Covid adds to ‘out of control’ mental health crisis

Mental health was sidelined at the beginning of the pandemic, believes Robert Baughan, public services union UNISON’s national health and safety officer.

“There was a hierarchy of concerns,” he told Workplace Report. “Am I physically safe? Will I get paid? Those issues tended to dominate the agenda. As the pandemic has continued, it has become clear that issues such as low pay in areas like social care, and poor employment practices that affect people’s ability to self-isolate, are affecting mental as well as physical health.”

Growing evidence

Evidence of the impact of the Covid crisis on mental health has been mounting. Office for National Statistics (ONS) figures released in August showed almost one in five adults (19%) were likely to be experiencing some form of depression in June 2020. This figure had almost doubled from around one in 10 before the pandemic.

And Health and Safety Executive (HSE) annual statistics show that work-related stress, anxiety and depression were already at the highest level for 20 years even before the pandemic took hold in the UK (see Workplace Report December 2020 page 14). Union surveys show the pandemic has worsened an existing mental health crisis, affecting groups from those working at home to key workers on the frontline of the pandemic response.

Retail union Usdaw’s April 2020 Impact of coronavirus survey of 7,357 members showed that 70% are experiencing anxiety and had raised concerns with their employer Usdaw general secretary Paddy Lillis recently commented that his members are “under pressure like never before”.

“At some point or another everyone has felt confused, frightened and worried by the coronavirus and our survey demonstrates the extent of that,” he said. “I have never known a single issue cause nearly three-quarters of our members to raise concerns with their employer in such a short space of time.”

Usdaw members are among those coping, on a daily basis, with concerns including anxiety about exposure to the virus and social distancing in workplaces, increased customer abuse, isolation from friends and family, stress and worry about the future, job security and family income.

In the spring of 2020, a survey by general union Unite of 22,000 workplace activists found mental health issues were at the top of workers’ lockdown concerns. Almost two thirds (65%) of respondents said they were dealing with an increase in members’ mental health concerns. Many working at home were suffering from loneliness and isolation, particularly clinically extremely vulnerable workers advised to “shield” during the first national lockdown. They were also dealing with excessive work pressures, financial concerns and fears about returning to work.

In an October poll of 13,500 members of general union the GMB, two thirds (66%) of respondents said their work during the pandemic has had a serious negative impact on their mental health. Six in 10 (61%) said their job was causing them stress or otherwise impacting on their mental health, with frontline workers 70% more anxious on average than the ONS estimates for the whole population before the pandemic struck.

Highest anxiety levels

Workers in retail, schools, outsourced services and care reported experiencing the highest levels of anxiety. Fear of taking the coronavirus home was the most frequently cited cause of stress at work (reported by 36% of respondents), followed by workers’ fear for their own safety (reported by 30%).

In November, a survey by the teachers’ NASUWT union found that 75% of teachers in Wales said their current level of stress and anxiety was high or very high. The findings, based on 780 responses, “laid bare the reality of teachers and headteachers struggling to cope with significant additional workload pressures arising from the pandemic”, it said. The union found a similar picture in Scotland, where 74% of more than 700 members cited their current levels of stress and anxiety as high or very high, and in Northern Ireland, where 81% of 929 members reported the same.

And last month, a Britain Thinks poll for the TUC found that working during the pandemic continues to have a negative impact on the levels of stress and anxiety of two-fifths of Black and Minority Ethnic (BAME) workers (38%). It found that 88% of BAME workers are more likely to have concerns about returning to work than White workers (78%) – and with good reason. While half of White workers (49%) report their employer has done a Covid-secure risk assessment for their workplace, as the law requires them to do, this falls to 36% for BAME workers. Under health and safety law, employers have a duty to assess the risk of stress-related poor mental health arising from work activities and take measures to control that risk. Baughan points to the HSE Stress Management Standards as the key tool employers should be using to manage work-related mental health arising from concerns about Covid in the same way as they would for other stressors.

Step-by-step approach

The standards set out a step-by-step risk assessment approach and cover six key areas of work design:

• Demands – including workload, work patterns and the work environment;

• Control – how much say the person has in the way they do their work;

• Support – including the encouragement and resources provided by the organisation, line management and colleagues;

• Relationships – including promoting positive working to avoid conflict and dealing with unacceptable behaviour;

• Role – whether people understand their role within the organisation and whether it ensures that they do not have conflicting roles; and

• Change – how organisational change (large or small) is managed and communicated.

Somewhat belatedly, the Department for Business, Energy and Industrial Strategy (BEIS) guidelines on Working safely during coronavirus (Covid-19) now include considering the mental health and wellbeing aspects of Covid-19 as one of eight priority actions employers should take.

Sea and rail

In the rail industry, a spokesperson for the RMT transport union said that unions and employers have agreed protections including risk assessments, social distancing and personal protective equipment. The unions have also agreed a worksafe procedure with Network Rail, which should be rolled out to train operating companies, allowing workers who believe they are in serious and imminent danger to remove themselves from any situation. The union also makes clear to members that under section 44 of the Employment Rights Act 1996, they have the right to refuse work that puts them at serious and imminent danger.

