As head of wellbeing for GWR, the UK’s largest train operator, Barbara Davenport is responsible for the diverse needs of 5,000 employees. Here she describes using a triage process to rehabilitate those affected by a mental health issue.
Geographically we’re the largest train operator in the UK, with commuters and tourists using our trains to travel from Penzance to London and from Wales to the West Country and the Thames Valley Region.
We have to meet certain requirements for our operating licence, such as in service medicals for train drivers, but we also run lots of other wellbeing initiatives, including health MOTs each year for our colleagues to get a mini health check. We’ve got a health kiosk that travels around the country to benefit everyone in the business. The individual results are kept anonymous, but a lot of overall usage data and MI is generated which reveals particular clusters where our wellbeing efforts are best targeted.
"Another area that’s much harder to assess is the mental health of the workforce. It’s clear when someone’s been tipped into some kind of crisis, but the challenge is getting to them before they get to that point."
We have an Employee Assistance Programme (EAP) in place, run by Validium, the mental health experts, for any of our employees to call for emotional support or financial, legal, debt and eldercare or childcare support, but even though it is used, with a 7% annual utilisation rate, it was still dependent on employees making the first move and proactively seeking support.
“We wanted more people to get the help they needed sooner so we decided to ask Validium to set up a specialist rehabilitation programme.”
We wanted more people to get the help they needed sooner, so we decided to ask Validium to set up a specialist rehabilitation programme, staffed by their professionally qualified psychologists and psychotherapists, that managers could proactively direct employees towards if they thought they might be struggling with a mental health issue.
The overall aim was to stop an initial condition, such as stress, anxiety or trauma, from turning into something more chronic, such as depression or post-traumatic stress disorder (PTSD).
“It was important to know in advance that any investment wouldn’t be wasted.”
Creating the business case
The board is extremely interested in the impact that mental health disorders have on the business. It’s hugely costly to leave people absent or struggling to perform, not just because of the increase in sickness absence and management time in dealing with it, but also because of the implications for staffing stations and trains, as well as the knock-on effect on customer service and our overall performance. Also, it is human failure if we can’t help valued employees to get better and not be chronically ill.
Even so, investing in specialist rehabilitation treatment isn’t a cheap option so it was important to know in advance that any investment wouldn’t be wasted. If the employee wanted to engage with the support, the first step was for Validium to carry out a psychological health assessment to clearly determine what issues were limiting their ability to attend or perform at work, recommended treatment and a prognosis for recovery. In this way, we were able to clearly triage those being referred into one of three categories: those who were likely to recover without any support; those who were unlikely to recover but might be fit enough to come back into the workplace in some other capacity; and those who needed treatment to recover.
Even if someone needed 20 CBT sessions, but there was a 90% chance of recovery, we were still able to make a strong business case for funding their rehabilitation. If their condition was so serious that it represented more than a reasonable adjustment, we also had the information required to look at other options. Including moving them to a role or another part of the business that was better suited to their needs.
Of the 37 employees referred, 28 proceeded to assessment and 20 received treatment. For those employees who were absent, the clinical opinion was that the absence would continue for at least six months without any intervention. Instead, the rehabilitation process provided by Validium brought about an 81% symptom recovery, resulting in a 100% return to work, to generate a direct cost saving of £160,000. Not to mention the indirect benefits associated with saved management time and staff replacement costs.
By giving managers the skills and tools needed to approach people struggling to cope, they have become much more confident at managing mental health. Managers now feel able to ask people that are struggling how they are.
They know that they can say: “I’m sorry you’re feeling like that, we’ve got a support service that can help you to understand what’s going on and maybe help you feel better.”
Clearly, the employee has to want to get better for the scheme to work. They need to engage in the treatment and support for it to have an effect. We can’t make them get better if they don’t want to, so sometimes difficult business decisions need to be made in individual cases. But if they want to engage and work towards their recovery, we want to give them the chance.
Overall, the upfront psychological assessments have become a valuable tool, enabling us to quickly triage absent employees and make business-based decisions about how best to direct rehabilitation funds. Most employees come back on a phased return and although Validium works within the clinical bounds of their profession, we get useful data on how best to support individuals. That, together with the expert treatment provided, has enabled us to successfully rehabilitate many valued employees to save the business with significant saving around direct absence costs. Even after taking into account the costs of the programme and treatment.
“The rehabilitation process provided by Validium brought about an 81% symptom recovery, resulting in a 100% return to work, to generate a direct cost saving of £160,000. Not to mention the indirect benefits associated with saved management time and staff replacement costs.”
Barbara Davenport | Head of Wellbeing | GWR