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Adrian Wakeling: What's the difference between stress and mental illness?

Friday 10 October 2014

Adrian Wakeling, Senior Policy Analyst at Acas discusses the cause of the difference in perception between stress and mental illness.

Adrian Wakeling

Adrian is a Senior Policy Analyst at Acas and is part of a team responsible for informing the future strategic direction of Acas and influencing the wider debate on the value of employment relations.

Adrian Wakeling Displays a larger version of this image in a new browser window


This year's World Mental Health Day (October 10) is focussing on schizophrenia. The Mental Health Foundation website explains that "The causes of schizophrenia are unknown but episodes appear to be associated with changes in some brain chemicals. Stressful experiences and some recreational drugs can also trigger an episode in vulnerable people."

In many ways this description highlights the problem facing many managers at work tasked with looking after wellbeing and mental health initiatives - whether or not they have been trained to have those 'difficult conversations'.

If the cause of an individual's condition is physiological - such as a chemical imbalance - then many managers would steer well clear and assume that the problem is a purely medical one. However, if the condition has been triggered by 'stressful' workplace experiences, many more managers may feel inclined to take some action. Judging by the Mental Health Foundation's website definition, things are not always that clear cut. And it can be very hard for managers, no matter how much training they have had, to know when to intervene, how far to go, and what degree of responsibility (and accountability) they have.

At a very informative roundtable recently (organised by the Work Foundation), someone crystallised the dilemma. Stress, they said, has become normalised in the workplace (indeed, many people would argue that it has become the new 'back ache') and employees feel relatively happy talking about 'feeling stressed out'. And yet, completely the opposite is true of mental illness, which, as we all know, still carries a real stigma.

So what is the cause of this difference in perception between stress and mental illness? The reason for the difference appears to be that stress is seen as something that is done to you, whereas mental illness is seen as something inherent within you - something you carry.

This is why managers often feel responsible for the 'stress' inflicted upon an individual employee. The HSE Management Stress Standards have helped to cement this very pragmatic relationship between cause and effect. The six 'stressors' - poor relationships, work overload, lack of clarity of job role, poor change management, lack of management support and little say in your work - are all 'organisational failings'. Unfortunately, mental illness is seen as a physiological or psychological 'failing' that is the responsibility of the individual to resolve with his or her doctor.

Life and work do not, of course, follow these neat lines . As the Mental Health Foundation advice shows, there is often an overlap between work and life problems and many 'stressors' have the potential to trip people and cause them to fall into more serious medical conditions.

Acas has today published a policy paper pdf icon Is it time wellbeing grew up? [83kb] looking at the way we measure wellbeing in the workplace. The paper asks whether the HSE Stress Standards are still fit for purpose?

Do you use the Standards and, if so, in what context? I would be very interested to hear from you.

If you are interested in how schizophrenia can be managed in the workplace, there is an excellent blog on the Work Foundation website by Karen Steadman.

1 Comment

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  • Posted by Werka  |  22 December 2014, 2:47PM

    Hi, I'm Werka from I would like to point out it's not so easy to determine what is being caused by stress at work and mental illness. Especially when stress at work (the six stressors mentioned in the article) may lead to a mental condition.