Mental Health Conditions Guide

What is a mental health condition?

Mental health problems can affect people at any time of life and in different ways. There are many different mental health conditions, which vary in severity. Some examples include conditions such as:

• anxiety;
• depression;
• schizophrenia;
• self-harm;
• bipolar disorder;
• dementia.

How can mental health conditions affect you and others at work?

Mental distress can affect how people think, feel and act. As a result, people suffering from mental ill health may behave, communicate or respond in unexpected ways that may be at odds with a given situation. Although in some cases mental health conditions can affect how people do their jobs, many people can remain in employment and fulfil their work roles.

There are a huge range of mental health conditions just as there are a huge range of physical health conditions, so it is important not to generalise about mental health. Symptoms that may be displayed include:

• low mood;
• irritability/emotional changes;
• deterioration in performance;
• loss of confidence;
• loss of interest;
• becoming withdrawn from social interaction;
• disturbed sleep/tiredness;
• gastrointestinal disturbance;
• an increase in short-term sickness absence.

In some cases the condition can be caused by stress at work (especially depression and anxiety). Also, these conditions, and some others, can be made worse by stress. For that reason it is important that employers try to remove or manage the causes of stress (the HSE's Management Standards for work-related stress offer useful advice on achieving this).

What are employer's responsibilities?

Employers have a legal duty to protect the health and safety of those at work and they must undertake risk assessments (stress would require such an assessment).

If a mental health problem has long-term effects on a person's normal day-to-day activity, then it is likely that the person would be defined as disabled under the Equality Act 2010 (even though many people with a mental health condition do not actually think of themselves as disabled). As a result, employers should consider any reasonable adjustments which may help to keep an employee at work or to return to work after illness. These adjustments will depend on the condition, the person and the job they do.

Some common work adjustments include:

• a phased return to work after absence starting with part-time work and building up hours over a period of weeks or months;
• reviewing aspects of the job that are particularly stressful and rearranging responsibilities;
• adjusting the content of the job with task variation;
• considering a review of training, development or support needs after absence or illness;
• working at home for some of the time;
• time off for attending counselling/therapy, etc.;
• changing shift patterns or exploring different work options (e.g. part-time work, job sharing);
• flexible working around agreed outputs;
• a later or earlier start to avoid rush hour travel;
• assessing the physical work environment;
• providing a quiet place for an employee to go in case of feelings of stress or anxiety;
• providing a mentor in the workplace.

It is important for employers to deal openly and sensitively with employees' mental health issues so that they feel supported and confident talking about their issues. Employees should feel safe in the knowledge that their problems will be kept as confidential as possible. Many people with mental health issues face hostile reactions from others and will be reluctant to discuss their issues with their employer. Your union health and safety representative may be able to talk this through with you and possibly act on your behalf, or come to any meetings you have.

Once a person's mental health issues are out in the open, employers should keep abreast of changes in the employee's personal circumstances (e.g. treatment, illness), which may contribute to a person's mental distress and inability to cope. It may be helpful to establish an agreed plan of action with the employee should symptoms be identified within the workplace. This will ensure that the employee is fully aware of the actions that may be taken by the workplace and the support that will be provided.

Work adjustments should be reviewed on a regular basis as part of normal management practice in order to ensure that the adjustments continue to meet the needs of the individual.

Employers should do what they can to reduce the stigma surrounding mental ill health.

What help is available for employees?

The TUC has a number of resources on its website. You should also contact your union or health and safety representative for advice if you have any issues relating to mental health at work.

MIND provides high-quality information on mental health and campaigns to promote and protect good mental health for everyone.

The Health for Work Adviceline can offer front-line assistance for managers and employers, health and safety representatives and employees who need help and advice when dealing with mental health conditions at work (e.g. mental health first-aid advice or temporary/long-term work adjustments). For more information about work adjustments for those suffering with mental health conditions, or for advice about other employee health issues, please contact the free Health for Work Adviceline on 0800 077 88 44.

Further sources of information

• The NHS Choices website provides information on a number of specific mental health conditions (e.g. depression, anxiety, obsessive compulsive disorder, post-traumatic stress disorder, long-term illnesses, eating disorders, etc.) in addition to advice on treatment and talking therapies such as counselling and cognitive behavioural therapy (CBT).
• SHIFT is an initiative to tackle stigma and discrimination surrounding mental health issues in England. Whilst SHIFT closed at the end of March 2011, its website still holds many useful resources.
• The MINDFUL EMPLOYER initiative is aimed at increasing awareness of mental health at work and providing support for businesses in recruiting and retaining staff.