without mental health

There is good evidence that poor mental health and
stress can lead to increases in a range of physical
illnesses. These include coronary heart disease,
stroke, and diabetes. This can happen directly by
mental distress affecting physiological vulnerability,
but also indirectly by increasing the dependence
upon negative lifestyle factors such as smoking
and alcohol consumption. These are major social
and workplace issues but also mean that there is a
compelling business case to act now.

The project of FCC Delegation Lleida-Tarragona

(Spain) offers an example of a structured and
pragmatic strategy to address alcohol and other
drug issues. It goes beyond reactive interventions,
considering the importance of creating a working
environment which understands the problems
associated with the use of alcohol and other drugs,
supporting the affected worker and fostering job
retention.
7
3. “What employers can do to promote
mental health and prevent stress”

The workplace can provide a mentally healthy shorter working hours and doing away with
environment that is supportive to all the workers. overtime do not automatically result in lower
A wide range of interventions can promote mental productivity. Optimising working processes
health and prevent stress and help to develop (e.g. by job enlargement, job rotation, flexi-time)
resilience amongst employees as well. Really and restructuring tasks to lessen pressure (e.g.
long-term effects can be achieved only with creating clerical jobs to relieve skilled personnel
comprehensive health promotion and prevention from administrative tasks) can motivate
strategies, developed and implemented in a employees on the long term. These measures
coordinated effort by those responsible on all serve at the same time to promote the mental
levels. The combination and coordination of various well-being of the employees.
interventions both on individual and organisational
level is essential for maintaining the mental health
of employees. IFP Energies Nouvelles (France) has built a
structured and transferable collective approach
Which of the following elements can be used to the prevention of psychosocial risks. Today,
or combined depends on specific company this approach focuses on work organisation and
requirements. management. The strategy was initially focussed
on measures for a treatment of people experiencing
Less stress on the long-term? Only with stress-related conditions.
improvements in the working conditions!
Aim: Reducing and modifying potential
sources of stress in the working environment • Increase control over own work and
empowerment
In relation to mental health problems, interventions Employees should have certain amount of
focussing solely on changing individual behaviour autonomy in organising their own work.
are not particularly effective either for employees or Professionals have agreed on this for quite
for companies. They need to be supplemented with some time. Freedom to organise their own
organisational measures addressing the potential working day and to carry out tasks under their
sources of stress in the working environment. own initiative, is an important health resource to
This is the only way to positively influence factors the employees. Setting out target agreements
relevant on an organisational level, such as work in place of detailed specifications on processes
satisfaction, motivation and productivity. Some would be a practical measure to start with.
examples of organisational interventions for
promoting mental health are shown here:
To promote mental health at work the Municipality
• Reorganise poor working processes of Zwolle (Netherlands) encourages her
n face of increasing work intensity, higher employees to take charge of their own work,
time pressure and the extra work involved, no (mental) health and employability. To support this
company can expect its employees to increase attitude the municipality offers the employees
their output. In fact, the risk of psychological training on psychological resilience.
problems increases with negative consequences
for the mental health of the employees. Contrary
to general opinion, studies have confirmed that
8
 “What employers can do to promote mental health and prevent stress” | 3

• Include employees in decision making and • Clear roles and expectations

problem solving processes It is important to be clear about what employees can
Employees should be involved in relevant expect from the organisation and what duties and
decision making processes whether by surveys tasks are expected of the employee. If employees
or in forums and workshops. This is a central feel that their employer has failed to deliver what has
prerequisite for maintaining a mentally healthy been promised it can result in reduced motivation,
workforce. commitment and performance.

• Balancing efforts and rewards • Encouraging and strengthening social support

There is also a strong correlation between an Of course social support cannot simply be regulated.
effort and reward imbalance and negative impact But what can be done is to design the organisational
on mental health. Within reason, employers conditions to encourage and strengthen a supportive
can take steps to minimise this, for example culture in the company: applying a transparent
by paying a decent wage to the lowest paid decision making and information policy built on
employees. open dialogue and trustworthy cooperation. By
providing opportunities for after work activities for
• Improving communication and feedback example or allowing extra time to help colleagues,
Creating a culture of recognition and trust the management can show that it explicitly
in the company is essential for professional encourages the staff to support one another. The
communication and cooperation. In turn, this most important factor of all is the example set by
plays an important protective role in promoting the management who should also take part in the
and maintaining the employees‘ mental health. activities themselves and use social support as a
Suitable methods to use are communication criteria in their performance appraisals.
trainings – verbal and non-verbal, internal or
external – and training courses in personnel • Further training and qualification
management techniques and staff behaviour. Continuing education and further training belongs
Employers can train their managers in supportive to every good personnel development strategy. By
leadership style. A manager should attend to providing opportunities for personal development it
employees needs, act as a mentor or coach, can at the same time hide potential for promoting
encourage creativity, motivate employees and health and character development.
communicate goals.

