Mental health crisis takes its toll on UK workforce

“Jeremy Hunt is not quite right,” says John Godfrey, a former head of policy at Downing Street under Theresa May who is also chairman of Business for Health, which campaigns for investment in preventative health and care. “Statistically, it is much more about long-term sickness.”

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Indeed, the Bank of England and Imperial College Business School have said the “majority” of the increase in economic inactivity between 2019 and 2022 is down to increases in long-term sickness. About 2.5 million people are not working for this reason. Data published by the Office for National Statistics on Friday showed that economic inactivity because of long-term sickness or disability increased by 462,000 people between 2019 and 2022, more than the 41,000 increase that might be expected due to the changing age composition of the population.

Mental ill health appears to be playing a significant — and in some age groups, growing — role in this picture. IPPR, a think tank, said in December that a mental health issue was the most common condition among working-age people who were not in work due to poor health.

Such figures are not a surprise to Bertrand Stern-Gillet, chief executive of Health Assured, Britain and Ireland’s largest independent provider of employee assistance programmes, which help staff deal with personal problems. “We’ve got a perfect storm. People’s mental health has probably never been worse, and we’re in a climate where it’s more acceptable to be transparent about it and seek support. Those things together have resulted in a situation where there’s so much pressure on the NHS and the traditional pathways to get support. You end up in a spiral, people can’t get support, they get worse and that’s when they’re off on long-term sickness,” he said.

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Whether poor mental health is a sole cause, contributor or result of economic inactivity and/or a physical malady is harder to gauge, but Stern-Gillet noted an alarming trend in the nature of calls to his company’s assistance phone lines. Between January 2022 and the start of this year, he said there had been a doubling of what the company classified as “high risk” calls which can be as serious “as someone taking steps to complete suicide, or coming up with a plan”.

Kayleigh Frost, the firm’s head of clinical support, said long waiting times to begin treatment for mental health issues via the NHS were pushing more people to ask their workplaces for help. “If you throw in the cost of living crisis, paying for private counselling will be a luxury for many people. That demand is shifting over to [employers]. We’ve never been set up as a crisis support service but we’ve had to accept that over the last 12 to 18 months. We are the only option for many individuals,” she said.

Fergus Craig, commercial director at AXA Health, the insurer, said that it had seen a “very significant ramp up in claims relating to mental health” since the pandemic, with such claims almost doubling. According to Deloitte, poor mental health costs UK employers about £56 billion a year.

Godfrey, corporate affairs director at Legal & General as well as chairman at Business for Health, said the problem of mental health-related inactivity had been steadily growing for several years. It encompasses people on long-term sick leave, those who have left the workforce entirely and “people turning up to work and not doing very much because they’re not focused”.

There is widespread agreement that greater understanding and acceptance of the seriousness of mental health issues, and therefore people’s willingness to report them, is behind some of the rise. “The old stiff upper lift attitude is fading away,” Godfrey said. “And employers are getting much better at recognising it and trying to do something about it rather than just telling people to shoulder on.”

Rachel Suff, senior policy adviser at the CIPD, a professional body for human resources workers, highlighted a rise in benefit claims related to mental health issues by young people. Between July 2021 and July 2022, the number of working-age people newly awarded disability benefits doubled. About a third of the new claims are for mental or behavioural conditions, although among claimants under 25 that figure rises to 70 per cent.

“That is not people who are just feeling a bit down. If you’re signing on for benefits, that’s the serious end of the spectrum,” she said.

This arguably presents a more worrying sign for the labour market than early retirement.

“It’s so sad and such a public health issue,” Suff added. “This is the workforce of now, and in the future. There is public policy focus on those over 50, but there should be a spotlight on what’s happening with younger workers.”

Employers are increasingly aware of such issues and working harder to refer people more quickly to therapies via health insurance schemes, Godfrey noted. “It means they don’t sit there for six months on an NHS waiting list, getting worse and being perpetually signed off by their GP.”

However, Suff noted that there was a limit to how much the private sector can do, not least because small organisations employ more than half of private sector workers and many will not have a formal human resources function. “Most people work in small organisations that don’t have HR. Occupational health [support] needs to be available for the whole nation — 80 per cent of health conditions are acquired during employment.”

The government appears to be preparing to act, with a reported plan in the works to offer all workers annual health checks and subsidies for small and medium businesses to introduce occupational health services.

Stern-Gillet agrees, saying public mental health provision needs to improve to help tackle one of the key contributors — and results — of economic inactivity. “The situation is untenable. Organisations like ourselves. . . will probably tide us over until the NHS pathways clear up.”

Behind the story

Improving occupational health services has been a focus of a workforce review by Mel Stride, the work and pensions secretary, and it is hoped that planned measures such as subsidies for small and medium-sized enterprises could help bring hundreds of thousands of people back to work (James Hurley writes).

The Chartered Institute of Personnel and Development also wants reforms of statutory sick pay. These would widen eligibility and make it more flexible, extending protection for those on the lowest incomes, supporting phased return to work and helping small employers hit by staff sickness. It says statutory sick pay is very low compared with most other European countries. Many low-income workers, including those in part-time work, can’t access the system at all because of a lower earnings limit.

A 2016 study by the European Agency for Safety and Health at Work found the UK looked at return-to-work considerations “at the end of the sickness absence, with limited provisions for early intervention”. Countries such as Germany, Austria, the Netherlands and Denmark “recognised the need to address the issue of long-term sickness absence leading to permanent exclusion from the labour market and have developed appropriate regulations, policies and institutions to deal with it”.

According to reports, Steve Barclay, the health secretary, wants a greater focus on illness prevention to help stop people developing long-term conditions and wants to help employers pick up conditions earlier.

John Godfrey, of Business for Health, suggests more generous tax relief for measures by employers to speed up access to care. However, he said investment in public mental health resources was also needed. “What happens quite often is you’re referred by your GP to a waiting list. The longer you’re ill and off work the higher your chances are of never returning,” he said.