Summary of the impact

Professor Cary Cooper as chair of the Science Coordination team of a government Foresight programme led the development of evidence-based policy and a longer-term vision to optimise `Mental Capital and Wellbeing in the UK in the 21st Century'. He was also lead scientist on one of its five programme pathways — `Work and Wellbeing'. The MCW Foresight findings showed that in England alone, mental ill health costs the economy £77bn a year, demonstrating the significance of the research. The findings were presented to the highest levels of government in the UK and Europe, businesses, academia and interested parties. As a result there has been a significant drive and awareness to improve factors that affect wellbeing for example revised flexible working arrangements under the Children and Families Bill. Cabinet Secretary Lord Gus O'Donnell corroborates that `the report made politicians realise that they needed to care about wellbeing and that attacking mental health issues was a key way to raise wellbeing'.

Underpinning research

In 2007 the UK Government Office for Science (GOS) commissioned a `Foresight' programme, a form of evidence-based policy, to investigate `Mental Capital and Wellbeing' (MCW). `Mental capital' was defined as a person's cognitive and emotional resources and `mental wellbeing' as a dynamic state in which an individual is able to develop their potential (for example at work and socially). The government had identified a series of challenges, over the next 20 years, including a demographic age-shift, changes in the global economy and the world of work, together with changes in the nature of UK society, in attitudes, values and expectations and in new science and technology. Shortly afterwards, figures were released estimating that stress and a lack of wellbeing at work costs £25.9bn per annum in sickness absence, presenteeism (being at work but not at full mental capacity or efficiency) and labour turnover. Further, approximately 40% of incapacity benefit is claimed under mental health and stress, costing the economy roughly £5bn per annum (Sainsbury's Centre for Mental Health, 2008).

Professor Cary Cooper CBE, Distinguished Professor of Organizational Psychology and Health, was appointed as Chair of the Foresight Science Co-ordination Team. The team was comprised of five distinguished scientists , each chosen for their expertise in their field and each representing one of five key inter-related programme areas: `Mental Capital through Life', `Learning through Life', `Mental Health', and `Learning Difficulties' and Cooper led the `Wellbeing at Work' pathway. The programme ran from 2007 to 2008, in which time the team commissioned more than 85 state-of-the-art international science reviews from over 400 leading experts in academia, government, the private sector and professional associations. The final project report `Mental Capital and Wellbeing: Making the most of ourselves in the 21st Century' (2008), pathway reports and scientific reviews from the programme were published on the Government's MCW pages. The key findings were also published as a book, edited by the five experts (Cooper et. al, 2009). More recently, the research has been developed into an edited series of reference books on Wellbeing, with Cooper as the series editor.

These key findings included:

• The need to catch learning difficulties such as dyslexia and dyscalculia early enough to prevent significant health costs and increases in antisocial behavior
• Better identification of common mental disorders, such as stress, depression and anxiety, to further growth in the current figure of 1 in 6 people with these disorders.
• Fear of unemployment — uncertainty around job security and longer working hours have increased stress at work, and stress is now the leading cause of sickness absence in the developed and emerging BRIC (Brazil, Russia, India and China) countries
• Earlier diagnosis and better treatment regimes for dementia, important given an increasingly elderly population. The findings revealed that the cost of dementia, over the next 30 years, will rise from £17bn to £50bn.
• A need for managers to focus on developing their social and interpersonal skills to enable them to manage people properly, that more time and money should be invested in flexible working arrangements, and that conducting anonymous stress audits would be beneficial for monitoring the wellbeing of employees (from the `Work & Wellbeing' pathway evidence).

At the forefront, the report demonstrated that there was a need for `an integrated, cross government response to future challenges' that would recognise `social as well as medical determinants, and the necessity to align policies from several major departments' (MCW One Year Review, 2009: 1). The MCW final report contains a depiction of the mental capital trajectory of individuals from birth to death and the factors that may act upon it example e.g. different environments (school, family, work etc.) and summarises the key findings from across the five pathways (Appendix B, page 53). Research on Work and Wellbeing has been furthered by three of Cooper's PhD students (Gibbs, 2011, Biron, 2010 and Hesketh, forthcoming), leading to on-going publications and impact in the field.

References to the research

The research has been published in international peer reviewed journal and as reference books, that have been sold worldwide (figures from publisher available on request):

Details of the impact

The MCW Foresight programme findings have raised awareness through their contribution to critical debate on mental capital and wellbeing. Specifically, they have had impact on government policy, business, academic and charity work and attracted international interest to develop similar programmes. They were reported to the senior management teams of relevant UK government departments, including the Departments of Health, Work and Pensions and Education). Cooper and the government's Chief Scientific Advisor presented the findings to the Permanent Secretaries on 10^th December 2008. The Chief Scientific Advisor confirms the `considerable impact on policy development, research and the strategic thinking of many of the project's stakeholders in government and elsewhere', saying that the Government Office for Science is `particularly grateful to Professor Cooper for his continued active support for the report and in championing the study with key organisations and fora with an interest in this area.' This included presentations to professional institutions such as the Chartered Institute of Professional Development (CIPD) and the Confederation of British Industry (CBI).

`The MCW One Year Review' (2009) details the dissemination of the findings between October 2008 and November 2009 and includes statements from national and international organisations who have adapted their policies and strategic thinking following the programme. A sample of these activities and the reach of the impact are presented below.

