Why cancer could be the missing link in mental health support

Creating a positive cancer culture is vital if employers want to help employees with the disease and also those caring for sufferers

Mental health has been at the forefront of workplace wellbeing strategies for the past few years, and for good reason.

Mental ill health is the most common cause of long-term absence from the workplace, costing UK employers an estimated £45m per year. Employees cite stress, depression and anxiety as the conditions keeping them away from work for – according to Health and Safety Executive – an estimated 17 million days in 2021/22.

According to the CIPD, the most common causes of workplace stress are workload, followed by relationships/family and then by management style. Close behind in fourth place is personal illness.

That physical health impacts mental health is well proven. The National Institute for Mental Health found that people with chronic medical conditions including cancer, high blood pressure and diabetes have a higher risk of depression. However, what really sets this group apart is the interventions required to reach and support them.

The challenge of comorbidity

That mental ill health can be directly linked with physical ill health raises questions for employers: do strategies designed to tackle mental ill health (the top five being EAPs, flexible working, staff surveys, risk assessments and manager training) work for employees experiencing stress, anxiety and/or depression at the same as a chronic illness?

A mental health strategy that fails to reach an entire cohort of employees is not only ineffective, but costly. In the case of cancer, while around 1.5% of an average workforce will get a diagnosis, the costs associated with it are disproportionately high, in some cases exceeding 10% of employers’ healthcare budgets.

Failing to support this cohort with their mental health can lead to extended sickness absence and reduced productivity beyond that experienced as a direct result of the physical disease, as well as increased healthcare claims and, eventually, higher insurance premiums.

Accounting for cancer

Around 36% of those people who get cancer are of working age, and – according to Cancer Research UK – three in 10 will experience mental health issues such as anxiety and depression. A 2021 survey by the charity Maggie’s found that three in five people who have or have had cancer feel that the mental challenge of the disease is actually harder to cope with than the physical treatment and side effects.

To create a mental health strategy that accounts for mental ill health comorbid with conditions such as cancer, employers must have an understanding of the challenges experienced at every stage in the disease, from diagnosis to survivorship. It’s also imperative to identify and support caregivers.

Cancer and mental health

Diagnosis

The mental trauma of a cancer diagnosis can be – understandably – significant. The newly diagnosed often feel a need to protect friends and family by holding in their feelings. This can be exacerbated if they also choose not to disclose their diagnosis at work, which a reported 50% of employees do not, and are therefore cut off from support.

Delays in treatment after the Covid-19 pandemic are also a significant cause of stress and anxiety for those recently diagnosed with cancer.

During treatment

A study published in 2021 found that cancer patients undergoing treatment – in this case radiotherapy – suffer depression, anxiety and stress. There are similar reports for people going through chemotherapy, which itself can cause brain fog, fatigue and low mood. The physical side-effects from treatment such as surgery are also a significant factor in mental ill health.

There is also a more practical, financial, factor to consider. A survey by charity Maggie’s found that 83% of people with cancer said that unexpected expenses since their diagnosis affect their mental health, with more than one-third feeling the impact strongly.

Cancer survivorship

Post-traumatic stress disorder is common among cancer survivors and can last months or even years after treatment has ended. Fear of cancer recurrence is increasingly recognised as a significant challenge. One 2018 study on breast cancer survivors found that half the group reported some level of fear of recurrence, while 20-50% reported that the fear profoundly affected their lives. Financial anxiety also remains a factor for this group.

Caregivers

Macmillan estimated in 2016 that there were more than 1.4 million cancer caregivers in the UK, although the true number is probably much higher. Almost 90% of caregivers are also juggling a job, although many will choose not to disclose their carer status to their employer, making this a hard to reach but also especially vulnerable group.

Around 30% of caregivers say their mental health is bad or very bad, while 93% agreed that the increase in the cost of living was having a negative impact on their mental and/or physical health.

Reaching the cancer cohort

Including those living with or beyond cancer, and their caregivers, in mental health policies and interventions is a continuing challenge, not least because, as an employer, you may not know who they are.

The work, therefore, begins with creating a cancer-positive culture; an environment in which conversations about cancer are initiated, information shared, support available, and in which people feel able to reveal their diagnoses.

A vital part of creating that culture is having leadership and line managers who know the organisational policies relevant to those with cancer, as well as how to offer appropriate support.

While EAPs can fall short in terms of supporting those with cancer, dedicated digital solutions that connect those living with and after cancer, and their caregivers, to expert support, can help them manage the physical, psychological and even practical impacts of cancer that can result in mental ill health.

Download your free guide to creating a cancer positive culture in the workplace