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Increasingly, and some would argue not before time, mental health is becoming an agenda item for employers. The OECD reports that the UK loses 15 million working days per year due to depression, anxiety and stress. Quite apart from this measurable cost, we suggest that lost productivity, poor retention and the effects of bullying brought about by anxiety and depression are almost immeasurable. Professor Sir Cary Cooper cites the stigma around mental health and also argues that it costs employers dear.

50 years ago employers were not that concerned about accidents at work. Often the responsibility was put on the employee and those who knew about an unsafe practice, but allowed it, generally escaped any sanction. That changed in 1974 with the Health and Safety at Work Act; mere knowledge of an unsafe practice made one culpable.

Health was included in that agenda and the 1974 Act was followed in 1988 by legislation to cover exposure to hazardous substances, among others, and by European regulations covering the management of health and safety. Employers  had to create clear lines of responsibility for health and safety issues and safe working methods.

But responsibility for, and the need to act on, mental health has largely escaped employers.

The current profile of mental health is changing as the impact is increasingly recognised and the stigma is reducing, albeit marginally.

What can employers do?

The first point, in my view, is to recognise that there are illnesses which while not as obvious as a broken arm can be as debilitating and from which, as in a broken arm, an individual can recover.

Clinical depression is covered under the Equality Act 2010 and employers need to make reasonable adjustments for those suffering from it.

Psychotic mental illnesses such as schizophrenia are also covered.

In evaluating reasonableness, one measure is to assess whether the cost of the adjustments is less than the cost of recruiting and training a replacement. If the latter is greater then the adjustment is patently reasonable. If not, then there may still be other factors to take into account.

In other instances occupational health advice can be sought. Mild to moderate depression can usually be treated effectively with modern techniques such as cognitive behavioural therapy. Other approaches also have credence such as meditation, hypnosis or mindfulness.

Employers can encourage employees to seek help via their GP although use of occupational health may give the employer more control. For example, they will know whether the employee has visited OH.

Employees who take active measures to tackle problems that might otherwise be out of their control should be recognised for doing so. As with those who might refuse treatment for a broken arm, I suggest it is reasonable for employers  to be less sympathetic towards those who are not willing to take some responsibility.