Company culture: Managing stress, presenteeism and mental health


Poor mental health is a burgeoning issue, with depression, stress and anxiety rife within the PR industry. This chapter looks at some of the potential reasons for this and provides an action plan for employers looking to proactively address the issue and create a healthy workplace. 

You’ll learn:
•    Why you should take mental health seriously
•    How to identify mental health issues in your company
•    How to increase profitability by tackling those issues effectively

30% of respondents in the 2016 CIPR State of the Profession Survey stated that they are ‘somewhat unhappy’ or ‘not at all happy’ when indicating their level of well-being in their jobs [1]

Nearly a third of UK staff persistently turn up to work ill and only 35% are generally healthy and present, according to the CIPD’s Absence Management Report [2]

The 2016 PRCA Census reported that 12% of those in PR changing their job opted to leave the industry completely for a new career [3]. And the overall level of staff turnover within the public relations industry is around 25% per year.

The statistics are pretty alarming. And the cost to the communications industry of failing to adequately address these issues is huge.

Mental health issues cost the UK £70 billion per year [4] while the annual cost of presenteeism is twice that of absenteeism [2]. Meanwhile, the cost of losing a single employee can be as much as 60% of that employee’s salary. And much of these costs are incurred not through healthcare, benefits, recruitment or training, but lost productivity.

The mental health epidemic

The communications industry is a notoriously high-pressure environment. People work long hours and deal with tight deadlines and demanding clients on an almost daily basis. Public relations regularly features alongside firefighters, airline pilots and police officers in lists of the most stressful careers.

But how often have you heard of someone in PR having a few days off due to stress, anxiety or depression?

Professor Sir Cary Cooper of the Manchester Business School says that: “presenteeism is the biggest threat to UK workplace productivity”. He warns there is a risk that staff are not coping with the competing demands of work and home life. And, given the levels of work-related stress in public relations it is not, I believe, unreasonable to describe the mental health issue in the communications industry as endemic.

I was diagnosed with clinical depression in 2004 and have suffered on and off ever since. About three years ago I started to write about my experiences on Facebook and on my blog, and in May I told my story at the CIPR in support of Mental Health Awareness Week [5].

The striking thing is that every time I share an article about mental health or post about my experiences, I have people message me telling me their own story or looking for support. I’ve lost count of the number of communications professionals I’ve spoken to privately about this in the last few years; some of whom I’ve known or worked with, some of whom I haven’t.

In 2015, the PRCA published data showing that 34% of PR practitioners have been diagnosed with or experienced some form of mental ill health [6]. Make no mistake, depression, stress and anxiety are rife within the public relations industry.

The culture of client first

So why is it the case that communications is so damaging to our mental health? Police officers, firefighters and nurses I can understand; they’re professions that deal with life and death. PR? Not so much. It’s PR not ER, as the saying goes.

The answer lies in the way that the industry deals, or rather doesn’t deal, with personal stress and pressure. Of all the people I’ve spoken to over the last three years, I cannot recall a single person who blamed the job solely for their condition. Every person had personal issues to deal with; illness, family problems, financial issues, divorce, death.

And that is where we fall down and why we have such a big problem. The culture in the public relations industry is that the job comes first. 

We are encouraged to be ‘always on’; to say ‘yes’ to every client demand no matter how unreasonable; to meet unrealistic deadlines. If there is blame to be had, the uncomfortable truth is that it has to lie with those responsible for reinforcing and perpetuating this culture within companies.

It makes little sense. Pushing people too hard can lead to emotional trauma and, ultimately, burnout. And stress, anxiety and depression have a significant and damaging effect on individual performance levels.

Lack of motivation and low productivity are commonplace among those suffering with poor mental health. 

No agency management personnel would ever admit, or perhaps even believe, that they put their clients before their employees. And yet I have heard stories from those suffering, and experienced first hand, a serious lack of compassion, people being put on performance reviews and issues being paid lip service to.

Failure to address such issues in the short term is far more costly in the long term in all sorts of ways, not least client retention, recruitment and training costs and, ultimately, profitability.

Part of the problem is simply that there is a lack of understanding of what poor mental health is and of what to do about it. There’s still a great deal of stigma around depression and, quite simply, it isn’t talked about enough. Agency leaders don’t know where to turn to for advice.

Identifying poor mental health

Recognising that an employee is suffering from a mental health issue is not easy, especially given that the communications industry is high pressure at the best of times. But there are a few things to look for that might alert you.

