Why We Need a Multi-Level Approach to Workplace Health & Wellbeing
What do you think of when you think of workplace health and wellbeing?
When I tell people that I’m working in this area, it usually sparks two discussions. Firstly, people often comment on their company’s efforts in workplace health and wellbeing. Most mention that they offer health benefits such as EAP and health insurance, or health promotion events like exercise classes, mindfulness workshops and mental health days. Undoubtedly, both types of interventions are very useful in their own right. However, for organisations that are genuinely aiming to enhance employee health and wellbeing, it’s crucial to broaden the focus of their strategy. Why? Because these interventions primarily concentrate on the individual and neglect the broader work environment that can impact employee health. A recent study has endorsed this idea after concluding that that individual level interventions such as resilience training and wellbeing apps did not significantly improve the wellbeing of 46,000 UK participants [i]
Strategies that overly focus on the individual have limitations.
Research has long highlighted that an effective employee health and wellbeing approach necessitates a multi-level perspective.[ii]. This encompasses not only the individual, but the job they perform, the team they work with and the organisation they work for. Overly focusing on the individual interventions has limitations. They can be reactive in nature, for example, using an EAP only once an individual becomes ill. Additionally, they may assume that managing stress is solely the responsibility of the individual. However, no amount of resilience workshops will combat all the stress of an employee who is working a 60 hour work week or is performing the job of two people. Again, both can be useful in supporting employees and should remain a focus for future inventions. Yet neither equip the individual to resolve the root cause of their work-related stresses. And that brings us to the second discussion that people often mention to me - what’s causing them stress. According to the 2023 CIPD report on health and wellbeing at work[iii], the biggest work-related causes of stress are workload, management style, pressure to meet deadlines and relationships at work. While everyone should be accountable and understand how they can influence the situation, these stressors are not directly controlled by the individual. They are intrinsic to the nature of the work that they do and the team dynamics. They are typically controlled by their manager, who in turn, is influenced by the leadership of the organisation. Equipping both parties with skills to address stress should be a top priority. If a workplace health and wellbeing strategy does not focus on the work and team levels, how can we expect employees to feel less stressed?
Work and team levels drive employee health and wellbeing.
The broader focus on how the work and the team can impact employee health and wellbeing has gained attention in academia and national and international frameworks. At a national level, the health and safety authorities in the UK and Ireland have created dedicated resources to help organisations address work related stress and psychosocial hazards [iv][v]. It is important to be aware that organisations have a legal obligation to protect employees against stress at work. Both authorities have created free tools and resources to assist organisations in this regard. I myself used the HSE stress indicator tool[vi] for my own research to measure work related stress. It was particularly useful to get a detailed breakdown of the specific issues that were causing stress. Furthermore, it assessed the risk levels for each source of stress and had suggestions to help rectify this. The only critique I had of this tool is that it didn’t consider the wider organisational level items that can affect health and wellbeing. In particular, organisational culture and the role that leadership can play in this.
Culture is key.
Recognising the significance of culture, the world health organisation identifies it as a potential cause of work-related stress [vii]. This dynamic was the focus of my own research which explored how organisational culture impacted work related stress in the accounting profession. The results identified five constructs of culture that impacted participants’ main cause of work-related stress: their demanding working conditions of long hours and tight deadlines. There was a social norm or expectation that long hours and being stressed was ‘expected’ and that they should be able to ‘handle it’. They often learned this from the behaviours modelled by others and in particular, those in senior positions such as managers and leadership. A competitive mindset and ambitious career goals made many participants rationalise why they worked these hours. There was also a perception that those who could not do so may be perceived as ‘weak’. This resulted in stigma around mental health and a lack of psychosocial safety as many participants did not feel comfortable voicing their work-related health concerns. The findings indicated the importance of considering how cultural priorities may impact the effectiveness of a health and wellbeing intervention or in creating psychological safety. It’s therefore important that organisations train employees to identify current cultural patterns before they can take meaningful steps to create healthier ones.
Address employee needs.
A key starting point is understanding your employee’s current state of health and wellbeing, the issues they are facing and what additional support that they need. Strategies must be employee driven after consulting them on their priorities. For example, a 2023 mental health at work report in the US found that employees rated a healthy and sustainable work culture as more important than self-care resources[viii]. Without consulting employees first, strategies and resources may be directed towards interventions that aren’t particularly desired by employees and therefore are not as effective. To capture employee feedback, an anonymous survey can be a useful starting point where there are large numbers of employees in the organisation. Furthermore, they can also be effective in smaller settings if employees don’t feel comfortable voicing their opinions in a one to one or group setting. With this data, a solution orientated approach can be taken to bring about the necessary change needed to improve employee health and wellbeing.
Behaviour change starts with education.
And how do we practically go about this change? Like any behaviour change, the starting point is awareness[ix]. It’s important that all employees are aware of how their work, team and organisation can impact their health and wellbeing. Personally, I had a very limited understanding of what could cause work related stress and I certainly underestimated the impact that it could have on my overall health. Therefore, education and training should be central to a workplace health and wellbeing strategy. By providing employees with the knowledge and tools to create healthier day to day habits, healthier cultures can be created. A critical aspect of this plan is making sure the leaders and managers are first trained, enabling them to support the creation of a healthy culture by leading by example. While this may not sound like the most appealing intervention for a workplace health and wellbeing strategy, it ensures that all employees can take steps to improve day-to-day health and wellbeing for themselves or those they manage, embedding it into the culture of the organisation.
For more information and support on how you can assess your health and wellbeing of your organisation, check out well work 360’s indicator tool and supporting services.
References
[i] Fleming, W. J. (2024). Employee well-being outcomes from individual-level mental health interventions: Cross-sectional evidence from the United Kingdom. Industrial Relations Journal.
[ii] Martin, A. et al. (2016) ‘The Psychosocial Work Environment, Employee Mental Health and Organizational Interventions: Improving Research and Practice by Taking a Multilevel Approach.’, Stress & Health: Journal of the International Society for the Investigation of Stress, 32(3), pp. 201– 215.
[iii] CIPD (2023) Health and wellbeing at work. Available at: https://www.cipd.org/globalassets/media/knowledge/knowledge-hub/reports/2023-pdfs/8436-health-and-wellbeing-report-2023.pdf
[iv] HSE (no date) Stress and mental health at work. Available at https://www.hse.gov.uk/stress/index.htm
[v] Workpositive (no date) What is work positive? Available at: https://www.workpositive.ie/information/whatisworkpositive
[vi] HSE (no date) Stress indicator tool. Available at: https://books.hse.gov.uk/Stress-Indicator-Tool
[vii] World Health Organisation (2020) Occupational health: Stress at the workplace. Available at: https://www.who.int/news-room/questions-and-answers/item/ccupational-health-stress-at-the-workplace.
[viii] Mind Share Partners (2023) 2023 Mental Health at Work Report. Available at: https://www.mindsharepartners.org/mentalhealthatworkreport-2023
[ix] Prochaska, J. M., Prochaska, J. O., & Levesque, D. A. (2001). A Transtheoretical Approach to Changing Organisations. Administration and Policy in Mental Health, 28, 247.