HISTORY is full of jobs that took an immense physical toll on employees, from miners and construction workers through to those who suffered “phossy jaw” (a destruction of the jawbone) in the match factories of the late 19th and early 20th centuries. But it is only in the past couple of decades that workers’ mental health has become more widely discussed and understood. The first World Mental Health Day was organised in 1992; the latest was marked on October 10th. Charity campaigns, like “time to change” in Britain, try to remove the stigma associated with mental-health problems.

Those problems are widespread. A recent review of studies in Europe found that 38% of the EU’s population suffers from a mental disorder (on a broad definition, ranging from anxiety to drug dependence) each year. As well as severe distress, this inevitably leads to absenteeism and poor performance. The World Health Organisation (WHO) estimates that mental-health troubles cost the global economy $1trn a year in lost output.

In a survey of American workers, 63% of respondents reported that stress in the workplace had a significant impact on their mental and behavioural health. According to a study by the Confederation of British Industry, which represents big businesses, 40% of employers in 2017 reported that more than 5% of their workforce had a mental-health issue. That was nearly a fourfold increase on a similar survey conducted in 2013.

This higher figure may actually be an encouraging sign. As the stigma surrounding mental illness fades, more people may be willing to admit to it. Society has certainly come a long way in its treatment of mental health. When Bartleby’s father suffered from depression after losing out from a job reshuffle in the 1960s, the doctors suggested electric-shock treatment. Bartleby’s grandmother suffered from severe post-natal depression in the 1920s; she was placed in a mental home and never saw her child again.

Nowadays treatment is much more likely to be associated with pharmaceuticals (though admittedly this can bring its own problems, notably the risk of addiction) and with therapy. Workers are more inclined to accept help if they feel the treatment regime will be considerate. “Cognitive behavioural therapy”, which teaches people to bypass unhelpful thoughts, has few negative connotations.

The business world has also made great strides in dealing with mental health. A 2017 report by Business in the Community, a British charity, for example, found that 53% of workers said they felt comfortable about discussing mental-health issues at work. But plenty of progress still needs to be made. Only 13% of those with a problem felt they would be able to discuss it with their line manager.

Zain Sikafi, a British doctor, has set up Mynurva, an online therapy service that schedules appointments after 5pm and at weekends, so that people can get help outside office hours. He says that people are reluctant to tell their friends and colleagues that they need therapy. That is why Mynurva has no app: it would be permanently visible on users’ phones. One approach that might encourage greater understanding, Dr Sikafi suggests, would be a change of terminology. Terms like “mental illness” are still associated with some severe conditions.

Some companies have a long-hours culture; others insist on near-continuous contact with their employees through their smartphones. That makes it very hard for workers to escape stress and to devote their attention to their families or to enjoy activities outside work.

On the other hand, flexitime has become more common, home working may create a calmer environment, and it is more acceptable for men to take time off for family events. And a reticence to talk about mental health in front of the boss may be unnecessary. Executives are people, too. A study by BUPA Global, a health insurer, of global business leaders found that 64% had suffered a mental-health issue at some point. That ought to make them sympathetic to staff in the same situation.

In theory, a more humane approach should be good for managers and workers for other reasons as well. The WHO says that “workplaces that promote mental health and support people with mental disorders are more likely to reduce absenteeism, increase productivity and benefit from associated economic gains.” Just the ability to talk freely about stress or anxiety may reduce the problem. Perhaps in future workers will be no more reluctant to reveal a mental condition than to report a broken bone or a dose of the flu.