Just how prevalent is mental ill-health at work? Firdaws Shahed rounds up the evidence that has emerged before and during the pandemic and makes some recommendations for employers.
Mental ill health is a clinically significant disturbance in a person’s behaviour, cognition, and emotional regulation. One in eight people globally suffered a mental disorder in 2019 (Institute for Health Metrics and Evaluation, 2022). By 2020, the estimates for anxiety and depression increased by 26% and 28% respectively, potentially influenced by the Covid-19 pandemic (WHO, 2022).
The state of a person’s mental health affects their ability to perform; it can hinder work productivity, which can result in additional costs to employers. Therefore, it is essential for employers to take active steps to address mental ill-health at work through recognition, prevention and awareness (LaMontagne et al., 2014).
The below graph shows that the percentage of sickness absences owing to mental health conditions rose before and during the Covid-19 pandemic, but has since dropped. Notably, the percentage point increase between 2018 and 2019 was greater than the rise seen during the pandemic itself.
The ONS reported that mental health accounted for 16% of sickness absences in 2020, but a Deloitte survey found it could be attributed to 28% of absences (Hampson et al., 2022).
A survey by the mental health charity Mind found that 52% of employees felt their work and home life balance had been disrupted during the pandemic and 41% felt their mental health deteriorated (Mind, 2021).
This chart above illustrates the percentage of mental health conditions by industry in the UK. Public, administration, education, and health reported the highest prevalence of mental health conditions (28%) followed by banking and finance (27%). The industries with the lowest reported mental health conditions were construction (12%), manufacturing and transport and communication both at 18%. This could suggest ‘white-collar’ professions are associated with greater mental health concerns.
According to HSE, professional occupations had the highest prevalence of work-related stress (2,530 per 100,000). Skilled trades occupations exhibited the lowest (860 per 100,000) (HSE, 2020). Before the pandemic, the main cause for work-related stress, depression or anxiety included ‘tight deadlines and too much responsibility’ (HSE, 2020). These factors are arguably more common within ‘white-collar’ professions. However, more research about occupations and mental health at work is needed.
Those in ‘blue-collar’ industries, which can often be male-dominated, may be unwilling to report mental health conditions due to a greater negative stigma associated with mental health in male-dominated settings (Stansfeld et al., 2009).
Presenteeism and leaveism
It has been estimated the cost of presenteeism to employers in 2021 was £24-28bn (Hampson et al., 2022).
The chart illustrates presenteeism by sector. Individuals within the private sector reported they would always or often go to work when experiencing mental health problems. Just 1% said they would take time off.
Presenteeism was more prevalent within poorer psychosocial environments (Whysall, Bowden, and Hewitt, 2017).
Leaveism is where individuals continue to work after working hours. Widespread remote working following the pandemic may have increased the likelihood of leaveism.
The balance between home-life and working-life has become blurred, thus making it more difficult for individuals to ‘switch off’. This, in turn, could negatively affect mental health because it leads to “overworking, a reduction in workforce morale, and burnout” (Deloitte, 2020). This is further supported in a study carried out by the Myers-Briggs Company, which found 26% of respondents felt the expectation to be constantly ‘on’ disturbs their personal life, and 20% agreed leaveism caused mental exhaustion (BPS 2019).
The pandemic may have heightened the awareness of presenteeism and leaveism. In 2018 27% of organisations took steps to discourage leaveism, but by 2021 this had increased to 41% (CIPD, 2021).
The underlying problem of leaveism is the distortion between work and personal life. Therefore, employers may need to implement strategies to clearly distinguish these boundaries. These could include:
- Increased flexible working arrangements and systems where individuals can access and ask for help
- Regular reminders that encourage employees to take annual leave. Furthermore, addressing concerns employees have about leaving work for co-workers by providing training.
- Implement redistribution policies for employees to share workload. Increase hiring during high-workload periods.
- Provide training for employees to recognise leaveism and training for line managers to place achievable targets with consideration of the individuals’ work style.
(Spicer, 2020) (Griffiths, 2018) (Deloitte, 2020) (‘Presenteeism’ and ‘leavism’: Bad for workers, bad for business, 2019) (Leavism and Presenteeism. What are they and how do they affect business? – advo-one, 2018)
Not seeking help for mental ill-health at work
The chart below illustrates the results of a survey of 1645 employees to assess the reasons employees did not approach HR or occupational health for their mental health problems. The most common reason given was the belief that support would not be provided (29%). This could indicate that the appropriate support is not offered by organisations, or that employees are unaware of existing support.
