Managing employee mental health in the workplace

We are delighted to welcome Bee Innes from Healthy Bee as our expert guest blogger. As an employee wellbeing specialist Bee is well placed to talk to us about mental health at work. She offers her thoughts on nutrition for stress and mood and explains the fascinating link between gut health and mental health.

Last month was mental health awareness month so I am delighted that P3PM have invited me to write a guest blog on employee mental health in the workplace.

We will start by looking at the scope of the problem and the cost to UK employers and move on to highlight some common misunderstandings about an employer’s legal duties. Finally, as a registered naturopathic nutritionist with 9 years of clinical practice, I shed some light on how nutrition and lifestyle medicine can support someone’s mental health.

Workplace mental health statistics in the UK

Government data on mental health from 2014 states that 1 in 6 people have issues with their mental health. Deloitte conducted a mental health survey in 2023 of over 3,000 working age adults in the UK, which indicates this figure may now be as many as 1 in 4. So, if you have 4 or more employees, even though someone may not have disclosed a mental health impairment as they have no duty to, it is reasonable to assume that this affects your organisation. How? Well let us look at some more of Deloitte’s figures:

• 63% of people taking their survey showed at least one sign of burnout
  59% of people who resigned or were planning to resign from their job cited mental ill health as a major contributor

• Presenteeism, the term used to describe reduced productivity at work resulting from a health issue, has been estimated by Deloitte in relation to mental health to cost £24 billion a year

• Absenteeism is estimated at £7 billion

• Turnover is estimated at £20 billion

• The annual cost of mental ill health to business is an estimated £51 billion

44% of employees with mental ill health do not feel supported at work. Deloitte’s figures do not look at the cost resulting from discrimination cases, so we can expect that to be even higher than £51 billion.

Employer duties under the Equality Act 2010

There are three main points I find many employers are not aware of when considering their duties under the Equality Act 2010 to make reasonable adjustments:

1. The condition must have a substantial adverse effect on someone’s ability to conduct day-to-day tasks discounting someone’s treatment/medications. So even if someone’s mental health is well managed by treatments and/or medications, the employer would still need to make reasonable adjustments if, without that treatment and/or medication, the employee would have substantial difficulty in completing daily tasks (assuming that the mental ill health is expected to have a long-term impact, i.e. 12 months or longer).
   

2. If someone has met the above criteria for long-term and substantial impact in the past, they will still be covered under the Equality Act.
   

3. No diagnosis is necessary for someone to be protected under the Equality Act.

What has the gut got to do with employee mental health?

When I conduct my complimentary employee wellbeing reviews with organisations, one of the things we look at is what their existing provision is and how well that is working.

It is good to see more employers having an Employee Assistance Programme or mental health first aiders. However, employers cannot access data on how many people have accessed the service or on their user experience.

It is important for organisations to provide actionable information to employees that they can take home and put into practice to support their mental health, whether they choose to disclose a mental health impairment or not.

Deloitte estimates return on investment of every £1 invested in workplace mental health initiatives to be £4.70 when support is implemented early enough.

There are many holistic therapies out there that employers can choose from to improve wellbeing. One thing that often gets overlooked, however, is the link between nutrition, gut health and mental health. So, let us have a look at some case studies from my own clinic to bring this to life.

Case study one

X came to me with digestive issues, caused by SIBO (small intestinal bacterial overgrowth). They described themselves as an anxious person. They had left their previous employment due to their stress levels. A period of extreme stress had triggered their gut issues.

We evolved to be able to deal with short-term stress such as running away from a tiger. This is the sympathetic branch of the nervous system, which produces physiological responses to help us deal with the stressor, by diverting resources away from less necessary tasks in that moment, such as immunity or digestion. However, when that stressor has passed, we revert to the parasympathetic state, also known as “rest and digest.” 

In chronic stress or anxiety, however, the body does not restore this balance and can get stuck in the sympathetic branch of the nervous system, also known as “fight, flight or freeze”. That is why stress is such an insidious health risk, as it impairs digestion and lowers your immune defences.

If you are not digesting your food, you are not absorbing the nutrients you need to make your calming brain chemicals – neurotransmitters like GABA – or your feel-good brain chemicals – neurotransmitters like serotonin. This then becomes a vicious cycle. Poor mental health leading to poor digestive health, which then further impacts poor mental health.

Another neurotransmitter, dopamine, is responsible for motivation and reward, an imbalance of which can lead to demotivation and addictions to things as seemingly insidious as coffee or sugar or as serious as alcohol dependence. Some clients when they first come to me are using alcohol to deal with stress, which impairs decent quality sleep and makes them feel sluggish and less sharp the next day, impairing their performance at work. When you give people the nutrients to make their own feel-good brain chemicals and the ability to break down and absorb those nutrients, the results are obvious.

But this is just one way that the gut can affect the brain. Toxins emitted by bacterial imbalance in the gut can travel from the gut to the brain along the vagus nerve and affect our mental health and function. The “gut-brain” axis is becoming a much talked about subject now.

Case study two

Y had had digestive issues from a young age. Researchers have found that people with depression have not enough of some types of bacteria in the large intestine and too much of others. After only 4 weeks of support to deal with an imbalance of bacteria in their large intestine, as well as the small intestine (SIBO), Y said “I finally feel like myself again and can’t recall the last time my mental health was this good”.

Case study three

Fluctuating blood sugar levels can play havoc with your mood and energy. Most people start the day with foods that send their blood sugars yo-yoing. This can cause symptoms such as poor concentration and memory, brain fog, feeling hangry or lightheaded if you go too long without food or having energy slumps throughout your day, making you less productive. This was the case for one of my clients, Z. Z was under performance review at work when they first came to me and had been referred to a memory clinic. We did two things. We stabilised their blood sugar levels through nutritional intervention and worked on hydration levels. Brain health improved and they were taken off performance review.

Boosting employee mental health in the workplace

If you want to create an organisational culture where employee wellbeing is fostered, mental health is something that you should be considering. When employers do not see this as a priority, this can result in huge cost implications for organisations, not only in terms of retention, productivity, sickness absence and presenteeism, but also in terms of potential discrimination claims. And whilst there are many ways of supporting better mental health at work, nutrition is certainly something that should be amongst those considerations. Of course, as a nutritionist, I would say that! So, I’d like to end with a quote from a research paper in a peer reviewed journal:

“The highest therapeutic potential is seen in the rational diet, physical activity, use of psychobiotics, and consumption of antioxidants. Research also shows that there are nutritional interventions that have psychoprotective potential.” (Grajek M, Krupa-Kotara K, Bia?ek-Dratwa A, Sobczyk K, Grot M, Kowalski O, Sta?kiewicz W. Nutrition and mental health: A review of current knowledge about the impact of diet on mental health. Front Nutr. 2022 Aug 22; 9:943998).

Bee Innes is a registered naturopathic nutritionist with 9 years of clinical practice. As part of her employee wellbeing solutions, she offers talks, pop-up clinics and content on topics such as mental health, energy and menopause with the aim of providing actionable tips that employees can put into practice to improve their physical and mental wellbeing. She also has a background in disability, having been bedridden for 8 years herself previously with burnout and chronic fatigue. She uses this experience to deliver disability awareness training alongside her employee wellbeing offerings. If you are interested in disability awareness training or a complimentary employee wellbeing review for your organisation, you can find out more here: https://www.healthybe.co.uk/workplace-wellbeing-programmes/