WeThrive Mental Health Whitepaper

A practical 8-point guide to stress,
anxiety, mental health, resilience and
wellbeing for HR Directors.

Before we start...
I’d like you to drift away from the real world for a
moment and imagine something. Take yourself, in
your imagination, to the best time you ever had at
work – what was that like?
Think about the people who were there, the
things you did, the kind of place it was, and ask
yourself what made it so good. What did it feel
like to be on the way to work, and how did you
feel on the way home from this ideal job?
Hold that feeling – we’ll come
back to it later.
WeThrive © 2016. All rights reserved

In the following pages we aim to unify and
make sense of several apparently separate
things, and offer eight ways to change the
way your staff feel about their work.
1. Is there really a problem with mental health at work?
2. Why is it likely to get worse if we don’t act?
3. There are legal reasons to act before damage is done
4. Everything is connected
5. Avoid sticking plasters
6. Encourage open discussion about what works
7. Help everyone become more resilient
8. Make the workplace an inherently healthy organisation*
Wellbeing Menu
* guess which is the most important step …

Yes. In 2013 there were 8.2 million cases of anxiety in the UK
alone1
. Quite apart from the human impact of all this misery,
there is a significant impact on GDP, with about £30 Billion2
lost to the UK each year.
Why is that? It’s ‘stress’ – which is not even a clinical diagnosis, yet is emerging as
“one of the leading contributors to the burden of occupational disease and injury3
”.
Worldwide, the problem is getting worse. The World Health Organisation says that
between 1990 and 2013 the number of people with depression and/or anxiety
grew by almost half, from 416 million to 615 million4
. Almost 10% of the world’s
population is now affected, costing nearly $1 trillion a year in lost productivity.
The WHO assumes that counselling or prescriptions are the likely answers, and that
spending $147bn on these interventions would pay back four-fold, improving
workforce availability by $399bn and saving another $310bn in healthcare costs.
However there is a better solution available – and it is in our
hands as employers
Is there really a problem with mental
health at work?
Action Point!
Count the combined cost of stress-related underper-
formance, illness and regretted loss of staff, and use the
total to make the business case for investment.
“Take care of your employees and they’ll take care of your
business”
– R I C H A R D B R A N S O N

It’s not a new idea that we now have too much information to
deal with – the Roman philosopher Seneca (the younger)
complained in the first century AD that ‘the abundance of
books is a distraction’.
Since then the speed of information transmission has increased by a factor of about
100 billion and we are now close to being overwhelmed, because the biological
limits of our own information processing abilities have been overtaken by the
machine-driven world we have built for ourselves.
Multitasking is not a solution to anything. First it reduces intelligence – the mere
fact of knowing there is an unread email in your inbox reduces your IQ by 10 points.
Then it makes you muddled - having to hold two tasks in your head at the same
time degrades your performance in the same way as getting stoned. But worst of
all, the attention-switching involved in attempting to multitask causes the release of
stress hormones cortisol and adrenaline. These make you angry, defensive and
impulsive, so you become isolated and make worse decisions5
.
The way we live is not really in tune with the biological, psychological or social
needs of our species, and the result is increasing anxiety and depression. However,
there are things we can do to make ourselves, and our employees, more resilient,
and our organisations will benefit from that too. It’s a win-win.
Why is it likely to get worse if we don’t act?
Action Point!
Make workloads, routines and communications
compatible with the way the human brain works –
it will make them more efficient and less stressful.
“Life is really simple, but we insist on making it complicated”
– C O N F U C I U S

It is not only common sense to reduce stress in the workplace, it is
a legal requirement, and the Health and Safety Executive suggests
a board member should champion stress-reduction and mental
health initiatives. So it is wise to include a section on stress and
mental health in your H&S policy, and carry out ‘suitable and
sufficient’ risk assessments.
You don’t have to use any particular framework to meet the legal standards, but there is
a range of tools available from the HSE including its own Management Standards
framework. This sets out standards for how employees are treated in six areas:
Demands, Control, Support, Relationships, Role and Change.
Taking one area from the HSE Standard as an example, it says of Demands on
Employees that you should give people enough to do, but not too much; that people's
skills should be matched to the job demands; jobs should be designed to be within the
capabilities of employees; and employees' concerns about their work environment
should be addressed.
It also says that employees should be able to indicate whether they can cope with the
demands of their jobs, and there should be systems in place locally to respond to any
individual concerns6
.
This puts the onus on the employer to find out what people feel
about the things that may be causing stress in the workplace, a
task WeThrive does well.
There are legal reasons to act before
damage is done
Action Point!
Assign someone, preferably at Board level, to take
ownership of mental health and wellbeing at work.
Management has to take the lead.
“The employer generally gets the employees he deserves”
– J . P A U L G E T T Y
3

