Stepping Up Week Mental Health

Document type: Micro-report
Author: Christina Butterworth RN, SCPHN, Hon.FFOM
Publication Date: 13/10/2016

  • Abstract

    ‘Stepping Up Week’ provides a combined focus and commitment to health and safety and positively influences health and safety culture and worker engagement. It helps to embed the Target Zero philosophy.  Each live site across the programme devises their own bespoke schedules of engagement events aimed at promoting discussion on health and safety topics.

    Stepping Up Week 5 focused on mental health and wellbeing, based on the “Have Your Say” survey and research from MIND. This micro-report will discuss the impact of Stepping Up Week to kick start the mental health and wellbeing programme and how the success has been measured.

    This document is relevant to any project implementing a wellbeing programme and will be of interest to project managers and those with responsibility for health and wellbeing.

  • Read the full document


    ‘Stepping Up Week’ provides a combined focus and commitment to health and safety, positively influencing health and safety culture and worker engagement. It also helps to embed the Target Zero philosophy. Each live site across the programme devises their own bespoke schedule of engagement events, aimed at promoting increased consideration of health and safety topics.

    For the first time on the project, Stepping Up Week 5 focused on mental health and wellbeing. This focus was decided upon, due to the mounting evidence available on the significant level of mental ill health in the UK, especially in the construction industry . The aim was to raise awareness of mental health at work and to determine the content of the Crossrail mental health and wellbeing programme.


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                                                     Figure 1 – Stepping Up Week 5 posters

    Wellbeing is a core influencer on people’s ability to perform effectively, efficiently and safely. To achieve this, Crossrail needs to ensure that staff have the emotional health and fitness to think clearly and react safely no matter the pressure faced, as well as the physical health and fitness that enables them to come to, and perform at work. As with any health related programme Stepping Up Week needed to be flexible, applicable and provide opportunity for sustainable health benefit. This was achieved by encouraging the workforce to get involved in the various activities on site so that they were better equipped to take responsibility for improving their own health. Stepping Up Week 5 provided them with the support, tools and opportunities to gain greater awareness, as well as life skills.

    Leadership Commitment

    Success also requires commitment from the top of the organisation and the leaders on each of the sites.
    The senior health and safety leadership team, which is made up of Directors from both the Principal Contractor Teams and Crossrail, signed the Stepping Up Week commitment letter, which highlighted:
    “There were 240,000 reported cases in the UK alone of work-related illness such as stress, anxiety and depression.
    We are asking sites to promote positive mental health and wellbeing this week with a special focus on the Worker, Workplace Safety, Wider Community and Wellbeing in general.”

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    Figure 2 – SHELT signing commitment letter

    Project managers were asked to:

    “Ensure that Stepping Up Week is fully supported by Crossrail site teams and their respective Tier 1 contractors. Additionally, we would like to ensure that Stepping Up Week remains a success through the engagement and support of all staff on the project.”

    All of the Crossrail sites were provided with guidance on mental heath from the central Crossrail health and safety team, including key statistics on mental health, recommended resources and training providers.


    Wellbeing has traditionally been viewed as a soft topic and a “nice to have” but research has shown the strong link between wellbeing and performance , both from an individual and organisational perspective. The prevalence of mental ill health in the workplace, also demonstrates that more work needs to take place.
    Research by Mind, the mental health charity, showed that 1 in 6 workers was dealing with a mental health problem such as anxiety, depression or stress and that work is the biggest cause of stress in people’s lives .
    The mental health foundation publication, Fundamental Facts about Mental Health provided a summary of research and included the following statistics:

    • One in four people in the UK will experience a mental health problem in any given year.
    • Mental health problems are one of the main causes of the burden of disease worldwide. In the UK, they are responsible for the largest burden of disease – 28% of the burden, compared to 16% each for cancer and heart disease.
    • In the UK, the estimated costs of mental health problems are £70-100 billion each year and account for 4.5% of GDP.
    • Research has found that 30% of people with a long-term physical health problem also have a mental health problem and 46% of people with a mental health problem also had a long-term physical health problem.

    Have Your Say Survey

    In the lead up to Stepping Up Week, Crossrail conducted its annual health and safety climate survey but this time also included new wellbeing and diversity and inclusion sections. The results of the survey showed that Crossrail was comparable with the working population and the information was used to start the conversation about mental health and wellbeing. The wellbeing survey was developed and conducted by Robertson Cooper and focused on the six essentials model :

    • Resources and communication
    • Control
    • Balanced workload
    • Job security and change
    • Work relationships
    • Job conditions

    Stepping Up Week Activities

    The activities that took place during Stepping Up Week 5, focused both on the Crossrail Golden Rules and High Risk Activities as well as the mental health and wellbeing elements , with the latter including:

    • MIND and Time to Change mental health workshops
    • Take 5 – action for the day
    • Resilience workshop
    • Stress and mental health toolbox talks
    • Male mental heath toolbox talks
    • Daily health & wellbeing messages
    • Stress related health checks
    • Yoga for health and wellbeing
    • Motivational speakers on Chronic Fatigue Syndrome and Post Traumatic Stress Disorder
    • Mental health in the office workshop
    • Mini health checks by the site nurse
    • Nutrition and exercise classes
    • Mental Health First Aid UK mental health lite workshop

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    Figure 3 – Anna Hemmings

    Motivational speaker, Anna Hemmings, world champion canoeist who bounced back from chronic fatigue syndrome (career limiting illness), by mastering the art of thriving on pressure. She developed an ability to perform at high levels, even in the face of tight deadlines, stretching goals and changing demands, building personal resilience and mental toughness were also included in her speech.

