LONDON (Reuters) - In ‘Billions’, a U.S. television show set in the world of hedge funds, traders at the fictional Axe Capital regularly attend sessions with an in-house psychiatrist.

The first Mental Health First Aiders in the Goldman Sachs London office on Fleet Street are seen in London, Britain in this handout photo obtained on May 30, 2019. Goldman Sachs/Handout via REUTERS

In real life, finance professionals are rarely so open about seeking psychological help.

On Wall Street and in the City of London, hyperambition and an ‘always on’ attitude are richly rewarded and people are often wary of revealing something that could be perceived as a weakness.

Two out of three people working in financial services have experienced mental health issues as a result of work or where work was a related factor, according to a 2018 survey, broadly in line with the wider workforce. The Mental Health at Work poll questioned over 4,600 British employees from a range of industries.

Many don’t tell their bosses for fear of damaging their careers.

“Stigma definitely still exists,” said Beth Robotham, an executive director at Goldman Sachs in London.

“Legislation is supposed to protect people from that kind of discrimination and employers are trying much, much harder but it would be naïve of me to say that that wasn’t an issue any more.”

Robotham experienced anxiety attacks when she was in charge of recruiting bankers focused on the healthcare sector for Goldman in Europe, the Middle East and Africa (EMEA) in 2010. It took her months to tell her managers and seek help.

“I just assumed that people like me must just fall out of ‘the system’, and therefore I should just keep quiet or else I will be pushed out,” she said.

Robotham, deputy chair of the City Mental Health Alliance, which promotes good mental health among London’s financial workforce, is one of a growing group of executives choosing to speak publicly about their problems to reassure others they are not alone.

SUFFER IN SILENCE

People can experience anxiety, depression and other mental health issues regardless of their job.

But punishing schedules can pile on extra pressure. All-nighters and 100-hour work weeks are not unusual in investment banking, particularly when working on deals or public offerings of debt or equity.

Some 44 percent of banking employees said they felt under excessive pressure to perform in their work, according to a survey of over 70,000 people carried out by Britain’s Banking Standards Board last year. A quarter said that working at their firm was bad for their health.

In recent years, banks have tried to lighten workloads, relax dress codes and give staff more time to focus on life outside the office to retain talent and avoid costly burnout.

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But bankers with mental health problems, especially those still early in their careers, are often reluctant to flag them in case their bosses think they can’t hack the pace.

Matt Evans, global head of investment bank recruiting and head of firmwide recruiting for EMEA at JPMorgan, said he spent nearly 20 years concealing his struggle with depression until the bank’s ‘This Is Me’ campaign in 2017 prompted him to share his experiences.

“There’s been no downside for me in telling my story. The support I’ve had has been significant,” he said. “I got promoted to MD after disclosing my condition.”

Evans was recently diagnosed with bipolar disorder and took three months off last year. He was phased back into work in December and says he is “100 percent convinced” the break will have no impact on his professional prospects.

But not everyone shares his confidence around attitudes to mental health.

While it is illegal for employers to discriminate against people for having mental health problems, more than half of 2,000 UK workers surveyed by health-tech firm Mynurva feared telling their manager would hinder their chances of promotion, while 57% believed disclosure would harm relationships with colleagues.

Mynurva, which provides online counseling, also reported a surge in demand from financial executives who are bypassing their employers’ services because they fear the consequences.

“The findings show the fear and embarrassment employees have when disclosing their condition to their employer. And it explains why professionals would rather suffer in silence than seek the necessary help,” said Dr Zain Sikafi, CEO of Mynurva.

MENTAL HEALTH FIRST AIDERS

One in four people will be affected by mental or neurological disorders at some point in their lives and the annual cost to the global economy is estimated at $1 trillion in lost productivity, according to the World Health Organization.

Brian Heyworth, global head of client strategy at HSBC and chairman of the City Mental Health Alliance, wants his bank and others to help employees before they become seriously ill.

“In an organization of 235,000 people, some will be having suicidal thoughts but many more will be sliding along the spectrum towards that point. We want to anticipate and prevent that,” he said.

HSBC is considering hiring on-site counselors as part of its ‘Healthiest Human System’ initiative, the brainchild of CEO John Flint.

JPMorgan’s first UK-based on-site counselor is due to start work at the bank’s offices in London’s Canary Wharf this summer.

The bank already has full-time counselors in nine U.S. locations, including New York, Delaware, Chicago and Texas and also offers a Resilience App providing stress management tips.

Goldman Sachs is planning to train dozens of UK staff as mental health first aiders so that they can spot signs that colleagues may be starting to spiral due to stress or anxiety -- including changes in appearance, working habits or social patterns, Robotham said.

Goldman has also launched a paid internship program in the United States for people who identify as ‘neurodiverse’. Neurodiversity covers a wide range of neurological differences including autism, dyslexia, developmental disorders and mental health conditions.

As the public profile of mental health grows, employers in Britain who fail to show adequate mental wellbeing provision for staff could be sued under the Management of Health and Safety at Work Regulations Act 1999, which compels employers to assess the nature and scale of health risks at work, including stress.

“The harm and detriment to an employer stemming from these kinds of issues are not solely financial, they can inflict greater damage to reputation, public image, productivity and retention,” said Matthew Cole, partner at law firm Prettys.

Cole said he had not seen any significant rise in the number of staff seeking damages from employers due to stress-related conditions but said companies were very sensitive to the risk.

“If an employee ends up with a psychiatric condition which prevents them from working in an environment where they might have otherwise earned six figures, that can amount to some significant liabilities.”

Prevention is much cheaper. Britain’s Mental Health Foundation estimates that mental health support in the workplace could save UK businesses up to 8 billion pounds a year.

The charity puts the cost of providing information and advice on mental health online and via workshops at around 80 pounds per employee per year.

Heyworth has grappled with anxiety and depression since childhood and was hired by HSBC after a period of leave from Bank of America. He knows that he is one of the lucky ones, both banks knew of his mental health problems and were supportive.

“Make no mistake, we are still in the foothills on this journey,” he said.

“The positive thing is that more people are now asking for help, but we also need to accept that there are probably more people who need help too. The next phase of the challenge is creating the conditions where we can reverse that trend.”