Comcare As one Working Together: Promoting mental health and wellbeing at work

The case for investing in mental health and wellbeing

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1.3 The case for investing in mental health and wellbeing

The APS needs a healthy, engaged workforce to ensure it can meet the challenges faced by a modern public service. Increasing demands for improved services for citizens and for greater efficiency in agencies can put pressure on managers and employees alike to ensure that productivity and performance remain high.

People are also working to an older age, and the way work gets done is changing—people are working from home, in new industries and with new technologies. We see changing expectations of work, flexibility, reward and engagement. We need to find ways to promote psychological health and wellbeing in this context.

Participation in ‘good work’ will drive health and productivity improvements. Recent Australian evidence shows that we have to get this right.6 A poorly designed or poor quality job where people feel insecure, overloaded or do not have much control over how they manage their work, will not deliver these benefits and can be more harmful to health than having no job at all.

Fostering a positive work environment that promotes mental health and wellbeing is fundamental to building organisational health and makes good business sense.8 The research is clear that workplaces that protect employee health and provide flexibility to take account of an employee’s health status are among the most successful over time.9 Long term sickness absence or resulting unemployment on the other hand, can have a negative impact on health and wellbeing. Good work is an effective means to improve the wellbeing of workers, their families and communities.

Creating mentally healthy workplaces delivers improved productivity, improves workforce participation and increases social inclusion. It is the core people management environment that is crucial here. Fostering more supportive, positive and engaging team environments increases resilience, enhances positive early intervention outcomes, and reduces the impact on individuals’ mental health.

The benefits go beyond simply reducing the costs associated with negative outcomes (e.g, absenteeism, mental health disorders, and psychological injury compensation claims). Organisational practices that improve employee psychological health and wellbeing (and reduce the incidence and duration of mental health symptoms) also result in improved performance for people with or without a mental health condition.

Mental disorders account for 13.3% of Australia’s total burden of disease and injury and are estimated to cost the Australian economy $20 billion annually in lost productivity and labour participation.7
Some of the evidence from recent research findings is summarised below:

• Organisations with strong organisational health (i.e., investment in quality people management) typically exhibit better service delivery performance.13

• Organisational health is associated with stronger financial performance, typically 2.2 times above average.14

• Approximately 30% of the variation in service delivery outcomes at a team level is attributable to organisational climate, specifically, the quality of supportive leadership and people management practices.15

• 70% of failed organisational change programs are attributable to poor organisational health.16

• Just under 7% of employees in any organisation will develop clinically significant depressive symptoms in any one year.17

• On average, every full-time employee with untreated depression costs an organisation $9,665 per year.18

• Implementing effective early intervention programs results in a five-fold return on investment, due to increased employee productivity.19

• Supportive leadership and sound people management can reduce frequency and costs of workers’ compensation premium rates. This impact extends beyond psychological injury claims. National research indicates that workplace psychosocial factors can contribute up to 59% of the risk for the onset of musculoskeletal injuries in the workplace.20

• Ensuring people with mental health conditions are able to keep their job will boost productivity and support social inclusion.21

• Removing obstacles to keeping employees at work, and minimising time off work, is associated with better long term mental health and wellbeing outcomes.22

• Early intervention—specifically, early identification and facilitating access to quality mental health care—is associated with a 492% return on investment (calculated by comparing early intervention and treatment costs with subsequent reduction in absenteeism and improvement in work performance).23

Promoting health and preventing harm to mental health and wellbeing is important because:

It’s the right thing to do—leaders and managers have a social and corporate responsibility.

It’s the law—leaders and workplaces are legally required to prevent harm to health and safety10 and not to discriminate in employment on the basis of mental health.11

It’s the smart thing to do—promoting mental health and preventing harm makes good business sense for a high performing APS.12

One additional point to emphasise is that there is overwhelming evidence that work is generally good for mental health and wellbeing.24 Employees spend a considerable amount of time at work, so the workplace can be used to help change the health of Australians. Using the workplace to drive important behavioural changes, we can head off problems and intervene early. To realise these health gains and to improve the work retention of people with injury, illness or disability, we need to promote the positive links between work and health. The APS needs to strengthen workplace retention policies to ensure employees with mental health conditions are able

to keep their jobs and continue to be productive
in their work.25
Australians need flexible and supportive workplaces, where employment discrimination on the basis of mental health is eliminated and employers and employees are provided with support so that the potential of the individual and the business are maximised.’5

National Mental Health Commission


1 World Health Organization 2011. Mental Health: A state of wellbeing, viewed 3 April 2013,

2 Aylward M 2010. Presentation at launch of Australasian Faculty of Occupational & Environmental Medicine position paper Realising the Health Benefits of Work. Sydney.

