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September 16, 2012

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Rise in working-aged people hospitalised for stress

The number of people in England being sent to hospital for stress is increasing, with admission rates highest among working-aged people (18 to 60-year-olds).

Provisional figures released last week by the Health and Social Care Information Centre (HSCIC) show that hospitals in England dealt with 6370 admissions for stress – the feeling of being under too much emotional or mental pressure – in the 12 months to May this year. This represents a 7-per-cent rise on the previous 12-month period, during which 5960 admissions were registered. Since the recession in 2008, there has been a 47-per-cent increase in admissions on account of stress.

Stress admissions rose at a faster rate than admissions overall, which increased by about 2 per cent in the same period. The North West Strategic Health Authority registered the highest admission rate of any of England’s 10 SHAs, with 1390 admissions; the South West SHA had the lowest rate, with only 350 people requiring treatment.

The HSCIC also noted that admissions for anxiety (the feeling of mild or severe unease, such as worry and fear) fell by almost 3 per cent in the 12 months to May, with the majority of admissions among the elderly.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, described the figures as “alarming”. He said: “Sustained periods of stress, anxiety and depression can lead to an increased risk of diabetes, stroke and cardiovascular disease. So what can we do in this time of austerity to reduce the impact of debt on the nation’s mental health?

“Admitting people to hospital for stress is usually an expensive solution to a problem that should have been solved earlier in a primary-care or workplace setting. We must invest in less costly, more effective early-intervention services for people experiencing such stress, instead of waiting for people’s distress and symptoms to require a hospital admission.”

Writing in his blog, stress expert Professor Cary Cooper said a ‘perfect storm’ is raging, “with fewer people in the workplace (with all the downsizing in the public and private sectors) doing more work, working longer hours, feeling less secure and being more micromanaged”.

He added: “We need to educate managers in the public and private sectors to be able to identify the signs of stress in their subordinates, to carry out stress and well-being audits to see what employees perceive as their pressure points; and then we need to take action to deal with the underlying causes identified by these audits.”

In separate news, researchers in the UK have found that people who have highly-demanding jobs and little freedom to make decisions are 23-per-cent more likely to experience a heart attack compared with people who are not exposed to work strain. However, the risk to the heart associated with job strain is much smaller than the risk from smoking, or failing to exercise.

Researchers analysed job strain in nearly 200,000 employees without coronary heart disease (CHD), who participated in 13 European studies between 1985 and 2006. At the outset of each study, participants were asked to assess whether they had excessive workloads and too little time to complete their work, and what level of freedom they had in making work decisions. They were then monitored for an average of seven and a half years, during which period the researchers recorded 2356 events of incident CHD (first non-fatal heart attack, or coronary death).

Lead researcher Professor Mika Kivimäki, from University College London Epidemiology & Public Health, said: “Our findings indicate that job strain is associated with a small, but consistent, increased risk of experiencing a first CHD event, such as a heart attack.”

“The overall population attributable risk (PAR) for CHD events was around 3.4 per cent, suggesting that if the association were causal, then job strain would account for a notable proportion of CHD events in working populations. As such, reducing workplace stress might decrease disease incidence.”

However, the professor added that this strategy would have a much smaller effect than tackling standard risk factors, such as smoking and physical inactivity, which, if eliminated, could prevent 36 per cent and 12 per cent of CHD incidents, respectively.

The research is published in The Lancet.

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