Why mental health shouldn’t dominate your employee wellbeing strategy

Mental health has taken centre stage in employee wellbeing

The mental health of employees is now high on the agenda at most organisations. And rightly so.

There is no question, then, that mental health should be part of every employee wellbeing strategy. According to recent data from the CIPD, it seems that most organisations agree. In fact, mental health is currently dominating the wellbeing agenda.

  • 57% of organisations are focusing on mental health to a large extent, whereas only 25% are focusing on physical health to a large extent;
  • 74% of organisations are providing employees with access to counselling, yet less than 40% are providing access to gyms and physiotherapy; and
  • 84% of organisations have increased their focus on mental health in response to COVID-19.

Is this the right approach? Should employee wellbeing initiatives be so heavily skewed towards mental health?

We don’t think so. Because when you look more closely, the data actually tell a different story.

There is much more to employee wellbeing than mental health

If your goal is to meaningfully improve employee wellbeing and performance across your organisation, your wellbeing strategy should place equal focus on four health systems:

  • Metabolic health: How well your body processes, uses and stores calories
  • Musculoskeletal health: How well your bones, joints and soft tissues feel and move
  • Mental health: How well your mind feels and how well your brain performs
  • Immune health: How well your body fights infection and regulates inflammation


Firstly, because these four systems exert an equally significant influence on wellbeing and performance, when we consider the most important outcomes: longevity, quality of life, work absence and work performance.

Secondly, because each of these systems is reciprocally connected to the other three. Dysfunction in one increases the risk of dysfunction in the others. In other words, they don’t operate independently, so we shouldn’t treat them as if they do.

Let’s take a look at the data.

The impact of health on wellbeing and performance


The leading cause of death in working-age people (20–64 years) in England – by some margin – is heart disease, followed by liver disease and lung cancer. To put this into perspective, the annual number of deaths from heart disease in this age group is more than 60% higher than the number of deaths from either liver disease or lung cancer, and more than three times the number of deaths from suicide.

The modifiable risk factors for heart disease are predominantly related to metabolic dysfunction – including being overweight, high blood pressure, diabetes, and high cholesterol.

Quality of life

The leading cause of morbidity (reduced quality of life) in working-age people (15–69 years) in England is musculoskeletal disorders (22-29%), followed by mental disorders (12-20%). At a more granular level, low back pain (the most common musculoskeletal disorder) is responsible for 14-15% of morbidity, with depression (the most common mental disorder) accounting for 5-7%.

Interestingly, the top three risk factors for morbidity generally are: 1) high body mass index (BMI); 2) smoking; and 3) high fasting plasma glucose (blood sugar). High BMI and high blood sugar are both markers of metabolic dysfunction.

Work absence

In 2018 (a ‘normal’ year without a global pandemic), the top three causes of sickness absence in the UK were minor illnesses (38.5%), musculoskeletal problems (27.8%) and mental health conditions (17.5%).

Minor illnesses include colds, flu and sickness bugs, the frequency and severity of which is largely determined by immune health.

In 2020, COVID-19 was the third leading cause of sickness absence (after minor illnesses and musculoskeletal problems), highlighting further the importance of immune health to work absence.

Work performance

Presenteeism – the phenomenon of people working when unwell or not operating at full capacity – has been observed in most organisations in the UK. Needless to say, presenteeism is bad news for work performance.

It’s safe to assume that the leading causes of morbidity and work absence (outlined above) are also responsible for causing the unwellness and underperformance in most cases of presenteeism.

Cognitive function – an aspect of mental health that includes processes such as perception, memory, learning, attention, decision making, and communication – has a huge influence on work performance, yet is rarely considered in employee wellbeing discussions.

All aspects of mental and physical health are connected

As we’ve seen, metabolic health, musculoskeletal health, mental health, and immune health are all equally and independently important for employee wellbeing and performance. But they’re also reciprocally linked to one another.

For example, having heart disease (metabolic health) makes it 2x more likely that you’ll have depression (mental health), and vice versa; having depression makes it 2.5x more likely that you’ll have chronic pain (musculoskeletal health), and vice versa; and having chronic pain makes it 4x more likely that you’ll have heart disease, and vice versa.

The mechanisms at play here are complex, but it’s thought that immune dysfunction is likely to be intimately involved.

It’s now well established that metabolic disease impairs the immune system, which helps to explain why obesity, type 2 diabetes, and heart disease are all associated with worse COVID-19 outcomes. It also appears that metabolic disease negatively impacts cognitive function.

This tells us that the health of the mind and the health of the physical body (including the brain) cannot be untangled from each other.

The impact of COVID-19 on mental health

The pandemic has certainly had a negative impact on mental health – with loneliness, stress, hopelessness, and suicidal thoughts all increasing since March 2020 (although, interestingly, anxiety about the pandemic has fallen).

But physical health has deteriorated to a similar degree. While 45% of UK employees report worse mental health as a result of the lockdown, 40% report worse physical health. Weight gain (metabolic dysfunction) has been common during lockdown, particularly in people who were already overweight before the pandemic. Musculoskeletal health has also declined, with increases in pain frequency and intensity. This is perhaps no surprise, since the lockdown has resulted in an increase in unhealthy eating habits and a decrease in physical activity.

These phenomena are not independent. Mental health and lifestyle habits during lockdown are interwoven with metabolic health, musculoskeletal health and immune health. It can be a vicious cycle.

What does all this mean for employee wellbeing?

There’s no doubt that mental health is crucial to employee wellbeing and performance, but it shouldn’t dominate the agenda. The data clearly demonstrate that metabolic health, musculoskeletal health and immune health are equally as important.

These four systems are jointly responsible for determining – in large part – how your employees feel and perform day in, day out. Therefore, you can increase the impact of your employee wellbeing strategy by placing equal focus on all four systems. By doing this, you can help turn a vicious cycle into a virtuous one.

How BioMe can help

We take the pressure out of employee wellbeing for you, by making a truly sustainable difference to them.

Our unique modular solution has been designed to empower your employees with everything they need to make meaningful, long-term improvements to their metabolic health, musculoskeletal health, mental health and immune health.

We work with you to develop a bespoke and cohesive solution to fit and enhance your wellbeing strategy.

Please get in touch to find out more

T: +44(0)7894 088 345

E: team@biome-wellbeing.com

W: www.biome-wellbeing.com

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