Impact on UK government policy and strategy:

The findings from the MCW programme fed into:

• The White Paper `No Health without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of All Ages' (2011)
• The government's dementia strategy, in particular to support `Objective 16', which called for a clear picture of research evidence and needs.
• The Department of Health's `New Horizons: A Shared Vision for Mental Health.'
• The Green Paper on Families and Relationships and into a joint project between the Department of Health and the Prime Minister's Strategy Unit (2002-2010) on antenatal and early years' services, which was announced in Building Britain's Future.
• The Qualified Teacher Status — revised standards introduced in 2007, requires beginner teachers to have a better understanding of the development of children and young people.

The Training and Development Agency used the report to train providers to meet these standards.

• The Learning Revolution White Paper developed by the BIS Informal Adult Learning team. MCW programme findings were used in the initial stages of BIS's work on the economic opportunities of an ageing population, one of the New Industry, New Jobs commitments.

Five Ways to Wellbeing:

The `Five ways to Wellbeing messages', commissioned by the MCW project, aimed to identify a core set of actions that individuals should be encouraged to build into their daily lives; the wellbeing equivalent of `five fruits and vegetables a day'. These actions, 1. Connect, 2. Be active, 3. Take notice, 4. Keep learning and 5. Give, were published as a postcard set that has been used by organisations throughout the world. Examples within the UK include Start, an arts-based mental health service, run by Manchester Mental Health and Social Care Trust and by Lambeth Primary Care Trust to campaign for improved wellbeing and happiness in the area.

Work and Wellbeing pathway:

The findings from the Foresight Work and Wellbeing pathway have influenced:

• The law on flexible working — the GOS has proposed that the Children and Families Bill be revised to state that the, `current right to request flexible working is available to parents of children under 17 (under 18 if the child is disabled) and carers of adults who are either a relative or within the home' (Source: GOS e-mail, available upon request). The legislation was only for parents with children aged 6 and under.
• Professor Dame Black's (National Director for Health and Work) review of the health of the working population, leading to the national strategy for mental health and employment.
• The evidence base for `Working Our Way to Better Mental Health: A Framework for Action', the first cross-government national strategy on mental health and employment (2009).
• The DWP's creation of a National Centre for Working-Age Health and Wellbeing, to disseminate good practice from the research literature.
• The Perkins Review, which focused on people with mental health conditions in the benefits system and those with the most severe conditions at risk of becoming dependent upon benefits. The MCW programme helped to provide the evidence base for their work.
• The work of the Cabinet Office Strategy Unit, leading to publication of the `New Opportunities: Fair Chances for the Future' White Paper in January 2009.

Impact on UK third sector:

• The Future Vision coalition, 11 mental health organisations including MIND and Royal College of Psychiatrists, used the findings in their report `A Future Vision for Mental Health'
• The development of the National Institute for Health and Clinical Excellence (NICE) guidance on child mental wellbeing in early years, at home and preschool.
• NICE guidance on promoting mental wellbeing at work, following an independent NICE evaluation of the Foresight evidence, which uses the Foresight definition of mental wellbeing. Cooper was a member of the NICE expert reference group and acted as an adviser and reviewer of the NICE guidance.
• The findings informed the work of Age Concern and Help the Aged on the DoH's mental health strategy `New Horizons'.

Impact on Business:

Foresight worked with the Technology Strategy Board (TSB) on developing opportunities presented by the MCW report including stratified medicines, biomarkers, technologies for learning and brain training.

Impact on research and academic communities:

The MCW report has influenced the strategic plans for 2009-2014 of the Medical Research Council (MRC) who included Mental Wellbeing as a strategic aim in `Research Changes Lives' and the Economic and Social Research Council (ESRC) who have two strategic challenges which build on the report: Health and Wellbeing and New Technology, Innovation and Skills.

International impact:

• European Commission — The EC's Directorate General for Health and Consumers held an event to present the findings from the MCW programme to an EU audience.
• Swedish government — Cooper and the Chief Scientific Advisor for UK government presented the MCW findings to Swedish ministers of Social Affairs and Employment, senior officials and members of the Swedish research committee. One former minister confirms that Cooper gave `a most impressive presentation on the influence of social determinants of health on Mental Capital and Wellbeing' and says that he made a `substantial impression on a significant number of Swedish MPs' (full testimonial available).
• Danish government — Following a keynote address by Cooper in 2009 at the annual conference of the Danish government's agency on the Working Environment they are considering developing their own Foresight-style programme on work and wellbeing.

Sources to corroborate the impact

1. Interviews with Cooper on BBC TV News and radio stations including BBC Somerset, BBC Wales, BBC Scotland and BBC Ulster.
2. Articles on the Foresight findings appeared in several national newspapers, including The Guardian, The Daily Mail, The Telegraph and BBC News Online (some papers featured multiple articles, please see reference 1).

Testimonials:

3. Head of the Foresight follow-up team, GOS — corroborates the details provided in this case and the continued impact on government policy for example that the findings listed in the OYR have recently fed into the government's new mental health strategy.
4. The UK government's Chief Scientific Adviser- corroborates the impact of the MCW report and Cooper's on-going work to disseminate the results.
5. Chief Scientist at GOS, when the programme started, and now Chief Science Officer at Cambridge University — confirms the scale of the programme, the reach of the impact and the interest the findings have generated across UK government.
6. Cabinet Secretary and Lord — corroborates the impact on public policy, nationally and internationally.
7. Professor at Karolinska Institute and Member of the Swedish Parliament (2006-2010) - corroborates the meeting held between Cooper and top-level representatives of the Swedish Government and the subsequent invitation to speak at the Swedish Parliament.