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Mental Health & Employment Helping People to Stay in Employment

Toolkit for Individuals March 2012

This toolkit is supported by the European Union Programme for Employment and Social Solidarity – PROGRESS (2007 – 2013)


Introduction


Introduction This toolkit, developed as part of a European project, has been designed to help people with mental health issues to remain in employment.

• Good relationships can provide both help and support. Maintaining friendships and making new relationships with friends, family, colleagues and support workers will prevent you from becoming isolated.

This toolkit has been developed by social and clinical researchers at Technische Universität Dresden’s public health research association using insights gathered from individuals with mental health conditions, as well as health professionals and employers from across Europe. The toolkit aims to reflect the themes that emerged and highlight areas of support.

• Getting involved in your workplace and speaking to your employer can help you to recover whilst in work and help your employer understand how they can help you.

The toolkit is provided as a series of actions for people with a mental health condition, and their families, to promote overall mental health and wellbeing and to help people to stay in work. Every action is backed up with examples and further resources, giving you easy access to additional information.

Themes emerging from interviews: • Lots of people manage their mental health conditions and have successful careers - having a mental health condition is not a barrier to employment.

What is the toolkit? This toolkit contains guidance on topics which could be helpful in coping with mental health problems, helping you to remain in work: • Prevention - Preventing episodes of mental ill health through selfmanagement; • Good work and a good workplace - Helping your employer and GP understand how they can help you through ‘good work’; and • Strengthening good relations - Maintaining good relationships with friends, family and colleagues. Focusing on a combination of these three areas can help you to both remain in employment as well as promote your own health and wellbeing.

• Everyone can support their own mental health and wellbeing. • Mental health conditions vary from person to person, so an individual approach is required - find out what works for you. • Emotional wellbeing and mental ill health are part of a continuum, and our mental health can vary throughout our life. • Good work - where you feel valued and engaged, where your opinions are taken seriously, and where there is flexibility in work to suit your needs - will help you to recover from a period of mental ill health and aid the return to work process. • You should utilise the support and help that your family, friends and colleagues provide, as well as the support offered from line managers, employers and health professionals.

Prevention

Good work and a good workplace

Strengthen good relationships

All of these topics can help you to remain in work and manage a mental health condition. They are also all inter-related: good work and a good workplace can help to prevent work becoming a factor in causing mental ill health; and strengthening your relationships at work and at home can help provide preventative support.

How to use the toolkit If you have a mental health condition managing your condition and your job can sometimes be difficult. This toolkit provides you with ways to help you manage the two, and utilise the support available from a variety of sources: • You can support your own mental health and wellbeing and improve your quality of life through positive action - keeping physically fit and healthy, taking advantage of opportunities to improve your self-confidence and self-esteem, and setting yourself realistic goals.

• Don’t re-invent the wheel – you may already have your own coping mechanisms that work for you. • Go through the toolkit step-by-step – there will be some help and resources which are more applicable to you than to others. Try to focus on the areas that are important to you. • You may already have grappled with these topics. But this toolkit aims to provide you with some good practice, to help ensure you’re doing the right thing for you. If you aren’t, rethink your approach. Be open to new possibilities.

Mental Health and Employment. Toolkit for Individuals | 1


Prevention Mental health problems are commonplace – 1 in 4 of us will suffer from a mental health condition at some point in our lives. Both personal problems and problems at work can play a big role in our mental health. Prevention is about helping to reduce the impact of your mental health on your work, and the impact of your work on your mental health. The following section aims to provide you with resources to show how you can help prevent mental ill health through ncreasing your resilience; protecting your mental health and physical health through good work; and remaining in employment


Actions for individuals

Why do it?

Try to keep active.

When you are physically active (through leisure or good work), your body How to Look After Your Mental generates endorphins - ‘happiness hormones’. Health: mentalhealth.org.uk

Physical activity can contribute significantly to your physical and mental health.

