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As a senior tax partner at EY, David Brewin was used to making important decisions. But it was his assistant who took charge one day in 2010, telling him she had cleared his diary and that he should not argue but get into a car she had ordered to take him to an appointment booked at the Priory, the mental healthcare group.

“Looking back on it, I was resigned, even relieved,” he recalls. “She had known I had had concerns, and had noticed me change and become less engaged. I went for two weeks and ended up staying for a month. Ironically, the Priory was one of the sanest and healthiest places I have ever been.”

Despite a successful career at the professional services firm, he concedes: “There was always something that wasn’t quite right. Big set-piece events were stressful and the job was challenging, but I just pushed on. With a divorce, the breakdown of a relationship and a change in roles, I could no longer find energy or meaning.”

A growing number of professionals are speaking about their experiences of depression and anxiety to set an example for others and to encourage employers to take a more active role in protecting mental health in the workplace.

Some estimates suggest one in six employees are affected, and it costs UK business £26bn a year through absenteeism and “presenteeism”, when staff turn up but are unproductive. Men aged 40-44 years have the highest incidence of suicide.

A long day: meeting high performance targets can come at the expense of mental health

Geoff McDonald, a former top executive at Unilever, was surprised when he had a panic attack in the middle of the night in 2008. He woke up thinking he was going to die, and sought help from his doctor. “The only reason I am still alive is that I was very open about my illness and able to reach out for support.”

He contrasts his experience with that of a friend, a banker who committed suicide by jumping off a rooftop restaurant terrace in central London two years ago. “He had a macho personality and couldn’t tell anyone,” he says. “Depression is in many ways the scourge of the strong. I began to think it was especially important to help men become more vocal about mental illness.”

Mr McDonald thinks the economic downturn and pressures of 24-hour communications have increased the risks. “We are expected to do more with less, in a world which is more volatile, uncertain, ambiguous and complex. That is all contributing to people moving from a position of stress to distress and maybe becoming ill.”

There are signs of positive change. Since its creation late last year, the City Mental Health Alliance, an umbrella group seeking to promote more active discussion of the issue, has signed up 26 leading companies, banks and professional service firms in London.

Nigel Jones, a partner with Linklaters, the law firm, and vice-president of the Alliance, says: “Physical health is easier to deal with, providing a gym or a good staff restaurant. Mental health is more difficult to talk about.”

He says growing awareness of mental illness has brought support for a series of high-profile initiatives. While companies may see a direct financial benefit, he believes interventions are simply “what a good employer should do”, regardless of any economic arguments.

Mr McDonald, who is now a non-executive director at Mental Health First Aid (MHFA), a charity that provides training, agrees: “It only takes one suicide in your corporation for you to put the business case aside and ask what you can do.”

One response is to encourage senior employees who have had mental health problems to speak out, to tackle stigma, provide role models and encourage others to come forward. Steve Wilkinson, a partner at EY, says training is offered across the firm, as well as a “buddy” system of informal support. “We need more people to talk about it,” he says.

Mr McDonald cautions that “mindfulness training” alone is not sufficient. “Sending staff on a course is like sticking a plaster on a gaping wound,” he says. “We can’t address the issue without tackling the environmental factors.” He says companies should encourage staff to take breaks; work from home or away from office distractions periodically; receive better feedback from managers; and be offered tasks that make them feel they are making a positive contribution “beyond growth and profits”.

Poppy Jaman, chief executive of MHFA, favours prevention. “Wouldn’t it be great if we developed an approach for mental health at work like we have for back problems?” she says. “You could make reasonable adjustments [at the beginning], just as you do in assessing desk space, chairs and footstools.”

She too argues for more structural change. “It’s ridiculous when companies set very high performance rates. If someone is performing at 120 per cent, that probably comes at the cost of something else. When someone is overperforming, we should not be celebrating but saying ‘you are doing way too much and you will burn out’.”

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