Health screening: Pressure tests to find stress

If you read nothing else, read this . . .

• Stress can be hard to quantify but it is possible to monitor using blood tests.

• Another method is tests that measure peoples’ heart rates when relaxed and under pressure.

Stress and mental health issues may be hard to spot among employees, but there are outward clues and a number of tests that can identify staff who may be suffering

Stress is perhaps the most challenging area for employers looking to create and maintain a healthy workforce.

According to the Health and Safety Executive, about 9.8 million working days were lost as a direct result of stress in 2009-10, with an average time away from the workplace of 22.6 days per case. According to data published by Mercer in May this year, mental health issues have now overtaken musculoskeletal disorders as the main cause of staff absence.

Louise Aston, director, Workwell campaign at Business in the Community, says: “Psychological health is still the elephant in the room. Only 15 of the FTSE 100 companies actively report on a proactive approach to emotional resilience. It is not just about individual resilience, but organisational resilience.”

She says the risk of stress is not just from those unable to work at all, but from ‘disengagement presenteeism’, which may cost employers almost one-and-a-half times as much as sickness absence.

Lifestyle choice

Eleanor Smith, rewards and mobility manager at law firm Linklaters, says there is a fine line between stress and pressure. “If you work for a magic circle law firm, it is tough,” she says. “A certain level of pressure can actually be very incentivising for certain people, but they need to contemplate whether that is a lifestyle choice they are prepared to make.”

Part of the reason why stress may receive less attention than more tangible medical conditions is because it can be hard to diagnose. The most important person is often the line manager, both for spotting stressed staff and as a potential cause in the first place. Aston says: “Line managers are typically promoted for their technical expertise rather than their emotional intelligence, but have a critical role in those difficult conversations, picking up the early symptoms of stress and actually being proactive around how they manage that. It is a massive issue.”

Sara Turner, UK head of benefits and wellbeing at KPMG, points out the need for a clinical method of identifying staff at risk. “If you ask most people whether they feel stressed, they will say ‘yes’. You need some kind of intervention to demonstrate whether they are or not. Some people may say they do not feel stressed at all, but they are. They just do not realise it.”

Stress and mental health issues can be hard to quantify, but they can now be monitored through blood tests that track cytokines, hormones and other elements, says Valerie Phillips, head of business at Randox Health Checks.

Symptom of stress

One option is to measure cortisol an anti-inflammatory agent produced in the glands above the kidneys as a symptom of stress. Dorian Dugmore, director of Wellness International, part of Adidas UK, says: “It reduces your immune function and wipes out some white blood cells, so when people are constantly stressed, their adrenaline and cortisol levels rise.”

Other tests measure people’s heart rates when they are relaxed and again when they are under pressure. “You ask them if they would like to sing and all of a sudden it gets erratic,” says Dugmore.

This can then be compared to future readings taken when people may feel under pressure.

Turner recalls a workshop KPMG ran for its HR staff around depression, where a doctor highlighted the link between mental health and physical conditions, which could act as a warning sign. “People with depression might report back problems, aches and pains or headaches and they are actually very symptomatic of a mental health condition,” she says. “Likewise, people with significant chronic health issues are more likely to be anxious, stressed or depressed than people who do not. You have to start drawing it all together.”

Read more from the health screening roundtable discussion