Resources and support

If you feel anxious, depressed, stressed or feel that everything is too much, physical activity can help to alleviate these feelings and help prevent further mental ill health.

How to Look After Your Mental Health Through Exercise: mentalhealth.org.uk

Being more active can in turn help you relax more, experience more intense periods of rest and help you to sleep better.

Up and Running: mentalhealth.org.uk

Think about where you can incorporate exercise into your working day Five Ways to Wellbeing: or at any point throughout the day – for example, try stretching exercises mind.org.uk at work or consider a brief walk during a break. There are a lot of different activities that you may enjoy. Your company may offer discounts or access to local gyms and sports clubs. Focus on improving your quality Try to ensure work does not become the main focus of your life. of life and aim for a good Pursuing a regular job can be good for you - good work can aid recovery balance between your home and and help prevent mental ill health. your work life. But try to ensure that your home and your work life are in balance. Try to organise your daily routine Consider flexible working options to suit your needs. so that you have a good workUse your free time productively - look after your health and wellbeing life balance, and that your and focus on improving your quality of life. personal and professional lives Maintaining good relationships with your family and friends is an are separated. important part of this. These people can help to lighten your spirits and listen to you talk about your problems. Use your free time to maintain these relationships and look forward to meeting up and spending time together.

Five Ways to Wellbeing: mind.org.uk Positive Steps for Your Mental Health: workplacementalhealth.co.uk Working out what might be right for you: rcpsych.ac.uk/mentalhealthinfo Guide to Surviving Working Life: mind.org.uk Wheel of Life: workingfamilies.org.uk Flexible working and work-life balance: acas.org.uk Work Life Balance Centre: worklifebalancecentre.org

Focus on improving your self-confidence, especially at work.

Remember that self-confidence and assertiveness are not aggressive or How to stop worrying: passive traits. A good measure of self-confidence is when you are mind.org.uk satisfied with your life and the way things are going. How to increase your selfRemember that you are an Try to pursue your goals with a sense of self-confidence, but without esteem: mind.org.uk individual with the same rights as hurting others or being aggressive. Hot to be assertive: mind.org.uk everybody else. Motivate yourself and develop your own self-esteem. Improved self-confidence will help you to engage with people that you are usually intimidated by and also help you to cope with difficult situations.

Try to keep calm when you are at the centre of a situation and use stress-reduction strategies and coping mechanisms that work for you.

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Actions for individuals

Why do it?

Resources and support

Accept who you are and understand your limits at work. Consider how many times you recently said “no” to someone. Try to leave work problems at work, and set yourself realistic goals and limits.

It is usually not helpful for you to continue to think or talk about work problems after work with colleagues, friends or family. Leave your work problems at work – relax, sleep well and treat yourself in your own free time. This will give you enough energy and motivation for the next day.

Coping with stress at work: time-to-change.org.uk Stress self-help leaflet: ntw.nhs.uk How to stop worrying: mind.org.uk How to assert yourself: mind.org.uk Guide to Surviving Working Life: mind.org.uk Guide to relaxation: mind.org.uk

To avoid stressful situations in work, develop realistic expectations of what you can do – don’t try to take on more work than you can realistically handle. Manage your own expectations and your own demands – both at work and at home. Placing too high a demand or expectation on yourself can cause stress and anxiety. Do not work yourself up too much before a task. It may be difficult to perform some tasks, so understand your limits and start with something you can do. If you are feeling pressured to do a big task at work, it can be very difficult to do smaller tasks properly. Try to take a step back from such stressful situations. Assess your current workload or situation and do not shy away from saying "No". Consider whether a stressful situation has occurred which has stopped you completing other tasks. Do not be afraid to say "No" when you realise that you may have too much work.

Try to organise a daily routine for If you plan your day well, you can keep yourself active and meet your yourself, and try to stick to it. goals. A well planned day can stop you from spending time feeling stressed or nervous, and completing the tasks you set yourself will help improve your self-confidence and self-esteem.

