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The rise of the stress industry

We see constant reminders in both national and HR press that work-related stress is on the up, having outstripped musculoskeletal disorders as the single biggest reason for long-term sickness absence.

People are increasingly being put under intolerable levels of pressure at work through the imposition of unmanageable workloads and the lack of supportive and empowering management.

Working in social care, I would be the first to say that many staff are driven beyond reasonable limits in what is expected of them. Cuts in public expenditure mean that people working with increasingly chaotic and difficult client groups have to cope with fewer colleagues on the ground to share the burden with, while accepting longer hours and cuts in pay.

Elsewhere, I see plenty of evidence of people being forced to work very long hours in order to get a job done as companies strive to boost profits, or deliver on contracts won at low bidding prices, by cutting staffing costs.

It is beyond doubt that some people are genuinely pushed beyond endurance, particularly where poor working conditions are compounded by an aggressive and bullying manager or colleague, and they become seriously ill as a consequence. So for all too many people, stress-related illness arising from extreme pressures suffered at work is a reality.

However, what I worry about is the casual way that the word 'stress' is bandied about these days. It is too often used as a way of enabling people to opt out of facing up to situations that may well be unpleasant for them, but by any rational analysis fall far short of constituting a plausible cause of severe mental illness.

I was very struck by a letter to The Times by Dr Rich Braithwaite, consultant psychiatrist at St Mary's Hospital in Newport. His view is that, "Anxiety and depression, known to most of us as worry and sadness, are normal human emotions. Some people experience these emotions more intensely or frequently than others, but this does not make them mentally ill." He goes on to say, "Mental illness has become massively over-diagnosed in recent decades, partly due to Big Pharma's tendency to play on doctors' natural instincts to help people in distress. True depressive illness is far less common than cancer and…affects perhaps 1% of the population."

Anybody providing employee relations advice services will know that it is an everyday occurrence for organisations of any size to have one or more staff at any given time signed off with what is described on certificates as "work-related stress". This is shown in the survey figures for the seemingly inexorable growth of this as a reason for absence. They will also advise organisations who are planning to confront an employee about their conduct or performance to factor in the likelihood that they will immediately receive a 'Fit Note' indicating that the employee is not fit for any work at all for the duration. I increasingly see employees being signed off with "stress" because things haven't gone as they would like in a workplace situation and they perceive it as unfair, even if it isn't really by any reasonable standard.

The real tragedy of the ease with which doctors sign people off lies not in the costs to organisations. Of course these are high, particularly in the public sector, where employees are particularly susceptible to stress caused by perceived unfairness. Neither does it lie in the impact on services to customers or on colleagues who have to cover additional workloads, thus adding to their own potential for putting up with levels of pressure that become genuinely harmful in some cases.

The tragedy lies in the effects on the "stressed" employee. I've seen people who have been signed off for weeks on end by a GP who has colluded with them in avoiding facing up to a particular work issue, and the more they have internalised the diagnosis, the more it has entrenched as a reality. By the end of three or six months of it, they have rendered themselves unemployable either in their current job or, for the short to medium term, any other job.

The problem has been compounded by people and institutions who have a vested interest in the spread of the concept and discourse of work-related stress. After all, the sale of various measures to help organisations prevent and manage stress within their workforces has become a sizeable industry.

Rather than putting two and two together and making five from the statistics on the never-ending rise of work-related stress, government officials and journalists alike need to start interrogating the data to find out what really lies behind the sick notes. And GPs need to wake up to the fact that they do no favours by signing people off rather than challenging them when they present with apparent trauma caused by events which are a normal part of working life.

Helen Giles (pictured) is HR director of Broadway Homelessness and Support and managing director of Broadway's Real People HR consultancy.