Mental illness is the second largest contributor to years lost due to disability (YLDs) in the Asia-Pacific region. Nowhere, though, do more than half of those affected receive any medical treatment. This is not some temporary crisis. It is business as usual.

Across the region, policy makers and health systems are taking note. In 2010, Japan declared mental illness to be one of just five priority diseases; China passed its first ever mental health law in 2012; Indonesia significantly modernised its legislation in 2014 and India adopted its first mental health policy the same year. Meanwhile, at the international level, APEC and ASEAN have also begun to engage with the issue.

The huge cost of mental health problems to employers has become more widely recognised. It is important that employees have ownership and take leadership of the mental health agenda, including openly sharing their experiences of mental health problems, argues Sue Baker, Director of Time to Change, England’s largest ever programme to end mental health stigma and discrimination.

Just as mental health issues, including depression, are a global issue so, sadly, are the stigma, shame and discrimination experienced by those of us with mental health problems. This is most present within families, friends, and at work.

In the UK, despite the fact that one in six workers is experiencing depression, anxiety or stress, many do not feel able to discuss this at work or seek support. The earlier people access help, the better. If they have to take time off, a supported return to work as people recover can lead to more positive outcomes for both the employee and the employer. A preventative focus on the resilience and wellbeing of all staff and a culture of openness are also needed.

Mental health issues themselves do not discriminate—they can happen to anyone. However, the factors and work practices that contribute to poor mental health, and undermine mental wellbeing at work, are well recognised, including poor management, excessive workloads, threat of redundancy and lack of autonomy. Therefore, we also know what could help promote and protect the mental health and wellbeing of the whole workforce.

Whilst there have been significant improvements in public attitudes in recent years, 49% of adults say they would feel uncomfortable talking to their employer about their own mental health.

The huge cost of mental health problems to employers has become more widely recognised with presenteeism (attending work while sick), absenteeism and staff turnover due to mental illness costing British business nearly £26bn a year and an average of £1,035 per employee; the total costs of mental ill-health in the UK equate to £70bn or 4.5% of GDP according the OECD. If employees are not getting the right support and not feeling comfortable enough to open up, these costs will remain very high. However, if workplaces can implement the right practices and create the right culture, it will not only be better for staff but will also make economic sense.

A third of UK employers that my organisation works with have made changes to policy, a quarter have delivered training for line managers (who have a key role to play), and two thirds have delivered mental health awareness to all staff, including resilience building, mindfulness and Mental Health First Aid.

The importance of sharing experiences

As well as ownership and leadership at board and executive level, we have also seen the vital importance of staff having ownership and taking leadership of this agenda, including openly sharing their experiences of mental health problems; this can be transformational in relation to achieving culture change. Hearing from a colleague with first-hand experience can unlock a more open dialogue and culture, as well as changing attitudes and overturning stereotypes. In the UK, we are seeing some top business leaders, executives, managers and staff at all levels share their experiences of mental health problems; and we are witnessing the powerful change this can bring about.

We would like to see this in all workplaces; silence has existed for too long. The economic, social and human costs of stigma are too high a price to pay for inaction.

Other powerful forces are also shaping our workplace culture. The way we work is changing and in-demand skills such as teamwork, collaboration, joint problem solving, flexible working and staff development all require employees who are mentally healthy, resilient, motivated and focused. Good mental health should become core business for all employers.

Sue Baker will be one of the speakers at an upcoming Economist conference, The Global Crisis of Depression. Some of the issues discussed in this blog will be explored further at a panel discussion on "The challenge of depression in the workplace".

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of The Economist Intelligence Unit Limited (EIU) or any other member of The Economist Group. The Economist Group (including the EIU) cannot accept any responsibility or liability for reliance by any person on this article or any of the information, opinions or conclusions set out in the article.

The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.

These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit. 

This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.