and careers guidance
Postgraduate Diploma in Career Guidance and Development
Mental health conditions at work
Incidence: 16 % + at any one time
Economic costs to business: £26 billion p.a.
– Under-performance & presenteeism
– Sickness absence
– Early withdrawal from workforce
Total costs to wider society: £ 115 billion p.a.
– As above plus...
– Medical and care costs
– Tax lost + welfare benefits costs incurred
(Foresight Mental Capital Project, 2008; Sainsbury Centre 2007; Friedli & Parsonage, 2007)
Sources of Stress
• Workload • Tasks
• Hours/shiftwork – Control
• Travel – Emotional labour
• Physical risk (Service sector)
• Psycho-social risks – Ambiguity
– Bullying – Restructuring
– Sexual harassment – Job insecurity
– Use of alcohol/drugs
Careers and stress
Career concerns are known to be a
source of work stress (e.g. Baruch, 2009)
• Metaphors of
– Glass ceilings
– Golden cages
• Work/life balance
– Bi-directional conflict
• Older workers
– Network erosion Hush...don’t tell your
clients about the health
“Employment is nature's physician, and is essential
to human happiness”
Galen of Pergamon, Greek physician,
surgeon and philosopher, 172 AD
“Working is, for most patients, a positive clinical
outcome and can be an intervention in its own right”
Royal College of Psychiatrists
“There is a strong evidence base showing that work is
generally good for physical and mental health and well-being.
Worklessness is associated with poorer physical and mental
health and well-being. Work can be therapeutic and can
reverse the adverse health effects of unemployment. That is
true for healthy people of working age, for many disabled
people, for most people with common health problems and
for social security beneficiaries...Work is generally good for
health and well-being.”
(Waddell & Burton, 2006: ix).
To summarise so far...
health hazards at work
that make them
stressed or mentally ill !
Going to work helps
with mental health
conditions get better !
read the small print...
Does unemployment cause mental health conditions ?
o Yes, it is a very powerful causal factor but...
o Some reverse causality (health selection for job loss or re-employment)
o A minority are happily unemployed
Does work cause good health ?
o It tends to but is not a panacea
o Poor quality work or insecure may have neutral or detrimental effects
o Some individuals at certain times may be vulnerable to psycho-social health
• Most accessible to unemployed with health
• Insecure, temporary, low status, servile
– pay, hours, qualifications, experience
• May lead to unemployment, not secure work
• Results in fractured employment biographies
Problems with the stress
vLocates responsibility for causes and
management of distress within the individual
vFocus on anxiety ignores the complexity of
emotion at work
vImplies work is usually pathenogenic
vHuge evidence base shows unemployment is
associated with greater mental distress
The Whitehall studies
• Michael Marmot & colleagues explored
health in the British Civil Service
• Found a status/income gradient in physical
and mental health
• Social inequality has health consequences
• Control at work is a key issue
e.g. Stansfeld et al (1999)
promotion (WHO, 2004)
• No health without mental health
• Health is more than the absence of illness
• Requires a climate that respects and protects
The workplace is a key arena for public
mental health interventions
Well-being and productivity
Recent research suggests a healthy
workforce leads to enhanced productivity
• Employee engagement and co-operation
• Sustainable performance
e.g. Harter, Schmidt & Keyes (2002)
Key messages about employees
and mental health
• Unemployment: usually more stressful than work
• The quality of work is very important
• Income/status gradients at work affect health
• Work is a key arena for mental health promotion
• Positive well-being may promote sustainable
Interventions and wider challenges
• Stigma, media and
• Flexible working
• Reasonable adjustments
• – Performance management
• Support services:
– Attitudes to mental health
– Employee assistance
– Occupational health (OH)
– Vocational rehabilitation (VR)
Lack of coherence in
– Occupational therapy (OT)
– JobCentre Plus/DWP services
support services ?
– Executive coaching/mentoring
A role for career guidance ?
Three thoughts about the potential for career
related support to contribute to the
management of mental health issues at work.
A holistic approach to career and mental
health counselling may be desirable (Zunker,
– Career and personal concerns overspill & interact
– Work dominates waking hours & defines identity
Stress management vs career guidance approaches
Future focus offers hope
Identify resources strengths based
Focus on choice & goals
= promotes sense of
Exploring work identity rebuilding self-concept
Encourages networking builds social capital
Career guidance has several features consistent with a
recovery based approach to mental health
For more information
Royal College of Psychiatrists
Work and mental health online resource:
BARUCH, Y. (2009) Stress and Careers. In C.L. Cooper, J. Campbell Quick & M.J. Schabracq (eds) International
Handbook of Work and Health Psychology 3rd edition. Chichester: Wiley-Blackwell
FORESIGHT MENTAL CAPITAL AND WELLBEING PROJECT (2008) Final Report. London: The Government Office
FRIEDLI, L. AND PARSONAGE, M. (2007) Building an economic case for mental health promotion: part 1. Journal
of public mental health, 6, 3:14-23.
HARTER, J.K. SCHMIDT , F.L. & KETYES, C.L.M. (2002) Well-being in the workplace and its relationship to
business outcomes: A review of the Gallup studies. In C.L.M. Keyes & J. Haidt (eds) Flourishing: The
positive person and the good life (pp205-224). Washington DC: Amercian Psychological Association.
SAINSBURY CENTRE FOR MENTAL HEALTH (2007) Work and wellbeing: developing primary mental health care
services London: SCMH
STANSFELD, S.A., FUHRER, R., SHIPLEY, M.J. & MARMOT, M.G. (1999) Work characteristics predict psychiatric
disorder: prospective results from the Whitehall II study. Occupational and environmental medicine, 56,
WADDELL, G. & BURTON, A.K. (2006) Is work good for your health and well being ? London: Department for
Work and Pensions
WORLD HEALTH ORGANISATION (2004) Promoting mental health: concepts, emerging evidence, practice.
Summary report. Geneva: WHO.
ZUNKER, V. (2008) Career, work and mental health: integrating career and personal counselling. London: Sage.
Any questions or comments ?