FABIAN POLICY REPORT MINDS AT WORK Making mental health a priority in the changing world of work Edited by Josh Abey, with a foreword by Alastair Campbell and contributions by Luciana Berger MP, Paul Farmer, Barbara Keeley MP and more FOREWORD The Changing Work Centre was established by the Fabian Society and the trade union Community in February 2016 to explore progressive ideas for the modern world of work. Through in-house and commissioned research and events, the centre is looking at the changing world of work, attitudes towards it Alastair Campbell, former director of communications and how the left should respond. The centre is chaired and strategy at Downing Street, is an ambassador by Yvette Cooper MP and supported by an advisory for Time to Change. panel of experts and politicians. E HAVE COME a long way on mental health. WThere is greater awareness and under- standing and a better appreciation of mental health and mental illness than 10, 20 or 30 years ago. That Community is a modern trade union with over a hundred is on one level a success. But though we have moved years’ experience standing up for working people. With in the right direction on the stigma and the taboo roots in traditional industries, Community now represents of mental illness, that has not been matched by workers across the UK in various sectors. sufficient progress on services for those who need them. So we rightly encourage people to be more open, but then don’t always have the capacity to provide real support. We have seen improvements in the workplace too. But it is far from universal. There are employers who understand the importance of wellbeing both to their organisations and the individuals within it. Who know that a happy and healthy workforce is a more productive and innovative workforce. But there are others who still seem to see mental illness as an inconvenient lifestyle choice or a reality that exists only in the mind of the staff member trying to take them for a ride. Of course it exists in the mind. It doesn’t make it any less real and it is even more painful if people feel they cannot be open about their feelings without fear of rejection or dismissal. A Fabian Society report Like all publications of the Fabian Society, this General secretary Andrew Harrop report represents not the collective views of Deputy general secretary Olivia Bailey the society, but only the views of the individual Report editor Josh Abey writers. The responsibility of the society is Editorial director Kate Murray limited to approving its publications as worthy Assistant editor Vanesha Singh of consideration within the labour movement. First published in December 2018 Cover image © Shutterstock 2 / Fabian Policy Report CONTENTS So just as all too often politicians talk of how mental health is a priority, but fail to follow through with the policies and funding to make 4 Call to action their words a reality, too many employers talk the talk on mental health Josh Abey and Kate Dearden at work, but do not put in place the measures that would make a real difference to their employees. Whether it’s big employers offering in- 8 Challenges and consequences house counselling for staff or small employers offering real flexibility in Chris O’Sullivan working hours, there are plenty of practical steps organisations can take 10 Time to thrive to make their workplaces better for those with mental health conditions. Paul Farmer The world I want to see is one where people feel they can be as open about their mental health as they are about their physical health. We are 12 Mental health getting there. But we have a long, long way to go. Employers can and in the new economy should take a lead. We would all be better off for it. Sally Anne Gross I have asthma. But nobody ever defines me by my asthma. 14 Accommodation Theresa May has diabetes. Nobody defines her by her diabetes. Yet all too or integration? often people who are open about mental illness are defined by it. He’s a Gill Dix schizophrenic. She’s bipolar. He’s a depressive. We need to see beyond illness labels and see what an individual has to offer. And we need to 16 Mutual and meaningful change the lens through which we view mental illness. Dr Ruth Yeoman Recently a profile writer said of me that I have had a successful life 18 Unions at the heart and career ‘despite a history of mental health struggles.’ I felt moved Roy Rickhuss to write and ask if, the next time he wrote about me, he could delete ‘despite’ and insert ‘in part because of.’ Because that is how I feel about 20 Setting the standard it. A breakdown in the 80s made me prioritise my life better, do more Luciana Berger MP to look after my own health, and made me resilient. Depression I think 22 Risks and rewards gives me more understanding of other people and their problems. And Gillian Connor I have lived with family members with more serious mental health chal- lenges, including my brother Donald who lived with schizophrenia all 24 An equal response his adult life, but lived a good life to the full. His employer, Glasgow Dr Jed Boardman University, never saw him as a ‘schizophrenic’ but as an employee with schizophrenia which occasionally made him erratic, occasionally 26 Relentless focus required him to be hospitalised, but who could be managed well and do Barbara Keeley MP a good job for them. This is about changing attitudes in government and beyond. I welcome this collection as part of that campaign, and commend Com- munity and the Changing Work Centre for their efforts to put mental health at work on the agenda. F 3 / Minds at work Call to action Work is at the centre of the mental health debate. Josh Abey and Kate Dearden shine a light on the lives affected and call for action from government, employers and trade unions Josh Abey is a researcher at the Fabian Society and Kate Dearden is research and campaigns officer at Community ORK MAKES UP a huge part of our The emergence of a gig economy – where to those self-employed workers aged be- Wlives and has a significant impact on workers, enabled by technology, flexibly tween 16 and 64 who have a self-reported our mental health. This may be for better take on short-term contracts and tasks – mental illness. The definition of mental ill- or for worse – poor practice can exacerbate has undermined the security of more ness used includes depression, bad nerves mental ill-health, but work is also the place traditional employment relationships. and anxiety. where people can find both support and a sense of purpose. Action from government As Alastair Campbell notes in his The government has taken some steps to foreword to this report, we have made real New Fabian research improve mental health provision. The most progress in the battle to remove the stigma recent budget contained a commitment of that too often comes with mental ill- adds to this analysis, £2bn to pay for a 24-hour mental health health. But this has not yet been matched by highlighting a steep hotline, more mental health specialist by policy action, and too many people are ambulances and new mental health crisis going without the support and services increase in the number centres in every major A&E by 2023-24. they need. These new measures are welcome and Nowhere is that more the case than of self-employed workers should prove impactful if delivered. But when it comes to the world of work. While with a mental illness there has been insufficient focus on the some employers have taken action to interaction between mental health and support good mental health, too often the the world of work. issue is not taken seriously. Government In this sense, Labour’s offer is better has done too little to encourage businesses Recent reports from both the Office suited to the challenge. In her contribu- to do better. This report places work at for National Statistics (ONS) and Busi- tion to this report, shadow mental health the centre of the mental health debate, ness in the Community have shown that minister Barbara Keeley sets out a holistic and calls for employers, government and job insecurity contributes to poor mental approach that prioritises preventative trade unions to work together to address health. New Fabian research adds to this strategies and infrastructure investment the crisis. analysis, by highlighting a steep increase to improve the environment in which we in the number of self-employed workers work. Other Labour policies will contribute Change and challenges with a mental illness. Over just five years to minimising the conditions in which The world of work is changing. One of the the number has almost doubled, rising workplace mental ill-health develops: ban- key features of this change has been the from 105,000 in 2012 to 203,000 in 2017. ning zero-hours contracts, ensuring that expansion of employment practices that These estimates come from the Annual contracts reflect hours actually worked, promote insecurity – including zero-hours Population Survey, conducted by the ONS and extending the rights of employees to contracts and bogus self-employment. and released earlier this year; they refer all workers. 4 / Fabian Policy Report workers purchase private income protec- CASE STUDY: STEPHEN tion insurance policies. The government Stephen works three days a week as a receptionist for an organisation that should establish a collective insurance manufactures toiletries and cleaning products.