Mental health, work and the workplace

Nov 08, 2024

Informed Opinion - Prof Xavier V. Pereira
Jane (not her real name) sought treatment for anxiety and depression after experiencing severe stress at her workplace. Her superior was unkind to her and was harassing her. She was deprived of a proper workstation and a personal computer, and she was often humiliated by her superior in front of her colleagues.

John (not his real name) was diagnosed to have mixed anxiety and depressive disorder by a psychiatrist after he experienced stress at his workplace. He was good at his work but an increasing workload, including added responsibilities because of a promotion, was burdening him. In addition to depression and generalised anxiety, he also suffered from panic attacks.

Jane and John are typical examples of people suffering from mental health disorders because of stress in the workplace.

The theme for World Mental Health Day 2024 is It’s Time to Prioritise Mental Health in the Workplace. This year’s theme recognises the increasing trend of people suffering from mental health disorders in the workplace.

The most common reasons for stress, anxiety and depression occurring in people at the workplace are an unmanageable workload, difficulty in adapting to new roles and responsibilities, interpersonal difficulties with colleagues, superiors and subordinates, and difficulty in managing changes at work. An example of such a change is the transition from working from home to a return to working on-site, as is the norm after the COVID-19 pandemic. Another difficult change is the transition of working with hard copies or handwritten documents to soft copies or online documents.

Many companies, especially MNCs (Multi-National Companies), are addressing this issue of stress and mental health challenges among their employees by providing Employee Assistant Programme (EAP) services. EAP services allow staff to access counsellors and clinical psychologists. Some companies also provide medical insurance so that their staff can access psychiatric help. It is common these days for institutions and companies to conduct stress management and mental health awareness programs. These programs assist employees to manage their stress and identify symptoms of mental health disorders early. Early intervention in addressing mental health disorders provides a better outcome to treatment.

At times individuals who are diagnosed with more severe forms of mental health disorders require a long period of rest in addition to treatment. I often recommend Prolonged Illness Leave of about three to six months for such individuals. The first three to six months of Prolonged Illness Leave is often fully paid medical leave. Rest and treatment allow individuals to fully recover and return to work.

Certain groups of people are more often exposed to unfavourable work conditions than others. These individuals often suffer both physically and mentally. One such group are junior doctors.

Junior doctors often work in challenging circumstances. I can personally vouch that the most difficult period of my working life was when I was a junior doctor It has been reported that the dropout rate among Malaysian house officers is about 30 per cent. A heavy workload, insufficient rest, burnout and bullying by senior doctors are some of the contributory factors to mental ill health. There are now specialised services to cater for house officers and medical officers who experience mental health challenges. This is a proactive step by the Ministry of Health to assist junior doctors manage stress, receive counselling, and psychological therapy, and access psychiatric treatment.

Another group of people who are exposed to very trying work conditions are migrant workers. Migrant workers have become the mainstay of the labour force in many middle- and high-income countries and often are involved in the three D jobs, which are Dirty, Demanding and Dangerous. The plight of migrant workers was thrown into the spotlight during the preparation for the 2022 FIFA World Cup in Qatar. Many human rights groups called for a boycott of the World Cup because of the deplorable conditions that the construction workers had to work and live in. Many workers suffered physically and mentally, and some died. This forced the Qatari government to take measures to address the welfare of the workers. Thankfully these measures were effective in reducing morbidity and mortality amongst the workers.

Migrant workers are often exploited and are deprived of their rights to good working and living conditions in many countries across the globe. Advocacy plays an essential role in ensuring that these rights are upheld. NGOs have advocated for migrant workers over the years, pushing for the state to take on the responsibility of ensuring good working and living conditions for migrant workers.

Slavery is the worst form of forced work or labour and has been prevalent since the beginning of human existence. In the Bible, the book of Exodus details the story of Moses leading the Hebrew people, who were slaves in Egypt, out of captivity. These slaves endured much physical and mental suffering.

Shockingly, modern-day slavery exists, it refers to institutional slavery that continues to occur in present-day society. The International Labour Organisation estimated that close to 40 million people are in some form of slavery today. These include people who are in domestic work, work in construction, and agriculture. Many are also in forced sexual exploitation and forced labour imposed by state authorities.

Modern-day slavery is inhumane and strips a person of his or her dignity. It is often associated with human trafficking and the experience of severe stress and trauma that can result in mental health disorders like PTSD, Anxiety, Depression and Self-Harm (Human Trafficking and Mental Health: A Primer, Pereira XV, Verghis S, 2016)

Human trafficking and modern-day slavery need to be abolished.

It is also imperative that we promote mental health in the workplace and provide healthy work environments for all.

(Xavier V. Pereira is a medical doctor, psychiatrist and psychotherapist, and an adjunct professor at Taylor’s University School of Medicine. He is also co-founder, director and pro bono psychiatrist of Health Equity Initiatives, an NGO that serves refugees with mental health challenges.)