Stress and Mental Health at work and home

A person can experience excessive pressure and demands outside work just as much as they can at work. Stressors at home can affect those at work and vice versa. It is difficult to control outside stressors, but you need to take a holistic approach to employee well-being. To manage work-related stress effectively, you need to recognise the importance and interaction of work and home problems.

Definitions

Work-related stress is the adverse reaction people have to excessive pressures or other types of demand placed on them at work.

Mental health

Mental health is how we think, feel and behave.

Common mental health problems are those that:

are most frequent and more prevalent
are successfully treated in primary care settings like GPs rather than by specialists such as Psychiatrists

For further information on mental health see www.nidirect.gov.uk

Anxiety

Anxiety is an unpleasant feeling when you feel worried, uneasy or distressed about something that may or may not be about to happen.

Depression

Depression is when you have feelings of extreme sadness, despair or inadequacy that last for a long time.

Common Mental Health Problems (CMHP)

One person in four in the UK will have a mental health problem at some point in their life. While mental health problems are common, most are mild. The family doctor and primary healthcare team can usually deal with them without referring the person for specialist help.

Anxiety and depression are the most common mental health problems. Often these are a reaction to a difficult life event, for example moving house, bereavement, or problems at work.

CMHPs tend to be short-term and are generally treated by medication from a GP. The GP will review this treatment and if there is no improvement, consider referring to a specialist.

How CMHPs and work-related stress go together

Work-related stress and mental health often go together. The symptoms of stress and common mental health problems are similar, for example, loss of appetite, fatigue and tearfulness can be symptoms of both.

Work-related stress may trigger an existing mental health problem that the person may otherwise have successfully managed without letting it affect their work.

For people with existing mental health issues, work-related stress may worsen their problem. If work-related stress reaches a point where it has triggered an existing mental health problem, it becomes hard to separate one from the other.

How CMHPs and work-related stress are different

Common mental health problems and stress can exist independently. For example, people can have work-related stress and physical changes such as high blood pressure, without experiencing anxiety and depression. They can also have anxiety and depression without experiencing stress.

The key difference between the two is their cause and the way they are treated.

Stress at work is a reaction to events or experiences at work. CMHPs can arise through causes outside work for example bereavement, divorce, postnatal depression or a family history of the problem. However, people can have CMHPs with no obvious causes.

Organisations can manage and prevent stress by improving conditions at work. Doctors usually treat common mental health problems by prescribing medication. However, you and your managers have a role in making adjustments and helping the person to manage the problem at work.

Mental health problems

In practice, it can be hard to distinguish when ‘stress’ turns into a ‘mental health problem’ and when existing mental health problems become exaggerated by stress at work.

Many of the symptoms are similar to those that people experience when they are under considerable pressure; the key differences are in the severity and duration of the symptoms and the impact they have on someone’s everyday life.

Usually a general practitioner (GP) will make the diagnosis and offer treatment for example medication, talking therapies or a combination of both.

The majority of people with mental health problems are treated by their GP and most are capable of continuing to work productively. Evidence shows that employment can be of great benefit, both to the employer and to the employee.

Dealing with my mental health

If you already feel under pressure, it’s hard to distinguish when that ‘stress’ turns into a ‘mental health problem’ and when an existing mental health problem becomes aggravated by stress at work.

Many of the symptoms of stress and a mental health condition are similar; the key differences are in the severity and duration of the symptoms and the impact they have on your everyday life. The majority of people with mental health problems are diagnosed and treated by their GP and most continue to work productively. In fact, evidence shows that staying in work can be of great benefit to those affected.

Take action at an early stage

If you feel you have a problem the earlier you take action the better; early action can help prevent you becoming more unwell. Line managers and colleagues can also play a key role in identifying when you are behaving out of character, so be co-operative if your line manager approaches you.

Using ordinary management tools to identify problems and needs

It might be that certain tasks, work environments, times of the day or being part of a particular team is associated with your difficulties, If you feel you are having a problem raise it with your line manager, HR or someone else in the workplace. You could make use of the scheduled meetings, appraisals or informal chats about progress that you have with your manager; these may provide neutral opportunities to find out about and discuss any problems you have.

Remember

stress does not affect everyone in the same way
your employer can make adjustments to ease your stress, but only if you give them a better understanding of your position
discussions can be positive - working out how your employer can help

If you have had time off sick, you should discuss how you can return to work and integrate in advance of any return date. A documented plan that helps you both to agree when you have reached the stage of ‘business as usual’ can be valuable.

If you remain unwell despite support then you should seek appropriate help, consider asking to be referred to the organisation’s occupational health department if it has one or see your GP.

If you are returning to work after illness

Most people who have had an illness will recover but there will be a stage during your rehabilitation when you will return to work with some remnant of your ongoing mental health problems. This may mean that you need some support or changes in your role or work to make the return easier. You should talk to your manager and working together try to satisfy your needs.

It is possible that your condition may be one that is subject to the provisions of the Disability Discrimination (Northern Ireland) Order 2006 which may require your employer to make reasonable adjustments to help you get back into work – but if you don’t talk to your manager and discuss these issues honestly they will be less likely to be able to meet your requirements.

