This guide recognises the World Health Organization’s approach that good mental health is much more than the absence of a diagnosed condition:
Mental health is defined as a state of well-being in which every individual realizes his or her 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.’ 1
1.1 A working life approach to mental health in the APS
Mental health is an important issue for the Australian Public Service (APS). The workplace has a significant influence on people’s health and well-being. Creating the right work environment and managing potential sources of harm (such as high work demands, low levels of control and poor support), will benefit everyone at work. Improving mental health through work will help us to realise the health benefits of work. It underpins the drive towards greater productivity and social inclusion.
We will all be affected at some stage of our lives by mental ill health—either personally, or in our families or our workplaces. There will be people in our workplaces who are managing common mental health conditions such as anxiety or depression. We need to overcome stigma, prevent marginalisation and provide flexibility to overcome barriers to making a full contribution in work.
It can be challenging for managers to understand mental health conditions, how mental ill health can affect an employee, and how to respond. On top of this, managers need to be aware of the legislative framework relevant to managing mental health, including the Work Health and Safety Act 2011.
Health status can change over time and managers need to recognise and respond to warning signs of ill health so that employees are assisted to find the right help and support. When an employee is off work due to ill health, managers have a critical role in providing suitable work arrangements and support to enable a constructive return to work.
That is why information in this guide takes a holistic approach to the employment life-cycle and provides practical assistance and links to trusted resources. It will help managers understand how they can create a healthy workplace and support those who may be experiencing mental ill health at work.
Work is the most effective means to improve the well-being of individuals, their families and communities…’
Professor Sir Mansel Aylward2
1.2 How to use this guide
The aim of this guide is to summarise good practice and provide practical information and advice regarding psychological health and well-being in the workplace. Mental health is a complex area—things are rarely black and white—so it is important to interpret the advice in this guide according to the needs of the specific situation.
The guide is organised around four principles, endorsed by the APS Diversity Council, which describe the commitment of the APS to best practice for mental health and well-being.
1. People management: Supervisors and managers understand how to recognise and manage potential mental health issues, especially as they relate to performance management.
Supportive, responsive and inspiring managers who understand their employees and teams make an enormous difference to the mental health of their employees. People management practices throughout the employment life-cycle (from recruitment through to separation) help to create engaged, high performing teams that support employees’ mental health and well-being.
Effective leaders know the value of committing to their people and integrating health and safety and well-being into everyday business. Leaders need to give high priority to prevention, early intervention and embracing the health benefits of work. Senior leaders set the ‘tone at the top’ and tackle the challenges to a life in work for those with mental health conditions.
‘I think it’s important that leaders at all levels of organisations see this as fundamentally part of their job. Not just about keeping your workplace safe, you know, stopping that spinning blade or that hole in the floor—looking at what the mental health environment is that people are working in, in the workplace, looks like. And, I suppose, walking the walk.’
Kate Carnell, CEO beyondblue3
2. Prevention: Workplaces foster a culture that promotes the health benefits of work, psychological health and well-being and minimises the development of mental ill health.
Management actions can help to create workplaces that are good for mental health and well-being and prevent harm to mental health caused by job-related stress, poor work design and management practices. Workplace conditions, which include good quality jobs, are strongly related to engagement and emotional health and well-being, and reduce the negative consequences of disengagement, ill health and sickness absence.4
3. Early recognition and support: Processes are in place to recognise and manage risks to psychological health when they arise, tailored to the specific needs of the workplace, and managers proactively manage workplace behavioural issues.
Recognising when someone may be unwell and offering support and assistance can help employees to manage work demands. Early intervention may prevent the employee from becoming ill, taking long-term sick leave or from needing to submit a workers’ compensation claim. Early intervention also benefits the team as it helps to maintain optimum team cohesion and functioning.
4. Rehabilitation and return to work: When mental health issues are identified, pathways and processes are in place to ensure easy access to effective care and rehabilitation.
Too many employees leave the labour market unnecessarily due to ill health. This can affect the individual’s well-being, their family, their friends and the community. The workplace culture and systems of work are critical to supporting employees with mental health conditions—helping them to stay at work, or return to work quickly, and participate in meaningful and productive duties.
