Louise Chunn is the Founder of find-a-therapist platform welldoing.org. She is a former Editor of Psychologies magazine.

Unemployment is known to be bad for mental health – but so is some work.

We are in the middle of an unprecedented revolution in our working lives. Within the next 20 years nearly half of current jobs in the US are at risk of being automated, according to the Oxford Martin School’s commonly cited prediction.1www.oxfordmartin.ox.ac.uk/downloads/academic/future-of-employment.pdf London will be as affected as anywhere by the global moves towards automation.

But working is what most of us want to do. Work not only gives us an income, but also a purpose. Unemployment increases the likelihood of depression and anxiety by up to a factor of 10 within 12 weeks, according the Royal College of Psychiatrists. In the Rust Belt states of the US, high rates of unemployment, economic decline and social stagnation have led to sharply rising death rates from drugs, alcohol and suicide – and we have become increasingly aware in recent months of the social and political ramifications of all this distress.2www.washingtonpost.com/news/to-your-health/wp/2016/12/30/an-addiction-crisis-along-the-backbone-of-america/?utm_term=.0e21bcf02885

If not working is bad for us, so, all too often, is working – despite the fact that, for most people, work is less onerous than in the past, better supported by technology and communications, and protected by more robust employment laws. Many people cite work as the cause of (or trigger) for their mental health problems, whether they are referring to the relentless out-of-hours drive for productivity, or the insecurity of gig economy jobs and zero-hours contracts.

This apparent paradox – that not working is bad for you but working doesn’t seem to be terribly good either – is explicable when we think about the future. The prospects for those who are out of work and those in work aren’t so very different: work is being destabilised and few industries will be unaffected. It is difficult to envisage how people of all kinds will occupy their time in the future or find meaning, drive and passion.

Meanwhile, depression and anxiety rates are reportedly going up3www.huffingtonpost.co.uk/entry/depression-and-anxiety-levels-are-on-the-rise-inuk_uk_57e4e292e4b0e81629a97a2f and the London suicide rate has increased by a third in the past two years.4www.london.gov.uk/press-releases/assembly/londons-suicide-spike-2-a-day Aside from the general precariousness, the proximate causes often include loneliness. In a city of 8.6 million, fewer and fewer people have the time or support structures to stay in close contact with family, friends, former colleagues or school friends. Many Londoners are not just new to the city, but to Britain. The weakness of traditional support structures can clash with the pressure to make a living. The risk of schizophrenia is doubled for those who live in cities,5www.gwern.net/docs/nature/2010-peen.pdf and urban living also raises the risk of anxiety disorders (21 per cent) and mood disorders (39 per cent).

Entrepreneurialism is often lauded as the future, particularly for young people. But millennials with Mark Zuckerberg-shaped dreams can suffer badly when beset with insecurities or failure. I recently organised a debate at Google’s Campus London at which Moshi Monsters’ creator Michael Acton- Smith described his own psychological stress, noting that the most active thread on the support network for entrepreneurs, Foundr Club, was related to mental health.

Stress and mental illness affect productivity. According to the Institute of Directors’ Andy Silvester: “127 million hours of work were lost in 2015 due to mental health-related absence – the equivalent of around 75,000 individuals losing the entire year. The number of days taken off work with mental health problems has increased 25 per cent year-on-year, and stress, depression and anxiety together rank as the largest reason for absence in the workplace.”6www.iod.com/Portals/0/PDFs/Campaigns%20and%20Reports/Mental%20Health/a%20little% 20more%20conversation.pdf?ver=2017-03-01-101940-680

But you don’t actually have to be signed off for mental ill-health for it to be affecting your work. More than six in 10 of the UK’s working population say that they have had stress-induced sleep problems to the extent that it has affected their work the next day, according to the Mental Health Foundation. The OECD estimates that our failure to cope adequately with mental health issues costs the UK some 4.5 per cent of its GDP.

Despite the significant percentages, mental health at work remains under-discussed and is often stigmatised as weakness. There is disagreement over whether mental ill-health should be declared to employers, with mental health campaigner Ruby Wax firmly against, and most mental health charities, including the Duke and Duchess of Cambridge’s Heads Together, of the opposite opinion. A recent survey by AXA/PPA healthcare showed that 38 per cent of those who had been frank about their condition felt they were treated worse by colleagues than someone with a physical illness.

