By Patrick Durkin
AIA’s Australian and New Zealand chief executive Damien Mu is shooting hoops on the rooftop of the insurer’s Melbourne headquarters when AFR BOSS magazine greets him to talk about Australia’s mental health crisis.
Basketball is a pastime Mu loves – he was on the St Kilda Road rooftop court the last time BOSS met him and suggested it as the spot for photos. Mu, who draws cheers and gentle teasing from staff as he practises his shooting, loves to show employees his human side.
Born in Melbourne to a Sri Lankan mother and half-Burmese, half-Chinese father, Mu represents a new type of leadership he partly sees as an antidote to Australia’s soaring rates of mental illness.
“It’s one of the reasons I was comfortable doing the [photos] like that, because I think we have a role as leaders to show a human side, not just to society but in particular to your team,” Mu says in his office, which is filled with sports memorabilia, family photos and inspirational books.
“The unintended consequence of being high energy and working hard is the team think that is what is required to succeed. What they don’t see is the down time we all need and that you are not always up.”
Mu has “little tools” to help him cope with his daily struggles and the regular travel that keeps him away from his two young children.
“One is my ‘perspective metre’, where I pull out an imaginary stick and tap myself on the shoulder to get back to thinking about what is important and how fortunate we are, which just eases the burden,” he says.
“The other is my little ‘pity party’ where I have my imaginary cupcake with an imaginary candle in my pocket. When I’m having a moment, I acknowledge that feeling rather than hide it. I usually pull it out on a Friday night on a flight back to Melbourne after a busy week and blow the candle out.”
Insurers are experiencing an epidemic of claims around mental health, which means that Mu, as much as anyone, has an incentive to try to solve it.
According to a soon-to-be-released white paper prepared by AIA and health data company Quantium, lifestyle factors such as diet, sleep and exercise are key to the problem.
The insurance group is not alone in identifying mental health as a workplace issue. Companies are offering a range of measures aimed at improving their workers’ mental wellbeing, from mindfulness sessions and digital mood trackers to workplace health screening and free in-house counsellors.
Professor Ian Hickie, from the University of Sydney’s Brain and Mind Centre, is not convinced by most of the corporate sector’s efforts to improve the mental health of staff.
“I’m strongly of the view that much effort at the moment is a waste of time and money – largely token attempts to appear engaged with mental health and wellbeing,” he says.
Others are more forgiving. Jono Nicholas, head of mental health consultants Wellbeing Outfit, says corporate Australia is at the beginning of the journey, while arguing that companies such as fast food giant KFC, consultants EY and investment house Wilson Asset Management are genuinely going beyond window dressing.
“The real challenge is flicking the switch to say this isn’t a welfare play but a core strategy for business to deliver a competitive advantage,” Nicholas says. “That moves it from the HR department to the CEO and boardroom.”
Georgie Harman, CEO of independent non-profit organisation Beyond Blue – which has signed up 600,000 people to its Heads Up initiative to create mentally healthy workplaces – says “we’ve come a million miles” from five years ago.
Then, Harman would “bash down the door and people would look at me a bit funny. Now I almost have to bash people away with a stick,” she laughs. “But it’s true, some are doing it much better than others – fruit bowls and yoga don’t cut it.”
The statistics speak for themselves. The Australian Bureau of Statistics says mental illness affects one in five Australians. The Productivity Commission’s recent draft report on mental health estimated the cost of mental illness and suicide to be $500 million a day, with an estimated annual cost to the economy of $28.6 billion. That amount almost doubles when indirect costs such as productivity loss and absence are taken into account.
Others put the cost higher. The Royal Australian and New Zealand College of Psychiatrists says it costs the economy up to $60 billion a year – about 4 per cent of GDP. For business, lost wages, decreased productivity and support services related to mental health amounts to about $13 billion annually, KPMG says.
The problem is particularly pronounced among young people, especially women. The number of women aged between 15 and 34 who have depression and anxiety rose from less than 13 per cent in 2009 to more than 20 per cent in 2017, according to the Household, Income and Labour Dynamics in Australia (HILDA) survey.
Debate rages on whether mental health problems are are really on the rise or if we are simply seeing an increase in diagnosis because discussing it has become more acceptable.
Views also vary on whether the prospect of bosses facing jail time – new industrial manslaughter laws in Victoria could apply to cases where workers take their own life – have also spurred employers into action.
Either way, the cost to insurers means they have among the greatest business incentive to tackle the problem.
AIA says mental health has become its third-largest cause of claim, behind cancer and musculoskeletal conditions, and has been rising since 2011. At the same time, cancer and musculoskeletal claims have declined.
The insurer paid out $190 million for mental health claims in 2018 – 14 per cent of its total claims. The value of payouts has increased by as much as $30 million each year since 2015.
Medibank is experiencing a similar epidemic, with double-digit growth in mental health claims. The health fund supported more than 55,000 hospital admissions for mental health and paid $146 million in benefits in 2018-19.
“One in five Australians today have a mental health issue, but the concerning thing is only about one in two will raise that concern,” Medibank’s chief customer officer, David Koczkar, says. “We know the focus over the last 30 years has been on physical safety, and the incidence of physical injuries in the workplace over the past 10 to 15 years has gone down by as much as 20 per cent. At the same time, claims for mental health conditions have gone up by 5 per cent.
