Improving the mental health of Indian workers

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With research from the India State-Level Disease Burden Initiative suggesting that as many as one in seven Indians may be affected by mental health problems, there is a pressing need to support and improve the mental wellbeing of the population, including all workers.

The recent national lockdown aimed at limiting the spread of Covid-19 may also be taking a severe toll on the nation’s mental health, with a survey from the Indian Psychiatric Society suggesting there was a 20 per cent rise in the number of people reported to be suffering from mental health problems in late March.

Safety Management asked three experts from the public and occupational health fields what practical steps employers can take to support and improve the mental health of Indian workers.

We interviewed:

Dr Rajesh Sagar, Professor of Psychiatry at the All India Institute of Medical Sciences (AIIMS), New Delhi.

Dr Kamalesh Sarkar, Director and Senior Scientist at the Indian Council of Medical Research National Institute of Occupational Health (ICMR-NIOH) Ahmedabad.

Suresh Tanwar, Head of Audit and Consultancy at the British Safety Council (India).

How much effort are Indian businesses putting into supporting the mental wellbeing of their workers? Given the likely mental stress that the Covid-19 pandemic is placing on the Indian population, should Indian businesses be doing more to protect workers’ mental health?

Suresh Tanwar: Mental health has not got the desired focus in Indian companies. In the industrial scenario, while we put health and safety together as a single subject, safety has actually been accorded the higher importance. I think this is mainly because the results of poor safety are immediate and visible – such as a major fire, serious injury or even a fatality.

Generally, health effects are seen to be delayed ones and therefore mental health has not been been something that senior leadership have focused on. In light of Covid-19, things have started to change as mental health issues have been identified as one of the adverse effects of the national lockdown. This has been recognised by some businesses and public and occupational health experts, and we have, for example, recently seen some webinars on the mental health of workers organised by various organisations for their clients and companies.

Suresh Tanwar, Head of Audit and Consultancy at the British Safety Council (India).

Dr Kamalesh Sarkar: Some progressive organisations and multinational companies in India have recognised the importance of mental health, due to demanding work pressures, a competitive work environment in this VUCA (Volatility, Uncertainty, Complexity and Ambiguity) world and the pace of modern-day lifestyles.

It is worth mentioning that some organisations in India have launched formal mental health policies for their business, in addition to their already existing environment, health and safety (EHS) policies.

The crux of these workplace mental health policies is that the organisation will seek to treat mental health in the same way as any form of physical health and will support and assist in seeking to ensure the good mental health of their employees. These organisations sometimes have an in-house counsellor visiting their workplace clinics – for example, once a week. Surprisingly, employees do come forward and discuss their issues with the counsellors and this concept of having an in-house visiting counsellor is becoming very popular.

Other organisations have EAP (employee assistance programmes) in place,if they feel that their employees would prefer not to directly disclose that they may be experiencing a mental health problem. These EAP lines are generally either offered and run by private companies or by non-governmental organisations (NGOs). Some of the EAPs that are run by NGOs which are quite popular are iCall (Mumbai); Sahai (Bengaluru); St Stephen’s Hospital and Emmanuel Hospital Association (New Delhi) and Lifeline Foundation (Kolkata), to name a few.

Generally an EAP helpline sees trained psychologists providing counselling to the anonymous caller in nine different Indian languages and seeking to help the person to deal with the mental health problem. They always maintain the confidentiality of the caller.

Some of the progressive organisations that are successfully running EAP programmes are Bharti Airtel Limited, Kellogg India Ltd., Worley Parson India Ltd., to name a few. However, these services are only offered by a handful of businesses.

During the Covid-19 crisis, the anxiety experienced by employees has heightened due to issues such as job insecurity, salary cuts, uncertainties about the future scenario and fear of family members becoming ill or dying. The incidence of domestic violence is also on the rise. Hence, I feel that the mental health of employees still needs more recognition, especially considering the current Covid-19 crisis.

Dr Kamalesh Sarkar, Director and Senior Scientist at the Indian Council of Medical Research National Institute of Occupational Health (ICMR-NIOH) Ahmedabad.

How can companies support the mental health of their employees during the Covid-19 crisis?

