Last reviewed 1 February 2021

After almost a year of localised and national restrictions, Vicky Powell looks at workers' mental health and how the pandemic has affected levels of depression, anxiety, stress and morale within the workforce, often in complex ways.

Levels of depression and anxiety in workers

Just before the Covid-19 crisis, for the year up to March 2020, the Health and Safety Executive (HSE) estimated that 828,000 workers in Britain were suffering from work-related stress, depression or anxiety.

However, such was the impact of the national and global crisis of Covid-19 that by June 2020, the Office for National Statistics (ONS) reported that almost double that number — one in five adults — were likely to be experiencing some form of depression.

Similarly, just a couple of months into the lockdown, in May 2020, the ONS also found that the number of people reporting high levels of anxiety had “sharply” increased.

A statistician from ONS noted that even the generally psychologically protective factor of having a partner or spouse did not seem to help as much as usual.

The source noted, “One particularly striking finding is that 39% of people who are married or in a civil partnership reported high levels of anxiety. This compares with 19% pre-pandemic. It may in part be because of the challenges of home-schooling alongside work and other responsibilities”.

Overall, more than a third of adults in Britain said that the coronavirus pandemic had negatively affected their wellbeing.

The ONS said, “We saw a deterioration in all measures of personal wellbeing: life satisfaction, feelings that things done in life are worthwhile, happiness and anxiety”.

The link between physical health and mental wellbeing

Mental and physical health are of course inextricably entwined and a recent freedom of information request reported by various newspapers showed that there are more than 15 million patients waiting for vital treatment on a confidential NHS list, a figure nearly four times higher than the official figure of 3.9 million for new referrals.

After the first lockdown Professor Neil Mortensen, the President of the Royal College of Surgeons of England, urged that the health service “must never again be a coronavirus-only service”, following concerns that tens of thousands patients had failed to access proper care for conditions such as cancers and other life-threatening conditions.

Grief is certainly a powerful factor in mental and physical health and in 2020 far too many workers experienced bereavements, including as a result of the virus itself (many workers lost relatives in care homes), lack of access to health services or suicides. Some people were too afraid of the virus to attend A&E, others had cancelled health appointments and operations, while others had a deep desire to protect the NHS by not overloading it.

Underlying sources of workforce depression and anxiety

While some employees have been fortunate enough to continue to receive their full pay throughout the lockdowns, many have lost their jobs or face extreme job insecurity given that small businesses, larger companies and even entire sectors, such as the tourism, construction, events and food/catering industries, have experienced major financial impacts during the crisis.

At the end of December 2020, for the first time in its more than 70-year history, the UN agency Unicef launched a programme to feed children in the UK. A YouGov poll in May 2020 commissioned by the charity Food Foundation found 2.4 million children (17%) were living in food insecure households. By October, an extra 900,000 children had been registered for free school meals.

According to the HSE Stress Management Standards, there are six key areas of work design that, if not properly managed, are associated with work-related stress and poor mental health.

  1. Demands on workers such as workloads and the work environment.

  2. Control, or the autonomy workers are allowed in their work (and life).

  3. The support workers have from their organisation, line management and colleagues.

  4. The quality of relationships at work.

  5. The clarity of an employee's role and whether the employer ensures that they do not have conflicting roles.

  6. How change is managed and communicated for the worker.

Just glancing at the above shows how a perfect storm of mental ill health has been created for workers in the UK.

The impact of financial pressures, home-schooling and working at the same time, while simultaneously being isolated from the support of colleagues, extended family and friends, has taken its toll.

For introverted personalities, working from home may be enjoyable. However, more extroverted people, who are said to be in the majority, and perhaps especially younger workers starting out in their careers and needing more support, will be finding the isolation of homeworking very difficult.

Equally, some workers who now have to wear face masks all day, eg in shops and restaurants, may feel claustrophobic, frustrated and strangely isolated, with normal human contact limited even while they are in close proximity to their colleagues and customers.

The mental health charity Mind recently noted that more than two-thirds of young people (68%) and more than half of adults (60%) have said their mental health has become worse during lockdown.

Similarly, recent research on the coronavirus and employee mental health published by the Chartered Institute of Personnel and Development (CIPD) said, “The pandemic (and measures taken by government to control it such as lockdown and social distancing) will have a significant impact upon the mental health of employees. It is very possible that these mental health implications will be felt for many months or even years”.

In addition to the lack of work-life balance and reports of reduced motivation, loss of purpose and motivation, the CIPD report also highlighted employee fears of the dangers of contracting the virus.

Writing in The Lancet (Psychiatry), Professor Ellen Townsend has warned about the potential psychological harm of sensationalist scenarios about the virus. She said, “Frightening graphs depicting scenarios rather than predictions have been used to terrify people about the resurgence of the virus”.

