Interview: Keith Bushnell: Positive mental health attitude

When Keith Bushnell was knocked down by a bus in Madrid it put the spotlight on the priorities for the friends who were with him.

Bushnell, CEO of rehabilitation case management company HCML and a passionate Chelsea fan, was in the city last season for his team’s Champion’s League clash with Atletico Madrid. He recalls: “I was lying on the pavement being tended to by medics when one of my group asked them: ‘Can you make your mind up quick if he’s got to go to hospital, because we don’t want to miss the kick-off.’

“Luckily I wasn’t badly hurt and made the game, but though my friend’s question was partly asked in fun, it confirmed to me that people are strongly driven by their own priorities,” he concludes.

Since taking over the helm of HCML in 2010 from Helen Merfield, Bushnell has been focused on creating strategies to persuade employers to give greater priority to the health of their greatest asset – their staff.

HCML’s business model is to deliver independent medical needs assessments and subsequent case management services for solicitors and insurers acting for injured clients in employer, public liability or road traffic accident cases. It then aims to return clients to their pre-injury state through a ‘stepped’ care, evidence-based approach to recovery.

Importance of wellbeing
Since Bushnell joined HCML, he has led an initiative that involves the company expanding into employee wellbeing and absence management services, by talking to firms about the absenteeism arising from physical and mental health problems and focusing on the importance of wellbeing and making employees feel better about themselves and their employer.

Bushnell, who has seen HCML go from loss to profit and almost double its turnover from £4.5m to £8.3m in five years, wants the Croydon-based company to not only help get people back to work as soon as possible but prevent them going off sick in the first place.

“Staff should be given in-workplace guidance on how to self-monitor and self-manage,” he says. “Fortunately, managers are now recognising they need to be more proactive in encouraging staff to take care of themselves, whether it be about diet, sleep patterns, exercise or lifestyle in general.”

Much of that recognition stems from what he calls the “unacceptable £25bn cost to the nation” of absenteeism – and from the fact that increased stress in the workplace has led to a marked increase in absence due to mental health issues.

“Through [working with solicitors and insurers in] our assessment of both physical injury and consequent mental health issues – and from our expansion into the employer field – we come across a good deal of stress-related problems, particularly when it comes to managers who are under pressure to deliver business objectives,” Bushnell says. “[For example], call centres are a classic environment for stress.”

He continues: “Although I thought it should have eased along with the easing of the recession, we are not seeing any reduction [in streess] and there is still much more anxiety at work than there has been in the past. It is now as great a cause of absenteeism as physical problems, but mental health remains a subject no one wants to talk about. There needs to be a more mature approach by employers, who can be reluctant to go beyond traditional HR routes to seek solutions.”

Bushnell, who has established a record of increasing revenues throughout his career – for example, transforming EBITDA annual loss of over £800,000 to annual profit of more than £800,000 – stresses the importance of prevention and early intervention rather than allowing people to be off work long-term before acting.

“What’s often overlooked or ignored is that people off work for weeks and months can become very depressed,” he explains. “The result is the physical issues that might have caused them to go off in the first place might get sorted but they are then left with problems affecting their state of mind, where the very thought of going back fills them with dread.”

Encouragingly, he feels employers are becoming more acutely aware of the effects of mental health issues and absenteeism on morale, with the result that more of them are taking advantage of an HCML service called It’s The Time to Talk, which features confidential discussion and assessment, self-help or face-to-face treatment sessions.

In another early-intervention scheme, which will be launched this year, companies can pay a small fee to secure appropriate physiotherapy or mental health treatment for workers who have been absent for more than three successive working days.

“Employers often have private medical schemes for senior management, so why not for the troops?” notes Bushnell. “It’s a view I’m happy to say more companies are coming round to.”

Bushnell claims HCML’s emphasis on wellbeing and absence management is going to become a strong field for development, saying: “There is a big market out there — and in 12 to 18 months we shall have total integration of self-prevention and early intervention in place. I call it absenteeism and ‘presenteeism’ – keeping people both in work and productive, and then getting them back to work as soon as possible where necessary.”

NHS links
From taking the capabilities HCML has developed for the legal and insurance sectors into employers, Bushnell also wants to build on links being established with the NHS – especially at primary care level. “It’s a delicate area, especially as it would involve the private sector, but with the great pressures on funding facing the NHS being intensified by the demographics of an ageing population, such measures need to be looked at,” says Bushnell.

“Clinical commissioning groups are already looking at the private sector to see what services can be delivered more effectively. In five to 10 years’ time there will be greatly enhanced private involvement in the NHS and we want to be at the forefront of any area where we can offer high-value services.”

That is a policy, he adds, that will be underpinned by the recent appointment of two senior medical professionals with track records in innovation and service design and experience in NHS service delivery to the HCML team.

Meanwhile, Bushnell, confesses to a mental health problem of his own.

“It’s called OCD, Obsessive Chelsea Disorder,” he laughs. He has not missed a single game, home or away – places like Madrid and Japan included – for almost six years, a dedication so impressive it was justly recognised in a recent match programme.

All the same, he baulks at the idea of advising manager Jose Mourinho on how to handle stress. “He’s unlikely to appreciate it,” admits Bushnell. “But much as I love the club, which apart from a couple of walks a week along the banks of the Thames occupies almost all my spare time, I’d rather not try, as he probably sees himself as the expert already.”

This article was published in the 15 January edition of Post magazine.