Guide to Surviving Working Life: mind.org.uk How to stop worrying: mind.org.uk

You can also organise a weekly schedule, identifying what needs to be Guide to managing stress: completed when. Dividing the tasks up by priority can help you organise mind.org.uk your schedule better. Ensure you organise enough time for yourself – include time to relax and unwind, as well as to take appropriate breaks. Try to live a healthy lifestyle.

Many people try to have a balanced diet and enjoy physical activity in order to keep the body healthy. But it is also important to think about your mental health.

Take your physical and your mental health concerns seriously. This involves taking time out to do things that will improve your mental wellbeing as well as your physical health: • take notice of the joy in everyday activities; • do things that you know you do well and that make you feel good; • treat yourself from time to time and; • take time to relax to help relieve stress and worries.

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Tips for employees (work-life balance): mind.org.uk Five Ways to Wellbeing: neweconomics.org Five Ways to Wellbeing: mind.org.uk


Actions for individuals

Why do it?

Resources and support

Try to limit your use of drugs and Alcohol is often drunk in order to cope with problems, feelings or alcohol, which can harm your situations. But alcohol will not help to solve your problems and can mental health. seriously affect your mental health and wellbeing. Try tp moderate how much alcohol you drink. If you smoke, try to quite.

Alcohol is not a treatment for mental or physical illness either, and it can endanger your physical health. Try to have alcohol-free days, and when drinking, try not to regularly exceed the daily unit guidelines: - Men: no more than 2-3 units a day

Try to steer clear of illegal or unnecessary drugs.

How to Look After Your Mental Health: mentalhealth.org.uk Alcohol and Mental Health: mentalhealth.org.uk Drink Sensibly: 10 Ways to Look After Your Mental Health: mentalhealth.org.uk Smoking and Mental Health: mentalhealth.org.uk

- Women: no more than 1-2 units a day Most public places are smokefree. So giving up smoking is a good idea. When quitting, try to stay active to help keep your mind off smoking. Try physical therapy or yoga to help if you feel nervous.

Smokefree: smokefree.nhs.uk Psychological Effect of Street Drugs: mind.org.uk

Improper medication can cause serious and irreparable damage to your body. There is also a great danger of drug dependence, which will not help you. Ensure your workspace is safe and pleasant. Keep your workspace clean and tidy.

Try to keep your own workspace clean and tidy. This can help you to be more efficient and more focused.

Where possible, adding colours, plants and beautiful images to your workspace can help create a positive atmosphere which will help Try to create a work environment improve your emotional wellbeing. where you feel comfortable. Make sure that you are comfortable in your workspace and make adjustments to suit you.

Tips for employees (work-life balance): mind.org.uk Dealing with my stress: hse.gov.uk/stress Dealing with my mental health: hse.gov.uk/stress

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Good Work and a Good Workplace A fulfilling work-life balance can help you to remain healthy and can aid recovery. When your work is good work – where you feel engaged and valued in your job – this can help strengthen your emotional resilience and aid your recovery. Anyone can be affected by a mental health problem and it is at this point when we are most reliant on external support or aid. This chapter aims to give you advice on what actions you can take – either by yourself or with the help of your employer – so that you feel comfortable in your workplace and that you benefit from ‘good work’.


Actions for individuals

Why do it?

Resources and support

Don’t be afraid of taking on new tasks and challenges at work. Variety in tasks at work will keep you interested and engaged.

You are motivated to work if you have control over your workload, responsibilities at work and a variety of tasks.

Tips for employees: mind.org.uk

Be open to taking on new challenges, but be aware of your workload and your current tasks. Do not try to take on more than you can realistically handle.