Just because things have different names, that doesn’t mean they
are isolated things.
Your organisation may have a mental health agenda (good) but not have time and
energy for an engagement agenda. Look beneath the words, though, and all these
things are aspects of the same thing – how well the culture and environment of the
workplace matches the physical, mental and emotional needs of the employees. Get
the underlying conditions right and all the surface phenomena will improve.
Meanwhile, you may notice staff progressing from one state to another. If someone is
under too much stress for too long, the first sign may be inattention, irritability or
underperformance. If a suitable reprieve can be provided the situation may be
salvaged, but if worries continue people start to focus on the things they are worrying
about. As they do this, so they notice the stresses more and more. This wastes their
time and energy, but it also changes the way they think, reducing creativity and making
silo behaviour more likely.
At this point you have a staff member with behavioural ‘issues’, but in the long term
physical changes follow. Heart rate and blood pressure rise, digestion suffers, and the
immune system doesn’t work, making colds etc. more likely. People also start to feel
pain more acutely as mood changes.
So, what starts as stress can become anxiety and depression, and even lead to
intractable pain problems. There’s a longer explanation of this in appendix A.
Everything is connected
Action Point!
Get your management team to understand that mental health,
wellbeing, engagement, job satisfaction, discretionary effort and
so forth are part of a continuum, not separate areas of
responsibility. It’s a big problem and it needs a big solution, but
there is one available.
“Realise that everything connects to everything else”
– L E O N A R D O D A V I N C I
4

Wellbeing is hot news, unsurprisingly, but putting in wellbeing
initiatives is not a guaranteed way to improve employee health: a
study by the University of Birmingham says that “Despite many
interventions over the past thirty years it is somewhat surprising to
find that there has been rather limited research concerned with
discovering which interventions in this area are the most effective
in workplace settings.7
”
This doesn’t mean you shouldn’t give people free spinach, or that Pilates is a bad thing;
just that there’s no way of knowing whether it is a useful thing to do or not.
Bear in mind that the people who benefit from wellbeing are a self-selecting sample -
one US bank invested in a very fine gym - only to discover that it was largely used by
highly motivated, fit and active people. The same would very likely apply to
mindfulness sessions, Fussball etc.
All the people problems managers worry about, whether to do with engagement,
wellbeing, sickness, retention and so on, are manifestations of the same problem. All
the initiatives people put in place are attempts to ease the same problem. What you
need is a way of looking at the whole picture - and we think the best way to do that is to
look at the underlying needs of the human being. Once you understand these you can
see why a situation might make people cross, and why a particular solution might or
might not work. This is a very elegant and efficient way of looking at people problems,
and it is explained in appendix B.
Avoid sticking plasters
Action Point!
Look again at the support mechanisms, training
systems, benefits, in fact everything provided for staff,
and ask how is it integrated and directed – what is the
rationale and where does it fit in the big picture.
5

Many people with a mental health condition would rather that others didn’t
know about it. But there is no stigma at all in agreeing that some working
conditions make you happy and others make you stressed. There is a
continuum of physical and psychological health and we are all on it, and you
want your staff to know that it is OK to talk about that.
However, they probably won’t talk openly just like that - you need to take control of the
agenda. You can be proactive about mental health and wellbeing on three levels, and the
most urgent of these is taking care of the people who have an acknowledged problem.
Your line managers are usually the people in the front line of mental health issues at work;
they should know how to detect early signs, and know how to support affected staff.
Managers may worry about taking on this role, but you are not expecting them to become
experts, counsellors or therapists, just to recognise what is happening, be prepared to
listen, and know how to organise support.
Many organisations offer training - Mental Health First Aid8
is a good example of a course
that will help managers identify, understand and help people who may be developing
problems.
It is also worth considering becoming a Mindful Employer9
– this is an NHS initiative that
helps employers recognise and understand their responsibilities, and provides some useful
materials for line managers.
In some cases there will be a requirement to make reasonable adaptation for people who
have been ill, but it is always better to get upstream of the problem, recognise where
people are struggling and do what you can to take pressure off them, give them a little
extra space and see if you can help them build resilience.
This entails knowing what stresses people are experiencing; including the stresses they
haven’t recognised themselves.
Encourage open discussion about
what works
Action Point!
Do an audit now – do the policies and procedures
meet HSE requirements, and how many line
managers are happy that they can recognise and
handle mental health problems?
6

