Workplace mental health in the pandemic — why causation will be a key battleground

Mental health professionals have long recognised that the causes of stress, anxiety and depression are rarely linked to just one workplace or life stressor — causation of symptoms being more commonly multifactorial in origin.

The impact of the pandemic

All recently published studies and research have demonstrated that the pandemic has brought increased levels of stress and anxiety amongst many, both in the UK and globally. The reasons are legion, but include; social isolation, inability to work or receive support from loved ones, loneliness, fear of infection, illness, grief/bereavement and financial worries.

The statistics are sobering:

• The World Health Organisation (WHO) estimate that globally, levels of anxiety and depression have increased by 25% since the start of the pandemic with young people at greater risk of suicide and self-harm (The Lancet, 2 March 2022).
• A record 4.3 million referrals were made to mental health services in the UK in 2021 (Royal College of Psychiatrists Analysis of NHS Digital Data — British Medical Journal — 15 March 2022 — G.Iacobucci and others).
• In December 2021, 1.4 million people were recorded as awaiting treatment following referral to mental health services — with a 15.7% increase noted in children and young people.

The Director-General of WHO, Dr Tedros Ghebreyesus, described the impact of the pandemic as follows;

“The information we have on the impact of COVID-19 on mental health is just the tip of the iceberg…This is a wake-up call to all countries to pay more attention to mental health and do a better job of supporting their population’s mental health”.

The same WHO research highlighted, that children and young people are disproportionately at risk of suicide and self-harm and that those who contracted COVID-19 and had pre-existing mental health issues at the start of the pandemic, were also statistically more likely to suffer hospitalisation, severe illness and death.

The Royal College of Psychiatrists (RCP) have repeatedly called for increased funding and support to deal with the tsunami of referrals with many mental health services described as “overwhelmed”. The RCP in its spending review submission document, described COVID-19 as being the cause of the biggest mental health crisis since World War II — calling for almost £5 billion in extra funding over the next four years.

With the WHO, noting that governments spent on average just 2% of their health budget on mental health services — this crisis is unlikely to be alleviated in any meaningful way for the foreseeable future.

The workplace

Whilst the stark impact of the pandemic on global mental health is highlighted above, what then of the workplace?

HR News [5 May 2022], referred to an analysis of group protection data carried out by Zurich Corporate Risk which showed a 50% year on year increase in calls to its’ Employee Assistance Programme over the last 12 months.

Anxiety was cited as the “top” reason for those employees to seek guidance — an increase of 67% year on the previous year.
Other reasons included depression, concerns over their own health, employment and partner related worries and family/divorce/separation — the latter showing an increase of 73% when measured over the same period.

Whilst “work related stress” was listed amongst the top 10 — it was in fact only the sixth most prevalent amongst the employees who had sought assistance from the programme. That analysis noted that work related stress reduced dramatically during October and November 2021 which coincided both with the end of the Coronavirus Job Retention Scheme (Furlough), and when a return to the physical workplace started for many employees in earnest.

Nick Homer, Head of Group Risk at Zurich Insurance described the findings as follows: -

“Last year there was a notable leap in people seeking support for relationship issues which may be related to the stress of the pandemic and home working”.

Whilst noting that the reductions seen during the latter part of 2021, Mr Homer pointed out that year still saw;

“Huge increases in requests for support for anxiety and work-related stress”.

Commentary

HSE research published in December last year pointed to a large increase in new cases of workplace stress, anxiety and depression with over 800,000 new cases for the year April 2020 to March 2021 — a rise of 104,000 cases compared to the previous year. This also sits alongside smaller-scale studies pointing out to increase rates of employee “burnout” during the pandemic.

By way of contrast, other studies point to the pandemic engendering a sense of gratitude amongst employees towards their employers [Butler & Joffe, 2021] and that many are experiencing an improved work/life balance alongside a reduction in the stress of commuting to physical workplaces.

Several studies, most notably REACT, remain ongoing and we expect that the true impact of the pandemic on workplace mental health will not become clear for some time.

Employees were and are clearly not immune to the pervasive experience of the pandemic, whether by reason of social isolation and loneliness, illness, grief/bereavement, financial concerns or relationship difficulties.

Whilst noting the increases in workplace stress, depression and anxiety revealed by the HSE Summary Statistics, we envisage that for the majority of future claims presented for workplace stress and anxiety, a generalised or specific impact wrought by the pandemic will have played a causative role, in part, or in the main, in the development of symptoms.

Claims will need to be scrutinised by review of medical and occupational records.