3 Carnell K 2012. Presentation to Comcare National Conference, Sydney, 19–21 September.

4 Crabtree S 2011. A good job means a good life. Gallup Management Journal, 11 May 2011 p. 12. .

5 National Mental Health Commission 2012, A contributing life: the 2012 National Report Card on Mental Health and Suicide Prevention, Sydney, NMHC, p. 106.

6 Leach, LS, Butterworth, P, Strazdins, L, Rodgers, B, Broom, D & Olesen, S 2010, ‘The limitations of employment as a tool for social inclusion’, BMC Public Health, vol. 10, p. 621.

7 Australian Institute of Health and Welfare 2007, The burden of disease and injury in Australia, 2003, PHE 82, AIHW, Canberra, p. 61; Australian Bureau of Statistics 2009, Australian Social Trends: March 2009, cat. no. 4102.0, ABS, Canberra, p. 13.

8 Australian Public Service Commission 2011, Respect: Promoting a culture free from harassment and bullying in the APS, APSC, Canberra, .

9 Harter, JK, Schmidt, FL, & Keyes, CLM 2003, ‘Well-being in the Workplace and its Relationship to Business Outcomes: A review of the Gallup studies’, in CLM Keyes & J Haidt (eds) Flourishing: The Positive Person and the Good Life, American Psychological Association, Washington, .

10 Work Health and Safety Act 2011.

11 Disability Discrimination Act 1992.

12 Comcare, The case for work health, Comcare, Canberra, viewed 3 April 2013,

13 Keller, S & Price, C 2011, Beyond Performance, Wiley, New Jersey, p. 6.

14 ibid, p. 22.

15 Cotton, P & Hart, PM 2012, The impact of the psychosocial quality of work on wellbeing and performance, manuscript submitted for publication.

16 Keller & Price, op cit., p. 22.

17 Hilton, M 2004, ‘Assessing the financial return on investment of good management strategies and the WORC Project’, research paper, University of Queensland, p. 4, viewed 4 April 2013, .

18 ibid, p. 7.

19 ibid, p. 8.

20 Hauke, A, Flintrop, J, Brun, E, & Rugulies, R 2011, ‘The impact of work-related psychosocial stressors on the onset of musculoskeletal disorders in specific body regions: A review and meta-analysis of 54 longitudinal studies’, Work and Stress: An International Journal of Work, Health & Organisations, vol. 25, no. 3, 243–256.

21 Organisation for Economic Co-operation and Development 2012, Sick on the Job? Myths and realities about mental health and work, OECD Publishing, Geneva, pp. 36, 40.

22 Rueda, S, Chambers, L, Wilson, M, Mustard, C, Rourke, SB, Bayoumi, A, Raboud, J, & Lavis, J 2012, ‘Association of returning to work with better health in working age adults: A systematic review’, American Journal of Public Health, vol. 102, no. 3, pp. 541–556.

23 Whiteford, HA, Sheridan, J, Cleary, CM, & Hilton, MF 2005, ‘The work outcomes research cost-benefit (WORC) project: The return on investment for facilitating help seeking behaviour’, Australian and New Zealand Journal of Psychiatry, vol. 39 (Suppl.2), no. A37.

24 Royal Australasian College of Physicians, Australasian Faculty of Occupational and Environmental Medicine 2011, Realising the Health Benefits of Work: A Position Statement, RACP, Sydney, available at: .

25 OECD, op. cit., p. 15.

Part two

Information sheets

people management

1 Getting the facts right

In recent years we have seen an increase in mental health literacy in the general community. Considerable efforts have been made by organisations such as beyondblue to educate and de-stigmatise the area of mental health. Despite these efforts, there is still some way to go and many myths and misunderstandings exist, particularly around the work capacity of people with mental health conditions. It is often this misunderstanding that drives prejudice, discrimination, and intolerance towards people with mental ill health.

What is a mental health condition?

Mental health conditions influence not only how someone feels (e.g., sad, frightened, worried, angry) but also how the person thinks, behaves and interacts with other people. There are several types, but the main groups are:

Mood disorders, like:

  • depression (persistent sad mood, unmotivated, low energy, unable to find enjoyment)

  • bipolar disorder (when depression symptoms alternate with extreme ‘highs’—elated, buzzing with activity and ideas, over-confident to an extreme).

Anxiety disorders, like:

  • social anxiety (being terrified by what other people might think)

  • panic disorder (bursts of extreme anxiety with a range of physical symptoms)

  • agoraphobia (avoidance of situations and places that evoke fear of a panic attack)

  • obsessive-compulsive disorder (excessive checking, washing, or other rituals)

  • post-traumatic stress disorder (psychological distress following a traumatising event)

  • generalised anxiety (excessive worry about many aspects of life).

