Cardiff and Vale UHB Employee Wellbeing Service Dr Clare Wright Head of EWS Consultant Clinical Psychologist

Promoting Health and Wellbeing Flow Chart Initial Actions Common / Mild to Moderate Mental Health Problems Possible Signs: - Low mood/Irritability - Pre-occupied - Increased Alcohol use Involvement in: - Bullying and Harassment - Disciplinary or Grievance issues. Moderate to Serious Mental Health Problems Possible signs: - Lack of flexibility, - Extreme change to usual behaviour - Angry Outbursts - Withdrawn - Aggression - Extreme Impulsivity - Extreme Emotional outbursts Serious Mental Health Problems Possible signs: - Mood Disturbance - Delusional ideas - Obsessions & compulsions interfering with function - Eating Disorders - Suicidal intent Initial AssessmentSupport mechanisms Refer to and follow Sickness Policy Seek advice/ information and low intensity support / therapies e.g. recommended self help books, stress coping/ resilience and assertiveness training provided by the UHB Encourage and support self referral to Employee Wellbeing Counselling Service Encourage and support self referral to GP Consider referral to Occupational Health Service If previously or currently reviewed by Community Mental Health Team (CMHT) encourage to make contact directly Referral to Occupational Health Service Encourage and support self referral to GP Consider modifying duties e.g. change or relieve from duties Referral to Occupational Health Service Consider the following: - Encourage staff members to -Contact Staff Representative - OH Assessment - Rehabilitation Plan - Stress Risk Assessment - Preview Employee Wellbeing Intranet page - Contact OD&T Department to gain access to Stress e-learning programme Consider the following: - OH Assessment - Rehabilitation Plan - Professional competence Issues. Consider the following: - OH Assessment - Rehabilitation Plan - Professional competence Issues. - Refer to NICE guidelines for further information and possible treatments Modify duties where appropriate e.g. change or relieve from duties Support for staff post Violent and Aggressive Incident Consider the following: - Encourage staff members to contact Staff Representative e.g. for advice on legal options. - Referral to Case Manager - Refer to Employee Wellbeing Intranet Page (Pre Occupational Health Assessment) Consider referral to Occupational Health Service

The service offers consultation at 3 levels: Level I: Organisational Psychology: Tackling Work Related Stress at Source Level II:Training in Psychological Skills Level III: Employee Assistance / Counselling

Preventing Stress: Identifying potential stress hot-spots and consulting with managers/employees Responding to Stress Hot Spots: Consultation to managers to support assessment and interventions to reduce stress Consultation to: Occupational Health, Human Resources, Organisational Development and Training Incident Response Facilitated Learning Groups for Managers around HSE Management Standards Approach/ Stress Facilitation of Focus Groups Toolkit for Managers: Managing Stress in the Workplace Alcohol Awareness Training for Managers with Occupational Health Stress Awareness Presentations Assertiveness Training Stress Resilience Training Refresher Courses Formal Support for individuals involved in formal proceedings such as disciplinary. Cognitive Behavioural Therapy (1:1) Structured Brief Counselling (1:1) Computer Based Self-Help: Living Life to the Full Self-Help Book Library Post Trauma Consultation/ Support (1:1) Mediation Other Themes Consultation to individual Managers THE EMPLOYEE WELLBEING SERVICE Employee & Manager Assistance Psycho-education For All employees Psycho-education For Managers Organisational Assistance Organisational Referral Self Referral

Level III: Employee Assistance / Counselling 478 referrals FY 2011/12 50% clients achieved reliable and clinically significant change 16.3% reduction in sickness absence 22.2% self-reported improvement in workplace functioning 93% clients rated counselling “useful” or “very useful”.

Preventing Stress: Identifying potential stress hot-spots and consulting with managers/employees Responding to Stress Hot Spots: Consultation to managers to support assessment and interventions to reduce stress Consultation to: Occupational Health, Human Resources, Organisational Development and Training Incident Response Facilitated Learning Groups for Managers around HSE Management Standards Approach/ Stress Facilitation of Focus Groups Toolkit for Managers: Managing Stress in the Workplace Alcohol Awareness Training for Managers with Occupational Health Stress Awareness Presentations Assertiveness Training Stress Resilience Training Refresher Courses Formal Support for individuals involved in formal proceedings such as disciplinary. Cognitive Behavioural Therapy (1:1) Structured Brief Counselling (1:1) Computer Based Self-Help: Living Life to the Full Self-Help Book Library Post Trauma Consultation/ Support (1:1) Mediation Other Themes Consultation to individual Managers THE EMPLOYEE WELLBEING SERVICE Employee & Manager Assistance Psycho-education For All employees Psycho-education For Managers Organisational Assistance Organisational Referral Self Referral

Level II: Training in Psychological Skills Courses for everyone Understanding why I feel stressed Handling my emotions in the workplace Assertiveness training Relating under pressure training Sleeping well (under development) Courses for managers Mental Health First Aid Training Alcohol Awareness Action Learning sets in preventing and reducing stress / managing employee wellbeing

Preventing Stress: Identifying potential stress hot-spots and consulting with managers/employees Responding to Stress Hot Spots: Consultation to managers to support assessment and interventions to reduce stress Consultation to: Occupational Health, Human Resources, Organisational Development and Training Incident Response Facilitated Learning Groups for Managers around HSE Management Standards Approach/ Stress Facilitation of Focus Groups Toolkit for Managers: Managing Stress in the Workplace Alcohol Awareness Training for Managers with Occupational Health Stress Awareness Presentations Assertiveness Training Stress Resilience Training Refresher Courses Formal Support for individuals involved in formal proceedings such as disciplinary. Cognitive Behavioural Therapy (1:1) Structured Brief Counselling (1:1) Computer Based Self-Help: Living Life to the Full Self-Help Book Library Post Trauma Consultation/ Support (1:1) Mediation Other Themes Consultation to individual Managers THE EMPLOYEE WELLBEING SERVICE Employee & Manager Assistance Psycho-education For All employees Psycho-education For Managers Organisational Assistance Organisational Referral Self Referral

Level I : Organisational Health Psychology Stress Mapping to Identify potential stress hotspots Consultation to managers around employee wellbeing issues for staff Organisational Health reviews in hotspot areas Mediation

An Organisational Health Review, using the HSE Management Standards Approach, involves an approximate 18 month cycle of activity involving three key stages

Recommendation Understand Roles and Responsibilities of all key stakeholders Assess for Sustainability of Change Monitor and Review Action Plan/ Assess Effectiveness Report Findings Develop Action Plans Explore Problems & Develop Solutions using Focus Groups Support & Train Managers Individual Employee Assistance Psycho-educational Interventions Analyse Data Conduct surveys Gather Data Engage all Stakeholders Preparation Implementation

Level I : Organisational Health Psychology This work won the 2010 HSE Award for Best Management Practise in Workplace Stress (HPMA Excellence Awards) It has been written up as a case study by the HSE and can be found at

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