The month between World Suicide Prevention Day on September 10 and World Mental Health Day on October 10 is a good time to start considering the under-discussed topics of anxiety, depression and suicide in our society, especially as they relate to the workplace.
It is a quiet epidemic. There were 548 million people around the world suffering from depression or anxiety in 2017, a 50% increase from 1990, according to the University of Washington.
Despite its prosperous and harmonious surface, Japan is not a particularly "happy" country. Its suicide rate is the highest among G-7 countries and third in the G-20, according to the OECD. This year's World Happiness Report rated Japan as the 58th happiest.
Workers in Japan back this up. The Japan Productivity Center, through its periodic survey of 2,300 public companies, found in 2017 that a quarter of respondents reported an increase in the incidence of mental health problems. Only 10% reported a decrease.
Why is there this increase in anxiety at work? Universally, modern workers feel more isolated as digital communication encroaches on human contact and as diverse work styles further take away from informal, in-person social interactions.
Within Japan, given its tight labor market, staff are required to do more with less, leaving less time for managers to guide and support their staff. Ironically, compliance with work-reform rules drives employees to concentrate on their own tasks, allowing little time to socialize at work.
Moreover, the traditional Japanese monoculture is conducive to workplace bullying and depression for those who are different. While diversity is making slow progress -- almost a third of foreign workers report experiencing discrimination in the five years to 2017 -- the inclusion is often insufficient, with people treated as tokens.
Difference is not only defined by gender or nationality. TELL Japan, a bilingual hotline for people with depression, continues to receive more calls from returnee Japanese, who find themselves maladjusted to the Japanese workplace, than from foreigners, according to Vickie Skorji, TELL Lifeline's director.
In its effort to eradicate the causes of depression at work, the government implemented various laws. Work-reform laws for large companies, effective as of April 2019, cap the number of overtime hours to 45 hours a month to promote work-life balance and prevent karoshi, death by overwork.
More recently, the Diet passed the Harassment Regulation Act.
The blizzard of new regulations leaves management busy playing catch-up. When checking the box becomes a priority, it is easy to lose sight of the goal, which is to make work enjoyable and inclusive for all, leading to less depression at work. This is not an imperative that should be left for the government alone to lead.
First, undeterred by red tape, employers need to make sure depression is not left untreated. They must establish and make visible a framework to support workers, starting with early detection leading to treatment and follow-up. Early detection is possible if managers are trained to spot signs of mental distress in their staff, triggering referral and evaluation.
Once mental health troubles are detected, employers need to treat them with the same urgency and care that physical health requires. An employee assistance program, such as referral resources, must be available to staff as well as their managers. When employees seek time off for treatment, employers can devise a return-to-work plan.
Second, employees themselves can help to make an inclusive environment less likely to promote depression. It starts from small things. Turning a blind eye to a lewd remark or an inappropriate joke is not an option. Brushing aside an opinion just because it comes from an experience in another country is not an option.
While this takes courage in a culture that prizes conformity, we owe it to ourselves to call out inappropriate comments or actions so we can achieve zero tolerance for disrespect. Harassment, which often contributes to depression, or at least harms morale, for the victim, is best caught and addressed early.
Finally, community and family may provide an emotional safety net by showing an understanding of mental health issues. Isolation does not help depression. By being an educated listener and adviser, those outside work can nudge the troubled to seek appropriate help.
The decline of shareholder-first capitalism, as declared by a large U.S. business association in August, may help this battle. It is on the cusp of being replaced by a more balanced view of business serving customers and workers as much as shareholders. This suggests a work culture of respect, rather than squeezing staff.
This should resonate well with Japan, a latecomer to shareholder capitalism. Considering multiple stakeholders and fighting workplace depression share the same root, which is respect for all regardless of their position.
Lessening workplace depression with an all-hands-on-deck approach benefits everyone. The OECD estimates that the economic burden of mental ill-health amounts to 4% of GDP driven by the loss of productivity.
The fight against depression is a quiet one which requires patience. Japan's long-term success is an accumulation of microscopic successes in each individual workplace or family. In each microcosm, it is everyone's business.
Nobuko Kobayashi is Ernst & Young -- Japan -- transaction advisory services managing director and partner. The views reflected in this article are the views of the author and do not necessarily reflect the views of the global EY organization or its member companies.