This guide contains:
- Information sheets: the guide provides stand-alone information sheets on key topics to help managers when it is needed. The topics for these information sheets were identified from a survey of agencies by the Australian Public Service Commission in early 2012.
- Employee life-cycle: Appendix A to this guide depicts the typical employment life-cycle of an APS employee and provides links to information relevant to the management of employees with mental health conditions.
- Glossary: Appendix B contains a glossary of terms to help managers understand important common aspects of mental health and disorders. ‘Mental health condition’ is used as a broad term to describe a range of mental ill health circumstances, from relatively mild symptoms to severe mental disorders, which may or may not affect how a person does their job. Mental illness is a disturbance of mood or thought that can affect behaviour and distress the person or those around them. Mental health conditions include common problems such as anxiety and depression, as well as less common disorders such as bipolar disorder and schizophrenia. Some people may experience severe and disabling symptoms as a result of a long-term condition, and may seek to identify as a ‘person with disability’.
- Resources: a list of resources can be found in the ‘useful tools’ section in the information sheets. For those wishing to explore a particular area in more depth, many resources are available and most are free to download from the internet—see Appendix C.
1.3 The case for investing in mental health and well-being
‘Australians need flexible and supportive workplaces, where employment discrimination on the basis of mental health is eliminated and employers and employees are provided with support so that the potential of the individual and the business are maximised.’.5
The APS needs a healthy, engaged workforce to ensure it can meet the challenges faced by a modern public service. Increasing demands for improved services for citizens and for greater efficiency in agencies can put pressure on managers and employees alike to ensure that productivity and performance remain high.
People are also working to an older age, and the way work gets done is changing—people are working from home, in new industries and with new technologies. We see changing expectations of work, flexibility, reward and engagement. We need to find ways to promote psychological health and well-being in this context.
Participation in ‘good work’ will drive health and productivity improvements. Recent Australian evidence shows that we have to get this right.6 A poorly designed or poor quality job, where people feel insecure, overloaded or do not have much control over how they manage their work, will not deliver these benefits and can be more harmful to health than having no job at all.
Mental illness is the single largest cause of disability in Australia. Mental disorders account for 13.3% of Australia’s total burden of disease and injury and are estimated to cost the Australian economy $20 billion annually in lost productivity and labour participation.7
Fostering a positive work environment that promotes mental health and well-being is fundamental to building organisational health and makes good business sense.8 The research is clear that workplaces that protect employee health and provide flexibility to take account of an employee’s health status are among the most successful over time.9 Long term sickness absence or resulting unemployment on the other hand, can have a negative impact on health and wellbeing. Good work is an effective means to improve the wellbeing of workers, their families and communities.
Creating mentally healthy workplaces delivers improved productivity, improves workforce participation and increases social inclusion. It is the core people management environment that is crucial here. Fostering more supportive, positive and engaging team environments increases resilience, enhances positive early intervention outcomes, and reduces the impact on individuals’ mental health.
The benefits go beyond simply reducing the costs associated with negative outcomes (e.g., absenteeism, mental health disorders, and psychological injury compensation claims). Organisational practices that improve employee psychological health and well-being (and reduce the incidence and duration of mental health symptoms) also result in improved performance for people with or without a mental health condition.
Promoting health and preventing harm to mental health and well-being is important because:
- It’s the right thing to do—leaders and managers have a social and corporate responsibility.
