My thoughts on the mental health epidemic

It’s mental health awareness month and we are seeing important and much-needed discussions about?this critical and complex issue – particularly after two years of extreme disruption and uncertainty. Mental ill-health has become one of the leading challenges for governments and businesses alike, as record numbers of people grapple with loss, profound changes to their living and working environments, concerns about the future, and increasingly polarised and politicised societies. Discovery is no different, with mental health becoming a key factor in how we evaluate our members’ health; and in our employee offering to liberate the best in our people. Given we are a data-driven organisation, I wanted to share some of the insights we’ve seen in our member base and among employees – and the lessons we are learning about how best to assist and intervene in what is a very nuanced and personal issue.

Globally, there’s been a drastic rise in the prevalence of mental ill-health, with the World Health Organization finding that the global incidence of anxiety and depression increased by 25% in the first year of the pandemic. Other research[1] has pegged increases at 26% for anxiety and 28% for depression. Locally, we are seeing similar trends, with South Africa ranking the lowest in the?Annual Mental State of the World Report[2], as the percentage of people rating themselves as distressed or struggling increased from 28.5% in 2020 to 36% in 2021.?

We are seeing the above trends reflected in our own data. The prevalence of mental health conditions in the Discovery Health Medical Scheme (the largest open medical scheme in South Africa) has increased from 10.6% in 2017 to 12.5% in 2021 – a 19% increase. In our UK market, we’ve seen demand for mental health interventions climb as well. Between 2015 and 2021, mental health claims in our UK business increased by three-fold, and between 2019 and 2021, talking therapies claims increased by 44% (per life).

Clearly, this is an epidemic of a different kind that we have yet to fully quantify, understand and address. Optimal treatments differ from person to person, and at different stages of life. While by no means a panacea and without oversimplifying the issue, we have seen some encouraging evidence that certain behavioural interventions can make a difference. For example, physical activity can be an effective tool in helping to prevent or lighten the mental health burden; and providing timely and affordable access to talking therapies can assist in preventing the worsening of mental health status.

Data from the 2018 Britain’s Healthiest Workplace study (a comprehensive view of employee health and wellbeing spanning 129 organisations and 26,432 employees across the UK) show a clear relationship between depression and lifestyle choices: employees who have even mild symptoms of depression are more likely to be over- or under-weight, and not to undertake sufficient amounts of physical activity.

Conversely, the results of one longitudinal study carried out by colleagues at Discovery as well as researchers from WITS University, the University of Cape Town, the Harvard T. H. Chan School of Public Health and Massachusetts General Hospital, found that moderate amounts of physical activity led to the prevention of depression. There was a particularly strong relationship between engaging in physical activity and reduced incidence of depression in women. This was achievable even with small increases in physical activity – for example, increasing steps from 5,000 one day in a week to 10,000 steps one day in a week. These findings provide motivation for including physical activity interventions as part of a broader, holistic approach to mental wellbeing.?

In the UK, talking therapies and Cognitive Behavioural Therapy (CBT) have shown successes as well. Data on nearly 1500 Vitality members with access to Vitality’s Mental Health Cover module (who are therefore eligible for additional onward treatment if required) who had talking therapies treatment between 2019 and 2021 show that just 1.2% required further treatment within three months of treatment.?

These insights help us better serve our customers and inform our approach to our own employees. As a company driven by a core purpose of making people healthier, we are always looking for ways to extend this to our biggest asset – our people. We have prioritised employees’ mental health in several ways, with 24/7 emotional and mental support via our Healthy Company offering and various in-person and digital interventions including targeted webinars and training by industry thought leaders and clinicians, and employee roadshows with a focus on mental and emotional wellbeing. We also offered trauma support following the July 2021 riots in South Africa and recent KwaZulu-Natal/Eastern Cape floods as well as proactive nudges to employees to reach out to Healthy Company. In the UK business we have a network of employees trained as mental health champions and are rolling out mental health awareness sessions for managers, as well as issuing them with mental health toolkits. All employees also have access to talking therapy services (including CBT), and an online mental health self-help platform.

While more emphasis is being placed on mental health in a variety of contexts, it is still a stigmatised issue and often not treated with the urgency and sensitivity of other health challenges. At Discovery we continue to look for ways to better understand trends through data, and how we can implement proven interventions and treatments among clients and our own people.

Personally, I rely on a few key practices that are constructive to my mental health: short bursts of exercise to de-stress during the workday, and a mental sabbatical once a week – switching off my phone on Saturdays to spend focused time with my family. I’d love to hear what you are doing in your own life (or that of your employees) to safeguard and boost your mental health.?

[1] Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic, COVID-19 Mental Disorders Collaborators, The Lancet, Nov 2021

[2] https://mentalstateoftheworld.report/