Mental Health at Workplace: Guide for using WAP

Mental Health at Workplace: Guide for using WAP 

Mental health is just like physical health: we all have it and we need to take care of it. Good mental health means being generally able to think, feel and react in the ways that you need and want to live your life. But if you go through a period of poor mental health, you might find the ways you’re frequently thinking, feeling or reacting become difficult, or even impossible, to cope with. This can feel just as bad as a physical illness, or even worse.

Mental illness is prevalent and growing worldwide. Each year only in the United States, approximately one in five adults (46.6 million) experience a mental condition, and approximately one in 25 adults (11.2 million) are affected by serious mental illness (eg, schizophrenia, bipolar disorder) that substantially interferes with major life activities. Rates of depression and anxiety have increased 15% to 20% in the last decade. More recently, the coronavirus disease 2019 (COVID-19) has led to further increases in the incidence of adverse mental health symptoms, substance use, and suicidal ideation in the population of different countries. 

A common assumption is that mental health problems are just caused by issues at home, so some employers feel it is not appropriate – or indeed their responsibility – to intervene and support staff. In fact, in most cases people’s mental health issues are a combination of problems they face at work and outside work. A survey conducted by a leading HR Organization in UK found that 54% of people reporting poor mental health said that this was due to a combination of work and non-work issues, 37% said their poor mental health was just down to personal issues outside of work, while 7% said their poor mental health was the result of work alone (CIPD). For example, someone experiencing severe anxiety due to a debt problem might find that the demands of their job, which under normal circumstances are manageable, are now beyond them. Conversely, someone who is under prolonged stress at work might find challenges in their life outside work, such as caring responsibilities, become unmanageable. This can then create a negative feedback loop which further undermines their performance and puts greater pressure on them in the workplace. It’s therefore impossible to disentangle the impact of various factors on someone’s mental health, and so it’s in employers’ interests to actively support staff with mental health issues, whatever the original cause or trigger. The benefits for the employer can be significant, as many people with even a serious mental health problem can thrive at work if they feel supported and have the right framework in place, thus reducing potential sickness absence and increasing employee engagement.

 Mental Health issues affect Employers and their Employees:

Poor work performance and absenteeism are often side effects of poor mental health, and employers can lose millions of dollars because of them. The first step a company can take to address mental health in the workplace is to assess the mental health of employees.

Poor mental health and stress can negatively affect employee:

• Job performance and productivity.
• Engagement with one’s work.
• Communication with coworkers.
• Physical capability and daily functioning.

Mental illnesses such as depression are associated with higher rates of disability and unemployment:

• Depression interferes with a person’s ability to complete physical job tasks about 20% of the time and reduces cognitive performance about 35% of the time.
• Only 57% of employees who report moderate depression and 40% of those who report severe depression receive treatment to control depression symptoms.¹²

A study shown that even after taking other health risks—like smoking and obesity—into account, employees at high risk of depression had the highest health care costs during the 3 years after an initial health risk assessment.

Types of Mental Health Problems

In a period of poor mental health, you might find the ways you’re frequently thinking, feeling or reacting become difficult, or even impossible, to cope with. This can feel just as bad as a physical illness, or even worse. Mental health problems affect around one in four people in any given year in UK and one in five in US. They range from common problems, such as depression and anxiety, to rarer problems such as schizophrenia and bipolar disorder. The terms used to diagnose conditions are sometimes words that are in everyday use, such as ‘depression’ or ‘anxiety’. Although this can make them seem easier to understand, their familiarity may lead to confusion. For example, employers should be mindful of the difference between clinically diagnosed depression and the use of ‘depressed’ to describe feeling a bit down. There are many different mental health problems. Some of them have similar symptoms, so you may experience the symptoms of more than one mental health problem, or be given several diagnoses at once. Or you might not have any particular diagnosis, but still be finding things very difficult.

Everyone’s experience is different and can change at different times. Below are some commonly diagnosed forms of mental health problems with examples of some of their symptoms. This is not an exhaustive list, as people will react and respond differently, and men and women can respond differently too, so it is important not to dismiss other symptoms. Research has shown that men tend to have less knowledge about mental health and are also less likely to report their own experiences of mental health problems, as well as less likely to discuss mental health problems with a professional (Time to Change 2017). Just over three in four (76%) suicides are by men and suicide is the biggest cause of death for men under 35 (ONS 2017). When supporting staff, it’s important not to label people by focusing on a diagnosis. Instead, talk to them about how it impacts on their work:

Depression: Depression is a feeling of low mood that lasts for a long time and affects everyday life. It can make someone feel hopeless, despairing, guilty, worthless, unmotivated and exhausted. It can affect self-esteem, sleep, appetite, sex drive and physical health. In its mildest form, depression doesn’t stop someone leading a normal life, but it makes everything harder to do and seem less worthwhile. At its most severe, depression can make someone feel suicidal, and be life-threatening. Some types occur during or after pregnancy (antenatal and postnatal depression), or may come back each year around the same time (seasonal affective disorder).

