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Workplace mental health in England,
Ireland and Sweden: a comparative
study
Maria Wishart
Maria.Wishart@wbs.ac.uk
Workplace mental health in England, Ireland
and Sweden: a comparative study
1. Why England, Ireland and Sweden?
2. The dataset
3. Findings:
• Mental health absence and its impact
• Presenteeism
• Uptake of initiatives
• Hybrid working
4. Conclusions and implications
Healthcare overview
Ireland England Sweden
Population 5,194,336 67,736,802 10,521,556
Healthcare
funding model
Two tier
public/private
healthcare system,
private healthcare
insurance common
Publicly funded, private
care available for those
choosing it
Publicly funded,
private care has less
of a role than in UK
and Ireland
Primary care
access
Free primary care
for around 30% of
population
Universal free access to
primary care
Universal free access
to primary care
Sick pay
Statutory sick pay
for 5 days per year
Statutory sick pay for
up to 28 weeks
80% of salary for 364
days, extendable
OECD/European Union (2018)
Proportion of adults with mental disorders
3.7%
5.9%
4.7%
1.2%
18.5%
3.7%
5.4%
5.4%
1.4%
18.3%
3.7%
5.1%
4.8%
1.4%
17.7%
5.4%
4.5%
2.4%
1.3%
17.3%
0.0% 5.0% 10.0% 15.0% 20.0%
Others
Anxiety disorders
Depressive disorders
Bipolar disorders and…
Mental disorders
All EU United Kingdom Sweden Ireland
Estimated direct and indirect costs related to mental health
problems across EU countries, % of GDP
OECD/European Union (2018)
Estimated direct and indirect costs related to mental health
problems % of GDP
Total costs Direct costs Indirect costs
On health systems On social benefits On the labour
market
in million
EUR
% of
GDP
in
million
EUR
% of
GDP
in
million
EUR
% of
GDP
in
million
EUR
% of
GDP
EU28 607 074 4.10% 194 139 1.31% 169 939 1.15% 242 995 1.64%
Ireland 8 299 3.17% 2 232 0.85% 1 891 0.72% 4 176 1.59%
Sweden 21 677 4.83% 5 696 1.27% 7 558 1.68% 8 423 1.88%
UK 106 024 4.07% 36 353 1.40% 22 704 0.87% 46 967 1.80%
Data set
• Computer Assisted Telephone Interview (CATI) survey, for-profit and voluntary sector firms
operating for at least 3 years, with minimum 10 employees
 Ireland: Sep-Dec 2022: 1,501 firms
 England: Jan-May 2023: 1,902 firms
 Sweden: Sep-Dec 2023: 1,000 firms
• Business and employee characteristics
• General sickness and Mental health sickness absence measurement & practices
• Mental health initiatives and outcomes
• Presenteeism
• Technology and high-tech working practices
Headlines
• Significant country-level differences in:
• Patterns of mental health related sickness absence
• Patterns and types of presenteeism
• Engagement in mental health & wellbeing initiatives
• Adoption of hybrid working
• Reported impact of mental health on business operations
Mental health related sickness absence
41%
36%
17%
11%
17%
47%
46%
29%
17%
27%
69%
50%
31%
18%
32%
0% 10% 20% 30% 40% 50% 60% 70% 80%
250 plus
50-249
20-49
10-19
All firms
Sweden England Ireland
Proportion of firms reporting MH sickness absence in the preceding 12 months
Sweden 1,000 firms, England 1,878 firms, Ireland 1,484 firms
Mental health related sickness absence
32%
47%
40%
0% 20% 40% 60% 80% 100%
Ireland
England
Sweden
Proportion of firms with long-term MH absence Proportion of firms with repeated MH absence
44%
38%
88%
0% 20% 40% 60% 80% 100%
Ireland
England
Sweden
Sweden 400 firms, England 471 firms, Ireland 291 firms
Mental health related sickness absence
Proportion of firms reporting that MH sickness absence impacted operations
46%
58%
43%
0% 10% 20% 30% 40% 50% 60% 70% 80%
Ireland
England
Sweden
Sweden 400 firms, England 471 firms, Ireland 291 firms
Presenteeism
34%
32%
30%
22%
27%
43%
46%
39%
32%
37%
58%
65%
46%
44%
50%
0% 10% 20% 30% 40% 50% 60% 70%
250 plus
50-249
20-49
10-19
All firms
Sweden England Ireland
Proportion of firms reporting presenteeism in the preceding 12 months
Sweden 1,000 firms, England 1,902 firms, Ireland 1,501 firms
Presenteeism
Type of presenteeism reported, by country
41%
78%
60%
79%
61%
32%
0% 20% 40% 60% 80% 100%
Working when unwell
Working beyond contract
Sweden England Ireland
3%
2%
10%
9%
19%
5%