Working together to reduce stress at work: hse.gov.uk

Your colleagues are also there to support you through your recovery and can help motivate you. Good work relationships, where you feel valued and motivated, can also support your recovery. Learn how to manage stressful situations and recognise the early signs of stress. This can help to reduce stress levels, anxiety and nervousness. Look into adjustments that can be made to help alleviate stress.

You can minimize stress and pressure at work if you have a wide range of options to help alleviate stress. Ask your supervisor or line manager where change is possible. Ask yourself the following questions: • Job design – can I do my job any other way? • Workplace changes - can I make individual changes to my workplace (e.g. desk space, working environment)? • Variety in daily work – how can I make the work I do more varied?

Dealing with my stress: hse.gov.uk Dealing with my mental health: hse.gov.uk Guide to managing stress: mind.org.uk Guide to creating a mentally healthy workplace: enwhp.org

• Responsibility and freedom in completing tasks - how do I want to get Tips for employees (work-life things done? balance): mind.org.uk • Freedom to organise tasks throughout the day – how do I organize my How to stop worrying: daily schedule? mind.org.uk • Have a good work-life balance – can I make any changes at work to get a better work-life balance?

Guide to relaxation: mind.org.uk

Treat people fairly and equally.

Treat others just as you would like be treated.

What works for you? Supporting colleagues: mentalhealth.org.uk

Fair and equal treatment can support good teamwork and make you feel more valued in the workplace.

You and your colleagues are often in close personal contact for several hours. You can sometimes spend more time with your work colleagues than with your family. Your workplace should therefore be a healthy work Keeping us going – effects of environment, where everyone is treated equally, fairly and with respect. mental health on relationships: This will help your team to work better together. mentalhealth.org.uk Be mindful of other people and their feelings. Treat them as individuals. Speak openly with colleagues. Congratulate them when they’ve done well and use positive language. Congratulating people on a job well done will bring you closer as a team, and you yourself will feel good.

Talk with your manager and your employer about taking on more responsibility in your job role and your contribution to the decision-making process. You will feel happier and more productive if you have the opportunity to influence decisions made at work.

If you are part of the decision-making process and are engaged with other staff at work, this can help build your self-confidence and improve your wellbeing.

Employee role in the stress management standards: hse.gov.uk/stress

Having autonomy in your work also means that you help determine the pace of work, how you will complete each task and the order of priority for the tasks you are given. You may be given the leeway to complete the task yourself.

Management standards: control: hse.gov.uk/stress

Having a degree of autonomy in your work can help alleviate stress and shows that your employer can trust you to do your job well.

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Actions for individuals Be open to flexible working hours – they can help you to take time off when you need to. However, make sure that overtime or on-call services are not the norm.

Why do it?

Resources and support

Check your rights around working hours and pay.

Flexible Working: theworkfoundation.com

If you are regularly doing more hours than contracted, ensure you are adequately compensated – either through additional pay, or time off in lieu.

Tips for employees (work-life balance): mind.org.uk

Avoid spending all your time and energy in work. Plan your own personal projects, and ensure you have enough leisure time to complete them.

Working out what is right for you: rcpsych.ac.uk/mentalhealthinfo

Try to avoid making overtime and on-call duties a regular occurrence. A good work-life balance is very important for good mental health.

Flexible working and work-life balance: acas.org.uk

Flexible working: acas.org.uk

If you believe that your work-life balance is skewed too much towards work then explore alternatives with your line manager or supervisor to rebalance this. You can help to create a good work-life balance if you are involved in decisions about work, working hours or the tasks involved. How can you act?: • If you are not satisfied with the distribution of your work-life balance, talk about it to your line manager; • work effectively and concentrate on the essentials. You can save time by reducing unnecessary work and; • ask for opportunities to work flexible hours and for work that meets your needs. Ensure you take regular breaks. Your company should support this.

If you work too much without regular breaks, this can make you tense and lead to poor health. People can sometimes turn to nicotine, alcohol or food to help relieve stress; this is not the solution.