By careful training and education adapted to their

The mission of E.On Energy (Germany) seeks abilities the employees of Lohmann & Rauscher
to create a working environment based on open Ltd (Czech Republic) become assured of their
communication and inclusion where employees work competence and their employability. This
feel valued and respected. All the employees can empowerment greatly enhances their sense of
take part in seminars on communication skills. To wellbeing and mental health.
promote equalities internal mentoring programmes
are set up specifically to support the career
development of senior female staff.

9
3 | “What employers can do to promote mental health and prevent stress”

Managing stress: The basic element of • Making trainers out of employees

behavioural prevention. An effective element is to train employees on
Aims: Resilience to stress by learning and how to instruct their colleagues. In this way, the
practicing coping strategies suitable for “snowball effect” can be put to optimal use.
everyday use.
Relaxation as an optimal solution
Interventions aimed at increasing individual and Aims: To reduce emotional and physical
social skills for managing stress situations are tension in stress situations, encourage
effective. This has been substantiated in a whole self-regulation in dealing with stress
range of studies. They reduce absenteeism and
stress related disorders and at the same time Relaxation techniques are another good preven¬tion
improve the quality of working life - both for measure. Monitored studies have shown that stress
employees free of disorders, employees at risk of symptoms can be alleviated by using techniques
mental disorders and for those already suffering! such as muscle relaxation, meditation or autogenic
Training courses showing how to cope adequately training. Relaxation techniques are easy to get
or how to avoid stress should therefore form across and need little effort or cost.
the central element of the strategy in the field
of behavioural prevention. Because the range of Alleviate anger through exercise
techniques used in training courses on the issue of Aims: To modify anger, aggression, negative
stress are as varied as the causes, here are some feelings and perceptions, banish negative
recommendations: thoughts, increase self confidence, develop
social competence through group activities
• Using cognitive-behaviour techniques
A training course should contain elements of According to specialist literature, exercise can
cognitive therapy, a form of behavioural therapy. also help reduce stress at work either in the form
Cognition encompasses attitudes, thoughts, of company sport activities, fitness or jogging
valuations and beliefs and cognitive and groups. It is therefore a good idea to include it as
behavioural related techniques can help make an element of the company prevention strategy.
people aware of them, test how they compare Physical exercise is associated with a range of
with reality, modify irrational attitudes and help positive psychological effects, e.g. a reduction in
“transfer” them to everyday life appropriately. negative feelings or an increase in self esteem
Individual coping strategies can be developed if achieved by learning to master difficult situations.
necessary. At the same time, group activities can encourage
social skills and support among colleagues.
• Apply multi-modal methodology
Training courses should use multi-modular Careful needs assessment and evaluation are
methodology, for example a combination of essential
information materials, videos, role playing or If a concept for promoting mental health and
learning with models. In this way, the training preventing stress is to be successful it must be
takes on a workshop character that is more planned accurately and in cooperation with the
effective than up-front teaching. Concerted, employees. Before commencing, a systematic
practical training of the newly learnt techniques needs analysis should be carried out, specific targets
is essential. set out and regularly updated and evaluated.

10
 “What employers can do to promote mental health and prevent stress” | 3

Promoting mental health and stress

prevention

• w ww.bbc.co.uk/headroom – Staff and

employers will also benefit from greater
awareness through information campaigns. BBC
campaign Headroom has multi-media resources
to promote mental health and well-being.
• www.mentalhealth.org.uk – Downloadable
resources such as top 10 tips for wellbeing and
podcasts
• www.stuc.org.uk – Trade Union leaflets
promoting positive mental health at work
• www.mhfestival.com – Mental health arts
festival to promote mental health in Scotland
• www.healthscotland.com/workpositive –
Work-Positive is a line management resource
to support employers to tackle sources of
stress in the workplace. This includes a range
of downloadable tools for assessment and
addressing stress in the workplace
• A number of leaflets can be downloaded from
the UK Health & Safety Executive (HSE) website
including management standards to tackling
stress including audio www.hse.gov.uk/pubns/
stresspk.htm supported by a thorough stress
management toolkit for managers www.hse.
gov.uk/stress/mcit.htm
• www.prima-ef.org – EU programme looking at
workplace stress linked to violence including
harassment, and bullying.