Suresh Tanwar: The most important step that can be taken is to have an EAP (employee assistance programme) in place, if it is not already provided. Any employee having issues related to stress which could be attributed to factors such as work, relationships, their reporting manager, financial concerns or lifestyle, could get in touch with the appointed expert organisation for counselling on a one-to-one basis with complete confidentiality. That would go a long way to alleviating the effects of stress that may be building up.

The other initiatives could be around stress-related training programmes for employees. The senior management could also communicate about the support the business will offer to employees experiencing mental health problems such as anxiety. Companies can also revise and update their occupational health policies to incorporate and cover the various aspects of mental health.

Dr Rajesh Sagar: Whether employees are working on-site or at home, first and foremost we all need to publicly acknowledge and talk about the fact that staff may be finding the situation hard to deal with and acknowledge that the pandemic has evoked many forms of fears and uncertainties in all of us.

Keeping concerns within yourself often makes the struggle appear catastrophic and impacts on our ability to deal with it. Sharing concerns with other employees or with your manager helps not only to ‘ventilate your emotions’, but also helps you to get a sense of relief in the fact that everyone is going through the same distress. So it normalises and validates the feelings to a large extent.

Therefore, managers, and especially the human resources (HR) team, should frequently check with employees, through phone or video conferencing, about the concerns workers may have about going to work during the outbreak. They should also generally ask about employees’ emotional wellbeing. This provides an opportunity to gauge if staff are suffering distress and to respond to these concerns.

For those employees working on-site, HR leaders and people managers should communicate with them regularly about the safety precautions they are taking to minimise the health risks. Local protocols should be established on how employees will work, take breaks, eat their food, talk to others or commute to their homes. A support person should be appointed for a group of workers who can also visit the site and deal with any day-to-day difficulties that workers may be experiencing. Though a business will want and need to follow a fixed schedule of work, provision should be made for staff to take breaks and appropriate leave. A support person could also identify local mental health support resources that employees could be referred to, such as apps, websites, meditation or yoga classes.

For employees working from home, there is a huge blurring of personal and professional lives, which requires discretion. The best way to do this is to establish a routine for working while at home and adhering to it. This includes allotting a separate workstation; having fixed working hours that include lunch and coffee breaks ;and most importantly asking family members to be supportive towards you following this work routine.

Since home working will involve sitting for long periods of time, it is very important for staff to maintain their physical health. Employees can be reminded about the importance of taking breaks with suggestions on what they can do during these breaks to ensure they gain the appropriate health benefits. This might mean taking a walk, practicing deep breathing for relaxation, talking to your loved ones or playing a bit with your children.

It also important for staff to stay connected with family members (either through in-person or virtual interactions) and lastly, doing certain things each day which they find relaxing.

Dr Rajesh Sagar, Professor of Psychiatry at the All India Institutes of Medical Sciences (AIIMS), New Delhi.

Dr Kamalesh Sarkar: If employees go to the workplace an in-house nurse trained in psychology, a competent doctor with excellent communication and counselling skills, or hiring an in-house counsellor can be of great help to individual employees by providing someone they can talk to. The employees can openly talk to this person and address their concerns around matters such as job insecurity, salary cuts, uncertainties about the future scenario, fear of losing their jobs and fear of losing their loved ones to Covid-19.

If employees work from home, a business can hire the services of commercial EAPs or enter into an agreement with EAPs run by the kind of NGOs mentioned above like Sahai, i-call and the Lifeline Foundation. It is also worthwhile mentioning that the National Institute of Mental Health and Neurological Sciences (NIMHANS), Bengaluru has launched a Covid-19 helpline and this number can be shared with employees if the organisation has not engaged the services of an EAP provider.

What steps can people take to maintain good mental health during the Covid-19 crisis?

Suresh Tanwar: While work-related issues can escalate or aggravate a mental health issue in an individual, generally the way to manage stress rests to a great extent with us as individuals. Taking a break from work, controlling our anger, enjoying our hobbies – such as exercising – meditation and focusing on the positives rather than the negatives are some of the ways to help keep stress at bay and help us to maintain good mental health.

Dr Rajesh Sagar: Firstly, I would emphasise that the pandemic has created a range of complex situations for all of us, so feeling worried or anxious is a normal reaction. It’s okay to not feel okay at this time. However, people should try to ‘nourish their mental health’ by sharing their worries frequently with their loved ones and receiving support. It’s also important to remember that it’s okay at times to feel overwhelmed with the uncertainty that the situation brings. For this reason, it’s important to focus on things which are within our control, such as following a routine, pursuing hobbies, getting socially connected and practising self-care.

