Toespraak van minister Asscher bij het Target Depression Forum

Toespraak | 12-11-2015

It's been the worst year ever for Jim. Constant fights at home. Nasty arguments at work. No energy to go to the office, yet an overload of tasks to complete. At night, he couldn't be bothered to cook. Let alone go to the gym. The local pub seemed like a better place to forget his misery. Recent news about possible job cuts served as the last straw. He felt anxious, overwhelmed. His energy level hit rock bottom. Now Jim is at home. He’s been diagnosed with depression.

As an employer and as a policymaker, we want to know where it went wrong in this chain of events. What was the trigger of Jim's depression? Unfortunately, there is no straightforward answer to this question. Generally speaking, preventing illness requires knowledge of its causes. Yet in the case of depression, this is quite difficult.

Indeed, the search for the trigger resembles a whodunit. There are many clues, yet no smoking gun. Many possible suspects, yet only circumstantial evidence.

What’s the trigger in Jim's case? His unhealthy relationship, his unhealthy lifestyle, or his unhealthy work environment? And did any of these conditions trigger another one?

For example, Jim might be absorbed by his own problems to such an extent that he is emotionally unavailable to his wife. It’s a known fact that irritability and withdrawal can cause increased arguments.

In a whodunit, the smoking gun usually pops up right at the end, when a clever detective solves the crime. 'It was Colonel Mustard in the kitchen with a dagger'. Yet in the case of depression, we simply can’t afford to wait until the end. We need to intervene right at the beginning. We need to target depression without knowing the trigger. And we can only do so by fighting the conditions that are likely to trigger depression. By rounding up the usual suspects. It’s the only way to stop the snowball effect.

In the workplace, there are several of these 'usual suspects': conditions that are bound to lead to problems, although we can't put a finger on it.

One of them is stress. Indeed, chronic stress can cause a multitude of problems, most probably also depression. Research has shown that the stress hormone cortisol may play a role in the first stages and development of the illness.

In itself, work-related stress is the biggest occupational hazard in the Netherlands. It is important to recognize it as such.

Workers and employers need to signal the problem and talk openly about it. Workers can deal with stress better when they receive support from colleagues or their employer. It also helps when people are able to arrange their working conditions themselves, and when they have the right skills to do the job.

The responsibility for this lies primarily with employers and employees. By setting the agenda, and breaking the taboo, the government wants to stimulate an open dialogue between employers and employees. Last year, we launched a 4-year national campaign aimed at creating awareness of this issue amongst workers and employers. The campaign aims specifically at sharing best practices and personal stories. So far it has been a success. More than two thirds of Dutch employees find the campaign useful for them.

Stress is not the only 'suspect'. There are more work-related factors that could trigger depression. Bullying is one of them. Research has shown that work-related bullying and depression have a two-way relationship. On the one hand, bullying can lead to depression. Yet perhaps even more worrying is that depressed colleagues can be an easy target for bullies.

Work-related bullying can take many forms. Making colleagues look foolish. Talking behind their backs. Excluding colleagues from social activities. Sometimes it even involves physical abuse.

The past year alone, more than 500,000 people have been bullied at the workplace in the Netherlands. For 80,000 of these people, the bullying is chronic.

As with chronic stress, it is important to break the taboo surrounding work-related bullying too. Some 95 percent of employees say that bullying is never discussed at work. That’s worrying because bullying can have a tremendous impact on someone’s life. Victims lose their sense of dignity and their pleasure in work. They can suffer from severe psychological problems.

Yet, there's more. It disrupts teams, work processes, productivity. And it causes stress. Yearly, bullying leads to four million days off sick a year. That's 900 million euros employers need to pay in wages. In the end, bullying is a spoilsport for everyone.

This year I have started a campaign that addresses the importance of bullying and the need to fight the taboo. In this campaign, we also address the bystanders — those who witness the bullying yet oftentimes simply look on. I would like to see these bystanders and onlookers change into active participants who are able to signal, discuss and prevent bullying.

Besides these two usual suspects, there is a third factor I would like to discuss today. It's more abstract than stress and bullying, and perhaps less of a usual suspect, but equally relevant. It involves the worrisome development of disposable work. The hyperflexibilization of our job market. And the workers who are the victim of this. Those taking on three or four jobs to make ends meet. People who do not know whether they will have an income next month. People who find themselves trapped in the perpetual insecurity of disposable jobs. Many people are being laid off and replaced by flexible workers. Or they are hired back into the same job but without the dismissal protection.

Job insecurity might not be a trigger to depression for everyone. Similarly, unemployment might cause depression for some, but not for others. But again, we cannot wait for the smoking gun. Hence the government, employees and employers signed a social agreement in the Netherlands. Together, we signed for a better-functioning labour market with a renewed focus on the value of work.

It’s a move that shows hyper-globalists are wrong. Those who argue that 'Flexible working is a natural phenomenon' and 'a permanent job is a lie'. Together, we need to build a modern economy that fuels people’s prospects, rather than seeing them as fuel themselves.

Besides prevention, employers can also play an important role in signalling mental ill-health and in recovery and reintegration. Together with Minister Schippers, my counterpart at the Ministry of Health, Welfare and Sports, this year we announced measures to improve the performance of occupational healthcare.

Soon, people will get better access to occupational healthcare. All employees will be able to consult their occupational doctor about work-related health concerns, including depression. Now, they tend to meet their occupational doctor when they are already ill.

In the Netherlands there are guidelines for the treatment of patients with mental ill-health. These guidelines aim for instance at ensuring that employees with mental problems start with reintegration in good time.

However, stakeholders only follow these guidelines to a certain extent. There is room for improvement here. Hence the government stimulates the cooperation between occupational doctors and general practitioners concerning healthcare problems.

Ladies and gentlemen, by coming here today, you’ve shown that the issue of depression is on your radar. The next step is to aim and shoot.

It’s time for us to target depression together. By fighting the conditions that are likely to trigger the illness. And by offering help to those who suffer from it.

Today we have talked about a serious problem. I would like to finish with something more positive. Perhaps the antithesis of depression is pleasure. The good news: by targeting depression, you may stimulate just that.

Offering a healthy work environment and decent work not only prevents problems. It may also lead to something beautiful: Workers who are not just doing the job, but who are actually enjoying it.

Thank you.