Stress, anxiety and depression manifest themselves in different ways. And a case of ‘the blues’ isn’t really one of them. The key common indicators are motivation, productivity and general performance. If these have dipped uncharacteristically, it’s a warning sign that something is wrong.

But over and above performance, there are other indicators to be aware of. Mood is a big one. For me personally, I become very intolerant and tetchy if a depressive episode is on its way and I’ve learned to spot this and act on it sooner rather than later. So if you know someone who is normally fairly level-headed but is being unusually temperamental, absent minded and/or erratic, it’s possible they’re suffering from stress.

Sleep is another issue. When depressed, some people suffer terribly from insomnia while others struggle to get up in the morning. Either way, if you have an employee who seems to be so tired that they can hardly function, it might not be because they spent all weekend on the razz.

Another big indicator is diet. Again, this varies; while some people don’t want to eat anything when their mental health is poor, others can’t stop themselves. So an employee who appears to be losing or gaining weight rapidly may have a problem with depression or anxiety.

The key is to be aware of all of the symptoms and to have a management structure that watches for them. One person alone cannot possibly be responsible for the mental health of your company; if you’re serious about tackling the problem (and don’t kid yourself that you don’t have a problem) you have to bake it into everyone who manages people.

An action plan

Perhaps the most significant thing you can do to address the mental health issue in your own organisation is to be proactive about it. Don’t wait for your staff to approach you with their problems, because they won’t.

There are many reasons depression and anxiety are so rife but so hidden in the communications industry, but they all tend to lead back to stigma. PR professionals are taught not to show weakness. They fear that admitting they’re struggling to cope at any given time will damage their credibility and career prospects, so they keep quiet. And I speak from personal experience.

But you can break this cycle. Resolve right now to implement a culture that acknowledges mental health issues. Be proactive. 

Much of this will come from your management team and encouraging open dialogue among all levels of your organisation. It has to be implemented from the top down, with each level responsible for looking after the level directly below them. Encourage others to keep a watchful eye on those they manage as a part of their job role. Shield employees from pressure where you can instead of piling it on them. 

Don’t patronise people, but do provide escape mechanisms where employees can work in different ways if they need to from time to time. Simple things like flexible working hours can help anyone struggling with mornings or unable to sleep. Similarly, the option to work remotely is useful where someone is struggling to cope with the pressures of the office or dealing with people (which is common, as many depressed people simply want to hide away and be by themselves).

Think outside the box a little too. What about banning out of hours emails? People in the UK have the longest working hours in the EU [2] and a joint study by Lehigh University and Colorado State University [7] found that spending time on after hours work contributed to emotional exhaustion, increasing stress and negatively affected job performance. Just the ‘assumed availability’ of email is enough to create constant stress.

Be proactive

Above anything else though, don’t do any of this to pay lip service to the issue. Hard wire the approach into your management structure, hire someone to train your staff on recognising mental health issues and dealing with them. Teach people to show genuine concern for those suffering, approach them openly and ask how you can help with their recovery.

Don’t sweep presenteeism, stress, depression and mental health under the carpet. Make a commitment to tackle the problem and it will pay dividends in happier employees, increased productivity and greater profitability.

Case study

Focus PR is leading the way when it comes to operating a progressive approach towards mental health. The management team believes in prevention rather than cure and operates an ‘open door policy’ to create a nurturing culture.

“We don’t have a history of people being signed off from work with mental health problems, but there have been occasions where steps we’ve taken have potentially prevented them arising”, says Adrienne Conlon, Head of Operations.

Team members tackling personal issues are supported on a case-by-case basis, and assistance may include steps such as: access to paid time off so that an individual can manage a situation and return to work with a fresh head; paid time off to attend counselling sessions; the ability to start or finish earlier or later, or to work from home; and redistribution of workload.

Focus also provides a self-referral private healthcare plan that includes elements such as cognitive behavioural therapy, counselling and GP video consultations with a maximum 48 hour wait, all of which is handled directly and privately.

“We don’t believe in ‘burning and churning’ our team,” says Conlon, “and as a direct result of the care we show them, 40% of our team have been with us for over three years.”









Paul Sutton is an independent digital media consultant who is as passionate about addressing the mental well-being of the communications industry as he is about improving the social media return on investment of his clients. He has helped a diverse range of organisations to improve the effectiveness of their social media marketing, from large brands like Honda and L’Oreal to start-ups and small companies near his Oxfordshire home. He has now developed a service to assist communications agencies with implementing a best practice approach to mental health understanding and provision. For more information, visit

Twitter: @ThePaulSutton