It’s not even 9am on a Wednesday morning and I’m stood in a hall full of business executives and CEOs engaging in what has rather hopefully been described as an “energy boost”. We’re raising our arms; trying to find and release the tension in our necks. Our shoulders roll in unison. 

This is the Mad World Summit, an annual event designed to “add mental health strategies to the business agenda”. The session I’m in is intended to “kickstart the day with some positive psychology”, which is probably why we’re asked to “reflect on achievements we’re proud of” while we shimmy and stretch across the conference hall. 

With a rate of £695 per delegate, the conference is firmly aimed at ‘business leaders’ – the people making decisions for their workers. What they’re being encouraged to do here, on the surface, seems like a good thing: destigmatising mental illness in the workplace, establishing wellbeing programmes in order to help those who are struggling. 

But workplace wellbeing programmes are rarely as philanthropic, empathetic or radical as they seem: in fact, most exist only to prop up the status quo. To workers, such programmes are generally marketed as a way to make them feel better at work. Behind the scenes, the point is to protect the bottom line.

Because, as one prominent liberal mental health activist put it in a video shown at Mad World, mentally unwell workers are less productive workers. Companies lose money: either workers engage in ‘presenteeism’ – coming to work sick and bringing low levels of ‘productivity’ with them – or they take time off.

Either way, your company – and the economy – is losing money, and something has to be done. This in turn feeds into a narrative in which mental health is measured both by cost and by labour, with wellbeing measured only in terms of how much someone’s illness or distress is costing the economy, and by how able they are to work. 

But beyond the hype of conferences like this, there is little actual evidence that wellbeing programmes are doing what they set out to. One 2019 study looked at the impact of a wellbeing programme on 32,000 workers at a warehouse company in the US, finding that though diet and exercise levels were improved, there were no other significant differences in health outcomes: no reduced spending on health care, no improvement in mood. 

So why do companies keep implementing such schemes? One reason is that it looks good, as psychologist Jay Watts points out: “it’s good optics… all the better to sell to Generation Z-ers and millennials who require their companies to be ethical.” 

It also means that businesses have plausible deniability when it comes to protecting worker mental health. Presenting your workforce with a raft of apparently life-changing perks and encouraging them to “open up” to managers and colleagues means that no actual structural reform has to take place, no money has to be lost, and there need be no acknowledgement of just how rooted mental ill health and distress is in the structure of work itself.

After all, if you offer workers four sessions of therapy, ask them to take part in ‘positive psychology’ workshops, give them free fruit or teach them how to meditate and they choose not to take you up on it, the responsibility is theirs, not yours: you don’t have to acknowledge your part in their illness or distress.

You don’t have to pay your workers more or give them flexible working hours, give them paid sick leave or make sure they’re not doing overtime. You don’t even have to pay them for overtime. No notice for rotas on shift work, no change in how you contract, no change in the way your company deals with harassment or discrimination. It’s up to the worker how well they are, right?

“It’s the individual who is left pathologised rather than dysfunctional systems,” Watts says. “It completely underlines the neoliberal idea that if you are not working productively you are flawed, rather than splashing around desperately trying to stay upright in the toxic waters of capitalism.”

There’s no denying that many business leaders probably do care about mental health in a non-cynical way, and that in providing things like free yoga sessions or office fruit they sincerely believe they are doing something genuinely good. But, fundamentally, they care more about the bottom line; at best, they care about helping employees with their mental health up until the point it affects the bottom line. 

There’s also some basic, literal truth in one of the Mad World conference’s carefully chosen hashtags: “#WeAllHaveMentalHealth”. As we know from the thousands of awareness campaigns of the last few years, anyone can experience mental ill health. Even Prince Harry!

But this elides a lot. Yes, a CEO or a prince might have the same diagnosis as someone who’s living on benefits, who works on a zero hour contract, or has a stable but poorly-paying job. But do they experience their illness in the same way? Does stigma have the same affect on their lives and relationships? If they visit the same service or doctor as one another are they going to get the same care? Can they take the same amount of time off work without worrying about how they’re going to live? 

The answer to each of these questions is obviously no – and that’s without even touching any of the additional issues around poverty, labour and marginalisation that are so vital to a full and proper understanding of what mental illness actually means. In failing to even ask them when we design workplace wellbeing programmes or talk about mental health in financial and economic terms, we’re condemning them to failure. 

Walking around the Mad World conference hall at the start of the day, I’m stopped by a representative of a wellbeing company: a contractor who goes into businesses and teaches them how to better care for their workers. She proffers a basket full of pebbles and asks me to pick one, which I dutifully do. The point, she explains, is to put the rock somewhere you’ll come across it every day: when you do, you think of something you’re grateful for. Your boss, maybe?

I think of all the things I would be grateful for that don’t currently exist: less financial precarity, better protections for workers, a properly funded healthcare system, for mentally ill people to not be criminalised for suicide attempts or unduly restrained on wards, an end to austerity and to the harms of the criminal justice system. 

I thank her, walk off, and put the rock in the bin.