11
4. “What employers can do to support,
retain and employ people with mental
health problems”
Just like physical illness, mental health problems changing or reducing workload, flexible working,
can affect anyone, of any age and background. The phased return to work, flexibility to have breaks or
most common forms of mental health problems are to attend appointments.
depression and anxiety. Many of the symptoms are
similar to those that people experience when they
are under considerable pressure; sleepless nights, Raploch Urban Regeneration Company (RURC)
loss or increased appetite, fatigue, irritability, worry in Scotland is being realistic about what role
etc. When these symptoms are long lasting with managers are willing or able to take on in terms
a severe impact on everyday life functions, they of helping employees with mental health issues.
indicate the presence of a mental health problem. They should provide support when they can, but
if a manager identifies a specific problem, or the
Most people recover from their mental health member of staff raises it themselves, then it
problems. A small proportion of people, 1% or 2% of becomes an HR issue and the manager would be
the population, develop more severe and enduring better off seeking advice on what to do next rather
mental health problems, such as schizophrenia, than tackling it on their own.
bipolar disorder or severe depression, which
requires more intensive, and often continuing,
treatment and support during their lifetime. If a person‘s mental health problem requires them
However with support people can and do recover. to be absent from work, as an employer you
Offering early support can reduce the duration should ask the person what they would like their
and severity of a mental health issue and enhance colleagues to be told. This remains a sensitive area
recovery. By addressing stigma through training and many people worry about discussing this with
and campaigns you increase the chances of people colleagues when they return to work. To overcome
seeking help early. It also increases the chance of some of this difficulty, keep in contact with the
managers reacting well. In particularly stressful person in their absence as you would for someone
professions, routine counseling has proven to be with physical illness, whether short or long term,
effective in both identifying problems, but also in isolation can make it harder and more stressful to
de-stigmatising the issues. return to work. Have a policy where people can
informally visit before returning to work.
If mental health problems persist you may need
to assess risks for the person at work and any Good employers need to consider not just current
adjustments that may be needed. Remember employees, but also those people applying to join
that each person is different; see the person not the organisation who have experienced mental
the illness. Be positive and focus upon peoples‘ health problems. Employment for someone who
contribution to the organisation and their recovery. has experienced mental health problems can be
It may be useful to draw upon the specialist support beneficial for the person and for the company. It
of services such as occupational health, and for a is illegal to discriminate against applicants based
persistent mental health problem the person may upon previous or current mental health problems.
want to involve an advocate or health supports Good employers can be proactive.
outside of the workplace. Employers should try and
make reasonable adjustments where necessary.
These will vary according to the needs of the person
and the nature of the workplace but can include:
12
 “What employers can do to support, retain and employ people with mental health problems” | 4

There are a number of steps that you can take: Stigma, discrimination and recovery

• Education campaigns against stigma have been • A

 range of multi-media materials to address
developed across many European countries and mental health stigma can be obtained for the
workplaces are an important setting. Employers UK from www.time-to-change.org.uk and in
can often access a wide range of resources to Scotland from www.seemescotland.org.uk.
address stigma. • Challenge discrimination with The UK Equality
and Human Rights Commission www.
• Be clear in job adverts that you are receptive equalityhumanrights.com or The Scottish Human
to applicants that have experienced health or Rights Commission www.scottishhumanrights.
disability issues. Many people fear disclosure com.
therefore in application packs and interviews • A deeper understanding of the relationship
assure them that you will be confidential and between work and recovery can be obtained
supportive. If an applicant has had a mental through Scottish recovery Network www.
health problem that has resulted in sustained scottishrecovery.net or Voices of Experience,
absence from employment, then consider the Scottish national mental health service user
accepting a personal or health reference instead led organization www.voxscotland.org.uk
of an employer reference.

