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Stephen  Bevan

Mental health at Work – Still the elephant in the room?

Authors: Stephen Bevan Stephen Bevan

20 May 2011


This week there has been plenty of good quality coverage of the issue of mental health in the workplace. This is largely down to the excellent 'Taking care of business' campaign by the mental health charity Mind. On Tuesday I was invited to participate in a business summit, organised by Mind, hosted by AXA and addressed by Lord Freud, Minister for Welfare Reform.

The roundtable event was attended by a number of very well-informed folk from a range of backgrounds and there was a high quality debate. It was a wide-ranging discussion, but there were three themes which emerged which I feel need more attention from policy-makers, GP or employers.

First is the issue of stigma. Mental illness is very common (one in six of UK workers) yet it remains a difficult topic for people to discuss openly at work. Indeed, many people with depression, anxiety or more severe conditions such as bi-polar disorder report a ‘self-stigma’ which prevents them from fully accepting, and then managing, their condition. This can often be accompanied by feelings of shame and guilt which can prevent disclosure to others – even family members. This is, in part, a cultural issue and it is almost certainly true to say that the UK is a safer place to ‘admit’ to having a mental illness than it was even a decade ago, though much more needs to be done. A real concern is that, in many UK businesses, it is still the case that the ‘real men don’t get sick’ culture still dominates and that mental illness is seen as a performance deficiency and represents ‘career death’ for many.

Second, some employers and GPs need to understand that workplace adjustments or job redesign can help people with mental illness to stay attached to the workplace and to return to work on a phased or graduated basis. There is encouraging evidence that the Fit Note is beginning to influence the way both GPs and employers support people with long-term or chronic health conditions. Yet it is also true that far too few are indicating the kinds of, often simple, adjustments which can be made at work to help people retain that vital connection to the workplace.

Third, we need a much more nuanced understanding of the circumstances in which common mental health problems like depression and anxiety manifest themselves. For example, most employers and certainly the Office of National Statistics (ONS) only have the facility to collect data on one type of health condition at a time, and this means that most employers and policy-makers are virtually blind to the concept of ‘co-morbidity’. If a person has a chronic disease like rheumatoid arthritis which is accompanied by severe depression, very few corporate absence recording systems are able to record that both conditions may cause absence from work nor that interventions which help the individual manage one of these conditions may not be enough to facilitate successful return to work. We addressed the issue of co-morbidity in our 2010 report Body and Soul in which we highlighted the importance of understanding that mental illness often accompanies health conditions which are characterised by chronic pain, fatigue or by fluctuating and unpredictable ‘flares’ of inflammation.

While it’s great that prominent celebrities like Stephen Fry, Alastair Campbell and Ruby Wax are speaking out about mental illness, it’s also important that we convince more business leaders that employees with mental health problems need acknowledgement, authenticity, respect and a voice in the way they are supported at work.

Comments in Chronological Order (Total 4 Comments)

Health4Work

23 May 2011 1:03PM

This is a very informative article covering some very important points (e.g. the stigma surrounding mental health, the need for workplace adjustments for people with mental health issues, and the importance of understanding what makes common mental health problems arise in the first place). As you so rightly say, employees with mental health problems 'need acknowledgement, authenticity, respect and a voice in the way they are supported at work'.

The Health for Work Adviceline (www.health4work.nhs.uk) is an invaluable resource for employers in organsiations with fewer than 250 staff. It offers free occupational health advice to employers with fewer than 250 staff. Lines are open during normal office hours (0800 0 77 88 44) and the website has a call-back form for out of office hours.

Work and issues surrounding mental distress are very closely linked: they intrinsic to our identites (as seen by others) and subjectivities (how we see ourselves). Mental distress can be viewed, however, as a normal, if disturbing, response to personal circumstances. Alleviation of symptoms can be tackled from this perspective.
The Soteria Network seeks to promote the idea that mental distress can sometimes be alleviated without the use of medication. Compassionate professional and non-professonal support can be at least as effective in some circumstances, as the medicalisation of one's personal condition through prescription and diagnostic labels. Within this situation, employment can provide a helpful role, giving meaning and structure and personal contact and support.

Minimising medicalisation can also minimise stigma for those in mental distress, avoiding the over-certaintly of labels and stereotypes which can easily be adopted by employers and colleagues. By taking this approach at work, perhaps it will be easier to emphasise what we have in common rather than our differences which are still, in medical terms, so poorly understood.

Tim

28 Mar 2014 7:17PM

More employers need to be aware of much of problem this and how it effects productivity. A happy workforce will produce better results but employers often just use the carrot and stock method instead of investing in peoples health.

PDF Links.twentyone

06 Dec 2014 11:59AM

but employers often just use the carrot and stock method instead of investing in peoples health.