It has become the chief cause of long-term absence in the UK, but appropriate provision for mental health problems at work lags way behind. Keith Bushnell assesses how employers can limit absenteeism and reduce the strain on their insurance policies.
It is well known that physical health problems are the biggest overall cause of absence in the UK. To take one example, musculoskeletal problems accounted for 35 million lost days in 2011, according to Office for National Statistics figures for the UK labour market.
But when it comes to long-term absence, mental health is the biggest contributor. In A CIPD report in 2012, 66% of employers said stress was in the top five most common causes of absence, while 51% also cited more severe conditions including depression and anxiety.
This growing problem has presented UK employers with a substantial financial burden due to absence and loss of productivity, yet the health plans they fund are still heavily weighted towards physical illness such as MSK problems and back pain, exposing employers to further costs when it comes to employee absence caused by mental health issues.
The disparity between physical and mental health provision has recently been acknowledged by the government, whose figures reveal that three out of four people with common mental health problems do not receive treatment or appropriate support, and that individuals with mental health conditions are three or four times more likely to die from the ‘big killer' diseases than the wider population.
Although the nature of clinical support required for physical illness is clearly very different from mental health (this is reflected in the type of policy chosen), the approach to absence management should always be the same.
The key imperative for all employers, whatever their size, is to have the ability to identify struggling workers and help them to stay at work or facilitate as early a return as possible, only resorting to medical care if absolutely necessary and appropriate.
This requires an evidence-based approach to managing the relevant obstacles to full participation.
The importance of early intervention is revealed when absence and return-to-work statistics are assessed. Figures published in The British Medical Journal on general sickness absence show that once on statutory sick pay for more than six months, 90% of claimants remain off work for at least five years.
When staff have been absent from work for six months, the likelihood of their return is lower than 50%.
The probability then decreases to less than 30% for those absent for 12 months, and to less than 10% for staff off work for 24 months. Early intervention can prevent absence in the first place and stop problems from escalating.
Employers increasingly choose to use employee assistance programmes (EAPs) as a way of tackling absenteeism and providing support. According to the UK Employee Assistance Professionals Association, the EAP sector has grown by 69% since 2008, with 47% of the working population now having access to one.
These programmes can serve as staff-support services. However, when they are used instead of structured, evidence-based systems for tackling health issues, individuals can be put at risk of not returning to work and recovering as quickly as possible, which adds to the burden of employers.
To obtain good outcomes, it is essential to provide individuals with the right tools to return sustainably to work and manage independently their psychological symptoms.
This important mix is often not provided due to a lack of clinical knowledge, an inability to take action, or because problems are ignored or take too long to be resolved.
The fact that they are held totally confidentially by an EAP service means the employer is excluded from the recovery process and therefore cannot gauge progress and make appropriate workplace arrangements.