“Everything comes to us that belongs to us if we create the
capacity to receive it”
– R A B I N D R A N AT H TA G O R E
Some people can benefit significantly from learning to recognise
their own stress levels and intervene when they get too high.
People who learn to do this become more resilient, and so may
fare better when the big order comes in or the important customer
gets tricky.
There are various options for improving the resilience of staff, such as mindfulness
training. Practising mindfulness can be a very pleasant experience and can help many
people lower their background stress levels, so increasing their capacity to take on
challenges. Yoga, massage, exercise and so on may have a role in helping people
become calmer, and therefore giving them more headroom.
Mindfulness training10
can also be very helpful to staff who have a variety of mild
mental health conditions, including depression and some anxiety conditions. However,
it is less likely to work on some other problems, or in people who are very distressed,
and some employees may not enjoy it at all.
So a spread of different initiatives may be useful, giving people
with different mindsets a chance of finding something they can
identify with.
Help everyone become more resilient
Action Point!
Consider providing yoga sessions, mindfulness, relaxation, etc and
attempt to engage the people who you think are feeling the stress
and might benefit from them. Frame the exercise as relaxing and
stress-busting, or even fun, rather than as a wellbeing project.
7

Imagine you are at the seaside, up to your ankles in the edge of the
water - it will take a fair-sized wave to create a hazard to your health.
However, if you are up to your chin and standing on tiptoe, the margin
of safety is much lower. If the tide comes in or you lose your footing you
are in trouble.
So it is with our health. The art of keeping a healthy, happy workforce lies in making sure
that they have enough of this margin, which means reducing unnecessary and
unproductive stresses. The more you do this, the more room you create for staff to be
stretched and developed without drowning.
So the crucial thing is to know what is likely to create stress in the human being, particularly
at work. One way to discover that for yourself is to look at the opposite situation, when
things are going really well and you feel unstressed but energised.
Looking back to page 1, and the way you felt when thinking about your best ever time at
work, the chances are you remembered things like: being with people you got on with,
sharing a common purpose, being stretched but supported, doing things that are
interesting and useful to other people, and so on. In all probability you felt positive on the
journey to work and satisfied on the way home.
The WeThrive 4C model for intelligent performance maps that positive
experience into areas we can measure, and your staff will have a
similarly good time if you can arrange for staff to be well served in these
areas. See appendix C.
The model is deliberately written in plain language, and you could use it as the basis for
your own investigations into staff happiness and wellbeing, or you can use wethrive.net to
do that for you. Either way the model shows the underlying needs of your people; meeting
these is the key to getting the best from them, for the company and for their own job
satisfaction.
When you have looked at it, go back to the feelings you recalled at the
top of page 1. By no coincidence at all the positive feelings that arise
when work is working really well come about because your social,
cognitive and emotional needs are being met in that situation. All you
need now is to understand what they are, and have a mechanism for
auditing who needs help to get into that happy frame of being.
Make the workplace an inherently healthy
organisation*
8
how can you do this?...