Psychotic disorders:

  • schizophrenia (which includes strange experiences and beliefs, such as hallucinations and delusions, as well as social withdrawal and ‘flat’ emotions)

  • some depression or bipolar disorders (when people also have hallucinations or delusions associated with their lows or highs).

Personality disorders are slightly different—they describe maladaptive patterns of thinking, feeling and behaving that characterise the person across situations. Personality is regarded as being on a continuum from ‘normal’ to ‘abnormal or disordered’. Increasingly, diagnostic systems now recognise ‘maladaptive traits’ or personality-based difficulties that fall between normal and abnormal personality. The presence of these personality factors can complicate other mental health conditions such as anxiety and depression, and interfere with social and occupational functioning.

Substance abuse is a related issue that can have a devastating impact on the person’s ability to function at work and to relate to their friends and family.

How common are mental health conditions?

Mental health conditions are very common. The latest mental health survey conducted by the Australian Bureau of Statistics revealed that around one person in five (20%) had experienced a mental health disorder in the last 12 months and over twice that number (45%, or nearly half the Australian population) had experienced one at some time in their lives.

We know that one in five adults, or 3.2 million people, in Australia will experience a mental health difficulty such as depression, anxiety or a substance misuse disorder in any year.1

Along with these frequently occurring mental health conditions, 2 to 3 % of the adult population will experience a severe mental health condition such as schizophrenia or bipolar disorder.2

What are some of the myths about mental illness?

Myth: People with mental health conditions cannot work.

Many people with mental health conditions, across a wide range of workplaces, are highly successful employees. Organisations employing people with mental health conditions report good attendance and punctuality, as well as motivation, quality of work, and job tenure on par with or greater than other employees. Of course, people with mental health conditions can succeed or fail, just like any other employee. Things work best when there is a good match between the employee’s needs and their working conditions. Mental health problems can affect anyone, especially if the person is put under extreme stress for prolonged periods.

Myth: Once people develop mental ill health, they will never recover.

Medical professionals now have very effective psychological and pharmacological treatments for mental health conditions, with most people showing large improvements and some recovering completely. Many different factors contribute to the development of these conditions, so it can be difficult to predict with accuracy the degree to which any individual will recover. When we talk about ‘recovery’ we are not just talking about a reduction of symptoms; we are also talking about being able to live a fulfilling and productive life—and, for most of us, that includes work.

Myth: People with mental health conditions are dangerous.

This is one of the most damaging stereotypes. People with a mental health condition are very rarely dangerous or violent. It is much more likely that people with mental health conditions will be subject to violence rather than being violent themselves.

Myth: There’s nothing I can do to help someone with a mental health condition.

You can do a great deal—support from others is one of the biggest factors in recovery for most people. We can start by developing a supportive and inclusive workplace culture that builds on people’s strengths and promotes good mental health. It is entirely inappropriate to use derogatory labels like ‘crazy’, and we should learn the facts about mental health and educate others around us. We must treat people with mental health conditions with respect and dignity, just as we would anybody else.

You can also help people who have a support role for a person with a mental health condition—flexible and understanding workplaces allow carers or support people to undertake their additional role as and when needed.
Myth: Mental ill health is a form of weakness.

Mental health conditions are a result of a complex mix of genetic vulnerability and temperament, early life experiences, and current circumstances. Major stressors (like losing a loved one, financial or health issues, legal issues, work overload) can be significant contributors in precipitating mental health conditions. Any one of these areas, if sufficiently severe, may explain the onset, or a combination of less severe factors in several of these areas may also be enough to explain the condition. Either way, it is not the person being ‘weak’—telling them to toughen up and pull themselves together will not help. The same applies to addictions like alcoholism, gambling, or eating disorders. The individual is not morally weak or ‘bad’—the explanation is a combination of biological, sociological, and psychological factors. The fact is that anyone can develop a mental health condition.


1 Australian Bureau of Statistics 2007, National Survey of Mental Health and Wellbeing: Summary of findings, cat. no. 4326.0, ABS, Canberra.

2 Australian Institute of Health and Welfare 2012, Mental Health Services—in Brief 2012, cat. no. HSE 125, AIHW, Canberra.

2 Understanding my role as a

Supportive and responsive managers understand the needs of employees and help break down the stigma and discrimination surrounding mental health. This doesn’t require specialist skills or knowledge—it can be achieved by using the full range of people management practices such as effective communication, work design, performance management and provision
of reasonable adjustments.

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