The FT has an important article today about depression and business which we could equally extend to the economy:
The fact that we only talk about workplace stress when there is a high-profile case of mental ill-health is a problem. Such cases seem to be occurring more frequently, or at least more publicly. Sir Hector Sants, for example, the former head of the UK financial regulator, has stepped down from a senior role at Barclays after last month’s announcement that he was taking leave because of “exhaustion and stress”. António Horta-Osório, chief executive of Lloyds Banking Group, two years ago took a leave of absence on doctors’ advice, returning in early 2012. Carsten Schloter, chief executive of Swisscom, Switzerland’s biggest telecoms company, is presumed to have committed suicide in July, having talked publicly about the relentless demands of the job. The following month, Pierre Wauthier, chief financial officer of Zurich Insurance, committed suicide, blaming a difficult work relationship.
These events vary from deeply unpleasant for the individual affected to shocking and tragic for them and their friends, families and colleagues. They also bring to the surface how ill-prepared society is to deal with mental health, and highlight the lack of understanding of this widespread family of diseases – now among the world’s most prevalent illnesses.
I am no expert – beyond my own first-hand knowledge of depression: I “came out” (tellingly, this is the term that tends to be used) in the 1990s when I agreed to be featured in publicity for a government mental health programme. I now chair a charity, MQ, which aims to become the leading fundraiser for focused research so badly needed in this field. But I know enough to know this is an area where business can and should also take a lead.
This is not because of the role of the workplace as an incubator of stress: there is no direct link between stress and mental illness, still less suicide. Many people thrive on stress – and almost all survive it. Stress can provoke an underlying predisposition to mental ill health, but one cannot elide the two. They are not two sides of the same coin.
Indeed, mental illness is an illness, just like hypertension. That may sound semantic but it is important. It helps sufferers counter the (understandable) impulse to think: “I must snap out of it.” That will not lead them to good health, any more than it would for blood pressure. Recognising these illnesses as illnesses will help sufferers and those around them take them seriously.
In Australia the figures are pretty mind-boggling, according to the Department of health:
- Depression-associated disability costs the Australian economy $14.9 billion annually, with more than 6 million working days lost each year.
- Depression costs the Australian community over $600 million each year in treatment costs and depression will be second only to heart disease as the leading medical cause of death and disability within 20 years.
There is something to be said for the FT article’s approach to depression. De-stigmatising something so common is a big step forward.
But declaring depression an “illness” is also one of those big and bureaucratic solutions that creates as many problems as it solves. “Illness” may serve as an umbrella under which the afflicted can safely and openly find help but it is also a trap on number of fronts.
Common depression is not really a “mental illness” after all (though more severe cases can be). In most cases it is a highly curable emotional state that requires psychotherapeutic treatment and, if bad enough, drug support. Common depression is not some complex brain malfunction, it is unexpressed or unprocessed emotions from past trauma that can be lifted by establishing a strong relationship with a decent psychotherapist. It’s not easy process but the condition is not complex.
Casting depression as an illness leaps over this simple truth and takes the sufferer direct to either drugs or therapies designed to treat symptoms not causes. This is a constant problem that I have with the approach of organisations like Beyond Blue, which very strongly endorse simplistic approaches to depression like cognative behavioural therapies (that is, thinking positively) which are actually quite destructive to the normally depressed person who really only needs to have his or her unexpressed feelings endorsed not swept aside by bogus optimism.
The same applies to how organisations and an economy deal with depression. It is more complex than declaring it an “illness”. Although stress may not be a cause of depression, it most definitely is a trigger. But it is also true that those with an emotional imbalance to begin with are more likely to be drawn to an unbalanced lifestyle involving increased stress. For instance, there is a reason that Wall St pays so much of its ill-gotten gains on hookers. Some jobs are simply not designed for emotionally balanced people. If you ran a mandatory psychotherapeutic program on Wall St for a few years, there’d be nobody left.
As well, lot’s of organisations are run by very depressed people. Lots are run by personality disordered people. Declaring you’ve got a “mental illness” in such an environment is unlikely to be helpful to your cause when it may, in fact, simply replicate the trauma that is causing your issues in the first place.
This is the crucial point. Depression tends to repeat itself. Patterns of past behaviour arising from a trauma of some kind are likely to be repeated in the workplace. Calling that an illness and hanging in is locking in the depression.
Businesses and organisations should provide basic human resources decency and conditions but the responsibility for treatment of depression lies more with the individual. Only individual choices can change depressive states. What can be done is that treatment is made as widely available as possible and that depression itself be better understood through education, which is probably the role of government. Though, as said, on that front we’re not doing so well.
