Herbert Schilthuis: “The biggest challenge in healthcare is the availability of people for the longer term. Focus on mental well-being is key.”
Herbert Schilthuis, Head of the Occupational Health Department of Amsterdam UMC, on the challenges in employee well-being in a complex and hierarchical institute.
Herbert, you joined the Amsterdam UMC last year, after 14 years as Global Health Director at Heineken. Tell us about your current role in employee well-being.
I am head of the Occupational Health department of Amsterdam UMC, which means I lead about 60 people that work in occupational Health& Safety and environmental health. We monitor employee well-being of both the University and the two teaching hospitals VUMC and AMC in Amsterdam, a total of 19,000 employees. Together with my team, we set the policy on mental health, guide the divisions and departments in interventions and lead specific projects. We offer options and interventions, but whether it is adopted by the entire organisation depends both on our advice, and on the department’s own budgets and teams. In other words, it is a shared decision-making process. The Amsterdam UMC is a complex organisation where the departments have a lot of autonomy, and the approaches therefore differ per department.
That does indeed sound quite complex. In what way do you have a role in what is ultimately implemented in the departments?
In addition to our advisory role, we have a few legal mechanisms that can play a role. Legally, a company must regularly carry out a risk assessment, which also includes mental health. Our occupational health and safety service must assess and approve these risk assessments and the action plans. This helps us to be able to prioritise interventions in certain departments. In addition, of course, we see people with long-term absenteeism which is often related to mental health. In this process, we provide advice to the managers of the department and team leads and therefore ultimately influence the choice of interventions.
You work in an industry where COVID has hit hard. How would you describe the impact on the mental health of employees?
First, there is a positive spin-off since the awareness of the impact of mental health on the entire organisation has become more prominent. COVID has played an important role in this. That’s one. In addition, I would like to mention the first phase of COVID. During this period, employees of regular companies were already working from home. Of course, health care workers had to go to work and were exposed to large amounts of stress. Not only did they face serious COVID cases, but they also had to make complex ethical decisions; working with people who were extremely ill, and they themselves were at increased risk of exposure to the virus. In the later stages of the pandemic, there was a lot of stress related to workload in the hospitals, with many and long shifts, often in different departments than they were used to due to understaffing. There was a lot of illness among the staff, it has been very intense and has taken its toll. The ageing population also plays a role and affects the type of work in hospitals and the general shortage of employees is more acute in health care. We see people who stop working in healthcare because they are physically and mentally exhausted. So yes, the impact is huge and has serious consequences.
We see people who stop working in healthcare because they are physically and mentally exhausted.
Those are serious observations. If many of the hospital employees are suffering from stress and exhaustion, what consequences does this have for healthcare?
One of the major challenges we now face is the availability of healthcare workers, now and for the longer term. I believe that focusing on well-being, including mental well-being, is key in this. Before COVID, we were aware of the needs of our people and provided interventions. But with what we know now, I see more focus on keeping your people happy and vital and focus on the long term, and that has changed because of the pandemic.
This is not only a challenge for us in healthcare, I think it is a social challenge that we now face. Here in the Netherlands but also in our surrounding countries where we see hospitals closing due to problems with staff, as in France. So, for all of us in healthcare, we need to take better care of our employees, we need to have a good monitoring system, we need to prevent fallout and facilitate people to enjoy their work and want to continue working for their organization. In my position, I feel very responsible for this.
As an experienced leader in well-being, what are your key insights?
First, you have to create an environment in which people can be sufficiently stimulated under reasonable, but not too high pressure. In addition, you need to work on the stigma of mental health in the workplace. Managers play a crucial role in this, so they will need to be trained in understanding their role in relation to stress and workload, and in learning what they can do to recognise and discuss mental health signals in their employees. It is important to focus on creating a climate in which people can make their own decisions and have autonomy. The management style is really important. Leaders need to know how to refer their people to low-threshold mental support, such as coaching, for example, where Inuka is active. And they need to have the understanding on how and when to access or involve other forms of mental health support.
Leaders need to know how to refer their people to low-threshold mental supports
The insights that you have shared resonate directly with the best practice from research. where do you get your knowledge from?
I have been involved in creating employee well-being policy for quite some time, having built up such a program within Heineken over the years. It’s not something you build overnight. It takes years, because you need a lot of time to get these kinds of topics top of mind with decision makers, to get support and to be able to implement. This sometimes requires a different view from decision-makers, especially in a hierarchical organisation like this, where leadership positions are often inherent in expertise as a medical professional. It is fascinating to experience and lead this journey in two different areas, business and healthcare. I am very motivated to contribute to the change in mentality in this sector as well. COVID has helped a lot in creating awareness for well-being and in particular mental well-being, so my expectations are high here in Amsterdam UMC. I’m currently trying to pave the way for a more programmatic approach to mental health.
A more programmatic approach to mental health, can you explain that?
We are currently building the foundation for this, and we are mainly working on awareness. As I mentioned, our organisation has a fragmented approach to well-being, there is no comprehensive integral program.
There has previously been quite a focus on addressing mental health as an issue related to individuals, but here we need to shift the mindset to recognise that work-stress is a function of the organisation and leadership, and impacts everyone. That is why we need solutions at the organisational level, and we have to tackle workload and stress in a holistic way – especially with preventive solutions and not just curatively. We need to move from specific projects for certain risk groups, to a broader programmatic approach across our organization. Finally, we need to get rid of medicalising mental health. In this way, we can help reduce stigma and encourage employees to access low-threshold psychological support at an early stage – preventively. Yes, we have big ambitions, but I am fully convinced that the support is there and that the time is right!
There has previously been quite a focus on addressing mental health as an issue related to individuals, but here we need to shift the mindset to recognise that work-stress is a function of the organisation and leadership, and impacts everyone.
Good luck with this challenge Herbert! Do you have a concluding thought for well-being leaders?
Well, what is perhaps my most important take-away from the corporate world is to have a holistic view of employee well-being. People basically spend half their lives at work, so you need to be able to offer something more than just focusing on the work-related issues. There are so many elements that affect your employee’s happiness and productivity. With a holistic approach, you can create an environment that supports the physical, mental, emotional, social, and financial health of your people. I think that is the direction we’re heading.
People basically spend half their lives at work, so you need to be able to offer something more than just focusing on the work-related issues.
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