Mental health related absence is the most common cause of long-term sickness absence in UK workplaces. Stress-related absence in particular has increased, with 37% of respondents to the CIPD and Simply Health Health and wellbeing survey saying that stress-related absence had increased in the last year. Work-related stress, depression or anxiety accounts for 44% of work-related ill health and 54% of working days lost, in 2018/19 (HSE, 2019). As well as sickness absence, poor mental health at work can lead to increased staff turnover, reduced engagement and high presenteeism.
These facts relate to a world pre-COVID-19; indications suggest that the pandemic (and measures taken by government to control it such as lockdowns and social distancing) will have a significant impact upon the mental health of employees. It is very possible that these mental health implications will be felt for many months or even years.
This guide outlines considerations and provides advice for employers, people professionals and people managers on how employee mental health can be supported as the course of the pandemic and our recovery continues. This will be particularly relevant in planning a return to the workplace for as employees who have been working from home, and as we potentially face the consequences of the economic downturn.
What is mental health?
Everyone has mental health and, like physical health, it fluctuates along a spectrum. It can vary from good mental wellbeing to severe mental health problems. Work can have a huge impact on mental health – it can promote wellbeing or trigger problems.
Poor mental health can include struggling with low mood, stress or anxiety. A mental health problem is generally defined as when poor mental health continues for a prolonged period. There may or may not be a diagnosis of a specific condition. Common mental health conditions include depression, anxiety, phobias, obsessive-compulsive disorders and bipolar (Mind have a useful list of mental health conditions).
Mental health problems affect around one in four people in any given year. Work-related stress is a form of poor mental health, defined by the Health and Safety Executive as a reaction to excessive pressure or other type of demand placed on an individual at work. Stress can be a significant cause of illness.
How will COVID-19 affect our mental health?
We do not yet know exactly what the full mental health impact of COVID-19 will be, although some evidence is now emerging. Research from the US has found that 1 in 3 people who have experienced severe COVID-19 symptoms have since developed a neurological or mental health condition. According to the Office for National Statistics, around 1 in 5 (21%) adults experienced some form of depression in early 2021; this is more than double that observed before the pandemic (10%).
There are many factors to consider including the impact of the lockdown and ongoing restrictions such as social distancing and self-isolation. Some employees will fearful about contracting the virus, others will be anxious about family and friends. Many will have suffered bereavements during this time, often without the chance to say goodbye or attend funerals. There will also be fears about job security, returning to the workplace (including using public transport for commuting) and financial concerns. Some employees are working longer or more irregular hours and many are combining work with other family responsibilities, leading to a poor work-life balance. There are also potential mental health implications for those who have been on furlough leave.
Early research into the health impacts of lockdown including findings of fatigue, musculoskeletal conditions, poor work-life balance, reduced exercise and increased alcohol consumption. In relation to mental health specifically, employees were reporting reduced motivation, loss of purpose and motivation, anxiety and isolation. Evidence from previous quarantine situations, prior to the current pandemic, suggests that there are long lasting effects on mental health. These symptoms ranged from irritability and anger to depression and post-traumatic stress symptoms.
The mental health charity Mind has found that more than half of adults (60%) and over two-thirds of young people (68%) said their mental health got worse during lockdown. Young people and those with pre-existing mental health conditions were particularly effected – and employees who had been furloughed also reported a slight decline in their wellbeing compared to others.
Although not a mental health condition specifically, 1.1m people in the UK are now estimated to have Long-COVID (symptoms that last for longer than 12 weeks). This is an unknown condition and little is understood about its duration or potential treatments. This may also contribute to poor mental health.
What should employers do?
It is well known that many employees do not feel comfortable in speaking up about poor mental health; this is unlikely to change following the pandemic.
Employers will need to adapt a range of measures to support employees experiencing poor mental health as a result of COVID-19 and its effects on society and the economy. This support will be required in the short term (such as during the return to the workplace for officer workers) as well as over the longer term. Measures will need to range from supporting employees to regain an effective work-life balance and addressing fears about return to work, right through to support for severe mental health conditions. Employers, particularly those who have employees working in front line response roles, should act now to put necessary support in place. It is important that businesses engage with their people to understand how they feel about the return to the workplace. There should be consultation with staff at a company level but it’s also important that line managers understand the specific concerns of their individual team members so they can best support their mental wellbeing and future ways
What remains important is that people experiencing poor mental health are not labelled by focusing on a diagnosis, and instead discussions and support focus on the impact it has on them at work.
