Returning to and thriving at workfollowing mental ill-health absence

Prof. Karina Nielsen, Dr Jo YarkerWork Wellness Institute Webinar20 April 2020

Overview

1. Why return to work following mental ill-health?2. Our approach3. Our findings 4. Implications for wellbeing and productivity

1. Why return to work following mental ill-health?TOO MANY• 1 in 3 ‘fit notes’ issued for mental disorders (NHS Digital, 2017)• 57% lost work days is due to stress, anxiety or depression, £5.2bn to Great

Britain each year (HSE, 2018)

FOR TOO LONG• The longer people stay off, the less likely they are to return• Some figures suggest 20% relapse, 20% exit work (e.g. Norder et al, 2017)

WITH TOO LITTLE SUPPORT• Managers do not know how to, or can not afford to, make adjustments • Employees are unsure of what to say, or what to do

• Interviews with 38 employees and 20 managers at multiple time points over a four month period

• Used our recently developed the IGLOO Framework to explore the resources that help returning workers stay at work (Individual, Group, Leader, Organisational level resources)

2. Our approach

The IGLOO model

I

G

L

O

O

Home Work

Outside influences(legislation, policy)

Organisational factors

Line Management

Group and team support

Individual resources

Group and social networks

Links to services (healthcare services)

Individual resources

Sustainable Return to Work

Organisational factors(community and voluntary)

Outside influences(welfare and healthcare)

Nielsen, K., Yarker, J., M

unir, F., & Bültm

ann, U. (2018). IGLO

O: An

integrated framew

ork for sustainable return to work in w

orkers with

comm

on mental disorders. W

ork & Stress, 32(4), 400-417.

Job crafting

• Task job crafting: Demarcation between work and leisure• Cognitive job crafting: Placing a conscious focus on life, not just

work, setting realistic expectations about the job for, supporting others with CMDs

• Role of nutrition and exercise (e.g. Joyce et al, 2016)

Work

• Task job crafting: creating structure in the day, identifying discrete sub-tasks, identifying and prioritizing core tasks, taking small breaks between tasks

• Relational job crafting: Limit social interaction, changing work location according to task, setting colleague expectations

Non-work

Group level resources

• Support for the returner is higher where good relationships prior to absence, and collective identity of the team

• Knowing colleagues are there..

Work

• Understanding, emotional and practical support from friends and family is important.

Non-work

Line managers and Links to services

• Role of good relationship with GP or healthcare provider (Norder et al, 2015)

• Stable relationship

Work• Good relationship between line manager and employee important –

available and listening• Access to other support• Knowing support is available• Line managers’ continued support and adjustments

Non-work

Organisational level resources

• Community and voluntary organisations and services have provided valuable support for workers with CMD (e.g. Mind)

Work• Wellbeing services, CBT• A number of HRM practices are effective such as individualized RTW plans,

flexible work, phased return, ability-enhancing practices e.g. assertiveness/ time management (Ashby et al, 2010)

Non-work

Overarching context resources

• Policies and practices operate within national context• Significant variations in national healthcare systems and

societal normsWork

• Stigmatisation (Time to change)Non-work

The IGLOO model

I

G

L

O

O

Home Work

Outside influences(legislation, policy)

Organisational factors

Line Management

Group and team support

Individual resources

Group and social networks

Links to services (healthcare services)

Individual resources

Sustainable Return to Work

Organisational factors(community and voluntary)

Outside influences(welfare and healthcare)

Nielsen, K., Yarker, J., M

unir, F., & Bültm

ann, U. (2018). IGLO

O: An

integrated framew

ork for sustainable return to work in w

orkers with

comm

on mental disorders. W

ork & Stress, 32(4), 400-417.

“For me it’s about creating that environment where I’m able to work, to function on some level, even if not at full capacity. …. It’s tricky, because every organisation, every person [is different]. Whether ..we look at sustainability through something formal from a legal perspective or something sustainable from moral stance, I don’t know. But …

I know what I need to sustain myself. I know what’s important for me that may not fit everybody, people are different, values are different. So that’s really difficult. I think there’s no definitive answer. It’s such an individualised need that people have. (Returned worker 15, month 4)

4. Implications for wellbeing and productivity

We need to:• Consider resources at all IGLOO levels at home and and work• Implement multi-level interventions• Equip the managers with the knowledge, skills and confidence to

support the returning employee• Encourage the returning employee to draw on a range of resources

rather than doing it on their own• Re-orientate our systems to cope with fluctuating conditions

(including GP services and fit notes, absence policies, SSP benefits)

And do so in a flexible, individualised way, for the long term.

4. Implications for wellbeing and productivity

• To read the full report and guidance visit: https://productivityinsightsnetwork.co.uk

• To read the conceptual paper: Nielsen, K., Yarker, J., Munir, F., & Bültmann, U. (2018). IGLOO: An integrated framework for sustainable return to work in workers with common mental disorders. Work & Stress, 32(4), 400-417.

• If you would like to know more about our work or get involved in our research please contact us:• Karina Nielsen k.m.nielsen@sheffield.ac.uk• Jo Yarker jo@affinityhealthatwork.com

Toolkit: http://www.affinityhealthatwork.co.uk/our-research- individual, group, line managers and Human Resource professionals

Thank you for your time.

Guidelines – colleagues example

Guideline introduction

Guidelines explanation

Action planning

Guideline – additional information

Questions?

• What is sustainable return to work?– Same tasks?– Same position?– No relapse?

• What are your experiences supporting RTW?• What tools do you use?