Healthcare experts have issued a stark warning that Britain's ingrained 'never complain, never explain' attitude is preventing employees from speaking up about mental health struggles, dramatically increasing the risk of conditions like anxiety and depression.
The Political Backdrop and a 'Sick Note Culture'
The debate intensified last year when Health Secretary Wes Streeting addressed what he termed a 'sick note culture', instructing GPs to consider referring patients for activities like gym sessions rather than automatically signing them off work. This approach, however, has raised significant concerns among frontline health workers.
Lisa Sharman, Head of Education and Training at St John's Ambulance, cautions that such rhetoric risks minimising the very real effects of burnout. 'When public language suggests people are exaggerating or being written off, it can make some individuals feel even less safe to speak up,' she stated.
Stigma and Fear as Major Barriers
Ms Sharman emphasised that any negative language around mental health pushes progress back decades. Stigma and fear remain huge barriers, with many employees worried they won't be taken seriously or that speaking out could harm their job prospects.
This fear is substantiated by St John Ambulance's own research, which found that nearly a third of employees have lied to their employer about being physically ill when they needed time off for their mental health.
Despite training over 40,000 workplace mental health first-aiders to offer early support, Ms Sharman worries these efforts are being undermined by political narratives accusing the nation of laziness.
The Scale of the Problem in Numbers
The statistics reveal the immense scale of the issue. In the 12 months to June 2024, nearly 11 million 'fit notes' were issued in England, with an estimated 6.1 million handed out without an in-person appointment with a GP or nurse.
By July last year, the NHS had issued over 11 million such notes, with 93% declaring patients 'not fit for work' without a concrete plan to help them return.
Currently, Britain has around 11 million economically inactive working-age adults. A record 2.8 million of these have been declared unfit due to long-term illness, with half citing mental health problems like anxiety or depression.
Warnings of a Looming Crisis
The government-commissioned Keep Britain Working Review in November 2025 warned the UK is 'sliding into an avoidable crisis'. It highlighted an exponential rise in 16 to 34-year-olds out of work for mental health reasons.
Former Health Secretary Alan Milburn, leading a review on youth unemployment, has suggested work is good for mental health. He called the nearly one million young people not in education, employment, or training a 'national outrage' and an 'economic catastrophe'.
However, Ms Sharman stresses the danger of terms like 'burnout' becoming buzzwords. 'It’s not always burnout, per se, but it’s exhaustion, emotional overload, or feeling unable to cope. Those are really real experiences... we can’t dismiss them,' she explained.
She advocates for addressing root causes rather than just prescribing 'duvet days', and warns against reversing hard-won progress in mental health awareness. 'It's out now, we need to make sure that we are addressing it in the right way,' she concluded.