The law and mental health
Employers have a duty to protect the health, safety and welfare of their employees. This includes mental health and wellbeing. You can find out more about health and safety at work in our health and safety factsheet.
Employees who have a mental health condition may be disabled as defined by the Equality Act 2010, and will therefore be protected from discrimination during employment.
Employers are required to make reasonable adjustments for employees with disabilities. This may well in the future include Long-COVID, although this is yet to be determined. What is ‘reasonable’ will depend on the circumstances, the nature of the disability and the resources of the employer. It could however include amendments to hours or location of work, provision of specialist equipment or the duties of the job itself. More information is available on our disability discrimination topic page.
Under health and safety legislation, employers have duties to assess the risk of stress-related poor mental health arising from work activities and take measures to control that risk. More information on stress at work is available in our factsheet. You may also wish to refer to the Health and Safety Executive Stress Risk Assessment tool.
Employers must follow the law – but this only sets a minimum standard. Employers who go above and beyond will see improvements in organisational culture, employee engagement, reduced absence and presenteeism and a reduction in staff turnover. In the current situation, the minimum standards set by law are unlikely to be sufficient to support employees through the many different potential mental health and wellbeing impacts of COVID-19. Not everyone will wish to disclose a mental health condition and not all conditions will fall under the definition of the Equality Act: it is however good practice to make adjustments and provide support for employees regardless of definition.
Prevention – what employers can do now
Employers have several areas of focus to consider. Firstly, supporting the mental health of employees who are continuing to work in essential and key worker roles, many of whom have spent months working under significantly increased pressure that may make them more vulnerable to stress or other mental health conditions. Secondly, the need to support those who continue to work from home as well as those who are returning to the workplace as restrictions end. Finally, there is the impact of potential redundancies on employees who may be at risk of redundancy, those who 'survive' a redundancy situation and those employees (such as HR) who need to manage the process.
The resilience of all employees has been challenged by the current situation – although the mental health and wellbeing implications of this will vary from employee to employee.
Employers and HR may wish to consider some of the following:
- Brief managers on the potential mental health implications of COVID-19 and their specific roles and responsibilities in relation to supporting staff.
- Communicate regularly on wellbeing and mental health support, wherever possible supported by activities that encourage physical, mental, financial and social wellbeing.
- Provide mental health awareness-raising activities – work towards a culture where is acceptable to talk about and seek support for poor mental health.
- When employees who have been working from home begin to return to the workplace, consider if a re-induction into the workplace will help them feel connected and engaged, as well as reassuring them about measures you are choosing to put in place. This could also help cover any health and safety changes in line with the government’s COVID-secure workplace guidelines and good practice.
Support for employees throughout redundancy situations, including those involved in undertaking them, along with manager guidance and training, should be provided. The CIPD has a range of guidance on supporting health and wellbeing in the workplace, available on the wellbeing topic page.
You can also download the workshop materials provided here to run a briefing session for people managers on mental health and wellbeing.
Where the signs and symptoms of poor mental health and wellbeing are well understood at all levels within an organisation, it can support early intervention and the opportunity to take early action to prevent the situation escalating. Sharing information about mental health can also enable employees to identify signs, especially early ones, in themselves and seek support.
Some of the typical signs and symptoms of poor or declining mental health may be more difficult to identify in employees working from home or more flexibly.
Typical signs include:
- Working long hours / not taking breaks
- Increased sickness absence or lateness
- Mood changes
- Distraction, indecision or confusion
- Irritability, anger or aggression
- Uncharacteristic performance issues
- Over-reaction to problems or issues
- Disruptive or anti-social behaviour.
Note: if one of more of these signs are observed it does not automatically mean that an individual is experiencing poor mental health but it should be a prompt for a manager to have a wellbeing conversation. Take care not to make assumptions.
