Line management, the foundation of a mentally healthy NHS

Justin Varney

19 / 5 / 2016 3.17pm

As part of Mental Health Awareness Week, and to celebrate #EQW2016, Dr Justin Varney, national lead for adult health and wellbeing, and interim deputy director of health and wellbeing (healthy people division) at Public Health England, explains the importance of effective line management to support mental health. 

Line management, the foundation of a mentally healthy NHS

Mental Health Awareness Week (MHAW) is an important week for me. As somebody who has experienced mental health issues when I worked in the NHS, I know from personal experience how debilitating and isolating it can be if you don’t have good line managers and if your colleagues and workplace isn’t open about mental health issues.  

This year MHAW provides an opportunity to take stock of developments, specifically within the NHS. It allows us to re-consider how we can take action personally and professionally. Many people in their lifetime will experience a form of mental ill-health at some point, be it stress, depression or anxiety, so as individuals and as line managers it is something that we really should think about before it touches our working lives.

Earlier this year the Mental Health Taskforce published its landmark report which identified a roadmap for the next five years to address the inequity in how we think about physical and mental health. It was great to see explicit discussion of the beneficial relationship between good work and health, as well as the recognition of the significant gap in employment rates for people with mental health issues.  

What is interesting is that the most important protective, or destructive, risk factor for work-related mental health issues is the relationship between a staff member and their line manager. This is the fundamental building block on which all employers should be building their response to mental health, and physical health, issues in the workplace. If you are not investing in line management, then investing in wellbeing programmes is unlikely to have much impact and ultimately is a waste of money.
The NHS England Five Year Forward View highlighted the need for action to improve the mental and physical health of the NHS workforce. The association between staff ill health and patient outcomes is clear, so investing in staff health for the NHS, as for any other business, is good business sense.

PHE, alongside NHS Employers, have been actively supporting this work, including how it considers and addresses mental health and wellbeing in both primary and secondary care.  NHS Employers has led a large scale programme of line manager training and support, alongside PHE supporting NHS organisations to use the evidence-based Workplace Wellbeing Charter as a roadmap to implement NICE guidance on workplace health in a structured way. We are also piloting a tailored NHS Health Checks that includes specific components on mental health and musculoskeletal health (two big risks for NHS staff), the NHS Health Check is being delivered by the NHS occupational health teams and staff are already telling us how much they value the opportunity to have protected time to talk about their own health.

Improving the employer response to mental health is fundamental to helping people to achieve their potential in the workplace, retain them and also recruit new and diverse talented individuals with mental health issues in a supportive and asset based way.
As somebody who worked in the NHS in both primary and secondary care I know that when you have mental health issues your line manager and colleagues’ response is key to whether you feel able to reach out for help and find the support you need.

There are three things that all of us can do:

  1. Simply using opportunities to raise awareness through this week in conversations in the practice, ward or office can make a real difference to someone who is struggling in isolation with the black dog of depression or looking after a loved one with mental health issues.  
  2. Have a look at the excellent resources from Time2Change and the Mental Health Foundation to think about the conversation you might have as a line manager, before you need to have it, will make it so much easier when you do. 
  3. Make time to connect this week with a friend, a colleague or someone you haven’t spoken to for a while. When you are living with a mental health issue one of the hardest things to do can be to ask for help, when someone reaches out to say hi, it can be that break in the clouds that gives you a ray of light to lift your head up to. So please take some time this week to connect.
I hope that this year Mental Health Awareness Week gives all of us an opportunity to reflect on how we, as individuals and employers, can build a good foundation for a mentally healthy workplace and ensure that those who need help get it, especially from from line managers who are trained, compassionate and recognise that good health is good for business.

More information 

Find out more information on mental health in the workplace or about the NHS Employers How are feeling NHS? toolkitJoin the Mental Health Awareness Week conversation on twitter #MHAW16 or find out more about Equality Diversity and Human Rights Week #EQW2016. 

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