• You can also make links with your local Supporting, retaining and employing people
employment centre, or supported employment with mental health problems
agency. In many cases wide range assistance
is available to employers to support the • w ww.euse.org - European Union of supported
employment of people who have experienced employment, which has national members in
mental health problems. most EU countries.
• www.tuc.org.uk/extras/mentalhealth.pdf -
Employment advice for unions and workplaces
• www.mentalhealth.org.uk/publications - What
works for you, booklet about supporting
colleagues designed with workplaces.
• www.samh.org.uk/assets/files/273.pdf -
Working it out-a guide to managing mental;
health in the workplace by SAMH

13
5. “How to create a mental healthy work-
place - A plan of action in 7 steps

Step 1: Getting started: communication and When the mental health topic is placed on the
consultation agenda of the organization, it is particularly important
It is important to have clear leadership and to be clear about what employees can expect from
meaningful involvement in the development the organization. Be aware that all employees need
of a mental health programme. Organisational to be informed about all the steps you take in the
commitment to promoting the mental health of action plan. Employees should be involved in the
all employees is crucial regardless of their role decision making process when dealing with stress
within the organisation. Any programme should try and mental health problems. Employee involvement
to address the range of mental health issues and will lead to a sense of ownership of the programme,
provide clear definitions including: greater employee flexibility and commitment to
measures and changes. The organisation can inform
• promote positive mental health in the staff through a range of communication methods
workplace such as intranet, newsletters, team meetings and
• understand and prevent issues that cause stress training sessions.
and mental health problems
• support employees who develop mental health
problems Deutsche Post DHL summarizes the prevention of
• develop effective policies to reintegrate and mental illness in two words: Respect and Results.
employ people who have experienced mental Despite the size of the organization, all employees
health problems (about 200.000 in Germany), can be reached with
activities thanks to the excellent infrastructure.
Mental health and well-being needs to be Besides the central health steering team under the
addressed at an organisational level. All elements leadership of the Board of Management member
of the organisation have a role to play in designing, responsible for personnel, there are local health
implementing, monitoring and reviewing policies steering committees. By forming topic-specific
and practice. Ideally you should form a mental health health circles employees participate directly in
and well-being working group with representation health promotion activities.
from senior management, employees, trade unions,
human resources and occupational health.
Step 2: Gather evidence
It is important to consult with employees and
Health promotion at work is a part of the mission managers to identify strengths and weaknesses
statement of Procter and Gamble in Belgium in your organizations approach to mental health
through the Vibrant Living/Well being Program and and well-being. This is needed to inform your
this mission is endorsed in the Brussels Innovation interventions. Stress risk assessments can help to
Center. It is an integral part of the Site action plan. inform these surveys but need to be supplemented
Health promotion at work is written in a policy. The by wider information on mental health promotion,
policy consists of three pillars under the umbrella retention and employment. Ideally you should
Vibrant Living/ Well being. The three pillars are undertake a survey with employees to understand
Body (physical health), Mind (mental health) and their needs and ideas for a mental health program.
Resilience. You should also carry out an organizational workplace
assessment of policies, practices and structures
that affect mental health and wellbeing:
14
 How to create a mentally healthy workplace – A plan of action in 7 steps | 5

• Employee survey: A survey or consultation Individual level:

carried out with the employees to find out how • Changes in a person‘s usual behaviour
mental well-being and workplace stress factors • Poor performance
can be improved and how they perceive the • Changes in emotional mood (tearfulness)
working and employment conditions for those • Problems with colleagues
experiencing mental health problems. This can • Increased sickness absence including frequent
be planned together with the employees and short spells
promoted widely to get a good response and
to give better support to the findings. If the The earlier you notice that an employee is
feedback is inadequate, discussion groups can experiencing mental health problems, the better for
be organised with the staff. all concerned. Your early actions can help to prevent
the employee becoming more unwell. Particularly
• Organizational assessment: A workplace managers should play a key role in identifying and
assessment should be undertaken by senior addressing the barriers to normal working life which
management or authorized staff within the the employee might experience.
organization. This should capture relevant
organizational policies on health promotion, Step 3: Setting targets
employment and discrimination. This can be done To be able to asses the effect of your activities, the
by using a questionnaire in the resource packs we objectives and targets should be established. For
have indicated. You can also organize meetings example targets can be:
with middle managers and/or employees to • to reduce levels of stress at work on specific
discuss the current situation at work and the topics by 10% in one year
factors which lead to stress and potential mental • to decrease the sickness absence percentage
health problems (see also ENWHP Mental Health due to psychosocial reasons by 5% within two
Check at www.enwhp.org). years
• to re-integrate / employ an agreed number
employees with long-term absences or mental
In the preparation phase of the mental health health problems in 2 years
promotion project Cohesio within the oil and gas
company MOL (Hungary), a stress management You should discuss as a group what you see as
pilot programme was implemented. Several, valuable targets for a program that are wider than
scientifically sound situation analyses among this such as awareness of program, uptake of
employees were conducted (e.g. health attitude initiatives, sense of wellbeing.
examination, heart rate variability and sleep quality
examination of shift workers) which served as Step 4: Develop concrete plans and measures
a basis to inform the mental health promotion Formulate plans to meet the targets that have been
strategy and objectives. set. Try to have a blend of long-term plans for the
organization, with achievable solutions that achieve
quick wins, high impact and balance cost/benefits.
Early signs of mental health distress at an It is important to involve the employees in these
individual and organisational level processes to ensure that measures fit with their
Organisational level: needs.
• Work not finished; less productivity; more
overtime Measures should be clearly formulated and targeted.
• Lower quality of work (more errors) You can target specific groups of employees (a
• Less customer friendliness and poor services department) or the whole organization. For each
• Increased sickness absence activity consider: who is taking responsibility, what
• Poor teamwork and collaboration between is to be completed, where, when and how.
departments
15
5 | How to create a mentally healthy workplace – A plan of action in 7 steps