Where signs are identified, managers should have a conversation with the employee. This can be as simple as a phone call or online meeting to check in with the individual. A good starting point is for the manager to simply ask someone how they are. Where appropriate share any observations in a non-judgemental manner and check if support is required. HR should look to provide simple guidance to managers on structuring these conversations. The sooner such a conversation takes place, the more quickly support can be provided to the individual.
Where more specialist advice is required, consider a referral to Occupational Health.
In an advance of any planned or phased return to work, rather than wait for signs or for employees to express concerns, managers can be proactive. Encourage them to contact their team members to discuss any concerns that they may have or any specific issues pertaining to them (such as health conditions of vulnerable family members).
Effective communication plans detailing how the organisation will be approaching the return to work and prioritising the health and safety of employees will also help to allay concerns and fears, supporting mental wellbeing.
Many employers face difficult decisions about their workforce as a result of the pandemic. For some, this will include making employees redundant. Those employees that are sadly made redundant may experience reduced wellbeing or poor mental health as a result.
Unemployment can have a significant impact on mental health; research suggests that the average number of people with psychological problems among the unemployed was 34%, compared to 16% among employed individuals. Redundancies can also have a negative impact on employees that remain with the organisation (sometimes called ‘survivor syndrome’). They may experience a range of emotions; guilt, anxiety about further job losses and stress relating to the process of redundancy had they themselves been at risk. Redundancy processes can also cause stress and anxiety for those that have to undertake them.
Where redundancy process cannot be avoided, organisations may wish to consider the following to support the wellbeing and mental health of employees:
- Remind employees about any support services that are available to them. This is especially important whilst processes are ongoing.
- Ensure that redundancy processes are conducted fairly and empathetically with effective communication and consultation. Train managers where necessary.
- For employees exiting the organisation, wherever possible provide access to outplacement support and financial wellbeing services.
- Provide as much information as possible to employees in order to reduce uncertainty about the future. Ensure regular updates take place and employees have the opportunity to ask questions.
- Ensure that workload reviews take place and objectives are updated to reflect the new circumstances. This is especially important to avoid an increase in workload for remaining employees.
For more information, refer to the guide on redundancy procedures during coronavirus.
Managing mental health disclosures
Disclosures about mental health conditions may be made to managers or directly to HR. Where they are made to HR, wherever possible HR should encourage the employee to share the information with their manager. Consideration should be given to:
- Referral to Occupational Health or the employee’s own GP where specialist advice is required.
- Signposting to organisational support services for mental health and general wellbeing.
Wherever possible, HR should provide training to managers on how to a respond to a disclosure, as well as how to approach the provision of ongoing support.
Managers who receive a disclosure can follow this simple framework from Mind and consider the following:
- Arrange a time to have a conversation with the employee. Where they are working from home this may need to take place via online meeting – this is preferable to a phone call where possible. Let the employee chose the time and medium to ensure that they will not be interrupted.
- Embed confidentiality in those conversations – reassure employees that their personal information will be treated sensitively. It is fine to ask what information, if any, they wish to be shared with colleagues.
- Encourage people to talk – and to take up mental health and wellbeing support.
- Discuss a plan for support – ideally this should include reasonable adjustments or practical support and a time period for review. Discuss what signs and symptoms or triggers to be aware of and the possible impacts on work. Plans will need to be flexible as mental health conditions may fluctuate.
- Reassure – be clear with employees that no assumptions will be made about their mental health and that the organisation will provide the necessary support.
Both managers and HR should seek additional advice where required, especially where mental health conditions are particularly complex.
In an emergency, if you are seriously concerned about an employee’s mental health and believe they maybe in immediate danger, call 999.
Supporting the return to the workplace
The complex nature of wellbeing and mental health means that there is no single solution for supporting the returning to the workplace. It is likely that any return to workplaces will be gradual and phased. As well as some former homeworkers returning to the workplace, the end of the furlough scheme will mean that some employees will be returning to work for the first time in several months; this may include returning to a physical workplace or working from home.