Having said that, if at any point people feel their anxiety, sadness, irritability, poor sleep patterns, impulsivity or loneliness is way out of their control and they are unable to cope with it, it’s okay to seek help in the form of tele-counselling and other tele-psychiatry health services. The human resources team at a business should also try to refer employees to the necessary mental health facilities and support services.

Dr Kamalesh Sarkar: I would advise organisations to support their employees as their people are a valuable asset to the future success of the organisation. As these employees have now become vulnerable due to the Covid-19 crisis, it is the right time for organisations to spend on supporting their mental health and also on occupational health.

If an organisation is finding it difficult to spend on mental healthm then they could hire the services of an occupational health physician and share the numbers of any EAPs that staff could access.

If a competent occupational health physician is hired during this period, this person can assist the organisation in addressing the mental health issues of staff. An occupational health physician can also take a bigger role within the business, such as conducting webinars for all employees on coping during the Covid-19 pandemic. These webinars could emphasise the preventive measures to follow to control the spread of infection. These would include physical distancing, frequent handwashing with soap and water, taking regular physical exercise, using good nutrition to boost your general health and maintaining good mental health. In short, we need to think positively and try to achieve holistic wellbeing in this unprecedented crisis.

Apart from promoting ways of maintaining good mental health among staff, an occupational health physician can also help in formulating guidelines for return to work policies. They could also conduct regular stress-buster sessions at work, run employee engagement activities and assist in creating a good work-life balance policy. They could also help a business to ensure that every employee has someone they can approach at work in times of difficulty, such as a manager or supervisor.

In my view, the Covid-19 pandemic has also created an opportunity to improve the country’s public health infrastructure, and its approach to occupational health, including mental health. India has more than 500 million workers and more than 90 per cent of them work in the unorganised sector. These unorganised workers are the main driving force of the economy. But they are highly exploited both socially and economically and as a result most of them work in very stressful situations and conditions that may lead to chronic stress and burnout. So I suggest there should be continuous monitoring of chronic stress and burnout among workers in all organisations and steps should be taken to alleviate this stress. This will improve the productivity of organisations.

What other steps can employees take to boost their mental strength during the Covid-19 situation?

Suresh Tanwar: People need to understand that they can reach a breaking point when the good stress that enhances their performance leads to some kind of breakdown as a result of not able to cope up with their work and/or their situation. People should engage with their colleagues at work on non-work related matters to support their own and others’ mental wellbeing. Don’t forget to give yourself a break from work and build resilience, because difficult times like these will come and go; and we will all have to boost our mental strength to deal with them in future too.

Dr Kamalesh Sarkar: Actually, the Covid-19 crisis may be viewed as a blessing in disguise for some employees, as they have actually got an opportunity to spend quality time with their family members, which otherwise it was not always possible to achieve. This is the best time to develop excellent bonding with all members of the family, further augmented by viewing old photographs and videos of the good times that were spent together.

Technology has also enabled employees to interact with friends and relatives in India and abroad. This is the best time for employees to develop a support system for themselves which can help them to come out of any crisis in the future and the current one. The employees could also participate in stress-buster sessions at work and achieve a good work-life balance.

They could listen to some good music to relax their body and mind, attend online yoga sessions and webinars on mindfulness

Dr Rajesh Sagar: I would like to state some key pointers that can really boost mental health during the current crisis. These are:

  • Normalise your anxieties as everyone is undergoing similar distress
  • Acknowledge and share your feelings as much as you can
  • Maintain your physical health. Eat a healthy diet at regular intervals, maintain sleep hygiene and find time for mini-walks during breaks
  • Segregate personal and professional life while staying at home. For those working on site, follow every possible local safety protocol, communicate about your needs and seek assistance whenever required.
  • It’s a good time to invest in yourself. Engage in hobbies that help you to feel yourself and relaxed.
  • Practice very simple relaxation exercises like deep breathing or any other cultural school of yoga that helps you to stay calm and peaceful
  • Stay socially connected. Make an effort to spend quality time with your family members or friends through tele-communication.
  • Share your piece of happiness for every single day at group meetings or group chats at home.

Finally, seek out specific mental health support if you require it. Reach out to local mental health professions if they are available.


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