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    Figure 4 – Mental health awareness session by Mental Health First Aid UK

    Measurement of Success

    A meeting was held with the site health & safety leaders after Stepping Up Week 5, with feedback on the mental health elements being very positive. The mental health and resilience workshops were all evaluated by delegates and received the most positive feedback. Many delegates expressed their gratitude to Crossrail for raising awareness of mental health and providing workshops that helped individuals develop skills to cope with the pressures of life and work and stated that it gave them a greater understanding of how they can help their colleagues. All delegates stated that they would recommend the course to others.
    Following an evaluation of the activities held during Stepping Up Week 5, a review of the evidence available from the “Have Your Say” survey and research on good practice, the Crossrail mental health and wellbeing programme was developed.
    The mental health element of the programme was based on the ACAS Promoting Positive Mental Health at Work advisory booklet that focuses on three workstreams:

    1. Tackle the stigma of mental health
    2. Practical things you can do to help
    3. Develop solutions by listening

    The wellbeing element of the programme was based on three workstreams:

    1. Improve understanding of occupational health and wellbeing and develop a culture of wellbeing.
    2. Improve communication regarding health and wellbeing throughout the organisation to increase awareness of all staff
    3. The Robertson Cooper Six Steps to Wellbeing model:
    • Create a shared view and vocabulary of wellbeing*
    • Build awareness and visibility of wellbeing
    • Create local support and champion network to drive localised approach
    • Educating and up skilling local managers and staff
    • Create governance and accountability structures that reinforce the need to change
    • Provide access to resources and opportunities to change behaviour


    • Monitor progress, refocus as needed and celebrate/share success

    * “Employee wellbeing is a positive state in which the individual is able to function at or near their optimal level based on their physical, mental, emotional and social functioning.” Adapted and adopted from original by Nuffield Health

    Lessons Learned

    Stepping Up Week demonstrated that looking after the health of our people is not only the right thing to do, it is vital if Crossrail is to deliver the project on time and within funding and help build a productive workforce capable of delivering the unprecedented number of major projects just around the corner. The positive feedback from the programme confirmed that raising awareness of mental health and providing workshops that helped individuals develop skills to cope with the pressures of life and work benefitted individuals and gave them a greater understanding of how they can help and support their colleagues.
    Crossrail is also part of the Health in Construction Leadership Group and other industry groups, sharing the work we have done to increase the profile and understanding of good mental health and wellbeing, for sustainable engagement and performance across all industries.

    Recommendations for Future Projects

    Programmes such as Stepping Up Week have a beneficial effect on employee engagement and wellbeing and are recommended to other projects
    Planning for such events should start at least 6 months before the event and works best with a team of people; generating ideas, developing impactful communications, co-ordinating the week and capturing the lessons learned to continually improve the process for the next Stepping Up Week.
    Measuring success should be part of any event or wellbeing programme, to demonstrate a return on investment and the effectiveness of any activities in order to drive any wellbeing programmes going forward.



    [1] Health and Safety Executive, Health and safety in construction sector in Great Britain, 2014/15, , accessed October 2016

    [2] Depratment for Business Innovation & Skills “Does Worker Wellbeing Affect Workplace Performance” Bryson, Forth and Stokes, October  2014 , accessed October 2016

    [3] MIND, Mental health facts and statistics, , accessed October 2016

    [4] Robertson Cooper, , accessed October 2016


  • Authors

    Photo of Christina Butterworth

    Christina Butterworth RN, SCPHN, Hon.FFOM - Crossrail Ltd

    Christina is the Crossrail Occupational Health and Wellbeing Specialist, and is ultimately responsible for leading the organisation’s effort to prevent work related ill health and promote good health and wellbeing at work.
    Working as part of the Health and Safety Improvement team, she provides high level support and advice on evidence based practice and quality standards. Managing the Crossrail health and wellbeing programme and collaborating with our Principal Contractors on targeted intervention and robust process management.
    Christina has had a varied career in occupational health working for a number of large national and international organisations and works tirelessly to continuously improve occupational health and wellbeing. Working with like-minded individuals to provide optimal health for our staff and leadership commitment at all levels.
    Christina joined Crossrail in 2014 and works with stakeholders in the Construction and Rail industries to set standards of good practice.