• evidence based medicine
• workplace counselling
• workplace stress

Mental health problems at work are big news;^1–7 hardly a week passes without a new report highlighting stress at work or the proportion of absences from psychiatric causes. The numbers involved are enormous,⁸ to the point where one might be concerned that this was yet another public health issue.⁹ Both unions and employers perceive a problem, though it is by no means clear that they perceive the same problem. It is therefore perhaps unsurprising that they tend to advocate different solutions.

While occupational factors such a stress have demonstrable health outcomes,^10,11 workplace stress also has major economic implications. One report has suggested that it costs the UK £3 billion per year¹²—significant in relation to the £11 billion that the CBI calculates sickness absence as a whole costs the economy.¹³ Besides sick pay, replacement costs and lost productivity, an increasing proportion of this cost burden is comprised of compensation pay-outs. The TUC reported that there was a 12-fold increase in cases of stress at work; the value of claims is over £300 million.¹⁴

The Walker case, in which a social worker successfully sued his employers for psychiatric illness caused by his work, underlined the duty of care that employers have to their employees and confirmed that harsh financial penalties could result from failing in this duty of care.¹⁵ This issue received publicity recently with an Appeal Court ruling which, in redefining those circumstances under which an employee can claim for damages, may curb the numbers of such cases coming before the courts.¹⁶ In three out of four cases before them, the judges allowed the appeals, removing almost £200 000 from claimants who had originally been awarded compensation for stress related illnesses.

“Any alleged harm must …