One in three sick notes are for mental health problems, ‘alarming’ report shows

One in three “sick notes” handed out by GPs are now for mental health problems, amid soaring levels of anxiety across Britain, official figures show.

The new data – from the first such investigation across the NHS – reveals that in total, more than 5 million people are being signed off work every year.

Mental health and behavioural conditions were the most common reason by far, making up 31 per cent of cases, with a 14 per cent rise in notes relating to anxiety and stress in one year.

The Royal College of Psychiatrists said the figures were “alarming,” urging employers to do more to help support staff struggling with common mental health problems such as depression.

The head of the NHS said mental health was now “front and centre” of the health service agenda.

Musculoskeletal conditions – such as bad backs – were the second most common reason given for issuing the notes, the NHS data shows.

The report follows the introduction of a new “fit note” system by the Department of Work and Pensions.  It was intended to end a “sicknote culture” and get employees back to work quicker, by improving access to treatment and finding ways to ensure pressures were manageable.

The notes have to be issued by GPs if an employee seeks more than seven days off work.

But the new statistics show that one in five of those signed off for mental health problems was off for at least three months.

The report, which cover notes issued over a 28 month period, show a sharp rise in the numbers going off sick with anxiety and stress-related conditions, with 573,000 cases in 2016/17, compared with 503,000 cases the previous year.

Simon Stevens, the head of the NHS, said: “These figures explain why the NHS is now putting mental health front and centre, in what was recently independently described as ‘the world’s most ambitious effort to treat depression, anxiety and other common mental illnesses’.

He said funding for services had risen by £1.4bn in the last three years, with an extra 120,000 people getting treatment.

“When it comes to mental health, what’s good for patients is also good for taxpayers, because untreated mental health problems directly affect work, unemployment and benefits,” Mr Stevens said.

Dr Jed Boardman, from the Royal College of Psychiatrists, said: “These statistics are alarming.”

He urged GPs and employers to do more to help those with mental health problems to get back to work, saying both needed to be far more active in coming up with suggestions to help struggling individuals.

“If anything, this new data may underestimate the scale of the problem,” he added. “Almost half of benefits claimants of Employment and Support Allowance in England are receiving payments as the result of mental and behavioural disorders.”

The new system, introduced in 2010, was supposed to encourage GPs and employers to find ways to get employees back in to work, by finding adjustments to hours or duties, to ease pressures.

But the figures show that in the vast majority of cases employees were simply signed off, with just one in 20 fit notes suggesting accomodations that could be made.

The figures show that that Knowsley, in Merseyside, had the highest number of notes compared to its working age population, while Richmond in south west London had the lowest.

Dr Steve Mowle, spokesperson for the Royal College of GPs, said the figures might reflect changing attitudes, and reduced stigma, with employees feeling more able to speak up about mental health conditions.

“We know that working is beneficial for our patient’s long term physical and mental health and wellbeing, and we need a society-wide approach, including involvement from employers, to put measures in place to get people back into work, where possible, safely and appropriately,” he said.

A spokesman for the Confederation of British Industry said: “The health and well-being of employees is a key priority for employers. Businesses have a duty of care to their employees that considers mental and physical health as well as safety. Most firms will usually have policies in place – especially if they are large businesses – to help support their staff.”

A Government spokesman said: “We’re helping thousands of people to remain in, or get back into work after a period of ill-health.

“We’re determined to go further, and these statistics will provide us with a better understanding of why people take sickness absence in different areas across the country.”

“Supporting people with mental health conditions is a top priority, which is why we’ve commissioned two expert-led reviews and have invested a record £11.6bn into mental health services.”

In numbers | Mental Health

One in six

UK people will experience a mental health problem each week

19,481 times

UK children contacting Childline with suicidal thoughts, in the year 2015/ 2016


Cuts to mental health trust budgets in England from 2011 to 2015


The rise in referrals to community mental health teams in England during the same period


Proportion of British people who meet the criteria for diagnosis of mixed anxiety & depression, according to most recent 2014 study


Beds for mental health patients that have been closed from 2011 to mid-2016 in England


Proportion of people referred to a talking therapy who have a three month wait between referral and treatment (England – May 2016)


Additional amount pledged by the government towards mental health by 2020/2021 – the same amount cut from the budget between 2010 and 2015

Sources: Mind, NHS, Young Minds, RCN

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