4%
13%
9%
27%
4%
6%
9%
15%
37%
0% 10% 20% 30% 40%
Training for line managers
Leaders role modelling
Investigating causes
Reinforcing messages about life
work balance
Sending home people who are ill
Sweden England Ireland
Addressing presenteeism, by country
Sweden 543 firms, England 692 firms, Ireland 417 firms
Engagement in Mental Health & Wellbeing
initiatives
85%
70%
46%
36%
46%
86%
64%
58%
42%
52%
90%
82%
77%
74%
78%
0% 20% 40% 60% 80% 100%
250 plus
50-249
20-49
10-19
All firms
Sweden England Ireland
Proportion of firms disagreeing that MH is a personal
issue that should not be addressed at work, by country
73%
79%
67%
0% 20% 40% 60% 80% 100%
Ireland
England
Sweden
Proportion of firms offering MH initiatives, by country & size
Sweden 1,000 firms, England 1,902 firms, Ireland 1,501 firms
Engagement in Mental Health & Wellbeing
initiatives
Adoption of strategic/policy initiatives, by country Adoption of skills training & monitoring initiatives, by country
23%
32%
20%
21%
22%
32%
45%
18%
44%
42%
39%
40%
46%
51%
63%
0% 10% 20% 30% 40% 50% 60% 70%
Mental health plan
MH lead at board level
MH budget
Have employee mental health
champions
Use data to monitor MH&W
Sweden England Ireland
68%
40%
53%
69%
74%
62%
66%
76%
49%
30%
57%
52%
0% 20% 40% 60% 80%
Awareness raising for staff on
mental health issues
Training for line managers in
managing mental health
Risk assessment/stress audits
Training and support for those
returning to work
Sweden England Ireland
Sweden 784 firms, England 970 firms, Ireland 722 firms
Engagement in Mental Health & Wellbeing
initiatives
Investments in employee wellbeing, by country
Adoption of workplace practices to reduce risk factors, by
country
42%
38%
30%
41%
50%
46%
40%
31%
53%
30%
40%
22%
67%
72%
95%
0% 20% 40% 60% 80% 100%
Supplying healthy food and drinks
Financial wellbeing advice
Training aimed at building
personal resilience
Access to counselling support
Support with physical activity
such as gym memberships,…
Sweden England Ireland
90%
89%
68%
95%
95%
85%
81%
84%
90%
0% 20% 40% 60% 80% 100%120%
Encourage open conversations
about mental health in the
workplace
Make appropriate workplace
adjustments to those who need
them to support their mental…
Ensure all staff have a regular
conversation about their health
and wellbeing with their manager
Sweden England Ireland
Sweden 784 firms, England 970 firms, Ireland 722 firms
Hybrid working
7%
11%
16%
25%
16%
21%
68%
72%
63%
0% 20% 40% 60% 80% 100%
Ireland
England
Sweden
Yes, have always Yes, since COVID No
Hybrid working, by country
Sweden 1,000 firms, England 1,894 firms, Ireland 1,499 firms
Hybrid working
Encouraging a good work life balance for remote workers, by country
54%
74%
67%
64%
86%
63%
44%
76%
67%
70%
88%
72%
63%
66%
67%
72%
83%
86%
0% 20% 40% 60% 80% 100%
Time sheets or other tracking method
Encouraging employees not to
answer email outside working hours
Company-wide communications, e.g.,
from HR department
Regular formal
conversations/reminders from line…
Regular informal
conversations/reminders from line…
Role modelling behaviour from
managers
Sweden England Ireland
Sweden 295 firms, England 438 firms, Ireland 404 firms
Conclusions
• Significant differences in MH absence, presenteeism and hybrid working - role
of culture and socio-political context
• Despite reporting higher levels of MH absence, Swedish firms significantly less
likely to report impacts of MH in the workplace
• Swedish firm interventions more likely to be focused on strategic initiatives and
investment in employees than on training and reducing risk factors
Implications?
• Mental health-related absence: should we be minimising or managing it?
• Encouraging work life balance with more embedded remote working: how
should employers manage psychological detachment issues?
• Presenteeism: is more presenteeism an inevitable consequence of remote
working, and if so, what should we do to address it?
• Mental health initiatives in the workplace: what should policymakers do to
encourage the adoption of mental health initiatives in the workplace? Which
kinds of initiatives should they encourage?
