Stress is highly evident in the workplace, with one in six British workers each year affected by problems such an anxiety, acute stress and depression. But what can businesses do about it and how can we ensure that employee wellbeing is placed firmly on the agenda?

Whichever way you look at it workplace stress statistics make stressful reading for employers. According to a survey by AXA PPP healthcare almost half of employees (45 per cent) said that workload was their main cause of stress while a corresponding number of managers cited stress in the workplace as their main cause. Meanwhile, figures from a report by mental health charity Mind reveal that one in six British workers each year are affected by problems such as anxiety, depression and unmanageable stress and such conditions are consistently reported major causes of workplace absence.

“Men in management positions used to be very uncomfortable about telling me they were stressed but many more people are prepared to talk about these issues now,” says Dr Nick Summerton, a practising GP and public health physician and also medical advisor to workplace health firm Bluecrest Wellness. He adds that you could ask whether the willingness for people to talk about it means more cases or just more being registered but he concludes: “I think it’s probably a bit of both.”

The responsibility for dealing with workplace stress falls on everyone’s shoulders: employers, managers and individuals who may be suffering the effects of it. It has to start at the top and a culture in which employees and managers can feel free to talk about it must be created. “Businesses need to be open, share facts and experience and raise awareness of the problem,” says Dr Mark Winwood, director of psychological services at AXA PPP Healthcare, who adds that getting senior management to talk candidly about their individual wellbeing sets a great example of openness from the top. “It gives a clear message that mental health is important and part of everyone’s overall wellbeing.”

The top tier is certainly talking about stress even if some still shy away from discussing their personal experiences. Cost associated with stress-related absence means the issue officially has the ear of the board and good employers are tackling it for business reasons, if not always more altruistic ones. “They know that there is a direct correlation between a happy and healthy workforce with productivity, efficiency and the quality of work,” says Neil Shah, director of The Stress Management Society. “So it makes good business sense but there are, of course, positive secondary gains that are beneficial for employees.”

Even though progress has been made, the opening statistics show that much more can be done by employers. Employee assistance programmes (EAPs) that provide access to counselling and other services are often seen as one of the fundamental measures that organisations can put in place to support the workforce. The vast majority (87 per cent) of FTSE companies have an EAP but Jayne Carrington, managing director of Right Management Workplace Wellness, says information about these is often poorly communicated. “My frustration is around how well these are promoted and this has to come from the managers,” she says. “With our own system, we can have someone in counselling in five working days. It can take five months for a referral from the NHS.”

Dr Summerton says hearing that an employee can turn to counselling provided by their employer always ‘cheers him up’ since it is the stage after diagnosis that can be a problem when relying on NHS resources. “We’re seeing people earlier in the surgeries which is good but it is getting them access to counselling or some form of cognitive behaviour therapy (CBT) which we know is effective that can be difficult,” he says.

Availability of computerised CBT and a range of affordable online tools can help more employers provide access to such support and services. Obviously such solutions need to be properly assessed and validated but with some of the bigger EAP systems cost-prohibitive for smaller organisations, it at least means more options for more employers.

Andrew Kinder, chartered occupational psychologist and chair of the UK Employee Assistance Professionals Association, says the rise of online as well as self-help services shouldn’t be seen as a substitute for face-to-face support though. He also feels the broad spectrum of problems that EAPs can help with isn’t always as well understood or promoted as it could be. “For an employee to know they can get help with a debt problem, for instance, might be enough to relieve a person’s stress,” he says.

He adds though that while EAP systems show employers recognise their duty of care, such programmes could be implemented more effectively. “They shouldn’t be just as a tick box exercise but integrated with HR and a manager’s work,” he says, explaining that information from the system can help to identify trends about an organisation that may help put preventative measures in place that reduces stress.

Looking at the overall health of an organisation is in itself a growing trend. Dr Summerton says the “public health versus an individual approach” that he is starting to see in corporate health screening is a positive move. “So you are looking at the health of a lot of individuals, grossing up the information and then getting some messages about the company,” he says.

Danone is one organisation that is taking the “public health” approach. It first looked into health screening in 2011 and has worked with Bluecrest Wellness to introduce large-scale health screening which is affordable for the organisation and practical for the workforce. The checks carried out in the screen cover psychological wellbeing as well as a wide range of physical checks. Ann Evans, social innovations manager at Danone, explains that it will collect the usual information on sickness and the reasons behind it and explore issues with staff but adds it is the Bluecrest data that gives the breadth and depth required to form a clear picture of needs and issues, which is “solid enough” to make a case for investment in specific areas.  “It’s also a massive engagement tool for us,” she adds.

Shah, meanwhile, reports that more companies are realising the importance of undertaking some form of stress risk assessment or audit across the company. “If you ask people whether they are stressed at work they will tend to say ‘yes’ but what you really need to do is ask them questions relating to management and peer support, the level of control they feel they have over their work, the nature of their relationships at work and the way change is managed,” he says. Shah continues that understanding the issues, achieving a baseline and coming up with an action plan will help organisations move from a high stress culture to one of wellbeing. “Wellbeing is the ideal and the direction every employer should be heading towards in the highly competitive economy we find ourselves in.”

He sees managers as central to organisations being able to make this shift and says they must become the “champions” and “ambassadors” for the cause. “Not all staff need to be on board but we need the managers on board as this is the only way organisations can drive the message forward,” he says. And while he welcomes the move by companies to train managers so they feel able to manage stress in the workplace, he would like to see more organisations make it such training mandatory.

Carrington agrees that companies need to invest in training their management populations in this area so they are more competent and confident when dealing with those employees suffering from stress-related conditions. They also need to be more adept at identifying when someone has a problem and willing to have an open conversation with them. “If someone is coming into work late everyday because of something happening at home, have the conversation,” she says. “Perhaps giving them permission to come into work half an hour late would alleviate their stress because they could do what they need to do at home but still feel they were at work on time. Life has got much busier for everyone and people do have complicated lives.”

As Dr Windwood points out, though, managers can’t remove all work pressures but they can work with employees to develop “coping strategies” which along with other mechanisms such as a change in working hours or job role and resilience-building can help to reduce stress. He stresses proper training is required and that some managers are still fearful of saying the wrong thing. “Or that they could be accused of discriminating against, harassing or even bullying,” he says, adding that training should be given to give managers confidence to initiate a conversation but also prepare them to handle the employee’s response to their concern.

No-one would doubt there is still much work to be done to reduce the stress in the workplace and the incidence of stress-related conditions but progress is being made. What needs to happen next is for employers to be more open and transparent externally about their experiences and share case studies and best practice. While the stigma around mental health isn’t what it once was, admitting that an organisation had/has a problem can still be a step too far for many companies. Another weak spot is the level of disconnect that can exist between GPs and occupational health/the employer. The former aren’t always aware what support services are available for the individual from the latter and can act in isolation over the best next step for the individual. “I recently saw someone who had suffered a serious bereavement signed off for four weeks by the GP with no reviews [with the employer],” says Kinder. “In some cases the structure, meaning and purpose that work can help the individual but the GP didn’t see return to work as part of the recovery.”