Thriving at Work - the Farmer/Stevenson Review

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We start from the position that the correct way to view mental health is that we all have it and we fluctuate between thriving, struggling and being ill and possibly off work. People with poor mental health including common mental health problems and severe mental illness can be in any of these groups. An individual can have a serious mental health problem but – with the right support – can still be thriving at work.

A couple of weeks ago the Government published a report from Paul Farmer, CEO of Mind, and Dennis Stevenson – Thriving at Work, a review of mental health and employers.  

It is an important and authoritative report which calls for wide ranging action from employers and the government.  It is also long – 80 odd pages - and covers both public and private sector employers, as well as central and local government. The full report is available here but the key points so far as private sector employers are concerned are summarised below.

It should be no surprise that there is a lot of mental ill health about, it is costing business and the country a lot of money, and has a huge impact on the individuals themselves:

  • Around 15% of people at work have symptoms of an existing mental illness;
  • Individuals with mental illnesses lose their jobs at twice the rate of those without mental illness and at a much higher rate than those with a physical illness;
  • The total cost to UK employers of mental illness is estimated to be between £33 billion and £42 billion a year;
  • That equates to £1,119 to £1,481 per employee in employment across the whole population – the rate is much higher in the higher paid professional services, finance, insurance and real estate sectors;
  • A recent report in the Lancet suggests a tenfold return on investment in manager mental health training.  Other research suggests a return of between £1 and £4 for every £1 spent on workplace mental health initiatives more generally.


The report recommends the introduction of a set of core mental health standards with which all employers, regardless of size or sector, should comply, and an enhanced set of standards for larger employers (those with 500+ employees) and those in the public sector. The Core standards are as follows:

  1. Produce, implement and communicate a mental health at work plan that promotes good mental health for all employees and outlines the support available for those who need it;
  2. Develop mental health awareness among employees by making information, tools and support accessible;
  3. Encourage open conversations about mental health and the support available when people are struggling, at regular times throughout employment, and offer suitable workplace adjustments to those that require them;
  4. Provide employees with good working conditions and ensure they have a health work life balance and opportunities for development;
  5. Promote effective people management to ensure all employees have regular conversations with their manager about how they are, and train managers in how to have those conversations and in effective management practices more generally;
  6. Routinely monitor employee mental health and wellbeing, by collecting data, talking to employees and understanding risk factors.


The Enhanced standards add the following for the relevant employers:

  1. Increase transparency and accountability through internal and external reporting, to include a leadership commitment and an outline of the organisation’s approach to mental health.  There is a suggestion that this be made part of mandatory company reports in due course;
  2. Demonstrate accountability by nominating a senior individual to be responsible and accountable for the issue;
  3. Improve disclosure of problems to encourage openness and to allow the right support to be provided;
  4. Ensure provision of tailored in-house mental health support and signposting to clinical help.


There are additional recommendations to the government to consider legislative and other changes to implement the recommendations generally, and also specifically within the public sector.  The report also calls upon regulators to take a lead in ensuring the recommendations are implemented, and to include mental health in training programmes and assessments.  This follows on from the recent American Bar Association report which has led to a number of state bar associations making mental health training a mandatory part of CPD.

The report also calls on large employers to take a lead in encouraging suppliers to implement the recommendations and, where appropriate, to provide support to them in doing so, perhaps through facilitating training or other interventions.

There can be little doubt that the report envisages a revolution in the approach employers take to mental health.  It has a bold vision to achieve that change within ten years.  The last few years have seen an encouraging increase in employers taking action in this area.  This report, which has already received the full backing of the Prime Minister, will require a redoubling of that effort.  It is the right thing to do but, as the research clearly shows, it makes good business sense too and it seems likely that regulatory and legislative changes may follow which also make it a legal requirement.

For more information on the report, or to discuss how your organisation might respond to it and implement the recommendations, please do get in touch.

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