Call for evidence for major conditions strategy – Acas response

This is Acas's response to the Department of Health and Social Care's (DHSC) call for evidence for the major conditions strategy.

Our response

Acas (Advisory, Conciliation and Arbitration Service) welcomes the opportunity to respond to the Department of Health and Social Care's (DHSC) call for evidence on what the government can do to improve the health of the nation, ease pressure on the health system and reduce the number of people out of work due to ill health.

Acas is a statutory, non-departmental public body with a duty to improve employment relations throughout Great Britain. Acas has considerable practical expertise on the workplace challenges that employers and workers can face with regard to health conditions at work.

Our insights are gained through several services that Acas offers in connection with its statutory duty, including:

  • a national helpline which between April 2022 and March 2023 dealt with some 649,179 calls on a wide range of employment relations and workplace issues – approximately 11,433 of these calls related to stress or mental health
  • a website which, over the same period, received nearly 14.5 million visits seeking advice and support – Acas online guidance on supporting mental health at work and dealing with stress in the workplace have together received approximately 170,000 visits during this time
  • a conciliation service offered in every case where an individual is considering bringing a claim to an employment tribunal – between October 2022 and March 2023, the words 'stress' and 'mental health' were referenced in approximately 8,500 early conciliation cases or conciliation cases where an employment tribunal claim had been made (of a total of approximately 134,000 cases) (A number of keywords can appear on the same case and so the case will be counted against each keyword. For example, a case that has the keywords of 'mental health' and 'stress' will be counted as 1 against 'mental health' and 1 against 'stress'. These words have been cited either by claimants when completing their early conciliation notification form, or by our early conciliation support officers when inputting case notes.) 
  • training sessions, conferences and webinars, including on mental health and stress – on these topics, between April 2022 and March 2023, we ran 3 conferences with 399 delegates, 233 training events with 2,659 delegates and one webinar with 599 delegates

Acas's submission to this consultation focuses on the question 'How can we better support those with mental ill health?' and, in particular, the government's interest in "impactful interventions that can be adopted and scaled quickly".

Acas's evidence and insights on mental health in the workplace

This submission should be read in conjunction with our response to the previous call for evidence for the mental health and wellbeing plan.

Here, we offer further information based on recent insights particularly in relation to the importance of providing reasonable adjustments (changes that an employer must make to remove or reduce a disadvantage related to someone's disability) for mental health in the workplace, to support workers to stay and thrive in work and return effectively to work after a period of sickness absence. Although some people may not recognise their mental health condition as a disability, it's important that employers are aware that it could be according to the definition of the Equality Act 2010. Acas advises that employers should try to make reasonable adjustments even if the issue is not a disability.

In 2020, Acas commissioned a review into the evidence and guidance available to inform practices around work adjustments for mental health. This highlighted a need to enhance the guidance available and to further build the evidence base in this area. At the beginning of 2023, Acas commissioned research on mental health reasonable adjustments, leading to the development of Acas's practical guidance on reasonable adjustments for mental health for employers, managers and employees. In addition, Acas developed 5 case studies showing how different stakeholders (organisation, manager, employee, occupational health, and other support services) can work together to effectively support mental health adjustments in the workplace.

As part of the process for developing the Acas guidance, 611 survey respondents shared their experience of accessing and implementing reasonable adjustments for mental health. 61% respondents were employees with a mental health condition (the majority of whom were experiencing depression or anxiety, or both), 32% were managers and 7% were people who had supported an employee with mental ill health to secure work adjustments (including trade union representatives and mental health advocates). Although this evidence does not purport to be representative of the experience of all organisations and employees with mental health conditions, it provides valuable insight into experiences of implementing and accessing reasonable adjustments.

70% of employees in the survey indicated that their work played a role in causing their mental health condition and 97% reported that work exacerbated their mental health condition to some extent. This emphasises the importance of employers putting in place strategies to prevent workplace stress (see Health and Safety Executive Management Standards) and providing good jobs where employees can maintain their mental health.

Support from managers and colleagues is important for people with mental health conditions to sustain their mental health and stay in work. Only 42% of employees in the survey had shared their mental health condition and symptoms with their manager and 27% had shared this information with their colleagues. Having an open culture and raising awareness of mental health in the workplace is important to encourage disclosure and access support.

Managers play a vital role in employees accessing work adjustments. This was corroborated by responses from employees in the survey. However, a third of managers reported receiving very little advice, training and support to implement workplace adjustments for their employees.

Insights from Acas's operational work also indicate that employers and managers often lack confidence in dealing with workplace adjustments, including for mental health and that there is often a lack of understanding around the law and a fear of getting it 'wrong'.

Employees also often lack awareness of their rights concerning reasonable adjustments and report that employers take a significant time to implement adjustments for mental health, leading to problems worsening. They also report that employers doubt a genuine need for reasonable adjustments when the disability is not visible.

In the survey, managers also noted that high work demands, resource constraints, and the unacceptable burden placed on others in the team were the most common barriers to implementing work adjustments for mental health, which highlights the need for an organisation-wide approach to reasonable adjustments in the workplace.

Policy recommendations

In summary, Acas recommends that the importance of the impact of the workplace on maintaining mental health is recognised and given due importance when developing policy in this area.

In this regard, policy measures relating to supporting mental health in the workplace should consider how employers, workers and representatives can best be supported towards:

  • preventative approaches which promote good mental health, including measures to reduce work-related stress 
  • increasing awareness and reducing stigma of mental health in the workplace, making it easier for employees to access support 
  • increasing awareness of the rights of employees, and responsibilities of organisations regarding reasonable adjustments in the workplace to support people with mental health conditions to stay and thrive in work, and to return to work after a period of sickness absence
  • improving people management skills in relation to supporting mental health and implementing reasonable adjustments in the workplace

Further Acas support in developing and delivering policy solutions

Acas would welcome partnering with the government and other stakeholders to explore further avenues in which we can together help transform the way businesses support mental health and wellbeing in the workplace and provide high-quality work.

For example, clear and accessible guidance on mental health at work is highly important and Acas would recommend the government considers ways in which joint stakeholder guidance can maximise the reach and impact of such guidance.

Acas has extensive experience in chairing and participating in HR networking and sector-specific forums on challenging workplace issues and would be happy to explore how we might convene organisations to share blockers and best practice in this challenging area of workplace practice.