The constantly changing rules, regulations and advice about lockdowns and the various tiers have put employers and employees under immense pressure.

Hence, in these confusing times, it is wise for employers and employees to be mindful of the cornerstone of British health and safety law, the Health and Safety, etc Act 1974, which strongly emphasises that employers should do what is “reasonably practicable” to ensure the health, safety and wellbeing of their employees and others.

Indeed, the HSE reminds employers that government guidance such as a leaflet may not necessarily have the same standing as statutory law.

Hope for better mental (and physical) worker health in 2021

After a series of localised quarantines and national lockdowns that have lasted for much of 2020, morale and national consensus around Covid-19 and lockdowns seem to be at an all-time low, with frequent protests in London and elsewhere around the country.

The Health Minister, Matt Hancock, recently stated on camera that he expected the January 2021 lockdown would be the final one, based on availability of vaccine.

However, pinning all hope on a successful roll-out of the vaccine may not reassure struggling business owners forced to close once again, nor the unemployed, nor worried parents who are faced with working from home while again trying to home-school their children and protect their educational prospects.

Indeed, if social media is any indication, it seems a great deal of anxiety remains around the vaccine itself. Some workers are proving unwilling to be among the first to have the Covid-19 jab, if at all.

In addition, at least one major law firm, Morgan Lewis, has already advised that the UK Government has no legal power to compel vaccinations and nor do employers have any statutory right to insist their employees be vaccinated for health and safety reasons.

Nevertheless, there are good reasons for workers and employers to remain optimistic about better mental and physical health in 2021.

A word about achieving workforce immunity and health

When at least 70% of the population reaches immunity, doctors speak of “herd immunity”, which assumes that community transmission is reduced to a minimum.

It is well known that immunity can be natural or artificial. The latter — artificial immunity — is achieved by means of vaccines. Natural immunity is obtained by becoming infected by the virus but this approach is of course also risky, if the disease in question is potentially lethal.

Although very infectious, Covid-19 has a relatively low fatality rate of around 0.5% (although the new variant is believed to have a higher fatality rate), so kills 50 people in every 10,000. Clearly this is not as high as, say, smallpox, which has a fatality rate of 30% (so would kill 3000 people for every 10,000 who caught it).

The question is how to quickly protect the relatively small percentage of people who are the most vulnerable — those 50 in every 10,000 infected who are at risk of dying from Covid-19. These people will largely be elderly or but could include younger working people with co-morbidities such as chronic lung conditions, obesity, diabetes or heart problems.

Another important group to consider is frontline workers such as doctors, nurses and care home workers who have contact with people who are ill with Covid-19.

Some people in these at-risk groups of workers will be comfortable with taking the new vaccine but others will not, as is their right, and this perhaps is where a third, medication-based option, in addition to natural immunity or vaccine-induced immunity, may be attractive to some workers.

On this subject of medication, new research published in the journal Clinical Immunology & Research suggests that the anti-parasitic medicine Ivermectin can be prescribed by doctors to dramatically reduce mortality. Researchers argue that people would largely not need to be admitted to hospital but could be treated as out-patients at home and that immunity could be achieved in this way.

Other research on the drug Ivermectin has indicated that it not only reduces deaths from Covid-19 but could be used in a preventive or prophylactic way to protect doctors and nurses, as well as others who have had contact with ill people, from getting the virus.

Covid-19 and anxiety about the future

Perhaps the most pernicious aspect of the pandemic has been the creeping anxiety about exactly what the future holds.

Here employers can help to alleviate workers' concerns by sharing information about mental and physical wellbeing, exercise, healthy eating and vitamin intakes, and the latest information on vaccine and medicine-based solutions for Covid-19 for workers to discuss, based on their individual circumstances, with their GPs or, in larger organisations, the company doctor.

Individual concerns may centre around worries about becoming dangerously ill from the virus due to a co-morbidity such as diabetes and employees may wish to ask their GP or the company doctor about suitable medications for them should they become mildly or seriously ill from Covid-19.

Alternatively, workers' concerns may be centred around their suitability for the vaccine due to allergies, being unwell (eg with a fever), immunity issues, bleeding or bruising problems, pregnancy or worries around the vaccine itself, for example.

Conclusion

Mind's Chief Executive, Paul Farmer, has warned that the pandemic and its associated economic downturn will leave a “deep and lasting scar on our nation's mental health — given factors such as debt, unemployment, housing, and job security are connected with our mental health”.

To help combat this, employers should support their workers' mental and physical health by involving the widest range of players — workers themselves, their representatives, health professionals, business groups and local MPs and councillors — in the process of information-sharing on Covid-19 and work-related health.