If you are going through a hard time and would like to talk to someone, there are a wide range of organisations that may be of assistance.

Causes of stress outside work

Many things in people's lives outside work can cause them stress, for example:

Family

death (of a loved one)
divorce or separation from a partner
marriage
pregnancy
holidays
changes in health of a family member or close friend
trouble with in-laws
family arguments
children leaving home
childcare
remarriage of a family member
caring for other dependents, such as elderly relatives
family reunion
relationship breakdown or having a long-distance relationship

Personal or social issues

change in financial state, or debt or money worries
changes in personal habits such as giving up smoking, going on a diet
problems with weight
experiencing prejudice or discrimination
lack of friends or support
personal injury or illness

Daily hassles

traffic jams
public transport
time pressures
car troubles

Other

moving house, including taking out a mortgage
difficulties with neighbours
living with someone with an alcohol, drug problem or other addiction
(if studying) a deadline for coursework, exam results or trying to balance work and study
unemployment
poor living environment

Dealing with my stress

Stress produces a range of signs and symptoms, the following is not an exhaustive list of the symptoms of stress but if you feel that your attitudes or behaviour is changing due a situation at work or home, these may indicate stress and a need to seek further advice from your GP.

Anyone can suffer from work-related stress, no matter what work they do.

Behaviour

You may:

find it hard to sleep
change your eating habits
smoke or drink more
avoid friends and family
have sexual problems

Physical symptoms

Might include:

tiredness
indigestion and nausea
headaches
aching muscles
palpitations

Mentally

You may:

be more indecisive
find it hard to concentrate
suffer loss of memory
feelings of inadequacy
low self esteem

Emotionally

You are likely to:

get irritable or angry
be anxious
feel numb
be hypersensitive
feel drained and listless

What can I do if I think I'm stressed?

There are many organisations that may be able to help you with the issues that are causing your stress.

If you think you are suffering from any mental health problem or any of the symptoms identified in the table above, it may be advisable to speak to your GP. It is also a good idea to talk to your line manager, Human Resources department or Occupational Health provider.

It is important to take action and to review your lifestyle to see if you can identify any contributing factors.

eating on the run, or in a disorganised manner
smoking, or drinking excessively
rushing, hurrying, being available to everyone
doing several jobs at once
missing breaks, taking work home with you
having no time for exercise and relaxation

Stress at work is a reaction to events or experiences at work. Common mental health problems can arise through causes outside work for example , for example, bereavement, divorce, post-natal depression. However, people can have common mental health problems with no obvious causes.

NHS Choices

NHS Choices is the online 'front door' to the NHS. It is the UK's biggest health website and gives all the information you need to make choices about your health.

Stress - NHS website (www.nhs.uk)

Do employers have to do anything about stress outside work?

You don't have to, but it's good if you do. If you think about people's personal lives and outside stressors, you will be able to anticipate stressful times.

Your employee is not obliged to tell you their personal problems, but there are some practical things you could do to support them:

be sympathetic and proactive - arrange a confidential meeting with the person, allowing them the opportunity to discuss any problems they wish and allowing you time to voice your own concerns, it may help to clarify whether the person’s problems are work related or personal
be flexible - consider offering the person more flexible working hours, or even offer them some paid time off to deal with their problems
offer outside support - if appropriate, you could suggest they visit their doctor and allow them time off to do so, you could also suggest support groups
outline the support and services your organisation offers- for example, your organisation may have a work–life balance initiative in place, these are benefits, policies, or programmes that help balance out job demands and a healthy life outside work, they can include, childcare services, flexible working arrangements, family leave policies, employee assistance programmes and fitness programmes

Programmes of this kind can work effectively to:

retain staff
improve morale
reduce sickness absence and stress
increase productivity and commitment

Work-life balance initiatives

The website of the Canadian Centre for Occupational Health and Safety answers some questions about work–life balance.

Canadian Centre for Occupational Health and Safety website

The Flexibility website contains resources for new ways of working, including a checklist and an index of articles written about work–life balance.

If your employee has raised a specific issue with you, you might like to suggest they approach one of these support organisations.

Public Health Agency launch free Workplace Health and Well-being Support Service

For more details contact the service provider in your area:-

Two local organisations have recently been awarded a contract to provide NI businesses with a FREE Workplace Health and Well-being Support Service, called Work Well Live Well.

The service aims to mentor and support businesses through a structured four stage process with the ultimate aim of improving the health and well-being of the workforce.

As the service is free, demand is expected to be very high and there is a cap on places available.

You can request details of this initiative by emailing the relevant contact in your area:-

Northern Ireland Chest Heart & Stroke cover the Belfast, South Eastern and Southern Northern Health & Social Care Trust Region
emccrudden@nichs.org.uk
DHC Group - Health@Work Programme cover the Western Health & Social Care Trust Region
sabrina@derryhc.com

Find out more

Find out more about helping people with anxiety by going to the ANXIETY UK website.

ANXIETY UK is a national registered charity formed 30 years ago by a sufferer of agoraphobia for those affected by anxiety disorders; it is still a user-led organisation, run by sufferers and ex-sufferers of anxiety disorders supported by a high-profile medical advisory panel.

More information

For more information please contact a mental well-being at work advisor.

stress@hseni.gov.uk