Take a break: mentalhealth.org.uk

You should organise your workday so that you have a large enough break from work to help calm and relax you.

A short walk outside in the fresh air and a few deep breaths can help to remove tension and give you a clear head and energy for any upcoming work.

Work rest breaks: hse.gov.uk

Consider taking regular breaks from work and try to leave your workstation when you do take a break. Try to take long breaks for meals, where you can relax. This is better than taking only short breaks and having a quick meal.

Consider the options for making reasonable adjustments in the workplace.

Stress in the workplace can be a significant issue: job expectations; the job role and your working conditions can all lead to high demands.

Reasonable adjustments in the workplace: rcpsych.ac.uk/mentalhealthinfo

These stress factors at work should be minimized. Consider the variety of options you have to make changes in your workplace that will benefit Mental health and work: your mental health and wellbeing. reasonable adjustments: direct.gov.uk Over a longer period of time, stress can build up. Try to break through

the stress by making small changes e.g. sort e-mails and handle them in Examples of reasonable terms of importance, clean up the desk etc. adjustments: equalityhumanrights.com Consider three areas for change: • Workplace design; • job content and organisation; • job location

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Workplace adjustments: hse.gov.uk/sicknessabsence


“Pleasure in the job puts perfection in the work.� Aristotle

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Strengthen Good Relations Good mental health is everybody's business. Our family, friends and colleagues play as much a role in our mental health as we do in theirs. During a period of mental ill health, and during recovery, good relationships and good communication can be very important. This section focuses on the importance of remaining in contact with your friends, family, and colleagues - both from your personal and your professional life. These relationships can aid the recovery and the return to work process. Look out for help and support from among the people close to you. You will also find that your employer and your doctor can provide you with good help and will listen to your problems.


Actions for individuals

Why do it?

Resources and support

Do not be afraid to talk to people You do not have to be afraid of asking for help or assistance. Stepping at work or in private about forward shows that it is important for you to involve the people around mental health issues. you and it also supports good teamwork at work. Strengthen your friendship groups to help avoid discrimination and stigma. Have the courage to ask your employer for support if you feel you need help.

Talk about your feelings: mentalhealth.org.uk

Telling someone about your Being open about your mental health – especially how you are feeling – mental health problem: can help support anti-stigma campaigns and help to raise awareness of time-to-change.org.uk mental health issues.

Take advantage of any support the company offers. Discuss with your supervisor or manager what support you might need in your job, whether you are in recovery or if you are feeling well. Take into consideration both your mental health and the work you do. Ask what support your company can provide you with and what adjustments they might be willing to make. You may also like to try something new – including a new job role or training. Discuss this with your manager, who may be able to help you.

Getting Help: mentalhealth.org.uk Guide to Surviving Working Life: mind.org.uk Getting support from my company: time-to-change.org.uk

Understanding bullying: Psychological stress can increase when you feel helpless or in a tuc.org.uk stressful situation. Therefore, try to make changes to your working Bullying and harassment at environment that limit stress. You can do this with support from your line work: acas.org.uk manager or supervisor. You can gain more CV skills, strengthen your mental health and wellbeing and become more productive through a change in your job role or responsibilities. Look for help from your supervisor, line manager or employer in relation to your mental health condition. Provide feedback as to the support you receive from your supervisor.

Remain aware of potential problems or stressful situations at work. Your Talking to your employer about psychological wellbeing can be improved if you are actively working on your mental health: making a positive change and your superior considers your suggestions. rcpsych.ac.uk/mentalhealthinfo Talk about any issues or problems at work in a team meeting – others may have similar feelings or experiences. State your own ideas and opinions clearly and be responsive to suggestions from the rest of the team and from your employer.

Guide to Surviving Working Life: mind.org.uk

After a long break or a period of illness consider the option of a gradual reintegration into work. This can help build your confidence as you take on more work and responsibilities.

