The £45 Billion Challenge and Opportunity


Recently published analysis from Deloitte UK found that poor mental health costs UK businesses up to £45 billion each year – a rise of 16% since 2016. I see mental health as one of the big challenges of our lifetime along with climate change, habitat destruction and overconsumption.

Or perhaps we should look at this differently. Perhaps we should be looking at mental health as an opportunity, not a challenge and asking ourselves how we can capitalise on this £45 billion opportunity. And what is the role of the board and the executive committee in really pushing the mental health agenda forwards?

To explore these questions, I recently partnered with Savannah Group for an event hosted at KPMG to bring a room of senior executives together. Our aim was to educate and highlight the opportunities that addressing mental health in the workplace can bring. This is an outline of the key insights from the event.

Why should we make mental health a priority?

The recent report by Deloitte on the case for investment in mental health found that for every £1 spent by employers on mental health interventions, they get £5 back in reduced absence, presenteeism and staff turnover.

Additionally, when people were asked what the biggest drivers were for negative mental health, 39% said that their work contributed to their mental ill-health. As Amanda Mackenzie OBE, CEO of Business in the Community (BITC) explained: “If you assume mental health is on par with physical health and you had a physical issue at that scale the world would grind to a holt.”

Prioritising mental health should not only be a leadership priority but a moral imperative.

A leadership role is nothing more than creating an environment where people can be their best. John Flint, former Group CEO of HSBC described it as an imperative for leaders not only because it’s the right thing to do, but to safeguard against the inevitable workforce changes through technology.

He explained: “Think about how the workforce is evolving. Soon all the simple jobs will be automated which means fewer human beings but more critical roles. If that’s the case, then you better make sure that those human beings making those critical decisions are at their best.”

While mental wellness can be outsourced to the HR function, that will only get you so far. For a company’s culture and attitude towards mental wellness to radically improve, all leaders should be active.

Andy Brown of Anglian Water explained: In a lot of ways, employees should be on the balance sheet in the same way as cash: “Water businesses are long-term infrastructure business, so if you have a plan to maintain your pipes and production facilities that you have to look after, why wouldn’t you do exactly the same thing for your people?”

For Anglian Water, the moment of truth came when they saw their medical costs soaring by 10% each year.

The easiest would have been to reduce the medical package and benefits, but instead the board decided they would look at how they can improve the business. Andy explained “Being an infrastructure business, it comes as a surprise to a lot of people when we say that the most important asset in our business are our people. But if you start to address wellbeing then you get paid back many, many times from that asset.”

Join our growing network of employers
Receive Make A Difference News straight to your inbox

And the payback is quite quick. In the last five years the dialogue has changed to focusing on getting the best out of people. Proactively keeping them engaged and healthy is a much better idea than letting them get to a stage where damage recovery is needed.

Why are we not doing more?

A stigma still exists and for many businesses; it’s about coming out and saying it’s ok to not be ok. As Sir Ian Cheshire said: “The question leaders need to ask themselves is how is your business contributing to this problem?”

Unfortunately, in many businesses there is still a lack of confidence about raising the topic of mental health and discussing it.

A staggering statistic is that only 13% of employees who experienced poor mental health as a result of work raised this with their line manager. Ironically businesses are the last to react. We’ve had sports stars and TV personalities come out and speak openly about their mental health challenges, but persuading business leaders to be open has proven much more difficult.

Part of this is an exposure problem, with business leaders worried about negative repercussions if they do speak up. It’s much easier to talk about a physical ailment so it takes more confidence to come forward. The encouragement and support networks need to be there for people to be more proactive.

From a regulatory point of view all of the panel agreed that taxing company-provided mental health support as a benefit in kind is an antiquated idea and more lobbying is needed for the government to address this. The tax rules about in-house mental health provision are around 15 years old and the Working Well Coalition want them updated. They are asking the government to simplify the tax rules and not penalise people who ask for help. They believe that if these tax changes were made it would incentivise other great organisations to do a lot more.

Unfortunately, there is still a stigma that a person will be penalised for opening up about a mental health issue. In fact, as John Flint said, people who have been through a mental health issue have had to be incredibly resourceful in order to get through the challenges they have faced. They have a different perspective to people who have never experienced mental ill health and therefore they are a true asset to any business. It’s incredibly short-sighted to penalise someone purely on that basis.

How do you get buy in?

Contrary to many preconceptions, it doesn’t take much energy to persuade the board, and all of our panellists found it straightforward to encourage their board that it was the right thing to do. With HSBC, John Flint’s vision was to create the healthiest human system in Financial Services. Once that vision was established, a strategy was then developed to make it happen with every person in HSBC. John warned however: “It’s not about pushing this back up to the board. While you need the initial nod from them, they are too far removed to drive it. This is an executive challenge, so they need to own it.”

Starting a movement

The question for any business is how to get the best out of your total collective leadership. For starters, you need to ensure people are comfortable bringing their whole self to work and that you’re not mistreating them, burning them out, or unduly stressing them through progression reviews and performance reviews.