Minds at Work is a movement launched last year to change that response. Geoff McDonald was a global VP working in HR at Unilever when he was diagnosed with anxiety-fuelled depression. Just as he was recovering, a close friend – a London-based banker – killed himself. This gave McDonald, and two co-founders interested in mental health and wellbeing, the impetus to start knocking at the doors of businesses all over London: “I now have a very simple purpose: I want people in organisations – whether they be big business, the NHS, the police, the army or anywhere else – to feel that they have the choice to put their hand up if they are suffering from anxiety or depression, just as they would if they were suffering from a physical illness.”

At a Minds at Work event at the end of 2016, a 100-strong crowd listened as senior business people – from banking, law and advertising – talked about their own experience of mental illness. There are pockets of exemplary corporate response: Sara Cremer, CEO of content marketing company Redwood, described how her boss, Cilla Snowball, told her to take time off and promised not to treat her any differently when she returned. Cremer has since told her 150 staff about her depression.7welldoing.org/article/business-leaders-speak-mental-health

What can be done to maintain the delicate balance that allows work to be productive but not punishing, to make people feel absorbed and purposeful rather than wrung out and abused? The New Economics Foundation’s Wellbeing at Work report outlines the steps employers should take towards a healthier work environment, starting by avoiding a culture of overwork, employing sufficient staff for the tasks, and aiming for a life-work balance. Hours and pay need to be transparent and fair; job insecurity should be minimised and zero-hour contracts avoided.

In France, the national government has stepped in to grant employees the legal “right to disconnect”, avoiding work emails outside working hours. French companies with more than 50 workers must now draw up a charter of good conduct, setting out the hours when staff should not send or answer emails.

Workers’ rights would once have been the province of trade unions. But union membership has halved since its high of 13 million in 1979 and, for many people, there is no one employer, one boss, one set of rules, but a mosaic of freelance projects. That pushes the responsibility back to individuals, and makes it more difficult to resist the pressure to work harder when their mental health is compromised.

According to a report from the London Assembly Health Group, every week on average 14 Londoners choose to end their own lives. The London Assembly Health Committee has called upon the Mayor of London to provide better support for suicide prevention in the capital, including the idea of London’s becoming the UK’s first “zero-suicide”city.8www.actionallianceforsuicideprevention.org/sites/actionallianceforsuicideprevention.org/files/zero_suicide_final6.pdf

We are only just beginning to discuss the mental health implications of the post-work world, but they should be as much at the forefront of our thinking as the economic ones, with Londoners’ future purpose considered alongside our prospects for Universal Basic Income. In the meantime, many large businesses are hiring in-house psychologists or finding therapists for employees when they need them; SMEs, however, sometimes struggle to justify such activity as legitimate business expense. The Institute of Directors’ policy report A Little More Conversation argues for the appointment of a non-executive director to ensure openness, properly thought-out mental health policies inside organisations, and pressure on government to publicise existing schemes to the business world.

London really ought to be able to provide good working conditions for all its inhabitants. On the whole, people want to be treated fairly, work decent hours and be paid reasonably well for their efforts. The changing structure of employment complicates matters, to be sure: we are living through a time of alarming change. But it should not be beyond our wit to respond to the mental health problems that this uncertainty engenders. We have to begin with a culture of openness and responsiveness. This will be easier if we acknowledge that the economy and working conditions are implicated and that mental health is not simply a private, individualised problem.

Notes   [ + ]

1. www.oxfordmartin.ox.ac.uk/downloads/academic/future-of-employment.pdf
2. www.washingtonpost.com/news/to-your-health/wp/2016/12/30/an-addiction-crisis-along-the-backbone-of-america/?utm_term=.0e21bcf02885
3. www.huffingtonpost.co.uk/entry/depression-and-anxiety-levels-are-on-the-rise-inuk_uk_57e4e292e4b0e81629a97a2f
4. www.london.gov.uk/press-releases/assembly/londons-suicide-spike-2-a-day
5. www.gwern.net/docs/nature/2010-peen.pdf
6. www.iod.com/Portals/0/PDFs/Campaigns%20and%20Reports/Mental%20Health/a%20little% 20more%20conversation.pdf?ver=2017-03-01-101940-680
7. welldoing.org/article/business-leaders-speak-mental-health
8. www.actionallianceforsuicideprevention.org/sites/actionallianceforsuicideprevention.org/files/zero_suicide_final6.pdf