How mental ill-health effects employers
Research conducted by the Mental Health Foundation and the London School of Economics and Political Science (LSE) found the cost of mental health problems is 5% of the UK’s GDP – 72% of this cost is associated with a loss of productivity due to mental health problems (LSE, 2022).
Mental ill-health at work CPD
There is evidence to indicate a business and economic benefit for further action to address mental ill-health at work. It was found that for every £1 invested in mental health intervention in the workplace, £5 is saved (Hampson et al., 2022). Deloitte also found the return on investment (ROI) of mental health programmes is greater with earlier employer interventions.
Universal intervention involves cultural change to an organisation and building awareness around mental health problems within the workforce. This proved to have the highest ROI where for every £1 invested in mental health issues, £5.60 was earned. Proactive intervention involves early stage intervention by supporting employee’s mental health. This provided a lower ROI of £5 for every £1 invested. Reactive intervention involved organisations supporting employees once their mental health had already worsened. This proved to have the lowest ROI at £3.40 (Hampson et al., 2022).
This could indicate a possible significance of early employer intervention. There are benefits to both the employee and employer in terms of improved mental wellbeing and long-term productivity.
Effective mental health programmes
An effective mental health programme comprises three elements.
First, recognition of mental health issues. This will allow for early intervention and encourage organisations to utilise tools to assist employees. For instance, tracking performance could be used to identify presenteeism.
Secondly, prevention could include job redesign in positions where work-related stress is highest. This could include allowing for greater flexibility or remote working. Alternatively, job roles could be adapted, as observed at Northampton General Hospital NHS Trust. This had shown an improvement in staff wellbeing as commented by the health and wellbeing manager Anne-Marie Dunkley. (Northamptongeneral.nhs.uk, 2021).
Lastly, awareness training is crucial in producing efficient outcomes. As reported by BITC three in 10 managers felt the lack of appropriate training to address mental health was a barrier to supporting employees. (BITC, 2019).
The value of supporting employees
The greater the support organisations can provide to employees the greater the benefits both economically and organisationally. Developing a culture that values occupational health can produce positive spill-over effects, such as enhancing an employer’s brand and reputation, and encouraging greater productivity. As a result, the organisation could gain a competitive advantage over rivals.
A survey of 604 employees found that supportive and encouraging colleagues can help to develop positive wellbeing. A strong employer brand resulting from positive wellbeing may reduce the risk of high staff turnover (Benraïss-Noailles and Viot, 2021). Improving the employer brand will aid in building a highly-skilled workforce.
Negative spill-over effects associated with an organisation neglecting mental health at work include lower productivity. This could affect staff morale, quality of work and innovation.
Conclusions and recommendations
In conclusion, it is valuable for employers to raise awareness of and address mental ill-health at work. Investing in employee wellbeing can be beneficial for both the employer and society, though productivity and good health.
Here are three recommendations employers can consider to improve mental health at work:
- Making mental health a priority among senior leaders. This aids in developing a supportive culture that could stimulate wellbeing awareness and action across an organisation.
- Monitoring employee wellbeing metrics. Particularly during periods where the workload is higher.
- Considering changes in the organisation’s culture, educating staff in mental health awareness to help break down stigma.
advo-one. (2018). Leavism and Presenteeism. What are they and how do they affect business? – advo-one. [online] Available at: https://news.advogroup.co.uk/leavism-and-presenteeism-what-are-they-and-how-do-they-affect-business/
Benraïss-Noailles, L. and Viot, C. (2021). Employer brand equity effects on employees well-being and loyalty. Journal of Business Research, [online] 126, pp.605–613. doi:10.1016/j.jbusres.2020.02.002.
BITC (2019). Mental Health at Work 2019 Report Time to Take Ownership. [online] Available at: https://www.bitc.org.uk/wp-content/uploads/2019/10/bitc-wellbeing-report-mhawmentalhealthworkfullreport2019-sept2019-2.pdf [Accessed 22 Jun. 2022].
BITC (2020). Mental Health at Work 2020: building back responsibly [online] Available at: https://www.bitc.org.uk/wp-content/uploads/2020/10/bitc-report-wellbeing-mental-health-at-work-2020-Oct20.pdf
BPS (2019). Why employers should make sure their staff know how to switch off | BPS. [online] Available at: https://www.bps.org.uk/news-and-policy/why-employers-should-make-sure-their-staff-know-how-switch
CIPD (2021). Survey report HEALTH AND WELLBEING AT WORK 2021 in partnership with. [online] Available at: https://www.cipd.co.uk/Images/health-wellbeing-work-report-2021_tcm18-93541.pdf
Deloitte (2020). Mental health and employers Refreshing the case for investment. [online] Available at: https://www2.deloitte.com/content/dam/Deloitte/uk/Documents/consultancy/deloitte-uk-mental-health-and-employers.pdf
Deloitte (2022). Mental health and employers The case for investment – pandemic and beyond. [online] Available at: https://www2.deloitte.com/content/dam/Deloitte/uk/Documents/consultancy/deloitte-uk-mental-health-report-2022.pdf.