Anxiety: Anxiety is what people feel when they are worried, tense or afraid – particularly about things that are about to happen, or which they think could happen in the future. Occasional anxiety is a normal human experience. But if feelings of anxiety are very strong or last for a long time, they can be overwhelming. Someone might also experience physical symptoms such as sleep problems and panic attacks. There are different diagnoses of anxiety such as generalized anxiety disorder (GAD), social anxiety (social phobia), panic disorder or post-traumatic stress disorder (PTSD). But it’s also possible to experience problems with anxiety without having a specific diagnosis.

Panic Attacks: Sudden, unexpected bouts of intense terror leading to difficulty breathing; rapid, pounding heartbeat; choking sensations; chest pain, trembling; feeling faint. The memory of a panic attack can provoke fear and trigger another.

Obsessive-Compulsive Disorder: Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. The term is often misused in daily conversation – for example, people may talk about being ‘a bit OCD’, if they like things to be neat and tidy. But the reality of this disorder is a lot more complex and serious. OCD has two main parts: obsessions (unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind), and compulsions (repetitive activities that you feel you have to do to reduce the anxiety caused by the obsession).

 Phobias: A phobia is an extreme form of fear or anxiety triggered by a particular situation (such as going outside) or object (such as spiders), even when it’s very unlikely to be dangerous. A fear becomes a phobia if the fear is out of proportion to the danger, it lasts for more than six months, and has a significant impact on how you live your day-to-day life.

Bipolar Disorder: Bipolar disorder (once called manic depression) mainly affects mood. With this diagnosis someone is likely to have times when they experience: manic or hypomanic episodes (feeling high); depressive episodes (feeling low); and potentially some psychotic symptoms. Everyone has variations in their mood, but in bipolar disorder these swings can feel very extreme and have a big impact on life. In between, there may be stable times where they experience fewer symptoms.

Schizophrenia: Views on schizophrenia have changed over the years. Lots of people question whether it’s really a distinct condition, or actually a few different conditions that overlap. But a diagnosis may be given if someone experiences symptoms such as:

• psychosis (such as hallucinations or delusions)

• disorganized thinking and speech

• feeling disconnected from your feelings

• difficulty concentrating

• wanting to avoid people

• a lack of interest in things

• not wanting to look after yourself.

Personality Disorders: Personality disorder is a type of mental health problem where your attitudes, beliefs and behaviors cause you long-standing problems in your life. If you have this diagnosis, it doesn’t mean that you’re fundamentally different from other people – but you may regularly experience difficulties with how you think about yourself and others, and find it very difficult to change these unwanted patterns.

Psychosis: Psychosis (also called a psychotic experience or psychotic episode) is when you perceive or interpret reality in a very different way from people around you. You might be said to ‘lose touch’ with reality. The most common types of psychosis are: • hallucinations • delusions.

Indicators of Poor Mental Health 

 Solution

Employers can play a key role in positively impacting workplace mental health. The most common ways to improve workplace mental health include raising awareness and educating the workforce, creating a mentally healthy climate and culture and improving access to mental health services and supports. The best place to start any workplace mental health initiative is with an organizational assessment.

Employers can promote awareness about the importance of Mental Health and Stress Management.

Workplace health promotion programs have proven to be successful, especially when they combine mental and physical health interventions.

The workplace is an optimal setting to create a culture of health because:

• Communication structures are already in place.
• Programs and policies come from one central team.
• Social support networks are available.
• Employers can offer incentives to reinforce healthy behaviors.
• Employers can use data to track progress and measure the effects.

