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At 8.30 on a Tuesday morning in 2016, my phone rings. A colleague is calling from a Travelodge hotel. He couldn’t face going home the previous night, couldn’t face going to work, and now can’t face leaving his room. I want to help, but I don’t want to make matters worse. I have the classic manager’s dilemma when faced with a mental health problem.
One in four people suffers mental ill-health at any point. Indirectly, through family, colleagues and friends, almost everyone encounters it. As a significant employer and insurer, we know how serious the problem can be. Thriving at Work, the 2017 UK government-sponsored review of employer support for mental health, estimated the annual cost to UK employers of poor mental health was between £33bn and £42bn. More than half of the cost was due to “presenteeism”, when people come in to work but are unfit to do so.
Mental health problems — typically stress, anxiety and depression — account for 40 per cent of Legal & General’s income protection claims, just behind musculoskeletal problems. De-stigmatisation drives truthful reporting. I hugely admire those corporate leaders who are open and honest about personal mental health issues, likewise the sports personalities leading by example through our Not a Red Card campaign to encourage people to talk about mental health in the workplace. But we are still far from achieving parity of esteem between physical and mental health.
With all this in mind, I think about how best to help my colleague. At 9.30am that day, we meet off-site for coffee. Meanwhile, I have consulted one of the cognitive behavioural therapy professionals from our insurance business. By 11am my colleague is safe, receiving professional help. Many others are less fortunate. Diagnosis and treatment are slow without private health cover. The longer you wait for treatment, the greater the risk of never returning to work, school or university.
Today, one of our 150 trained mental health first-aiders would be helping. They have basic skills, know when to involve professionals, and can distinguish the mental equivalent of a minor sprain from a potentially broken leg.
Our understanding of the malfunctioning mind lags far behind that of physical illnesses. In the genomic age, neuroscience remains almost medieval, and mental health research is underfunded. Crucially, MQ a UK-based charity that funds research into mental health, was set up a few years ago with a £20m endowment from the Wellcome Trust. We all know we need much more research, including on how digital technology can help in diagnosis and management of conditions. We have been looking to invest in this digital area, but it is hard to select investments that are effective and capable of early adoption.
Science shows a correlation between mental and physical health. Exercise, diet and nutrition, plus sleeping well, all matter, as do working practices and environment. Mostly we no longer work in the “dark satanic mills” immortalised in William Blake’s “Jerusalem”. But even the most modern office, with sleep pods and head massages, may not offset the pressure of an “always on”, data-fuelled culture.
Employers are helping — we at L&G provide free healthy breakfasts for early starters to help them avoid an energy drink and fried food diet, and we try to do small nudges towards encouraging staff to take more exercise, such as reminding them to use the stairs rather than the lift. But we are conscious that more needs to be done — 21st-century industrial injuries are as likely to be mental as physical.
We are seeing more life insurance claims resulting from suicides, everywhere in the world. Mental illness does not respect status, wealth or age. Many conditions first emerge when people are in their teens, and there is a mental ill-health epidemic in schools. Equally, the ageing workforces of developed countries are likely to experience decline in their cognitive skills, as well as anxiety and depression.
Most people spend more of their waking hours at work than at home, so good working conditions and an employee wellbeing programme help — often that means dealing with non-work-related problems. The largest number of calls to L&G’s employee assistance programme relate to problem debt, which is unsurprising when you consider that research published in 2017 by the UK’s Money and Mental Health Policy Institute found that 67 per cent of UK employees in financial difficulty reported signs of poor mental health. Getting problem debt under control can really help, and this can be done via the workplace.
It is not an employer’s job to solve all personal problems, nor should we medicalise normal, everyday unhappiness, but good employers are doing more. It is in our interest to do so, and organisations like the excellent City Mental Health Alliance, of which L&G is a member, are helping spread best practice — for example, by recommending effective interventions.
Six months later, my colleague is back at work, and productive. A new, better work pattern has been agreed. It is a story with a happy ending, but sadly, unless we do more, that won’t always be the case.