“Wellbeing at work is everybody’s responsibility”

Your work includes research into the working environment and how this links with inclusion. Can you share further? 

“We spend so much time in and around work, it is better for our mental and physical health if we build wellbeing into our workplaces. We have found that workplace factors are much stronger than individual factors when it comes to measuring mental health: people assume it is individual attitudes but, in fact, how workplaces are designed and managed have a greater impact on individuals. By shifting the narrative to emphasise the necessity of change to the working environment will mean we can improve workplace wellbeing.

Linked to that, we can certainly see the role of inclusivity: people are able to work at their best in a good and healthy environment where they feel safe, feel included, and feel it is a fair place where they have a sense of voice.”

Tell us more about your view and your research into the idea that wellbeing and mental health shouldn’t just be the responsibility of the HR team.

“We are investigating the psychosocial aspects of the workplace – how work is designed, organisedand managed, the cultural aspect, types of work and line managers: also we are looking into how much autonomy workplaces offer, and how well individuals feel supported.

“A lot of that intersects with things around value: how much voice people feel they have in their workplace. This opens up the perspective to ask different types of questions – when we want people to be well, taking a more holistic approach at work may have more success, according to our research. If someone has to take time off work because of poor mental health, they may be offered medication, talking therapy and a return-to-work plan as well as taking time off work. All of that is important. But if the underlying factors at work make a person feel unsafe or excluded, most of those treatment options aren’t going to help in the long-term. You can have all the therapy in the world but if a person feels overwhelmed by their workload or doesn’t feel secure in their job, it is unsurprising if they will go off sick again or exit the workforce altogether.

“At the moment, interventions to keep people well at work largely follow three forms: primary interventions, secondary interventions and tertiary interventions.

1 Primary interventions are focused on prevention. If someone is struggling with a high workload, time pressure or being bullied, a primary intervention would look at what would make sense to remove to reduce these challenging factors.

2 Secondary interventions are focused on the individual and focus on helping them deal with environment – such as improving psychological skills including cognitive behavioural therapy, mindfulness, resilience training and ways to cope in a productive way. Other ways of helping them stay well at work might be technical skills – such as how can they can use technology better or to improve their time management.

3 Tertiary interventions are restoration after a person has been unwell including EAP (employee assistance programme), medication, and a return-to-work plan.

“It is much easier for workplaces to focus on the individual: that a person must be more resilient, to lean in or be more mindful or take time off.

“But a shift in thinking is important if we are to take responsibility for creating a safe working environment.”

Can you share an example of workplace cultural shifts?

“I do a lot of work in the NHS where there are high levels of turnover and burnout. There are pockets of the workforce that are particularly under pressure, such as ethnic minorities, women, those with caring responsibilities – and those who have intersectional identities. Senior leaders recognise the statistics but are often unsure what to do about it. Trying to change the working environment sounds great on paper but in the health service, resources are low and demand is high.

“But we did some work funded by the Wellcome Trust which showed 20 case studies of teams creating a change to their working environment by improving work processes or support. One of the examples looked at a self-rostering system for student nurses – when people picked when they worked to fit in around personal commitments such as a second job, caring for an elderly relative or family. The self-rostering system offered a more inclusive environment because it gave nurses autonomy and improved attendance across the board, which should lead to increased retention as well. But its equally important when developing interventions that we consider who is able to access it and who might not. For example, in a different intervention – but also on self-rostering – we found that the intervention excluded some people who didn’t have the technology to choose their own shifts. This meant that they had to make do with leftover shifts.

“Nevertheless, our case study showed that by understanding the issues that are affecting people’s ability to manage their workload or feel included, the solutions don’t have to come from outside sources. By speaking to nurses and managers, the idea of self-rostering broke down barriers and provided an intervention that came from within, and was not something external that was being forced onto this group of workers.”

How can we answer senior leaders who believe wellbeing isn’t a workplace issue?

“It’s a thought-provoking question. I sometimes ask leaders if their organisation is in a healthy financial position and staff are saying wellbeing is an issue, would they turn down a client to protect their people’s workload and wellbeing?

“In Britain, the law says that each organisation must have ‘a competent person’ responsible for employee wellbeing but I hope by some of the discussions we are having here it proves that wellbeing is everyone’s responsibility. Too often we pigeon-hole it to the occupational health and safety department or HR team or DEI team. But, actually, when we recognise that the underlying issue is a good and healthy environment, that is the responsibility of everyone – and that goes right up to the executive and the board.

“When we have siloed approach, we don’t have the full picture.”

What research and stats back up this whole-organisation approach to workplace wellbeing?

“There are very few quantifiable statistics that we can use but broadly speaking what we often see that the return on investment on mental health support is best case £3 or £4 for every £1 spent, and at worse cost neutral. In a recent project, improving the employee investigation process in a NHS organisation not only reduced the number of cases, but we were able to calculate that that organisation saved over 3,300 sick days and £700,000 a year.

“There’s also work carried out elsewhere, including by Will Fleming at the University of Oxford’s Wellbeing Research Centre, where data from a national survey of 143 organisations across the UK found that individual-focused interventions for wellbeing didn’t work as well as organisational intervention that tried to improve the working conditions of employees.

“Birkbeck’s research at the moment is looking at interventions and how we can understand organisational interventions better so we can create change and improve working conditions. For example, we are looking at parents and carers in the performing arts – the issues there are a lack of flexibility and underemployment which has a disproportional impact on parents and those with caring responsibilities especially when it intersects with class. If there is an inclusive workforce within the performing arts industry, it will be better for retention and for attracting new workers. Otherwise, only people in a certain financial position will be able to work in this industry.”

Further resources:

https://wellbeing.hmc.ox.ac.uk/authors/dr-william-fleming/

1. Teoh, K. (2023). The Value of Occupational Health and Human Resources in supporting mental health and wellbeing in the workplace. Society of Occupational Medicine & CIPD.
2. Teoh, K., Dhensa-Kahlon, R., Christensen, M., Frost, F., Hatton, E., & Nielsen, K. (2023). Organisational Wellbeing Interventions: Case Studies from the NHS. Birkbeck, University of London.
3. Cooper, A., Teoh, K. R. H., Madine, R., Neal, A., Jones, A., Hussain, A., & Behrens, D. A. (2024). The last resort: reducing avoidable employee harm by improving the application of the disciplinary policy and process. Frontiers in Psychology, 15, 1350351.