- It’s the law—leaders and workplaces are legally required to prevent harm to health and safety10, and not to discriminate in employment on the basis of mental health.11
- It’s the smart thing to do—promoting mental health and preventing harm makes good business sense for a high performing APS.12
Some of the evidence from recent research findings is summarised below:
- Organisations with strong organisational health (i.e., investment in quality people management) typically exhibit better service delivery performance.13
- Organisational health is associated with stronger financial performance, typically 2.2 times above average.14
- Approximately 30% of the variation in service delivery outcomes at a team level is attributable to organisational climate, specifically, the quality of supportive leadership and people management practices.15
- 70% of failed organisational change programs are attributable to poor organisational health.16
- Just under 7% of employees in any organisation will develop clinically significant depressive symptoms in any one year.17
- On average, every full-time employee with untreated depression costs an organisation $9,665 per year.18
- Implementing effective early intervention programs results in a five-fold return on investment, due to increased employee productivity.19
- Supportive leadership and sound people management can reduce frequency and costs of workers’ compensation premium rates. This impact extends beyond psychological injury claims. National research indicates that workplace psychosocial factors can contribute up to 59% of the risk for the onset of musculoskeletal injuries in the workplace.20
- Ensuring people with mental health conditions are able to keep their job will boost productivity and support social inclusion.21
- Removing obstacles to keeping employees at work, and minimising time off work, is associated with better long term mental health and well-being outcomes.22
- Early intervention—specifically, early identification and facilitating access to quality mental health care—is associated with a 492% return on investment (calculated by comparing early intervention and treatment costs with subsequent reduction in absenteeism and improvement in work performance).23
One additional point to emphasise is that there is overwhelming evidence that work is generally good for mental health and well-being.24 Employees spend a considerable amount of time at work, so the workplace can be used to help change the health of Australians. Using the workplace to drive important behavioural changes, we can head off problems and intervene early. To realise these health gains and to improve the work retention of people with injury, illness or disability, we need to promote the positive links between work and health. The APS needs to strengthen workplace retention policies to ensure employees with mental health conditions are able to keep their job and continue to be productive in their work.25
3 Carnell K 2012. Presentation to Comcare National Conference, Sydney, 19-21 September.
5 National Mental Health Commission 2012, A contributing life: the 2012 National Report Card on Mental Health and Suicide Prevention, Sydney, NMHC, p. 106.
6 Leach, LS, Butterworth, P, Strazdins, L, Rodgers, B, Broom, D & Olesen, S 2010, ‘The limitations of employment as a tool for social inclusion’, BMC Public Health, vol. 10, p. 621.
7 Australian Institute of Health and Welfare 2007, The burden of disease and injury in Australia, 2003, PHE 82, AIHW, Canberra, p. 61; Australian Bureau of Statistics 2009, Australian Social Trends: March 2009, cat. no. 4102.0, ABS, Canberra, p. 13.
10 Work Health and Safety Act 2011.
11 Disability Discrimination Act 1992.
13 Keller, S & Price, C 2011, Beyond Performance, Wiley, New Jersey, p. 6.
14 ibid, p. 22.
15 Cotton, P & Hart, PM 2012, The impact of the psychosocial quality of work on wellbeing and performance, manuscript submitted for publication.
16 Keller & Price, op cit., p. 22.
17 Hilton, M 2004, ‘Assessing the financial return on investment of good management strategies and the WORC Project’, research paper, University of Queensland, p. 4, viewed 4 April 2013.
18 ibid, p. 7.
19 ibid, p. 8.
20 Hauke, A, Flintrop, J, Brun, E, & Rugulies, R 2011, ‘The impact of work-related psychosocial stressors on the onset of musculoskeletal disorders in specific body regions: A review and meta-analysis of 54 longitudinal studies’, Work and Stress: An International Journal of Work, Health & Organisations, vol. 25, no. 3, 243-256.
21 Organisation for Economic Co-operation and Development 2012, Sick on the Job? Myths and realities about mental health and work, OECD Publishing, Geneva, pp. 36, 40.
22 Rueda, S, Chambers, L, Wilson, M, Mustard, C, Rourke, SB, Bayoumi, A, Raboud, J, & Lavis, J 2012, ‘Association of returning to work with better health in working age adults: A systematic review’, American Journal of Public Health, vol. 102, no. 3, pp. 541-556.
23 Whiteford, HA, Sheridan, J, Cleary, CM, & Hilton, MF 2005, ‘The work outcomes research cost-benefit (WORC) project: The return on investment for facilitating help seeking behaviour’, Australian and New Zealand Journal of Psychiatry, vol. 39 (Suppl.2), no. A37.