Amanda Lambert, People Director at Three explained that to kick off their mental health initiative, the leadership team shared a story each day about their mental health. They ran the initiative for a week with two board members coming forward and openly talking about their mental health issues.

The plan was to only run it for a week, but after these stories came out Three continued it for another week as others in the organisation had been inspired and wanted to come forward to share their story too. Still today, Amanda bumps into new faces in the lift and they recognise her from her mental health story. They tell her about how it touched them or an anecdote about someone they know struggling with similar issues.

John Lewis & Partners have also been pioneers for improving employee mental health. Tracey Killen, Director of Personnel explained that they started by asking and encouraging people to be open about their mental health. For John Lewis & Partners there’s also a strong business case.

The great battleground for recruiting brilliant people and letting them do their best work is creating an environment where they can be their best selves. As a company, John Lewis Partnership focused on sharing stories about what happened to an individual but also what they did to help address it. By ensuring there is practical guidance within the story, it helps people to see what changes they could make and take control.

Starting a movement in your organisation is key and John Lewis & Partners learnt that for 2/3rds of the people coming forwards, they were already struggling with an issue outside of work. Because of the support they’ve put in place, just 4% now stay out of work.

Mental health initiatives that don’t cost the earth

Tracey Killen from John Lewis explains that they took a three-pronged approach once they had the data and knew they needed to do something about it.

  • Firstly, they kicked off an initiative called ‘really good work’ which asked the question ‘are we designing work well?’ They then looked further at how they construct work and the components.
  • Secondly, they identified they needed more opportunities for growth. “People felt that they weren’t getting better every day or contributing more so we looked at how we can make those positions more powerful.”
  • Thirdly, they started a movement by giving 170 branches a small pot of money and encouragement to make their environment better.

John Lewis & Partners have a health team who helps support these branches along with their app, Unmind, which is used by 8,000 people. The aim is to provide opportunity for social connection, outside of their routine.

How do you implement mental health initiatives in businesses of scale?

The Stevenson Farmer report sends a clear signal that the government is behind mental health. The next step is to be pragmatic about where in the workplace this needs to be addressed.

John Flint explained that: “In the same way you do a physical risk assessment and say, we need to do the same for mental health. The initiative has to be owned by the executive and preferably the chief exec. Most big human systems become hierarchical over time. Getting good employee insight, finding out the stuff that you probably really don’t want to know and then being transparent with the staff afterwards is what’s needed.”

However, if you don’t have data it becomes difficult to do anything productive. It must be authentic however otherwise it will bounce off the organisation and fail. As Sir Ian Cheshire said: “People can spot a lack of authenticity a mile off”.

Once you get started, you have to be very aware of the framework from head office. You have to be careful that an Anglo-Saxon view of the world doesn’t cascade down into an Asian company.

Sir Ian Cheshire agreed explaining that different countries will be enthusiastic, but they’ll want to do it in their own way. Grassroots shouldn’t be too much of a problem; it’s getting it through the permafrost middle which is the tricky part, so leaders need to find the anecdotes and methods to get through.

How do you measure success?

Anglian used a ROI calculator for wellbeing and it surfaced an 8 to 1 benefit, but they quickly realised that it’s not about chasing the numbers. They still measure stats, but they don’t allow them to drive the change in behaviour. Instead they track how quickly they get someone into referral and the severity of symptoms etc.

Three on the other hand purposely don’t want to measure with an ROI so they measure on engagement with frequent surveys. They use an internal NPS score and are only interested in whether it is trending in the right direction.

What next?

The business case is compelling, so the challenge is how do you make a difference. When people are at their most vulnerable, the people they most often turn to is their partners, so it’s important that there is support for them too. With different generations at work it does make running initiatives a bit more complicated but re-emphasises that not one size will fit all. Businesses need to find the types of initiatives that work for them, and with an increasing number of people in the future facing these issues, we need to give middle managers the confidence and support to be able to direct people to the help they need rather than making them psychologists.

My call to action:

Let’s ask people how they are today. Let’s engage our CEOs. Let’s share our own stories about mental health. Let’s smash the stigma and support and encourage others who want to do the same. Let’s not be afraid of getting things wrong. Let’s start a movement.

About the Author:

Rob Stephenson is a campaigner and public speaker regarding breaking the stigma of mental ill-health in the workplace. He was diagnosed with bipolar disorder in 2002. Rob is the founder of, a social enterprise with a mission of showcasing executive level role models with lived experiences of mental ill-health. Rob recently completed the MindCycle, riding over 3,000km of the Tour de France route on a static bike in a number of corporate workplaces, stimulating conversation about mental health. Rob holds a first class degree in economics and is a prize-winner from Loughborough University. He qualified as a Chartered Accountant with PwC before moving into the Executive Search industry. Rob is an early investor in BetterSpace and believes that the marketplace can help organisations better look after the mental wellbeing of all employees.



Sign up to receive Make A Difference's fortnightly round up of features, news, reports, case studies, practical tools and more for employers who want to make a difference to work culture, mental health and wellbeing.