Action Point!
About WeThrive
Try it at www.wethrive.net
Get upstream of the mental health and wellbeing problem
by working towards an inherently healthy workplace – one
that understands what people need from work, measures
where they are getting it, and intervenes to help make it
better where they are not.
WeThrive asks people about life at work, using an interactive questionnaire
that covers all the areas necessary for people to thrive at work. It then gives
you a picture of who is suffering from what, how much stress this is causing
them (consciously or not) and what you can do to help them.
The reason for doing this is, of course, that the stresses, often unnoticed, eat
away at people’s intelligence, creativity and ability to collaborate. The
consequences range from minor disruption of work to long-term illnesses
and regretted losses of staff.
With WeThrive it becomes possible for owners, managers, consultants or
other agencies to intervene and make things better. Companies use it in a
number of ways: as a regular health check on the working culture and
environment; as a replacement for the staff survey or engagement survey,
getting more specific and actionable results; or as a way to inform annual
reviews and make them really relevant.

There is an infinite number of possible pathways for any one individual,
but we can generalise about the way stress turns into sickness.
We all know that there is a ‘sweet spot’ of pressure. Being under-stimulated is boring and
meaningless, and being over-stretched is unpleasant and unsustainable - something will
snap in the end.
There is no standard amount of stress which is ‘too much’ – everyone has a different
threshold at which we start to lose productivity. That threshold changes according to
multiple factors, including how interesting the work is – we can usually do a great deal
more of something fascinating before it starts to wear us down.
When the effects start to show the first sign might be inattention, irritability or
underperformance, and if a suitable respite is then provided the situation may be salvaged.
However, if nothing is done the symptoms start to become more regular and then to
generalise.
What happens next is the same thing that happens whenever someone is under stress of
any kind – they start to focus more and more on the thing they are worrying about. An
important principle kicks in: you get more of what you focus on. We have probably all felt
this effect in action – a sting from a wasp can be almost forgotten while watching a film,
but if there is nothing else to focus on the pain grows significantly.
As someone who is suffering from stress focuses on the stress in their work, so they notice
it more and more. This not only divides their attention, giving them less time to do their
work, it also compromises the quality of their remaining brainpower, making them less
collaborative and imaginative, reducing creative problem-solving and making silo
behaviour more likely.
In a stressed office a cultural change now develops. Instead of a team, a group which can
leverage each other’s capacity and become something greater than the sum of its parts,
you now have a set of individuals with their own conflicting priorities.
As well as being stressful in itself, this situation also prevents people from meeting their
psychological needs, as they now find it harder to associate with others and do things that
are interesting and useful. The mood in the office changes and a depressed air takes over –
some people may actually notice that they feel anxious and/or depressed by now.
Appendix A
– How stress can become a long-term health
problem.

There are many physical side-effects of increasing stress levels. As ancient body systems
sense a threat, survival becomes the main priority, and the best way to ensure survival was
through running or fighting.
That’s why the physical organisation of the body now starts to change. As stress hormones
like cortisol and adrenaline start to flood round the body, blood is diverted to the muscles
to power the running and fighting, and breathing rate, heart rate and blood pressure all
rise. Anything inessential is put on hold, like digestion, which is why people under a lot of
stress often have stomach pains, digestive problems or irritable bowel problems.
Another ‘luxury’ that is suspended in stressful times is the immune system. Medical
students have a strong chance of catching a cold before their finals as a result, which is
inconvenient, but there are more troubling possibilities. Everyday errors in cell reproduction
create potentially cancerous cells, and we depend on the immune system to clear these
away, too.
Now another problem manifests - our perception of pain is also affected by stress. This
happens for at least two reasons: attention is no longer focussed on the interesting
distractions in the outside world, but on the internal experience, including pain. Also,
transmission of pain signals into the spine increases as serotonin levels fall with depressed
mood.
In brief, someone who is stressed by work becomes anxious, focuses in
on their anxieties and becomes depressed. Aches and pains get bigger
and eventually they decide to take a day or two off and rest. This takes
them away from doing the things that make life interesting and
meaningful, and allows them time to focus on the problems and the
pain. In this vicious circle it is not hard to become housebound with an
intractable pain problem.