Griffiths, D. (2018). Is leavism affecting your work life balance? [online] Westfieldhealth.com. Available at: https://www.westfieldhealth.com/blog/don-t-let-leavism-get-in-the-way-of-work-life-balance [Accessed 22 Jun. 2022].
Hampson, E., Polner, A., Assal, V., Abrahams, N., Henry, J., Gosling, W., Siegel, S. and Hadley, J. (2022). Mental health and employers The case for investment – pandemic and beyond. [online] Available at: https://www2.deloitte.com/content/dam/Deloitte/uk/Documents/consultancy/deloitte-uk-mental-health-report-2022.pdf [Accessed 24 Jun. 2022].
CIPD (2022). Health and wellbeing at work | CIPD. [online] CIPD. Available at: https://www.cipd.co.uk/knowledge/culture/well-being/health-well-being-work [Accessed 21 Jun. 2022].
Health in the workplace -patterns of sickness absence, employer support and employment retention. (2019). [online] uk. The National Archives. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/817124/health-in-the-workplace-statistics.pdf.
HSE (2021). Work-related stress, anxiety or depression statistics in Great Britain, 2021. [online] Available at: https://www.hse.gov.uk/statistics/causdis/stress.pdf.
(2020). LFS – Labour Force Survey – Self-reported work-related ill health and workplace injuries: Index of LFS tables. [online] Available at: https://www.hse.gov.uk/statistics/lfs/index.htm [Accessed 17 Jun. 2022].
LaMontagne, A.D., Martin, A., Page, K.M., Reavley, N.J., Noblet, A.J., Milner, A.J., Keegel, T. and Smith, P.M. (2014). Workplace mental health: developing an integrated intervention approach. BMC Psychiatry, [online] 14(1). doi:10.1186/1471-244x-14-131.
LSE (2022). Mental health problems cost UK economy at least £118 billion a year – new research. [online] London School of Economics and Political Science. Available at: https://www.lse.ac.uk/News/Latest-news-from-LSE/2022/c-Mar-22/Mental-health-problems-cost-UK-economy-at-least-118-billion-a-year-new-research [Accessed 23 Jun. 2022].
MIND (2021). Coronavirus: the consequences for mental health The ongoing impact of the coronavirus pandemic on people with mental health problems across. [online] Available at: https://www.mind.org.uk/media/8962/the-consequences-of-coronavirus-for-mental-health-final-report.pdf.
nhs.uk. (2021). Northampton General Hospital named Health and Wellbeing Employer of the Year at national awards. [online] Available at: https://www.northamptongeneral.nhs.uk/News/Articles/AllNews/Northampton-General-Hospital-named-Health-and-Wellbeing-Employer-of-the-Year-at-national-awards.aspx [Accessed 23 Jun. 2022].
ONS (2022). UK SIC 2007 – Office for National Statistics. [online] Available at: https://www.ons.gov.uk/methodology/classificationsandstandards/ukstandardindustrialclassificationofeconomicactivities/uksic2007 [Accessed 20 Jun. 2022].
Stansfeld, S.A., Rasul, F.R., Head, J. and Singleton, N. (2009). Occupation and mental health in a national UK survey. Social Psychiatry and Psychiatric Epidemiology, [online] 46(2), pp.101–110. doi:10.1007/s00127-009-0173-7.
WHO (2022). Mental Health and COVID-19: Early evidence of the pandemic’s impact: Scientific brief, 2 March 2022. [online] Who.int. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1 [Accessed 16 Jun. 2022].
WHO (2018). Mental health: strengthening our response. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response [Accessed 16 Jun. 2022].
WHO (2022). Mental health: strengthening our response. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response [Accessed 29 Jun. 2022].
Whysall, Z., Bowden, J. and Hewitt, M. (2017). Sickness presenteeism: measurement and management challenges. Ergonomics, [online] 61(3), pp.341–354. doi:10.1080/00140139.2017.1365949.
Wilmot, A. (2022). Sickness absence in the UK labour market. [online] Ons.gov.uk. Available at: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/sicknessabsenceinthelabourmarket/2021 [Accessed 16 Jun. 2022].
YouGov (2022). YouGov | What the world thinks. [online] Available at: https://yougov.co.uk/ [Accessed 8 Jul. 2022].