Where employees do return to the workplace they may be working a range of different patterns and hours to allow for ongoing social distancing requirements. Some activities may remain curtailed. Of course, some employees never left work, continuing to work in essential and key roles under a range of challenging circumstances. The continuing threat of the virus will also mean that many employees will also be working whilst retaining care or childcare responsibilities and have other pressing personal issues that may have an impact on their mental health. Even if employees are not experiencing poor mental health they may have concerns and fears about return to a physical workplace, including using public transport or staying safe in the work environment.
Here are some potential interventions for organisations to consider to support employees returning to physical workplaces, even if only on a phased or reduced basis:
- Write a detailed communication plan covering practical issues such as hygiene and approach to maintaining social distancing in order to allay concerns. Refer to the government guidance on COVID-secure workplaces for the types of measures you should put in place.
- Provide manager training on mental health conditions including signs and symptoms. Make sure that managers are aware of the particular wellbeing and mental health implications of coronavirus (including on vulnerable groups and previously furloughed employees).
- Consider introducing an Employee Assistance Programme (EAP) where one does not exist.
- Review existing mental health services to determine if they are scalable and can cope with increased demand.
- Provide mental health awareness activities for the wider organisation. These can take various forms including promotion of national events, workshops or awareness campaigns.
- Offer resources for employees to access in their own time. These can be produced specifically for the organisation or curated using external sources.
- Consider adapting flexible working policies for quicker decisions and increased opportunities to change or reduce hours, or continued remote working where appropriate.
- Wherever possible, encourage senior leaders to include messaging about well-being and mental health in wider communications about the organisational response to the pandemic. This can help to create a culture where it is acceptable to talk about mental health.
- Establish an internal network of wellbeing or mental health champions who can support the organisation.
Where employees have experienced or are experiencing poor mental health, or have taken absence from work as a result of a mental health condition, there are some other specific actions that organisations and managers may take:
- Keep in contact with the employee on a regular basis and updating them on any key organisational communications or changes.
- Make it clear that the employee should not rush back to work until they are ready.
- Refer to Occupational Health or signpost other relevant services.
- Consider phased returns to work – even where the employee is working from home and not returning to a physical workplace. Conduct a formal return to work meeting, even if this is conducted via online meeting or phone call.
- Discuss the support the employee needs to help them to make a successful return and support their mental health – this should include the role of the manager and how they can help.
- Ensure ongoing dialogue and regular contact following the return to work.
- Review performance objectives and workload – adjust where necessary.
Returning from furlough
The mental health implications on employees of being placed on furlough leave is currently unknown. We do know that periods of unemployment can impact negatively on physical and mental health. Work can provide meaning, purpose and structure. Work also provides social connection and opportunities to learn and develop, both of which support wellbeing and good mental health. Employees who have been on furlough may be anxious about the return to work, and may be concerned particularly about future job security.
Organisations may wish to consider the following to support the mental health of employees returning from furlough:
- Contact the employee prior to their return where possible to discuss the return and provide practical information. Also keep in touch with returned employees on a regular basis. Returning from furlough isn’t just about the first day – concerns and anxieties may last for some time.
- Find ways to reconnect employees, to their team and the wider organisation. This could include opportunities to socialise (even if virtually), broader employee engagement activities and reminder of organisation mission, vision and values.
- Ask managers to review employee workloads, update objectives and priorities and provide a full update on what has taken place in recent months. Consider if any refresher training is necessary.
- Remind employees about support services and wellbeing activities available to them.
Longer term homeworking
A significant proportion of the workforce has now worked from home for several months, many of them successfully. However, there are a number of factors that suggest a continued focus on supporting employee mental health remains critical. First of all, there is continued uncertainty about the virus itself along with ongoing changes to restrictions, both of which can lead to increased stress and anxiety. Many working parents still do not have full access to childcare services and are continuing to balance work and childcare with the ongoing prospect of future school closures in the event of virus outbreaks. The now long term nature of homeworking means continued isolation from colleagues and valuable work related social activities, support structures and connections. Work-life balance and blurred boundaries between work and home may become more problematic as homeworking continues. Finally, fears around job security are also likely to be prevalent for many employees, especially in those sectors that have been most affected financially.
Many of the suggestions to support employee mental health set out above also apply to supporting long term homeworkers. Organisations may also wish to consider some of the following:
- Offer specific work-life balance support in the form of 1-2-1 coaching, guidance or training.
