Reflecting on the many changes over my working life; starting in the City as a trainee accountant, when computers were the size of a room and auditors worked with Tipp-Ex1 and calculators; I recall the daily struggle and fear as I adapted to corporate life in a traditional, stiff upper lip environment, where admitting to stress was not an option!
Thankfully, things have moved on and awareness of mental wellbeing at work is increasing; supported by charities, like MIND2 and members of the Royal Family3 .
The recent AXA Health Tech & You Roundtable4 discussion, hosted by 2020health5 and informed by the fourth YouGov State of the Nation Survey, considered the role of personal health technology in workplace mental wellbeing.
A widely known statistic is that “around 1 in 4 people will experience a mental health problem”6 , at any one time’7 . Our poll indicated that, “getting on for half the population … have experienced … mental health distress”8 at some point in their lives ; and 18% of those reporting mental health issues took 21 days or more off work.
The recent Farmer Stevenson Report, Thriving At Work10 , indicated untreated mental illness is costing employers £33 - £42 billion each year. The importance of an holistic approach, acknowledging that mental and physical wellbeing are intertwined, is also being reflected in government policy with commitment to seek parity of esteem11 ; and corporate initiatives, such as AXA’s Proactive Health Unit, aiming for a balance of mental and physical wellbeing.
The commercial good sense of supporting mental wellbeing in the workplace was flagged by AXA PPP healthcare’s Chris Tomkins12 , sharing recent analysis13 of wellbeing programmes14 ; where companies with programmes grew, on average, between 2.3% and 3.8% faster than those without. Exploring the question of ‘who pays’ for the personal health tech, the YouGov survey found about a third of people were willing to buy and wear a device if incentivised by employers. This rises to just over 50% if the employer supplies it, with people in the 18-24 age category the keenest.
To encourage adoption of technology in this arena the panel recognised the importance of trust. Before making personal data available to their employers’ workers need to feel confident there will be an effective balance, between supporting good mental health, and ensuring confidentiality, and associated fears of stigma and discrimination. Of survey respondents willing to wear a device, half said they would be happy to share the data.
Key fears were indeed those of discrimination and breach of confidentiality; older people were most concerned that their data would be shared with third parties, whilst 18-24’s were more concerned about their employer finding out about their lifestyle. These findings sit within the wider debate on personal health data sharing, a complex and challenging topic, and currently facing added uncertainty with the forthcoming General Data Protection Regulation (GDSR) legislation15 .
The survey found about half of those who had experienced mental illness at work shared their symptoms with employers. Encouragingly, nearly three-quarters of those that did disclose reported a supportive response. In building a culture of trust in an organisation, the panel highlighted the role and importance of openness by the leadership; that such leadership needs to be at every level, starting at the top and followed up with proactive and appropriately supported effort to cascade that down through all levels of the organisation.
Accreditation using trusted standards, of quality, safety and efficacy, was flagged as important to building trust; however, caution was urged when allowing digital devices, apps and channels to use brands such as NHS or MIND, without sufficient evidence or testing. Trust was also considered to play an important role in the way in which people became aware of personal health technology; peer vs professional endorsement was discussed, reflecting that personal recommendation by a friend often had the stronger effect. Digital marketing approaches, tailoring the offer to individual users, as in London’s recently launched Digital Wellbeing Platform, Goodthinking16 , were also explored.
Alongside trust, key to adoption is usability of the technology. The human element in design and implementation is critical. Henry Potts17 flagged the nuance of different design for different groups, with varying needs; illustrated by two examples. James Woolard highlighted a recent study showing digital CBT based treatments to be as effective as face to face interventions; enabling significantly more people to receive treatment. Chris Tomkins described an AXA initiative combining a human health professional with digital intervention achieved a 40% increase in engagement.
Finally, the panel considered the effect on mental resilience and wellbeing of the 24/7 all-pervasive digital exposure we now face. James Woolard indicated Finnish research into the importance of workplace on our psychological wellbeing, reflecting, “the territoriality of workplaces is … important, if we take that away through more virtual environments, what does that do to peoples’ sense of belonging?”. Considering the rise of the ‘gig-economy’, how might the costs, risks and benefits of improving mental health wellbeing in the workplace translate into a workforce that is increasingly made up of independent employed workers working flexibly and peripatetically across different clients and sites?
- Julia Manning, 2020health, Chair #HTYRoundtable
- YouGov Survey 2017 41% respondents had experienced mental illness in the workplace. Further 5% No Comment