“Corporate Australia needs to provide an environment where their employees feel happier, safer, more productive … What used to be nice to have is now a necessity.”
AIA’s journey began with a pilot program for its staff to use mental health technology company Medibio’s digital screening program ilumen to check for symptoms of depression, anxiety and stress, and offering them a “recharge day” once a quarter. That evolved into its Vitality program, which offers AIA customers the opportunity to earn points, lower their premiums and receive rewards.
“Clayton Utz has provided Vitality for all their staff, CBA just launched it for their staff, SunSuper has given it to their staff, [and so has] Mercer,” Mu says.
The white paper with Quantium drills further into the root causes of the rise in mental health concerns. The report concludes that if people were aware of their depression risk and took appropriate steps to change their lifestyle and behaviour, the national depression incidence rate could fall from 6 per cent to 4.7 per cent. That equates to 300,000 fewer depression incidences, with an estimated $3 billion boost to the economy.
“The lifestyle choices do have an impact,” Mu says. “We’ve got a nation not sleeping very well, not taking care of its diet … The pace at which we are working, technology disruptions – these things are all relevant.”
Workplace screening programs
Medibank has been working with more than 120 companies on health and wellbeing programs, with a focus on mental health. In addition to its Live Better program, which is similar to AIA’s Vitality, it works with companies to offer workplace health screening, mindfulness sessions and health and wellbeing hubs.
“A lot of the programs are step trackers, but ours looks at [what we call] eat, move and feel,” Koczkar says. “A lot of people maybe want to quit sugar, drink less alcohol, drop coffee, drink more water. The ‘feel’ element is either mindfulness activities or gratitude – for example, you can earn points for taking your neighbour’s bins out.”
More than 17,000 workers across Australia have used Medibank’s kiosk-style health screening, which tests blood pressure, weight and body fat percentage. The tests show that 65 per cent of workers have blood pressure levels that are considered high or pre-high, one of the biggest risk factors for stroke.
The health insurer’s 3800 employees can contact a dedicated nurse 24 hours a day to talk about a range of health issues, including mental health concerns and how to access a mental health provider.
Deloitte is working with Medibank to get its 10,000 employees moving. “We run a step-up challenge that forms an integral part of our approach to wellbeing, which includes physical, mental, financial and social wellbeing,” the professional services firm’s head of HR, Sam Sheppard, says.
Mirvac is also working with Medibank. The real estate group’s head of culture, Chris Akayan, points to its Thrive strategy, which offers a range of wellbeing-related initiatives for staff.
Last October, AIA, NAB, professional services firm PwC, insurer IAG and former Australian Competition and Consumer Commission chairman and mental health advocate Professor Allan Fels came together to release a report on mental health, including linking mental health concerns to financial factors.
“Given the strong relationship between mental health and financial health, we identified the need for NAB, and other businesses, to better understand and address this issue,” the bank’s head of social impact, Sasha Courville, says.
The list of actions employers are taking continues to grow beyond mindfulness and yoga classes to more specific measures such as in-house psychologists and free confidential counselling services.
PwC recently signed up to Medibio’s ilumen platform to help its employees improve their mental wellbeing. Supermarket giant Woolworths has created R U OK? ambassadors and invested in training 1500 staff to become accredited mental health first aid officers. Metro Trains in Victoria has wellness specialists, and food product company Mars is looking to measure depression among employees.
Wellbeing’s Nicholas also points to mining companies introducing different categories of leave and pay to help minimise the impact of fly-in-fly-out work, and fast food companies training managers to be able to make an early assessment and get young workers the right level of help.
Beyond Blue’s Harman says that if employers – big and small – are not thinking about the mental health of their workforce, they are losing money and productivity and will fail to attract or retain the best and brightest.
“This is such an important issue for business,” she says. “Implementing a mental health workplace strategy is not about ticking boxes or the feelgood factor, it’s about meaningful, ongoing structural cultural and policy changes.
“It has to start at the top [with] things like designing jobs so a person understands clearly what their role and accountabilities are and has a consistently manageable workload. We know that lack of clarity really stresses people out.”
Other measures include helping employees manage the demands of their work. “We all have days under a lot of pressure and days which are a little easier,” Harman says. “Consistently unmanageable workloads and high-stress, toxic environments are very bad for our mental health.”
Zero tolerance of bullying and harassment is essential, she says.
“Flexible work arrangements are also really important for people who have increasingly complex lives. [And so is] supporting employees at risk of developing a mental health condition or are the one in five living and working with a mental health condition.
“But also employing people with mental illness and embracing that as your diversity and inclusion strategy and recognising that people are living and working successfully. It’s not a few posters on the wall and a free pair of sneakers; it’s got to be long-term, meaningful, evidence based and measured, and based on listening to your staff’s feedback.”
The Brain and Mind Centre’s Hickie agrees: “Those who are really serious and expect to see a real return on investment will need to make much more sustained investments over a longer period,” he says. Very few are on that journey in Australia because employers don’t pay the real costs and very few appreciate the benefits that may be gained in the long term, he says.
“A few apps for wellbeing cost nothing and deliver very little.”
Whether you believe the mental health epidemic is being over-reported or is being driven by employers simply seeking to cover their liability, it is clear the issue will only continue to grow.
Businesses that fail to act will be hit with significant costs. Perhaps more real is the prospect that those who fail to act might find themselves on the wrong side of the law.