- Continue providing employees with ways to connect with colleagues whilst working from home. Promoting online communities, virtual social groups and using social media can all help to connect people.
- Encourage employees to create effective boundaries between work and home, take regular breaks and annual leave. Having a regular routine, such as start and end times can also help.
- Ensure that manager training includes spotting weak signals of poor mental health and wellbeing that are less visible as a result of homeworking.
- Consider what additional support can be provided to employees who may be especially vulnerable such as working parents, employees from ethnic minority groups, young workers or those who have previously experienced poor mental health.
Organisations may also wish to undertake a listening exercise and survey their employees about their current state of mental health and wellbeing, and seeking feedback on the specific support they feel would benefit them in the months to come.
Advice for people managers
People managers play a critical role in supporting employee wellbeing and mental health: how people are treated and managed on a day to day basis is central to mental health. Management style is also the second main cause of work-related stress.
HR professionals should consider encouraging their managers to undertake the following.
Regular check in meetings
Managers should be checking in with their teams, individually, on a regular basis. Ideally this check in should be 'face to face' via virtual meeting. This will help managers to be alert to signals of poor mental health. Encourage managers to have a wellbeing conversation; provide them with a simple framework or questions that they can ask their teams. HR must ensure that managers have a clear process to follow in the event of a mental health disclosure as a result of a check-in conversation.
Looking for signs
Managers should be trained on the potential signs of poor wellbeing and mental health, as well as how to handle a disclosure of a mental health condition. Managers do not need to become mental health experts but they do need to know how to identify and refer. Where managers are concerned about the mental health of their employees, they should signpost to relevant support services. HR should ensure that managers are briefed on any services that are available, such as Occupational Health and EAPs.
Managers can encourage employees to take care of their wellbeing and mental health by acting as an effective role model. Managers can share how they are looking after their own wellbeing at this time, encourage their team members to undertake any organisation-provided wellbeing activity and share wellbeing and mental health messages. This will help to create permission for their team to do the same and encourage people to seek help if they need it.
Connecting with others supports good mental health. Managers should take regular opportunities to bring employees together virtually or even face to face where circumstances/restrictions permit. As well as work-related meetings, encourage social connections through social media or informal online meetings. To avoid overwhelming people, taking part should always be optional.
There are many reasons in the current situation why employees may be unable to be as productive as they would be under normal circumstances. Managers should be sensitive to this and recognise that expectations may need to be adjusted in the short term or if particular situations arise (such as the temporary closure of a school). Existing objectives, workloads and deadlines should be adjusted to take into account the evolving context.
Learning can boost wellbeing and provide employees with a sense of achievement. It may also be especially helpful for employees returning from furlough leave to help them get back up to speed. Managers can still encourage learning whilst working from home – but it should not be mandated.
For more information on how managers can support mental health, download this CIPD guide written in collaboration with Mind.
Looking after yourself: advice for people professionals
People professionals had to respond with speed and flexibility to a challenging and changing context, and continue to do so as the situation evolves and changes. As well as managing existing workloads, there has been a need to adapt policies, support people managers, increase communication and deal with the complexities of furlough. The demands on the profession have been high since March 2020. This makes it important for HR to look after their own wellbeing and mental health at the same time as supporting others. HR professionals are reminded to:
- Seek support for their own mental health if they need it
- Talk to their own HR teams about wellbeing and mental health
- Prioritise self-care activities
- Take regular rest breaks and continue to take annual leave
- Be aware of the signs and symptoms of poor wellbeing and mental health and identify if they apply to themselves.
The CIPD has a range of resources to support members with their wellbeing and mental health, including the wellbeing helpline.
You can also watch this CIPD webinar on HR resilience: looking after yourself and your HR team.
DISCLAIMER: The materials in this guidance are provided for general information purposes and do not constitute legal or other professional advice. While the information is considered to be true and correct at the date of publication, changes in circumstances may impact the accuracy and validity of the information. The CIPD is not responsible for any errors or omissions, or for any action or decision taken as a result of using the guidance. You should consult a professional adviser for legal or other advice where appropriate.
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