The making of a mental-health crisis
How did depression and anxiety become the leading causes of long-term sickness?
Britain is shaping up to be the ‘sick man of Europe’ of the 21st century. Our problems are not just economic, but bound up with actual sickness, too. There are now more than 2.5million Britons who are neither in work nor looking for work because of long-term sickness. This problem has now become so serious that it is threatening to wreck the public finances.
Strikingly, according to data published by the Office for National Statistics (ONS), the principal driver of this sickness crisis is not the record-high NHS waiting lists or long-term health complications from Covid and the lockdown. Instead, it is being fuelled largely by mental-health issues, like depression and anxiety. Between 2019 and 2023, an additional 300,000 people dropped out of the labour market citing mental-health problems as their primary reason.
No doubt the pandemic and the lockdowns had a corrosive impact on people’s lives. However, it is important to take a step back before blaming the pandemic. There are deeper roots to this crisis. Depression, stress and anxiety have been among the leading causes of workplace absenteeism since at least the turn of the century.
For decades, mental-health entrepreneurs and trade-union bureaucrats have tried to establish a causal relationship between work and mental-health problems. A report published by the Trades Union Congress (TUC) in 2004 claimed that stress had become the No1 health threat to British workers. In 2012, the TUC enthusiastically embraced a report that argued that ‘excessive working time causes depression’. Three years later, it claimed that ‘stress makes a worker ill every two minutes’.
It is now all too common for the tensions and pressures that arise at work to be discussed through the prism of mental health. Feelings of frustration, sadness and isolation are no longer talked about as everyday difficulties. Instead, they are treated as symptoms of a disease. This has changed the way that large segments of the population view the challenges they face.
In his 2015 book, The Nocebo Effect: Overdiagnosis and its Costs, Stewart Justman observed how the medicalisation of everyday problems actually invites people to feel ill and encourages them to live up to their diagnoses. This is especially the case when it comes to mental-health problems. Attributing one’s difficulties to depression or anxiety can become a self-fulfilling prophecy.
Meanwhile, a broader antipathy to work has developed in recent decades, too. In my 2003 book, Therapy Culture: Cultivating Vulnerability in an Anxious Age, I drew attention to the growing tendency to present work as a potential threat to our wellbeing. You can see this in the widespread use of the term ‘work-life balance’. This pits work and life against each other, suggesting that ‘real’ life needs to be protected from the encroachment of work, which apparently can only have negative consequences. Of course, what this ignores is that work can actually be fulfilling. It can also be an important source of creativity and can help to give our lives meaning.
Hard work, in particular, is widely demonised nowadays as a barrier to personal fulfilment. As one prominent social psychologist argued back in 2000, ‘the possible benefits of positive emotions seem particularly undervalued in cultures [that] endorse the Protestant ethic, which casts hard work and self-discipline as virtues and leisure and pleasure as sinful’. This negative representation of the Protestant work ethic has since gained significant cultural traction. Whereas hard work was once considered necessary for self-realisation, today it is more likely to be seen as the first step into entering a clinic.
Indeed, in the Anglo-American world, a commitment to hard work has now been rebranded as ‘workaholism’. This is apparently a form of addiction that can have drastic mental-health consequences. From this standpoint, hard work is like a drug that people use to avoid facing up to their psychological issues. Hard workers are more likely to be ill, we are told, than their relaxed and laid-back colleagues who leave the office at the first opportunity.
This cultural devaluation of work, and the tendency to medicalise every negative emotion, is the backdrop to Britain’s long-term sickness crisis. This is not so much a health crisis as a cultural one. It can only be solved by reminding people of the importance of work, and by developing the cultural resources that can instil in people a sense of agency. Far too many people today see themselves as mental-health patients, rather than as people in control of their destiny. That has to change.
Frank Furedi is the executive director of the think-tank, MCC-Brussels.
Picture by: Christopher Lemercier.
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