Today Theresa May shone the spotlight on the role of the workplace as part of her vision for how to improve the nation's mental health. She is right to identify stigma at work as a major cause of people failing to get help earlier. But the government could instigate a far wider transformation in our approach to mental health by learning from countries like the Netherlands and Sweden and giving employers a bigger role in preventing illness in the workplace.
Most of us spend the majority of our waking hours at work. And according to CIPD, three out of ten employees have experienced a mental health problem while in employment. So even if you haven't, you can be sure that a colleague or a friend has.
As with most health concerns, the earlier mental health issues are identified and dealt with, the more successful intervention is likely to prove. But all too often, people suffer in silence. Not enough workplaces have either the culture or access to support for people to feel comfortable about disclosing mental health problems. Too few workers are willing to talk openly about mental health issues for fear of stigma or damaging their career prospects.
As a result, more and more people with mental health conditions are falling out of work and ending up on sickness-related benefits. In 2000, mental health conditions accounted for three in ten of those out of work on sickness related benefits. Today this figure has grown to one in two of those on sickness benefits. There is a vicious cycle here. While appropriate work is good for mental health, those on sickness benefits are at greater risk of isolation and other factors that can trigger, exacerbate and prolong existing mental health conditions.
The cost to the state is huge. Mental health problems account for over £10billion of spending on incapacity benefits and housing benefit. There is a cost for employers too; mental health also makes up a large part of the £9billion a year costs employers pay in sick pay and the associated costs. But there is of course an incalculable cost for individuals whose lives are blighted and whose needs go unmet.
Compared to government efforts to support people to move off sickness benefits and back into work, very little has been done to prevent people from leaving work in the first place. As a result, successive governments has failed to make any progress on reducing the 2.2-2.6 million people on sickness benefits over several decades.
There is much we can learn from other countries here. For example, in the Netherlands, the government has progressively increased the duration of sick-pay, thereby putting a greater financial liability on employers' for the costs when someone falls out of work. This has shifted the incentives for employers, and shifted behaviour too. Between 1980 and 2011, spending on sickness benefits as a proportion of GDP fell by more than half - from 2.6 to 1.1 per cent, and there was a 25 per cent decline in total disability insurance caseloads.
The Dutch system is not perfect and much can be learnt from its failures as well as its successes. But upcoming research from IPPR will show that the UK's current system of in work support and sick pay does not provide the right balance of incentives for employers to prevent employees from drifting onto sickness benefits.
We need to recalibrate our sickness absence system so that employers and the state do more to prevent sickness absence from developing in the first place. Additional obligations should be placed on employers so that they have a greater incentive to retain employees in work. And statutory sick pay should be more flexible so that it adequately supports people with fluctuating long term illnesses like mental health conditions.
Government is currently consulting on how to reform our sickness benefits system to meet its goal of halving the disability employment rate. Today the Prime Minister announces a new review on mental health and the workplace. These are both important opportunities to prevent ever more people drifting out of work indefinitely by re-thinking the role of employers in addressing illness in the workplace.