Although 30 million people in Europe and 350 million people worldwide struggle with depression, many workplaces underestimate its impact – write Dr Sara Evans-Lacko and Professor Martin Knapp

In our recently published study Importance of social and cultural factors for attitudes, disclosure and time off work for depression, we emphasise the important roles that managers and organisations play in supporting employees with depression. Working environments that promote social acceptance may mitigate the adverse impact and risk of depression in the workplace. Both manager reactions and organisational factors may be associated with how people with depression are perceived and treated in the workplace, and hence also associated with openness and disclosure among employees with depression.

To look at these issues, we analysed data from more than 7,000 employees and managers recruited from seven European countries: the United Kingdom, France, Italy, Spain, Germany, Turkey and Denmark. We wanted to get a better understanding of the social impact of depression in the workplace and the roles of managers and employers in facilitating a positive work environment and access to appropriate and effective treatment.
We found that 20 per cent of employed people report having a previous diagnosis of depression. Among employees with a diagnosis of depression, 20-55 per cent reported that they take time off work due to the illness. University-educated professionals are less likely to take time off work when depressed and, if they do, are reluctant to tell their employer the reason why.

There were some differences between countries. For example: Italians are less likely to reveal a prior diagnosis of depression compared to people in the UK and Turkey; managers in Denmark are more sympathetic towards depressed employees and less likely to discriminate against them than their counterparts in the other six European countries participating in the study; managers in France and Spain are the most likely to recommend that the employee seeks help from a healthcare professional for their depression.

We then looked at what manager and workplace factors might be most helpful for people with depression. Being offered flexible working hours and time can be helpful but this is not necessarily the best strategy, especially in isolation, because it does not promote social inclusion – which is what a depressed person usually needs. A better option to tackle mental illness in the workplace is for managers to offer direct help to depressed employees. Managers who avoid discussing an employee’s depression are only adding to the general ignorance of mental illness and not helping either the company or the staff member.

Other research has emphasised the importance of positive attitudes in relation to social acceptance of people with mental illness as a key factor driving stigma and discrimination and has shown a direct link between attitudes and the experiences of people with mental illness. Anti-stigma campaigns such as Time to Change have made important steps in addressing stigmatising attitudes, yet stigma is still a major barrier in the area of employment and many employers are not dealing with it adequately.

Addressing stigma and social exclusion of individuals with mental illness may be even more important during times of economic crisis. Attitudes about people with mental illness may harden during times of economic crisis, further deepening social exclusion. The economic recession has had enormous impact across much of Europe and other research that we undertook shows how the gap in unemployment rates between individuals with and without mental illness widened during the recession. It also showed that the disadvantage facing people with mental health problems is greater in countries with higher levels of stigmatising attitudes towards mental illness.

Although there are some examples of good practice, absenteeism and early retirement as a result of mental illness, especially depression, seem to be increasing across Europe. Manager responses, which focus on offering help to the employee with depression can help to develop positive perceptions in the workplace and also encourage openness and disclosure of employees with depression. By doing so, employees will feel more comfortable in discussing any potential mental health issues early on. Our findings suggest that some responses, such as flexible working hours, may be helpful but are not necessarily adequate and also emphasise the importance of support – and openness – of managers in addition to flexible working hours.

Depression is the leading cause of disability worldwide. Although 30 million people in Europe and 350 million people worldwide struggle with depression, many workplaces underestimate its impact. Given the high prevalence and the significant economic consequences associated with depression, employers and managers need to take a proactive approach to supporting employees with depression.

Dr Sara Evans-Lacko is a lecturer at King’s College London and Professor Martin Knapp works out of the London School of Economics and Political Science