Millions of mental health sufferers fear returning to the workplace

Discriminatory work practices that have left up to five million people with mental health problems fearful about returning to normal working arrangements must be overhauled as a matter of urgency, a major new report has warned.

With sufferers facing lower incomes “for decades”, an investigation into the entrenched barriers to jobs and workplace progression has found that typical income for people with common mental health conditions is £8,400 lower than for the rest of the population – leaving this group much more exposed to financial hardship during the pandemic.  

Led by the Money and Mental Health Policy Institute, and made up of specialists from the worlds of business, politics, trade unions and charities, the Mental Health and Income Commission is calling for both emergency and systemic reforms to end the “mental health income gap”, by ensuring more people with mental illness can thrive in work “during the pandemic and beyond”.

A&E nurse Suzanne had no mental health problems before a sexual assault seven years ago. She waited five years for therapy for PTSD and anxiety. Battling insomnia, she agreed a move away from night shifts with her employers, which reduced her income. 

Then, in order to be able to attend therapy, she moved to agency work on a zero hours contract last year. This means she now has no chance of promotion and higher future earnings but she felt it was necessary in order to look after herself. When the pandemic hit and Suzanne had to go into shielding, that also meant she had no income for more than three months.

Assume nothing

The commission has found that one in five people with mental health problems – equivalent to 3.7m people across the UK – say they have suffered workplace discrimination due to their condition, including being passed over for promotion or being made redundant.

More than two-thirds of people with mental health problems who have ever asked an employer for reasonable adjustments said their requests were either rejected or only partly met.

“Although we work in healthcare, there is a lot of assumption made at work about what I could or couldn’t do. There’s a lot of judgement that could be cleared up quickly and simply if they just talked to me rather than assume things,” says Suzann. 

“My PTSD and anxiety, my triggers and my capabilities are completely different to someone with the same diagnosis.” Suzanne, as an A&E nurse with 14 years experience, is very clear about the difference between the professional stresses that come with her role and the implications and restrictions of her mental health.

“It’s important for employers to have a conversation with people about that. I think people worry about making others uncomfortable by having these kinds of conversations about mental health but they need to happen. If someone spoke to me about my career goals, my strengths and what might hold me back then that would really help.”  

“Lots of employers want to help but don’t know how to broach it,” she adds.  

Build back better

Firm about the fact that she would not be in the same circumstances had she received treatment sooner after the original trauma, she says she wants to see a greater investment in mental health services, and financial support for those who can’t work that matches that offered to those with physical health issues.  

“So often people have to come back to work earlier than they should because of financial pressure. That just means they’re more likely to have to take more time off later. It becomes a vicious cycle,” she adds.  

“If mental health was understood and managed better within the workplace, including understanding why some people have to be off work for some time due to, for example, medication changes, we could change that into a positive cycle. Long term, better managed mental health would save money.”

The commission believes the government should adopt several emergency measures to help people with mental health problems stay in work during the pandemic, as well as long term changes to tackle the systemic employment issues which have driven the “mental health income gap”.  

They include introducing a right to flexible working for all employees during the pandemic – currently, the rules only protect the right to request flexible working that employers can easily reject.

The panel also wants to see the government oblige employers to report on their mental health pay gap in the same way that the gender pay gap must be confirmed, as well as an increase to the levels of statutory sick pay (SSP), with wider access to it.  

People with mental health problems are more likely to need time off work due to illness. But many struggle to get by with the current rate of SSP (£95.85 per week), while workers who earn less than £120 per week are ineligible for it. 

The commission argues that increasing the generosity of SSP – and making it a basic employment right for all workers – would help prevent existing income inequalities from growing during the pandemic.

More than four in ten people with mental health problems say they are worried about returning to their usual working arrangements after lockdown, amounting to five million people in total. Only 30 per cent of the wider workforce shares this concern, the commission has reported.

Commenting on the findings, Helen Undy, chief executive of the Money and Mental Health Policy Institute, said: “If the government is serious about ‘building back better’, it must address the employment barriers that are leaving many people with mental health problems dreading a return to normal after the pandemic.  

“The way the country has adapted to home working and other flexible arrangements has proved that we can do it. For millions of people with poor mental health, the idea of going back to business as usual – and losing this flexibility – is a huge worry.

“People with mental health problems have been more likely to be on low incomes for decades. The pandemic has not only exposed this inequality, it looks set to make it worse. We’re calling for urgent action from the government to put this right,” she said.

Mental health pandemic

Meanwhile, a recent study by the Mental Health Foundation found that key indicators of distress among UK adults were worse in the run-up to Christmas than they were at the beginning of lockdown.

The latest wave of the research, carried out after successful vaccination trials were confirmed, but before the latest lockdown was announced had already shown that the proportion of people who said they were “coping well with the stress of the pandemic” had fallen steadily, from almost three-quarters in April to 62 per cent by the end of the year.    

Revealing the data, Dr Antonis Kousoulis, director for England and Wales at the Mental Health Foundation, said: “At the beginning of the pandemic, we were very concerned that the longer it went on, the more serious the risks to our mental health would become.  

“Unfortunately, this latest data appears to support that fear. It is clear that for millions of people, distress is not going away and on some important measures, problems are getting worse.  

“There is no vaccine to protect our mental health against the consequences of the pandemic. Instead, we need to focus on prevention – including tackling the underlying causes of mental ill-health, such as rising unemployment, poverty and social isolation.  

"This is why we need a long-term Covid mental health recovery plan for England now, and full implementation of devolved nations' mental health recovery plans."