In our culture we like to think we can control the world. Usually we do this by inventing
categories of problems and then creating lists of actions to use in each category. This is
how medicine works – diagnoses are categories of disease, and treatments are lists of
things that have been shown to work in each category. You will have noticed that it is also
how HR legislation tends to work – identify potential mental health problems from, say, the
HSE list and apply the correct checklists and formulas to reduce the risk of each problem
occurring. It is an adequate approach, but there is something you can do that is more
elegant and efficient. It also operates upstream of the problems, before they have
occurred. Prevention is better than cure!
Everything alive will thrive if you put it in the right conditions. Take any seed and give it the
right nutrients, temperature, soil conditions, rain and sunlight; it will grow. If the conditions
are exactly right it will grow to its full potential, but compromise on any one condition and
part of that potential may be unfulfilled.
The same idea works exactly for animals, including homo sapiens. Our ideal conditions are
more complicated, including social, cognitive and biological considerations, but the same
argument applies. Given the right proteins and exercise we will grow to our potential
height. Given the right experiences we develop powerful social brains that can network and
become part of something bigger than themselves – but look at the brain scans of
neglected children and you see how this only happens if social conditions are right.
Assuming conditions are right, we grow well, and with the right mental exercises we
develop our intellectual capacities. Put these together with social abilities and you have the
employees you need.
So there is a set of social, emotional, practical and cognitive needs that
human beings need to have satisfied in order to do well. That includes
your people, beavering away in your company at the moment. If you
know how well those needs are being met – and where and why they
are not being met – you are perfectly placed to correct the problems
they are experiencing and get them back on track.
Appendix B
– How to be a happy human being.

Appendix C
– WeThrive 4C Model for Intelligent Performance
CONNECTION WITH
COMPANY AND CUSTOMERS
NEEDS
CLEAR AND CONCRETE
PERSONAL PERFORMANCE
EXPECTATIONS
CONSISTENCY OF
TEAM UNDERSTANDING
AND SHARED VISION
AMOUNT OF
TEAM CO-OPERATION
IN THE GROUP
SUFFICIENT
KNOWLEDGE
TO WORK WELL
HAVING THE
SKILLS
TO DO THE WORK
ADEQUATE
RESOURCES
FOR THE TASKS
SENSE OF
COMPETENCE
AT WORK
INTERACTION AND
ATTENTION
WITH COLLEAGUES
EXPERIENCING A
COMMON BOND
WITH OTHER
SENSE OF
STATUS
AND RECOGNITION
FEELING OF
SECURITY
SENSE OF
CONTROL
AND AUTONOMY
SUFFICIENT MENTAL
SPACE
TO KEEP A CLEAR HEAD
FREEDOM FROM
FOREBODING
OR ANTICIPATORY ANXIETY
FEELINGS OF
MEANING
AND PURPOSE
COGNITIVE
CAPABILITY CONNECTION
CONFIDENCE
4C MODEL FOR
INTELLIGENT
PERFORMANCE
EFFECTS
CAUSES

Fineberg, N., Haddad, P., Carpenter, L., Gannon, B., Sharpe, R., Young, A.,
Joyce, E., Rowe, J., Wellsted, D., Nutt, D. and Sahakian, B. (2013). The size,
burden and cost of disorders of the brain in the UK. Journal of
Psychopharmacology, 27(9), pp.761-770.
Advisory Conciliation and Arbitration Service - available at:
http://www.acas.org.uk/index.aspx?articleid=3915
Workplace wellbeing programmes and their impact on employees and their
employing organisations: A scoping review of the evidence base. A
collaboration between Health Exchange & University of Birmingham Fenton,
S-J., Pinilla Roncancio, M., Sing, M., Sadhra, S. & Carmichael, F.
World Health Organisation – available at:
www.who.int/mediacentre/news/releases/2016/depression-anxiety-treatme
nt/en/
Levitin, D., The Organized Mind: Thinking Straight in the Age of Information
Overload. Dutton Penguin, 2014.
Health and Safety Executive Stress Management Standards – available at:
http://www.hse.gov.uk/stress/standards/index.htm
Workplace wellbeing programmes and their impact on employees and their
employing organisations: A scoping review of the evidence base. A
collaboration between Health Exchange & University of Birmingham Fenton,
S-J., Pinilla Roncancio, M., Sing, M., Sadhra, S. & Carmichael, F.
Mental Health First Aid – see http://mhfaengland.org
NHS Mindful Employer programme – see http://www.mindfulemployer.net
There are many commercial and academic providers – see for example
www.oxfordmindfulness.org
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
References

Happier people.
Better results.
Try it today at www.wethrive.net

WeThrive Mental Health Whitepaper

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