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The mental health challenges facing occupational health in the wake of the coronavirus pandemic are set to be immense. Libby Morley argues that one way OH can help organisations kickstart support is to promote the idea that employees need ‘PPE’ for their mental as much as their physical health.
The idea that we need the equivalent of PPE (personal, protective equipment of course) for mental as well as physical health and safety was inspired between 2017 and 2019 whilst I was delivering mental health training within the construction and manufacturing sectors.
You don’t of course need me to tell you that access to adequate PPE has since then become probably the critical healthcare, infection control and, indeed, political issue of the coronavirus pandemic.
About the author
Libby Morley MSc OHA (Dip) RGN is owner of Mindshift Consultancy
But, as thoughts within occupational health become ever-more focused on the health and wellbeing challenges associated with getting Britain back to work, how we support and manage mental health, and the anxiety and mental health fallout from the pandemic, is becoming ever-more pressing.
Therefore, I’d argue that PPE for mental health – in other words not just the physical capes, gloves, masks and respirators that have so dominated the news for the past three months (although of course these remain critically important) – is a conversation that, increasingly, we within OH need to be having with employers.
So, what first do I mean by PPE for mental health? PPE, of course, is about prevention, prevention of illness or injury and preventing litigation.
Its purpose is to reduce risk and keep people safe and, in line with the 1974 Health and Safety at Work Act, provision of PPE is a legal requirement. It is primarily about minimising risk of physical harm, with a focus on being proactive. After all, there is no point in putting that hard hat on once you’ve been hit on the head and are unconscious, or providing gloves after someone has dermatitis or a burn or that high-viz jacket once you’re lying on the ground and have been knocked over!
But how can you translate these sorts of control measures (as defined within any risk assessment for health and safety) to mental health? I’d suggest the following seven (I hope practical) ways in which to open these conversations and to start to generate debate and thought.
1) A high-viz jacket is saying “see me”. The response from a mental health perspective is “we see you” and “you are safe”. To be mentally safe in this context requires a stigma-free culture. “See me” is therefore about their mental fitness and a workplace culture that acknowledges, understands and supports mental difference.
2) Matching the right type of hand protection to the job being done is acknowledging that exposure to some products or heat sources can cause harm to the skin. The mental health equivalent here is acknowledging and assessing the potential for work-related stress by performing organisation-wide or individual stress risk assessments and implementing control measures to reduce it.
3) The availability of hand wash or emergency rinsing agents is about ensuring that, if an accident occurs, despite control measures such as gloves or eye protection being used that swift action to prevent long-lasting damage can be taken. The mental health equivalent of this involves providing support if work-related stress or mental distress occurs. This could be via access to an employee assistance programme (EAP), funded talking therapy or availability of colleagues who have knowledge and confidence to talk about mental distress.
4) Occupational exposure limits and working time directives are about too much of something for too long being a risk to health and allowing workers to stop before harm is done. A working environment that supports the need to relax, reflect, and recharge is the mental health alternative.
5) Wearing a hard hat is acknowledging that we are not invincible; that we may be vulnerable if hit on the head. Provision of the hard hat is saying “things can go wrong, so, just in case, look after yourself and wear this”.The mental health equivalent is an employee who implements self-help strategies and takes responsibility for their mental resilience as far as possible.
6) Toolbox talks typically educate staff about PPE use and how to work safely. Translating this into mental “fitness” could include following national campaigns, holding regular health promotions on mental health and displaying relevant resources in the workplace or on the intranet.
7) Access to physical first aiders in the workplace is a legal requirement as per the Health and Safety (First-Aid) Regulations 1981. The Act requires employers to “provide adequate and appropriate equipment, facilities and personnel to ensure their employees receive immediate attention if they are injured or taken ill at work”. In essence, trained first aiders aim to keep people safe and try to stop a problem getting worse until the professionals arrive; they don’t walk by and ignore the symptoms.
Staff trained in mental health first aid or similar follow the same idea, however their role is not to wait until a crisis occurs before stepping in.
Many people have had no training in stress or mental health awareness, and many don’t know what to say or worry they could make a situation worse. Training related to stress and mental health increases knowledge, understanding and confidence and reduces stigma around this topic.
Further this enables confidence to have a good quality conversation, to reduce the isolation and distress felt and, if necessary, to signpost to the professionals.
Conclusion – parity of esteem, parity of ‘PPE’
Parity of esteem is the principle by which mental health is given equal priority to physical health, and was enshrined in law by the Health and Social Care Act 2012.
The current lack of parity is evidenced in various research that demonstrates a life expectancy that is 15-25 years lower in those living with severe mental illness.
My aim therefore has long been to make the concept of minimising work-related risk of stress and mental distress easy to understand and more relatable, especially within those sectors where physical health and safety and the usefulness of control measures and risk assessment is second nature.
Stress and mental health is one of the three health priorities the Health and Safety Executive has been focusing on since 2016 and, as we all know, mental health is set to be a massive issue for employers and occupational health as we come out the other side of the coronavirus pandemic.
Many businesses continue to be reactive rather than proactive in their approach to managing work-related stress. With many employees feeling unable to be honest with their employer about their mental health, this can lead to people becoming more unwell, being absent from work or attending work when not fit (presenteeism).
One way to highlight or focus on mental health, to forefront it as an issue, is to make conversations and support around it more visible. Using the idea of providing “PPE” for mental health is, to my mind, an easy and accessible way to kickstart and make this change.
Mindshift is offering a course on stress and performing an individual stress risk assessment, which has been approved by the Institution of Occupational Safety and Health. It also offers a range of courses and support to organisations around how to offer PPE for mental health, and how to make this a sustainable change that makes a difference. For more details, go to https://www.mindshiftconsultancy.co.uk/