To find out more, please visit:
https://www.enterpriseresearch.ac.uk/esrc-mental-
health-well-being-practices-outcomes-productivity-
project/

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Workplace mental health in England, Ireland and Sweden – a comparative study - Maria Wishart

  • 1. Workplace mental health in England, Ireland and Sweden: a comparative study Maria Wishart Maria.Wishart@wbs.ac.uk
  • 2. Workplace mental health in England, Ireland and Sweden: a comparative study 1. Why England, Ireland and Sweden? 2. The dataset 3. Findings: • Mental health absence and its impact • Presenteeism • Uptake of initiatives • Hybrid working 4. Conclusions and implications
  • 3. Healthcare overview Ireland England Sweden Population 5,194,336 67,736,802 10,521,556 Healthcare funding model Two tier public/private healthcare system, private healthcare insurance common Publicly funded, private care available for those choosing it Publicly funded, private care has less of a role than in UK and Ireland Primary care access Free primary care for around 30% of population Universal free access to primary care Universal free access to primary care Sick pay Statutory sick pay for 5 days per year Statutory sick pay for up to 28 weeks 80% of salary for 364 days, extendable
  • 4. OECD/European Union (2018) Proportion of adults with mental disorders 3.7% 5.9% 4.7% 1.2% 18.5% 3.7% 5.4% 5.4% 1.4% 18.3% 3.7% 5.1% 4.8% 1.4% 17.7% 5.4% 4.5% 2.4% 1.3% 17.3% 0.0% 5.0% 10.0% 15.0% 20.0% Others Anxiety disorders Depressive disorders Bipolar disorders and… Mental disorders All EU United Kingdom Sweden Ireland
  • 5. Estimated direct and indirect costs related to mental health problems across EU countries, % of GDP OECD/European Union (2018)
  • 6. Estimated direct and indirect costs related to mental health problems % of GDP Total costs Direct costs Indirect costs On health systems On social benefits On the labour market in million EUR % of GDP in million EUR % of GDP in million EUR % of GDP in million EUR % of GDP EU28 607 074 4.10% 194 139 1.31% 169 939 1.15% 242 995 1.64% Ireland 8 299 3.17% 2 232 0.85% 1 891 0.72% 4 176 1.59% Sweden 21 677 4.83% 5 696 1.27% 7 558 1.68% 8 423 1.88% UK 106 024 4.07% 36 353 1.40% 22 704 0.87% 46 967 1.80%
  • 7. Data set • Computer Assisted Telephone Interview (CATI) survey, for-profit and voluntary sector firms operating for at least 3 years, with minimum 10 employees  Ireland: Sep-Dec 2022: 1,501 firms  England: Jan-May 2023: 1,902 firms  Sweden: Sep-Dec 2023: 1,000 firms • Business and employee characteristics • General sickness and Mental health sickness absence measurement & practices • Mental health initiatives and outcomes • Presenteeism • Technology and high-tech working practices
  • 8. Headlines • Significant country-level differences in: • Patterns of mental health related sickness absence • Patterns and types of presenteeism • Engagement in mental health & wellbeing initiatives • Adoption of hybrid working • Reported impact of mental health on business operations
  • 9. Mental health related sickness absence 41% 36% 17% 11% 17% 47% 46% 29% 17% 27% 69% 50% 31% 18% 32% 0% 10% 20% 30% 40% 50% 60% 70% 80% 250 plus 50-249 20-49 10-19 All firms Sweden England Ireland Proportion of firms reporting MH sickness absence in the preceding 12 months Sweden 1,000 firms, England 1,878 firms, Ireland 1,484 firms
  • 10. Mental health related sickness absence 32% 47% 40% 0% 20% 40% 60% 80% 100% Ireland England Sweden Proportion of firms with long-term MH absence Proportion of firms with repeated MH absence 44% 38% 88% 0% 20% 40% 60% 80% 100% Ireland England Sweden Sweden 400 firms, England 471 firms, Ireland 291 firms
  • 11. Mental health related sickness absence Proportion of firms reporting that MH sickness absence impacted operations 46% 58% 43% 0% 10% 20% 30% 40% 50% 60% 70% 80% Ireland England Sweden Sweden 400 firms, England 471 firms, Ireland 291 firms
  • 12. Presenteeism 34% 32% 30% 22% 27% 43% 46% 39% 32% 37% 58% 65% 46% 44% 50% 0% 10% 20% 30% 40% 50% 60% 70% 250 plus 50-249 20-49 10-19 All firms Sweden England Ireland Proportion of firms reporting presenteeism in the preceding 12 months Sweden 1,000 firms, England 1,902 firms, Ireland 1,501 firms
