Helen Lockett, Director of Programmes, Centre for Mental Health

In the build up to September’s Stress Prevention and Mental Wellbeing event and October’s Employee Wellbeing Forum, Helen Lockett, Director of Programmes, Centre for Mental Health, discusses the impact of mental ill health in the workplace.

At any one time, one worker in six will be experiencing a mental health condition, such as depression or anxiety. Mental ill health is by far the predominant health issue for the working age population. It affects workers of all ages and types, however demanding their occupations are and whatever work they do.

The costs of mental health conditions to UK workplaces are estimated to be at least £1,000 per employee per year. The largest proportion of these costs is due to ‘presenteeism’, where people are at work but are underperforming due to ill health, while just under a third is due to sickness absence and the remaining costs are from recruitment and replacement. This equates, for example, to £1.3 billion a year for the NHS, with its workforce of 1.3 million, or £50,000 for a business employing 50 people (Sainsbury Centre, 2007).

Despite its prevalence, awareness of mental distress in workplaces in Britain is remarkably low. Most employers under-estimate how common mental ill health is and do not recognise the impact it has on their businesses. Most of the people who have symptoms of depression or anxiety that are sufficient to necessitate treatment do not receive it. This could be for a variety of reasons, but includes lack of awareness of the problem and that there are effective treatments available, stigmatising public attitudes associated with mental health conditions and the fear of the impact on their job and career. Consequently there are a high proportion of people in the workforce with undiagnosed and untreated mental health conditions.

Too often, work is seen as damaging to our mental health. ‘Stress’ at work is sometimes portrayed as an illness in itself. People with mental health conditions are signed off sick for fear they could not cope with work, and many never return. People who develop mental health conditions are twice as likely to lose their jobs than people with other health conditions or disabilities (Burchardt, 2003). This does not have to be the case. Only about 15% of mental distress in the working population is directly caused by work. Most distress originates elsewhere but can be made better if employers support rather than ignore or exclude people who are unwell; the workplace has a crucial role in the prevention and early identification of ill health and the promotion of mental health.

Organisations that have a proactive approach to the effective management of mental health at work indicate that at least 30% of the cost can be saved with relatively simple measures. Recognising that mental distress is common and encouraging staff to seek help when they become unwell are vital. Responding to a colleague who is showing the signs of distress sensitively and confidently can make all the difference for them and for their work.

Among the most crucial roles in this regard is that of a person’s line manager or supervisor. In 2008, the Employers’ Forum on Disability (EFD) carried out a survey across their membership to understand how managers see their responsibilities in terms of mental health at work. As would be expected from the high prevalence rates, line managers are frequently dealing with staff experiencing mental health conditions at work. The majority of managers who responded said that they did not feel equipped to respond appropriately and would welcome training (Employers’ Forum on Disability, 2008).

There is thus a clear need for and demand from line managers in workplaces across the UK to get the knowledge, skills and confidence to respond to mental distress wisely and positively. Human resources staff have a key role in ensuring that all line managers in their workplaces have the basic skills and that the organisation as a whole will be able to support individuals in making their recovery and where possible signpost them to sources of specialist support.

Fortunately there are now more resources than ever available to achieve this. The Employers’ Forum www.efd.org.uk offers a range of guides and tools for larger employers while the Mindful Employer initiative www.mindfulemployer.net offers smaller businesses peer-to-peer support and a Charter setting out what all employers can do to foster good mental health at work. Advice is also available from the Government’s Shift programme www.shift.org.uk and from Mind’s new Taking Care of Business scheme www.mind.org.uk.

At Centre for Mental Health, meanwhile, we have recently launched Impact on Depression, a set of training programmes for workplaces about mental health, based on a successful initiative developed by Australia’s beyondblue: the National Depression Initiative. Impact on Depression offers line managers and other staff, including Executive Teams, between one to three hours’ training to give them the competencies they need to manage mental health in their workplace. More details of the scheme and its impact on workplaces are available at www.impactondepression.co.uk.

About the Author:

Helen Lockett is the Director of Programmes and Performance at Centre for Mental Health. Helen has carried out research, evaluation and service development in the fields of employment and mental health and disabilities for over 15 years, after graduating in Social and Political Sciences from Cambridge University. Helen has worked at the Centre since 2006.

Helen is about to complete a Masters in Business Administration (MBA) at the University of Bradford School of Management through their distance learning programme. Helen regularly speaks at local, national and international events on the evidence base across the employment and mental health continuum as well as the policy and practice implications.

Helen managed the UK pilot of the Australian beyondblueworkplace programme, which we are making available as theImpact on Depression sessions.


Burchardt, T 2003, Employment Retention and the Onset of Sickness or Disability: Evidence from the Labour Force Survey Longitudinal Datasets. London: Department for Work and Pensions, in-house report no.109.

Employers’ Forum on Disability (2008). Government’s mental health plans must include line managers. (Accessed on 08/05/2010). Available at: http://www.efd.org.uk/media-centre/media-releases/2008/government-plans-for-mental-health-support-work-must-include-line-m.

Sainsbury Centre 2007, Mental Health at Work. London: Centre for Mental Health