If you’re fretting, chafing, sighing, grieving, complaining, finding faults, repining, grudging, weeping, vexing, disquieted in mind, with restless, unquiet thoughts, then you’ve probably been eating cabbage, which as you should know by now, sends black vapours up into the brain, provoking melancholy. It’s not the only cause, of course, and you should also avoid sorrow, fear, shame, disgrace and any other emotion as well as too much exercise, too much study, poverty, scoffs, pleasures immoderate and werewolves.
You’ll find all this and more in the hundreds of pages of Robert Burton’s 1621 masterpiece Anatomy of Melancholy, where he describes the causes and symptoms of psychiatric disorders and discusses possible cures, ranging from herbal teas to drilling holes in the head. What he doesn’t mention is work, except to say that hardworking servants have no time for such ladylike maladies.
That’s where the OECD steps in. Sick on the Job? Myths and Realities about Mental Health at Work says that on average, one in five workers in OECD countries suffers from a mental illness, such as depression or anxiety. From a third to a half of all new disability benefit claims are for mental health reasons, and that figure rises to 70% for young adults. The report highlights the “considerable lack of awareness, non-disclosure and under-treatment among adolescents and young adults, with the gap before the first treatment of a mental illness on average being about 12 years”.
As a result, many young people struggle to get through school, and once they leave they are unfit for work and go straight onto disability benefit. The human cost is appalling, and the economic cost is considerable too – around 3% to 4% of the EU’s GDP according to the International Labour Organisation.
As the subtitle implies, Sick on the Job tackles some of the myths about mental ill-health, and notably the idea that prevalence is increasing. It’s not, but there is much more public awareness of mental disorders, less stigma, and better assessment tools. Unfortunately, at the same time, that’s also meant that more people suffering from mental disorders have been excluded from work, perhaps because many jobs now require social skills or cognitive competencies that workers with mental health problems don’t have.
The problem could get worse though, as working conditions grow harsher and job insecurity grows. The share of workers exposed to work-related stress, or job strain, has increased in the past decade all across the OECD. And in the current economic climate, more and more people are worried about their job security (a rising fear among the employed according to this poll).
What can be done to improve the well-being of people suffering from mental disorders? The OECD report argues for a “three-fold policy shift will be required thereby giving more attention to common mental disorders and also sub-threshold conditions; disorders concerning the employed as well as the unemployed; and preventing instead of reacting to problems””
How about Burton? Apart from cutting down on the cabbage, what did he have to propose? In OECD jargon, we’d say a holistic approach to increasing overall well-being accompanied by timely, targeted interventions aimed at the most vulnerable.
But let’s hear him argue for a welfare state, pensions, social security and justice in his own, magnificent, words: “If they be impotent, lame, blind, and single, they shall be sufficiently maintained in several hospitals, built for that purpose; if married and infirm, past work, or by inevitable loss, or some such like misfortune cast behind, by distribution of corn, house-rent free, annual pensions or money, they shall be relieved, and highly rewarded for their good service they have formerly done; if able, they shall be enforced to work. For I see no reason why an epicure or idle drone, a rich glutton, a usurer… should live at ease, and do nothing, when a poor labourer… that hath spent his time in continual labour…, and without whom we cannot live, shall be left in his old age to beg or starve, and lead a miserable life worse than a jument.”
Cheers you up, doesn’t it?