  • 13. Presenteeism Type of presenteeism reported, by country 41% 78% 60% 79% 61% 32% 0% 20% 40% 60% 80% 100% Working when unwell Working beyond contract Sweden England Ireland 3% 2% 10% 9% 19% 5% 4% 13% 9% 27% 4% 6% 9% 15% 37% 0% 10% 20% 30% 40% Training for line managers Leaders role modelling Investigating causes Reinforcing messages about life work balance Sending home people who are ill Sweden England Ireland Addressing presenteeism, by country Sweden 543 firms, England 692 firms, Ireland 417 firms
  • 14. Engagement in Mental Health & Wellbeing initiatives 85% 70% 46% 36% 46% 86% 64% 58% 42% 52% 90% 82% 77% 74% 78% 0% 20% 40% 60% 80% 100% 250 plus 50-249 20-49 10-19 All firms Sweden England Ireland Proportion of firms disagreeing that MH is a personal issue that should not be addressed at work, by country 73% 79% 67% 0% 20% 40% 60% 80% 100% Ireland England Sweden Proportion of firms offering MH initiatives, by country & size Sweden 1,000 firms, England 1,902 firms, Ireland 1,501 firms
  • 15. Engagement in Mental Health & Wellbeing initiatives Adoption of strategic/policy initiatives, by country Adoption of skills training & monitoring initiatives, by country 23% 32% 20% 21% 22% 32% 45% 18% 44% 42% 39% 40% 46% 51% 63% 0% 10% 20% 30% 40% 50% 60% 70% Mental health plan MH lead at board level MH budget Have employee mental health champions Use data to monitor MH&W Sweden England Ireland 68% 40% 53% 69% 74% 62% 66% 76% 49% 30% 57% 52% 0% 20% 40% 60% 80% Awareness raising for staff on mental health issues Training for line managers in managing mental health Risk assessment/stress audits Training and support for those returning to work Sweden England Ireland Sweden 784 firms, England 970 firms, Ireland 722 firms
  • 16. Engagement in Mental Health & Wellbeing initiatives Investments in employee wellbeing, by country Adoption of workplace practices to reduce risk factors, by country 42% 38% 30% 41% 50% 46% 40% 31% 53% 30% 40% 22% 67% 72% 95% 0% 20% 40% 60% 80% 100% Supplying healthy food and drinks Financial wellbeing advice Training aimed at building personal resilience Access to counselling support Support with physical activity such as gym memberships,… Sweden England Ireland 90% 89% 68% 95% 95% 85% 81% 84% 90% 0% 20% 40% 60% 80% 100%120% Encourage open conversations about mental health in the workplace Make appropriate workplace adjustments to those who need them to support their mental… Ensure all staff have a regular conversation about their health and wellbeing with their manager Sweden England Ireland Sweden 784 firms, England 970 firms, Ireland 722 firms
  • 17. Hybrid working 7% 11% 16% 25% 16% 21% 68% 72% 63% 0% 20% 40% 60% 80% 100% Ireland England Sweden Yes, have always Yes, since COVID No Hybrid working, by country Sweden 1,000 firms, England 1,894 firms, Ireland 1,499 firms
  • 18. Hybrid working Encouraging a good work life balance for remote workers, by country 54% 74% 67% 64% 86% 63% 44% 76% 67% 70% 88% 72% 63% 66% 67% 72% 83% 86% 0% 20% 40% 60% 80% 100% Time sheets or other tracking method Encouraging employees not to answer email outside working hours Company-wide communications, e.g., from HR department Regular formal conversations/reminders from line… Regular informal conversations/reminders from line… Role modelling behaviour from managers Sweden England Ireland Sweden 295 firms, England 438 firms, Ireland 404 firms
  • 19. Conclusions • Significant differences in MH absence, presenteeism and hybrid working - role of culture and socio-political context • Despite reporting higher levels of MH absence, Swedish firms significantly less likely to report impacts of MH in the workplace • Swedish firm interventions more likely to be focused on strategic initiatives and investment in employees than on training and reducing risk factors
  • 20. Implications? • Mental health-related absence: should we be minimising or managing it? • Encouraging work life balance with more embedded remote working: how should employers manage psychological detachment issues? • Presenteeism: is more presenteeism an inevitable consequence of remote working, and if so, what should we do to address it? • Mental health initiatives in the workplace: what should policymakers do to encourage the adoption of mental health initiatives in the workplace? Which kinds of initiatives should they encourage?
  • 21. To find out more, please visit: https://www.enterpriseresearch.ac.uk/esrc-mental- health-well-being-practices-outcomes-productivity- project/