Why mental health at work is a structural issue

A new study suggests short-term mental health initiatives have little to no positive impact. What is needed is deeper structural approaches.

Stressed women at laptop


A Cambridge academic presented the findings of his study of the impact of short-term mental health initiatives such as resilience and stress management classes, relaxation classes, mental health and wellbeing coaching and events promoting healthy sleep at the British Sociological Association this week. The study comparing the experience of 26,471 employees – some of whom had taken part in mental health initiatives and some of whom hadn’t – showed they more or less had no effect on mental wellbeing.

William Fleming said that, while they might be a “convenient option” for employers concerned with mental health, they didn’t help the average worker. He stated that instead employers need to look at structural reforms to make workplaces and work more conducive to good mental health. He added that classes and initiatives put the onus on employees to improve their mental health, rather than addressing “the structures of work which cause harm through stress, trauma and uncertainty”.

It’s a point that we have been making consistently. The issues when it comes to mental health at work – as opposed to mental health outside work – are more to do with workload, bullying and harassment. Mental health initiatives that don’t address these things will not have much impact. You can tell someone to do yoga, use apps and take ‘me’ time until you are blue in the face, but unless you look at structural issues then nothing much will change. There are no quick fixes.

Bullying managers, for instance, may be part of an overall bullying culture. The manager may be under multiple unrealistic target pressures and that gets passed down the line. They may, of course, just be difficult individuals, but the structures in place make it difficult for them to be challenged. Often it ends up with the bullied person leaving rather than the bully.

I know of one company taken over by a venture capitalist who made wonderful speeches about how the workforce was the heart of the business and then promptly humiliated and bullied its way to getting rid of half of them. They brought in their own HR person whose job seemed mainly to protect the interests of the new owner and the managers who were good at getting rid of people.

The impact of workplace bullying on mental health can last a long time. It can destroy people’s confidence for months or even years.

Then there is workload. Workloads seem always to go up and never down – often it is a question of adding something that seems a small thing, but because nothing is taken away, those small things build up.

Even delegating can increase workload if you have to oversee the work of the person you are delegating to. Sometimes something that seems like a solution to the person not doing the actual work can be more stressful than the original situation. The important thing is to listen to the person and not make them feel like they are just being ungrateful and creating problems. They know what might work better for them.

I’m not saying that yoga and the like can’t help certain individuals, but these are extras and a blanket sticking plaster approach doesn’t generally work. It is about top to bottom changes that enable whistleblowing, that treat each person equally, that encourage regular workload check-ups, that listen to feedback and that support managers to understand individuals’ challenges. Will this improve in the wake of pandemic with so many other pressures on employers? It seems unlikely that we will get more than superficial tick box approaches, even if the longer term benefits in a world of skills shortages are many. Changing structural issues, particularly those long baked into older, larger firms, is hugely challenging and takes a lot of time and commitment.

But mental health will become a bigger and bigger issue in the future. Talking about mental health is a start. The next generation of employees talk about mental health a lot – and have a great deal of experience of the impact of poor mental health. They will expect action.

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