A wide range of initiatives have been outlined some of your planned actions, for example bullying,
in this brochure to help to inform your plans. It stress management or recruitment policies. This is
is not desirable to be too specific but we would valuable since mental health programs will have a
suggest that plans should involve the following greater chance of success if they are embedded
components: within wider policies of the organization.

Suggested Components for your mental

health and well-being work plan Like all projects designed to produce changes in
• Information and awareness campaigns organisations and individuals, the mental health
• Employee and manager training project of Alsom Field Service Switzerland has
• Anti-bullying and discrimination actions also sometimes aroused scepticism, ambivalence
• Tackling identified sources of workplace stress and indifference among their employees. In such
• Policies to support people if they develop mental difficult phases, it was and is particularly important
health problems for employees to receive a clear commitment to
• Recruitment practices that do not discriminate the project from senior management. Managers’
against people with mental health problems leading by example and commitment has thus
facilitated effective implementation of the individual
project phases.
The basic measures for managing and monitoring
psychosocial risk at Radenci Spa (Slovenia) are:
• Encouraging employees to take part in the However it is essential to have a clear written mental
decision-making process; health action plan and policy for your organisation.
• An honest and impartial management style; This allows you to see the whole range of issues
• Training and assessing managers’ communication in a single document and to plan for a co-ordinated
and interpersonal skills; response. It allows you to assess progress over
• Flexible labour arrangements; time across the range of mental health issues.
• Balancing professional and personal life,
supporting culture;
• Acknowledging employees’ good work; Step 6: Evaluate measures
• Providing a respectful and encouraging work Assess the effects of your actions and compare
environment for all employees; them with the target that has been set in the
• Carrying out regular employee-satisfaction beginning. If there are differences between the
measurements and taking action when results and the targets, determine where to apply
necessary; changes that will lead to improvement. Evaluation
• Providing employees with the information measures should relate to the clear measurable
and means they need to perform their work targets that you set such as staff absence, but
effectively; you may also want to evaluate other things. For
• Taking action in the case of excessive employee example employee awareness of the initiatives,
workloads. people’s involvement in activities, employee sense
of wellbeing.

Step 5: Implementation of actions and

measures
Commitment of both employees and management
is important for effective implementation of mental
health promotion programs. All organization levels
should be involved and communication should be
clear at all levels. When developing your plans you
may find that other existing policies may cover
16
Step 7: Consolidate mental health activities in The ProMenPol database and toolkit
policy of the company
This action planning process should be www.mentalhealthpromotion.net/ - ProMenPol, a
mainstreamed and become part of the daily routine European Commission funded project, identified
of the company. To ensure it is consistently part of and gathered useful and practical approaches to
the organization agenda, the following things can the promotion and protection of mental health. Its
be done: database and toolkit offers a structured selection
of mental health promotion tools in three settings:
• Keep on giving attention to signals of stress Schools, workplaces and older people‘s residences.
• Have regular meetings with employees to discuss At present it consists of a method of accessing the
stress and mental health problems at work and tools database using as a basis a 4 stage process
have a clear timetable for improvements for implementing mental health promotion in each
• Discuss workload and mental health in annual of the 3 settings.
performance interviews
• Involve mental health improvement plans in The stages of the implementation process are:
planning and control cycles • Preparation
• Incorporate mental health in the quality standards • Needs analysis and planning
policy of the organization • Implementation/intervention
• Encourage management to undertake relevant • Follow-up and evaluation
training and to show their interest in the mental
health of the workers The ProMenPol toolkit provides a process manual
for each of the stages of mental health promotion
implementation as well as an enhanced search
At Trinity Hotel & Conference Centre in function. These manuals (one for each setting)
Denmark the management team is responsible provide step-by-step instructions on how to
for the implementation of the health policy. The implement a mental health promotion project from
psychological work environment/mental balance is the beginning to the end.
an integral part of the annual employee performance
review, where a separate section focuses on “well-
being and cooperation”.