But despite these national-level agreements, members have reported Covid-related fears and concerns due to “sluggish action” by local managers. Some have not been advised to self-isolate when a colleague they have been in close contact with has tested positive for the virus, for example.

And, in addition to fears and stress around the impact of Covid on their physical health and the impact of isolation on those working at home, members are also experiencing financial worries. Those forced to self-isolate are generally on full pay for the whole period, and Covid-related sickness does not trigger sickness absence procedures. But many rely on overtime and premium payments to make ends meet, and these are not being paid.

Awareness of the mental health impact of Covid in the industry is growing – the RMT’s general secretary Mick Cash has spoken of the impact of the pandemic on his own mental health – and it is rising up the collective bargaining agenda, its spokesperson told Workplace Report.

In the shipping industry, for example, mental health is being discussed in the bipartite National Maritime Occupational Health and Safety Committee, particularly in relation to isolation. This has long been an issue in the industry, but during the pandemic seafarers have been unable to leave vessels for even longer periods of time.

In the Rail Industry Coronavirus Forum (RICF), unions are demanding employers have robust policies in place to recognise and acknowledge mental health problems.

The RMT is also discussing the appointment of mental health and safety reps to work alongside traditional health and safety reps and it is encouraging members to take part in the Rail Safety and Standards Board (RSSB) industry-wide mental wellbeing survey, which includes looking at the impact of Covid on mental health. The union is also working with the Confidential Incident Reporting and Analysis Service (CIRAS), a not-for-profit subsidiary of RSSB, to improve the reporting of abuse and on mental health and wellbeing.

Social care

Baughan says that, whereas as in some sectors, such as health, there has been evidence of employers wanting to work with unions in tackling these issues, in others, and especially in those sectors such as social care where employment conditions are far more fragmented, progress has been more difficult. Also, it is difficult to manage mental health when workers are still worried about both job security and their basic safety.

Unions say both the government and employers must do far more to prevent work-related mental ill health and provide support for those whose mental health has been affected by the pandemic.

“Uncertainty and confusion have been an issue for mental health,” said Baughan. “Workers don’t always trust government guidance because it hasn’t been as consistent and honest as it could have been. They have said they are following the science, but they have followed it when it is convenient and ignored it when it’s not. There has been a lack of trust and that has an impact on mental health.”

In response, UNISON has provided information members can trust on a Covid-19 advice page on its website to make sure that, as well as campaigning, the union is also a “trusted and credible” source of information.

“It helps mental health if people know what the risk is and can manage it properly,” he added. “Employers need to be as honest as possible about the risks and give assurance that the maximum is being done to mitigate them. That is a key factor in managing mental health.”

Mental health at work act

The GMB is demanding a mental health at work act that would specify the approach and methods expected of all employers in managing mental health in the workplace. This would require absences due to poor mental health to be reported to the HSE on the same basis as physical injuries.

“We urgently need full mental health risk assessments to become the norm, because protecting workers’ mental health is just as vital as protecting physical health,” said GMB national equality and inclusion officer Nell Andrew.

The GMB is also carrying out a Covid and mental health survey. This aims to identify what employers are getting right around supporting and protecting workers’ mental health, and where more needs to be done. It will use the results “to hold employers and the government to account” and ensure the right response to the long-term fallout from the coronavirus.

Education

Guidance from teachers’ union the NEU, Coronavirus: what you need to know – staff mental health and wellbeing emphasises the importance of collective action.

It advises members: “If Covid-19 protocols or new working practices in your workplace are unsafe or causing distress, don’t put up with them.”

Employers must negotiate, rather than seek to impose them, and adaptations to working arrangements must happen in consultation with NEU reps and members, it says. Expectations around workload must be both reasonable and negotiated and access to regular breaks is essential.

“Despite the crisis, there must be agreement that no-one should be constantly available or expected to respond to messages within unrealistic timeframes, or at evenings and weekends,” says the guidance.

Work with fellow trade unionists to tackle collectively issues causing concerns, such as hygiene issues, refusal to follow union guidance to allow vulnerable people to work from home, and refusal to pay those self-isolating, it advises.

Strike ballot held over Covid

This is exactly the approach taken recently by UCU members at Northumbria University and public and commercial services union PCS members at the Department for Business, Energy and Industrial Strategy (BEIS). The university and college lecturers’ UCU union branch at Northumbria University became the first union branch in the UK to win a strike ballot over health and safety relating to Covid-19. In response, the employer agreed to limit the amount of in-person teaching that takes place on campus.

Last month, more than 90 contracted-out support staff at BEIS voted to strike over a lack of Covid safety. The dispute concerns facilities management members. The union says contractor ISS was refusing to wind down support services sufficiently to enable members to shield safely. The overwhelming majority of support staff are from the BAME community, which has been disproportionately affected by the pandemic.

“If we are serious about improving our mental health, which incidentally was at an out of control epidemic proportion prior to the pandemic, then we need to give our representatives tools to work with,” the RMT spokesperson told Workplace Report.

“In just about every case, the failings by the employer are the lack of understanding or the avoidance of assessing mental health risk and putting in place adequate controls.”