Good mental health is one of the most basic needs we have, and yet also one of the most neglected.
The two most common mental health conditions, depression and anxiety, cost the global economy $1 trillion USD each year. Yet despite this the global median of government health expenditure that goes to mental health is less than 2%.
Mental and emotional health are at the heart of many of the most intractable public health issues of our time, from smoking and alcohol addiction, to poor diet and obesity (e.g. Thayer, R, The Origins of Everyday Moods). People who lose their jobs are also four times more likely to develop a mental health problem (Marmot, 2004; Waddell and Burton, 2006), so economic challenges are putting more pressure than ever on the health of individuals and families.
Mental health affects physical health too. Poor mental health has been linked to a variety of health risks, including cardiovascular problems, high cholesterol, diabetes, poor immune function and lack of sleep (Ryff, Singer & Love, 2004). Conversely, mental wellbeing is linked to improved educational attainment, reductions in use of healthcare services, safer communities with less crime, and an overall increase in quality of life (Flourishing People, Connected Communities, Department of Health 2009). Good psychological health also correlates with reduced mortality in healthy and sick populations, and reduced mortality from heart disease and other diseases (Chida and Steptoe, Psychsomatic Medicine, 2008).
Getting a grip on our mental and physical health, in an integrated way, can have far-reaching benefits. This is not a luxury, but an essential tool for public policy and a key ingredient in building good public health and quality of life for everyone. No wonder the World Health Organisation has argued there is no health without mental health.
Yet despite all this, we still have no official public mental health campaign in the UK.
Mental health at work
Mental health problems cost the UK economy and public services over £100 billion each year (Public Health England, 2012), and mental illness now costs UK employers £45 billion each year (City Mental Health Alliance). 2019-20 saw 17.9 million days off due to stress, depression and anxiety (HSE).
We don’t talk enough about mental health at work. A 2019 Ipsos MORI survey of the UK, US, Canada and Australia found:
- 82% of employees with a mental health condition did not confide in workplace management.
- 40% of employees had given a false reason for mental health-related time off.
- 50% wanted managers to help normalise the conversation about mental ill-health.
According to a 2021 report by construction engineering company Lloyd’s Register, 48% of UK employees said they believe disclosing a mental health condition to their line manager would impact career progression, and 29% had never discussed their mental health in line management meetings. Only 22% of respondents globally said they would feel comfortable speaking to a member of HR to discuss mental health concerns.
Companies that struggle to discuss mental health well struggle to attract talent too. In a 2018 City Mental Health Alliance survey of graduates, 69% of graduate applicants to financial, legal and professional services said they had experienced mental health issues, particularly anxiety (58%), depression (48%) and panic attacks (33%). Yet 64% believed disclosing mental health issues would hinder their chances of securing their first job, and nearly 80% said they were more likely to apply to an employer committed to good mental health.
From stress-related burnout to loss of top talent, smart employers have known for years that the health of any business depends on the health of the minds of its staff.
Mental health and race
Inequality, bullying and mistreatment are very bad for our minds, so fighting for fair treatment and an end to discrimination are important components to improving public mental health.
Whilst positive social contact is vital for our mental health, there is a wealth of evidence that discrimination is very bad for our minds. Everyday racism grinds people down and creates stress and worry, and the wider cultural discourse and global events have an impact too. In 2020 the Washington Post reported that anxiety and depression levels amongst black Americans spiked after George Floyd’s murder, and systemic racism continues to affect the mental health of black and minority ethnic communities every day.
People from black or ethnic minority backgrounds experience greater mental distress and receive poorer quality care (Alegría, Mulvaney-Day, Torres, Polo, & Cao, 2007; Gone & Trimble, 2012; Harris, Edlund, & Larson, 2005). People from black, Asian and ethnically diverse communities are also up to five times more likely to develop psychotic disorders than the White British population (Kirkbride et al, 2017).
In a 2020 YouGov poll, 38% of black and minority ethnic respondents said that they had experienced racism in the workplace, whilst Business in the Community (2019) found 58% had experienced non-inclusive behaviours in the workplace over the last three years, and 11% then left the organisation.
Promoting good mental health means taking these issues seriously. We can’t do everything, but we can help people understand and articulate how these things affect their minds, and encourage everyone to work together to make our communities, institutions and workplaces fairer and more tolerant.
It's time to talk
We know our minds are important. A 2013 survey by Mindapples and the mental health charity, Mind, found that 84 per cent of people in the UK believed their mental health is as important as their physical health. 72 per cent also felt mental health and wellbeing issues were not discussed openly enough in society.
Yet despite believing that mental health is important, 52 per cent of our respondents said they had never thought about the health of their own minds before. We know mental health matters, but turning that into positive actions seems to be more of a struggle. We appreciate mental health in the abstract, but how many of us see it as relevant for us day-to-day?
One reason for this disparity is that the term ‘mental health’ has become so associated with illness. Whilst physical health is something to be proud of having, mental health is often seen as something to be avoided, only relevant for sick people rather than a universal goal. So we have no positive image to move towards, and we struggle to motivate ourselves to take action.
Another is that we know so little about our minds. We are taught about plaque on our teeth, germs on our hands and salt in our food, but we aren’t taught about moods, stress, decision-making, creativity – the basic building blocks that make us think, feel and behave the way we do. We don’t learn the concepts, and we don’t know what’s normal. The result is that our minds can feel shadowy and mysterious, something over which we have little control. So we tune out the messages, ignore our minds and focus on easier things like watching our waistlines or cutting out sugar, and hope the experts will fix our mental health if something goes wrong.
It’s time for a change. We all have mental health, and looking after our minds is a normal part of having a successful life. So, if we can look after our bodies by brushing our teeth, or eating an apple, what about our minds?