Action steps employers can take include:

• Make mental health self-assessment tools available to all employees.
• Offer free or subsidized clinical screenings for depression from a qualified mental health professional, followed by directed feedback and clinical referral when appropriate.
• Offer health insurance with no or low out-of-pocket costs for depression medications and mental health counseling.
• Provide free or subsidized lifestyle coaching, counseling, or self-management programs.
• Distribute materials, such as brochures, fliers, and videos, to all employees about the signs and symptoms of poor mental health and opportunities for treatment.
• Host seminars or workshops that address depression and stress management techniques, like mindfulness, breathing exercises, and meditation, to help employees reduce anxiety and stress and improve focus and motivation.
• Create and maintain dedicated, quiet spaces for relaxation activities.
• Provide managers with training to help them recognize the signs and symptoms of stress and depression in team members and encourage them to seek help from qualified mental health professionals.
• Give employees opportunities to participate in decisions about issues that affect job stress.

Success Stories

Many businesses provide employees with resources to improve Mental Health and Stress Management, some of the companies and their interventions are as below:

Prudential Financial

• Monitors the effect of supervisors on worker well-being, especially when supervisors change.
• Conducts ongoing, anonymous surveys to learn about attitudes toward managers, senior executives, and the company as a whole.
• Normalizes discussion of mental health by having senior leadership share personal stories in video messages.

TiER1 Performance Solutions

• Focuses on six key health issues: depression, anxiety, obsessive-compulsive disorder, schizophrenia, bipolar disorder, and addictions as part of its Start the Conversation about Mental Illness awareness campaign.
• Provides resources to assess risk, find information, and get help or support using multiple formats to increase visibility and engagement. For example, information is provided as infographics, e-mails, weekly table tents with reflections and challenges, and videos (educational and storytelling).

Beehive PR

• Maintains the “InZone,” a dedicated quiet room that is not connected to a wireless internet signal, which gives employees a place to recharge.
• Combines professional and personal growth opportunities through goal-setting, one-on-one coaching, development sessions, and biannual retreats.

Tripler Army Medical Center

• Requires resiliency training to reduce burnout and increase skills in empathy and compassion for staff members who are in caregiver roles. Training sessions mix classroom-style lectures, role-playing, yoga, and improvisational comedy to touch on multiple learning styles.

Certified Angus Beef

• Provides free wellness consultations by an on-site clinical psychologist. Employees do not have to take leave to access these services.
• Holds lunchtime learning sessions to reduce stigma about mental health and the services available to employees.
• Offers quarterly guided imagery relaxation sessions to teach stress management strategies.

Houston Texans

• Provides comprehensive and integrated physical, mental, and behavioral health insurance coverage, including round-the-clock access to employee assistance program (EAP) services.
• Extends EAP access to anyone living in an employee’s home, with dedicated programming for those who are caring for children or elderly parents.

 What is a WAP?

The WAP is inspired by Mary Ellen Copeland’s Wellness Recovery Action Plan® (WRAP®): an evidence-based system used worldwide by people to manage their mental health.

The charity Mind have developed a useful Guide to Wellness Action Plans (WAPs or WRAPs or advance statements) document, which encourages employees to reflect on the causes of their own stress and mental health in the workplace and actively support their own mental health by taking ownership of practical steps to help address these triggers.

We all need to support our mental health at work, so all staff should be offered a WRAP – whether they have a mental health problem or not. This sends a clear message that the organization cares about employee wellbeing and helps encourage people to be open and seek support sooner.

What should a WAP cover?

• approaches the staff member can adopt to support their mental well-being

• early warning signs of poor mental health to look out for

• any workplace triggers for poor mental health or stress

• potential impact of poor mental health on performance, if any

• what support they need from you as their manager

• actions and positive steps you will both take if the staff member is experiencing stress or poor mental health

• an agreed time to review the WAP and any support measures which are in place

• anything else that the individual feels would be useful in supporting their mental health.

The WAP is not legally binding, but is intended as an agreement between you and your staff to promote their well-being or address any existing mental health needs, including any adjustments they may wish to discuss.

Wellness Action Plan (WAP) Template

A WAP reminds us what we need to do to stay well at work and details what our line managers can do to better support us. It also helps us to develop an awareness of our working style, stress triggers and responses, and enables us to communicate these to our manager. In cases where someone has had to take time off as a result of a mental health problem, a WAP can be used as part of the return-to-work process to set out what steps you and your manager plan to take to support recovery. The information in this form will be held confidentially and regularly reviewed by you and your manager together. You only need to provide information that you are comfortable sharing and that relates to your role and workplace. This form is not legally binding but it will help you and your manager to agree, together, how to practically support you in your role and address any health needs. It is the responsibility of the employer to ensure that data gathered in this form will be kept confidential and will not be shared with anyone without the permission of the member of staff.

Employee Signature:                                                 Date:

Employer signature:                                                 Date:

Date to be reviewed: