Across the UK, 70 million working days are lost each year due to mental health problems, costing employers approximately £2.4bn annually.
Stress, anxiety and other mental health conditions all rank among the biggest drivers of workplace absence, significantly impacting both companies and their employees.
That impact continues to rise, putting businesses under increasing pressure to ensure that employees are supported and engaged in their mental health.
Many employees are still reluctant to recognise or seek support for their mental health challenges – yet in helping to drive the conversation and providing support when it is required, companies can help to reduce the impact on their business.
A nationwide network of wellbeing centres run by The Priory Group – including one set to open this month in Bristol’s Aztec West – are at the vanguard of UK efforts to tackle mental health issues, and provide quick, easy and flexible access to expert treatment.
Business Leader spoke to Consultant Psychiatrist Dr Edward Burns, who is Priory’s Clinical Director for Outpatient and Wellbeing Centres, to learn more about why mental health issues are proving so costly to British businesses, and how Priory’s new services can help.
Why is it so hard for people to talk about mental health issues?
“A lot of the time there is a big stigma around mental health.
“Some of that stigma comes from individuals; there can be some self-stigmatisation, so people feel very worried about saying that there’s something wrong.
“A lot of people that I see will say they feel it’s their fault, that there’s a weakness, or there’s something that’s happened that they should have done differently.”
Is that changing?
“I’ve seen a massive change in how people talk about it; there is a lot more recognition of mental health issues.
“There’s very helpfully been a growing conversation in the media about mental health and mental wellbeing.
“There’s been people like the royal family being involved, and celebrities who have talked about their struggles with mental health – Ruby Wax has been very good and vocal about the idea that, actually, these are things we shouldn’t be ashamed of.
“But although some things have changed, other things haven’t. Sadly suicide rates in the country – despite suggestions they have been dropping – have not massively changed, and it remains the leading cause of death in men under the age of 50. It’s still a difficult thing for people to talk about.
“So although there’s been a change in the conversation, the bit I’ve not seen change is the resources and the development of treatments and therapies to match that demand.”
How important is it that people are able to speak up when they need help?
“The advantage of people being able to talk about their mental health earlier is that they might be able to catch it a bit earlier.
“One of the best indicators for a good outcome for someone is identifying and managing issues as early as possible.
“The earlier people can have conversations, and put their hand up and say ‘I need a bit of extra support’, the better the outcome. We’re not at that place yet. I don’t think everybody is able to put their hand up; it often goes on a little bit longer and then becomes a bigger problem.
“If people leave it for a long period of time – partly because they may feel there’s a difficulty in addressing issues – then we reach a point where they can be in really severe crisis.”
Is work a common trigger for mental health issues?
“We live in a very on-demand world where everything needs to be done straight away. There is probably increased stresses on people, and we don’t always recognise those happening.
“A lot of the time, if I see somebody who is getting stressed at work or showing signs of burnout, it’s quite an insidious onset.
“Sometimes there’s a lot of modelling that will happen in the workplace, where people start to copy what’s happening around them.
“People will say ‘my boss is staying until 10pm, so I should stay until 10pm’ and ‘my colleagues aren’t struggling, so I shouldn’t struggle’. Nobody is saying they are burning out or feeling stressed, so I shouldn’t be doing that. I need to keep going.
“Unfortunately I do see people when they’ve gone past that tipping point, when they’ve just kept going for too long, where they may have used drugs or alcohol to try to cope with some of the issues which arise with sleep or anxiety.
“People put themselves under a huge amount of pressure, and draw lots of comparisons. There’s a comparison in the workplace and a bit of competitiveness and this feeling that ‘if I’m experiencing mental health issues, depression or anxiety or whatever it might be, then that’s a sign of weakness, it means I can’t do the job and there’s a fault within me’, when actually, in my experience, it can happen to everyone.
“That comparison is really dangerous. People believe person x is coping, when in reality, we have no idea if that person is actually coping. You’re just assuming that they’re coping because you see them coming into work and doing things. That doesn’t necessarily mean they’re coping.”
Have there been any changing trends in the causes of conditions like stress, anxiety and depression?
“A lot of people talk about, in individual sessions with me, having to live that Instagram-perfect life, where your friends and colleagues, everything looks perfect, while you’re suffering with depression, and how is it happening to you and not to your friends.
“But what’s posted on Instagram or Facebook is not really always a true reflection of what’s happening in real life. It’s a bit of an artificial world.
“We’re not yet really at a point where we’re able to recognise the full impact of that, especially for children and adolescents, but it really is a constant thing about online bullying, trolling, that feeling that you’ve got to live the perfect life the whole time.
“That puts a big pressure on people to feel they can’t be sad or have episodes of feeling low, even though we know that anxiety is a normal phenomenon, but sometimes it gets out of control and becomes a condition.
“We know mood is likely to fluctuate – we should have highs and lows, we should have periods where we feel a bit better or a bit low – but when we feel under pressure not to experience that, and instead to be happy the whole time, it compounds the depression when it happens.”
How switched on are employers to the mental health needs of their employees?
“It’s a bit of a mixed picture. I’ve seen some who have got excellent support from their line managers, I’ve had joint meetings with people involved in support work, and we’ve been able to work out a plan about phased returns, etc, or reasonable adjustments to their workload.
“I think there’s been a change in the conversation and there are more people who are aware of the need to manage workplace stress and mental health.
“There was a paper a few years ago, the Stevenson/Farmer report, which made recommendations to the government that all companies should be looking at supporting employees and their mental health. So it’s growing.”
Is there a risk to reaching out for help?
“There are people who come to see me and they fear they are going to be made redundant, they’re going to lose their job.
“Companies cannot discriminate against someone because of their mental health. People shouldn’t be being made redundant or accepting changes to their working conditions, if they’ve been suffering from a mental illness, because actually they should be getting support and treatment for that to try to make sure they can reach their full potential at work.”
What work is The Priory Group doing with companies to improve things?
“We try to work with big companies to work out the pathway for people who are feeling distressed.
“The main aim is to try to keep people in work, but we’re mindful of the fact that people do sometimes have to take a bit of time out – however, it’s better to do it in a planned way rather than reaching a crisis point and having to be signed off.
“Companies do lose a huge amount of money annually because of mental health, but it’s not just because of people being absent – it may be because of presenteeism, where people are at work, but they’re not able to focus, they’re not productive, they’re not concentrating, they’re going through the motions of being at work but they’re not able to fully engage with it.
“That can happen through a wide variety of mental health conditions, or burnout, or stress. But people can access support and one thing Priory does is try to see people really quickly.
“Our corporate service is to try to help businesses. There’s the ability for training to be done at work sites, going in to meet up with senior managers or HR departments, or occupational health departments to try to develop a bespoke pathway through which people can get in contact if they’re feeling unwell. It’s about how to get someone early support through the corporate services.”
How do Priory’s wellbeing centres fit into this?
“We are expanding to try to cover mental health services in a broader way. Over the past few years there has been an expansion of wellbeing centres, where there are psychiatrists, therapists, psychologists, working in the centre of major cities. There are nine currently, with Bristol opening this year and others planned to be opened as well, including international expansion.
“People can come to a wellbeing centre, get therapy, and get back into work.
“Sometimes people need support for things outside of work, stresses with their children, or their partners, they may need to be able to access something for that, and so a lot of wellbeing centres will offer child and adolescent services. So children could have assessments for ADHD, autism, and sometimes getting that addressed and managed, the individual is less stressed about their home life and more focused on work.
“Corporate services will provide regular reports for the companies they’re working with, a detailed report on what’s happening, what are the trends – though anonymised, obviously not about an individual.
“If trends are appearing, it will be highlighted to the organisation so they might think about how they can do things differently.”
Why do businesses need to take this seriously?
“Some statistics suggest one in four absences from work is due to mental health, so it’s a significant issue. We lose something like 70 million days to mental illness.
“The loss to businesses is about £2.4bn annually, so it’s a big loss.
“We’re trying to really highlight to people that if you don’t start to tackle mental health issues in the workplace, you’re going to have people off, you’re going to lose days to sickness, you’re going to lose revenue, and an investment in managing that is likely to bring some returns by keeping people attending work, but also staying in the same employment.
“I think the companies that do provide support are going to be able to retain people better. It definitely makes a difference if you have a good, positive way of dealing with mental health issues and supporting people, my feeling is you will retain.”
What is your message to anyone considering reaching out to the Priory Group for help?
“I think, if a lot of people were unable to access us, they would probably get more unwell, and be waiting for longer for NHS services. So it’s about saying to people that The Priory Group is for anyone to think about as an option; it’s not just for celebrities, it’s not just for addiction, it’s for a broad range of all mental health conditions.
“There’s a lot of people here who are incredibly passionate about providing the best care and getting people back to the lives they need to live and getting them back into work as quickly as possible.”
Find out more about the Priory Group.