Mental Health Training for Managers Reduces Work-Related Sick Days

Work-related sick leave dropped 18% for employees working for managers that received mental health training.

A 6-month trial discovered that mental health training for managers may decrease employee work-related sick leave by up to 18%, and may lead to reducing work-related sick days.

Josie S. Milligan-Saville, BPsych, a research assistant with the School of Psychiatry at the University of New South Wales in Australia and colleagues argued that mental illness is "1 of the most rapidly growing causes" of long-term work-related absence in developed countries. The rising numbers are not a result of increased prevalence of illnesses, but "changes in the way society and workplaces perceive mental illness and its effect on work capacity," Milligan-Saville said.

The researchers developed a 6-month randomized cluster control trial to assess the effects of managerial mental health training on employee absence. On-shift managers were recruited from Fire and Rescue New South Wales (FRNSW).

Forty-six managers were assigned to an "intervention group" and received mental health training via the RESPECT Manager Training Program which, according to Milligan-Saville, focuses on 3 main topics "key features and effects of common mental health issues in the workplace, roles and responsibilities of senior officers in terms of employee mental health, and development of effective skills for discussion mental health matters with staff."

Data showed that work-related sick leave dropped 18% (P =.049) from baseline for employees working for managers in the intervention group, and rose by 29% from baseline for employees working for managers in the control group. Standard sick leave data was increased for both intervention (+ 10%) and control groups (+6%) during the follow-up period, but the researchers believe those numbers may have been "because the follow-up period occurred during the winter months" when standard sick leave is routinely higher.

Many workers with diagnosed mental health issues face occasional occupational impairment due to their illness, and those impairments can be exacerbated due to "social exclusion, poor self-esteem, and financial hardship," according to Milligan-Saville and colleagues. The research team sought to determine whether occupational impairments for employees with mental health issues could be improved by providing mental health training to workplace management.

Intervention group manager training was completed between February and April 2014 in 7, 4-hour face-to-face small group sessions (7-15 participants) under the direction of a clinical psychologist or consultant psychologist trained in "mental health-related educational programmers for workplace settings." Managers in the control group (n = 42) were asked to complete a baseline questionnaire and were offered "standard employee assistance manager support" as needed. At 6-month follow-up with managers in the intervention and control groups "knowledge, attitudes, confidence, and communication behaviors" were assessed and compared to baseline.

Employee absences were recorded for 1966 employees under managers involved in the study from 6 months prior to intervention and during the 6-month study period. In addition, researchers collected and assessed self-reported communication behaviors from managers, and completed a cost-benefit analysis on training costs in comparison to losses based on sickness absence rates and average hourly wages for FRNSW employees.

Additional data showed that managers receiving intervention had more confidence in communicating with employees about mental illnesses; 100% of managers (n = 10) in the intervention group initiated contact with employees with mental illness/stress related absences versus 67% of managers (n = 12) in the control group.

Cost-benefit analysis, according to Milligan-Saville and colleagues, revealed that "the cost of work-related sickness absence for employees was ₤6243.60 less per manager in the intervention group compared with the control group," suggesting a ₤9.98 return on every dollar invested in manager mental health training.

Milligan-Saville and colleagues wrote that "managers in the workplace have a key role in determining the occupational outcomes of workers" and "have the authority to implement adjustments to working conditions" that might alleviate work-related obstacles for their employees with mental illness.

The researchers argued that there are potential public health and economic benefits of mental health training interventions for managers. Milligan-Saville suggested that efforts to help improve employment outcomes for persons with mental illness have focused primarily on health care facilities and rehabilitation efforts, but that improvements could also be made via changes in the workplace affected by managerial training programs.

Although Milligan-Saville and colleagues suggest that further research is needed to determine the "exact mechanisms underlying the reduction in sick leave of employees whose manager underwent mental health training in the present study," they believe that the study results point to a measurable benefit to improving workplace understanding of mental illness which could provide "meaningful public health benefits."

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