Telling my manager: time-to-change.org.uk

Support in the workplace: time-to-change.org.uk

Use the support available from your company (e.g. occupational health or social services) or you can consult your family physician or a mental health specialist. Provide feedback on the support you have received. This will help your line manager to understand your position and help to design better support for you in future.

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Actions for individuals

Why do it?

Resources and support

Your wellbeing and your productivity can be increased through good relationships in the workplace.

Cooperation and teamwork not only provides strength in work and in everyday life but also creates a work atmosphere that makes it easier for you and your colleagues to solve problems together, to grow stronger as a team and to achieve common goals.

How to Look After Your Mental Health: mentalhealth.org.uk

Develop the courage to speak about your mental health issue with close colleagues.

What works for you? Supporting colleagues: Teamwork requires good relationships with your colleagues and this can mentalhealth.org.uk also act as a good support mechanism for you during a period of illness. Guide to Surviving Working Life: Stress at work or within a team can be minimized if good and respectful mind.org.uk communication exists among colleagues / the team. Active participation in team and departmental meetings creates clarity and trust, and strengthens relationships.

Maintaining good relationships with family and friends, and forming new relationships can help to reduce the risk of psychological problems.

Sincere and good relationships with family and friends are an important pillar of general support; they serve as a protective factor for you and your mental health.

Keep in touch: mentalhealth.org.uk

Ensure you communicate any problems or concerns you may have – whether this is with your doctor your friends and family, or your employer.

Do you know how to communicate a particular problem or a concern to your doctor or employer? Don’t be afraid of seeking professional help if you have any worries or concerns.

Ask for help: mentalhealth.org.uk

Keeping us going – effects of Stable and long-lasting relationships are particularly important in difficult mental health on relationships: times. Friends and family members give support, provide help during mentalhealth.org.uk recovery and also help you to evaluate your choices.

Make a list of problems or concerns you may have about your work – either on your own or with colleagues – that you can deal with methodically:

Getting professional help: time-to-change.org.uk

Working with your GP: Good communication in the rcpsych.ac.uk/mentalhealthinfo workplace provides a relaxed • are you satisfied with the current work situation or would you working atmosphere and change it? contributes to your own personal • what problems do you see or foresee at work? development. • do you have any solutions that you can think of that you and your Honest and open communication team can act on? with your doctor can also help • what can you do yourself? them to support you to remain Lack of communication is a type of psychological stress and can lead to in work. an increased risk of mental ill health. You therefore need to develop the courage to speak about the things you are passionate about. We are always communicating. Facial expressions and gestures show everyone how you feel. Be open about your concerns and feelings. If it is not possible to remedy a situation directly, it may help to bring in a neutral third party. Be open and honest with your doctor. They can provide additional support to help you stay in work or return to work quicker.

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“Good mental health is everybody’s business”


This publication is supported by the European Union Programme for Employment and Social Solidarity - PROGRESS (2007-2013). This programme is managed by the Directorate-General for Employment, social affairs and equal opportunities of the European Commission. It was established to financially support the implementation of the objectives of the European Union in the employment and social affairs area, as set out in the Social Agenda, and thereby contribute to the achievement of the Lisbon Strategy goals in these fields. The seven-year Programme targets all stakeholders who can help shape the development of appropriate and effective employment and social legislation and policies, across the EU-27, EFTA-EEA and EU candidate and pre-candidate countries. PROGRESS mission is to strengthen the EU contribution in support of Member States’ commitment. PROGRESS is instrumental in: • providing analysis and policy advice on PROGRESS policy areas; • monitoring and reporting on the implementation of EU legislation and policies in PROGRESS policy areas; • promoting policy transfer, learning and support among Member States on EU objectives and priorities; and • relaying the views of the stakeholders and society at large For more information see: ec.europa.eu/progress The information contained in this publication does not necessarily reflect the position or opinion of the European Commission, which is the Contracting Authority. Partners


Mental Health and Employment - Toolkit for Individuals