November 5th saw the publication of the Mayfield report on how to ‘Keep Britain Working’ – lighting the touchpaper for fundamental changes to workplace health. It makes clear the wider societal impacts of economic inactivity but also emphasises how lost earnings from long periods out of work can have hugely adverse impacts for individuals. It’s good though, to see the positivity too – that it’s a problem that can be solved and that there are solutions already available which can be better joined up. Sir Charlie Mayfield talks of creating a movement which would act like a magnet, drawing existing good practice together, rather than trying to reinvent everything.
Key themes
There are a variety of themes on the report. For example, there is a need for a new deal made between employers, government, and employees as well as an understandable focus on data and the sharing of best practice, with a new unit is to be set up to facilitate that. Another theme is how prevention and early intervention can make a huge difference.
The report highlights that there are today more people of working-age who are economically inactive for reasons of ill-health and disability than ever. For some that is unavoidable, but many would like to work given the opportunity. Specifically, and startlingly, there was an increase over 10 years of 530,000 younger people whose main health condition was mental health related. As the report notes “Someone leaving the workforce in their twenties can lose out on over £1 million in lifetime earnings.”
When people face ill-health, there is often a lag before they access effective support and treatment. This is especially true for mental health, leading to deterioration in outcomes and longer periods out of work or early exits. People are five times more likely to return to work if it is within a year than if they have been out of work for more of than a year. We need ‘stay in work’ plans, not ‘absence plans’.
What gets measured…
The report outlines three phases. Years 1 to 3, which will focus on action and learning with ‘vanguard’ employers and a new Workplace Health Intelligence Unit. Years 2 to 5 will be the expansion phase, with certified standards, and years 4 to 7 will be the general adoption phase. The concept of identifying and sharing best practice is a practical and positive step – ‘encouraging a race to the top’. Zurich UK will be one of those vanguard companies.
There’ll also be a big emphasis on measurement of outcomes, absences, return to work, participation rates for disabled people and more. There’s an understanding that data collection shouldn’t be an onerous requirement on employers and the framing is very much that change is being done ‘with’ employers rather than ‘to’ them.
The review notes the degree of fear in the system – employees fearful of disclosing health issues and employers fearful of engaging, as they are worried about potential perceptions of bullying, harassment and triggering tribunals. People are seen as risks to be managed rather than individuals to be supported and protected – there’s a need to rehumanise the process.
The anxious generation
Mental health is perhaps the most worrying trend. These higher numbers will be influenced by reduced stigma which is a good thing, but rising economic insecurity, inequality and NHS waiting lists will have contributed.
A recent book, ‘The Anxious Generation’, by Jonathon Haidt suggests a very direct and causal link between Gen Z’s social media use and the huge rise in mental health problems that Sir Charlie’s report charts. Subtitled “The Great Rewiring of Childhood”, it outlines four foundational harms – social deprivation, sleep deprivation, attention fragmentation and addiction. It argues that social media can be a harmful, addictive substance, and points to comparisons with the tobacco industry, where it took many years for the harms to be recognised and reigned in. The book also includes a variety of actions we can take.
“There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” It’s a quotation attributed to Desmond Tutu, but it’s an idea that can be applied to mental health specifically and workplace health more broadly. We should welcome the fact that the Mayfield report is asking some of those important questions.