17
The Edinburgh Declaration on the
Promotion of Workplace Mental Health
and Wellbeing
This Declaration states the commitment of the members of the EUROPEAN Network for Workplace
Health Promotion (ENWHP) to continue to campaign for the promotion of workplace mental health and
wellbeing, and to include it as an integral and central aspect of their workplace health promotion efforts.

This Declaration calls upon European Employers, Employees, Trades Unions, Intermediaries and
Governments, to give greater emphasis to workplace mental health promotion, and to implement measures
to protect and improve mental health and wellbeing at work.

Workplace Mental Health and Wellbeing

The World Health Organisation defines positive mental health as “a state of wellbeing in which every
individual realises their own potential, can cope with the normal stresses of life, can work productively and
fruitfully, and is able to make a contribution to her or his community.” This definition is consistent with the
International Labour Organisation concept of “decent work” in relation to mental health in the workplace.
There is no health without mental health, and work is a key determinant of both.

The costs of poor mental health and wellbeing are significant for employers and for society:
• 25 percent of European citizens will experience a mental health problem during their life time – it is an
issue that will touch all of our lives directly or indirectly
•  The WHO estimates that by 2020 depression will become the second most important cause of
disability. It is already the second most important cause of disability between the ages of 15-44 years
for both sexes combined.
•  Absenteeism, unemployment and long term disability claims due to work related stress and mental
health problems are increasing in Europe - around 10% of long-term health problems are due to mental
and emotional disorders
• The costs of mental health disorders in Europe are estimated to be €240 billion per year. €136 billion
is due to lost productivity through sickness absence.

The causes of poor mental health and wellbeing are complex and multifaceted. Work and the working
environment are only part of the problem, but they are fundamental to the solution. Work makes a
significant contribution to mental health and wellbeing by providing self esteem, fulfilment, opportunities
for social interaction and a source of income.

Employers are a significant beneficiary of such measures including through improved productivity, a more
motivated workforce, reduced absence and lower staff turnover. Improving mental health and wellbeing
can therefore have a direct impact on the bottom line.

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Workplace Mental Health Promotion
The Luxembourg Declaration on Workplace Health Promotion (WHP) defines it to be “the combined efforts
of employers, employees and society to improve the health and wellbeing of people at work.” WHP “can be
achieved through a combination of improving work organisation and the working environment, promoting
active participation, and encouraging personal development.” Workplace Mental Health Promotion is an
integral part of these efforts.

Since its foundation in 1996, ENWHP has been at the leading edge of WHP efforts in Europe. There
is an increasing evidence base for what works, and ENWHP actively promotes practical approaches to
improving workplace mental health promotion. Such approaches, which need to be embedded in an overall
WHP model, include:

1.  Encouraging employers to provide meaningful and stimulating work opportunities and supportive work
organisation for their employees.
2. Providing opportunities for employee skill development including selfconfidence and social
competence.
3.  Promoting greater employee participation in decision making.
4. Recognising the key role of managers in supporting staff.
5. Creating a positive working environment and setting clear job roles and expectations.
6. Reducing sources of stress in the work environment, and developing resilience to stress by promoting
coping strategies.
7. Encouraging a culture of enterprise, participation, equity and fairness, and challenging stigma and
discrimination in the workplace.
8. Supporting, retaining and employing people with mental health problems.
9. Developing and implementing strong policies on mental health and wellbeing at work.
10. Monitoring the impact of these policies and interventions.

ENWHP Business meeting,

Edinburgh, 1 October 2011.

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 www.enwhp.org

The European Network for Workplace Health Promotion (ENWHP) was founded in 1996 by a number of
organisations in the field of public health and occupational safety and health. Today, members from 31 European
countries share the common vision “Healthy Employees in Healthy Organisations”. In ongoing cooperation
the ENWHP has developed uniform quality criteria and disseminates examples of good practice to elevate the
importance of health at the workplace. The ENWHP Secretariat and the co-ordination of the “Move Europe”
campaign is based at the BKK Bundesverband in Essen, Germany.

The campaign work. in tune with life. move europe is cofunded by the European Commission under the Public
Health Programme 2003 – 2008.