Taking time off work with stress is being used
as a powerful strategic tool by some disgruntled employees who feel
powerless in the workplace and have no other way of expressing
their grievance, a leading psychiatrist has claimed.
But he warns that this can divert attention
away from unfairness and injustice at work.
Dr Maurice Lipsedge, an emeritus consultant
psychiatrist at South London and Maudsley NHS Foundation Trust, was
addressing the Royal College of Psychiatrists’ International
Congress in Edinburgh. He told delegates that the social, economic,
political and medical context of a culture influenced how people
react to pressure at work. With the weakening trade unions,
disaffected employees who had little power over their working
conditions tended to engage in the “infrapolitics of the weak” by
turning up late and leaving early, making deliberate mistakes,
taking long breaks, working unnecessary overtime, spreading
negative rumours about employers and – the most popular tactic – by
taking time off sick.
Dr Lipsedge said: “People nowadays have a
cultural template of how to behave when you feel overwhelmed at
work, which is call in at the GP and get a certificate. Once you’ve
got your doctor’s note you can’t be accused of malingering,” he
told the Congress.
Some 10 million working days a year are lost
due to work-related mental health problems, according to a report
published in 2007 by the Sainsbury Centre for Mental Health. But Dr
Lipsedge says sickness caused by work is not a modern phenomenon.
In the 1780s women working in the Lancashire cotton mills collapsed
due to the atrocious conditions under which they were forced to
work. They were “diagnosed” as suffering from “hysteria” and given
“electric therapy” with a portable electric shock machine to make
them docile and compliant. Two hundred years later, workers in
several Malaysian electronic factories, powerless in the face of a
tyrannical management, poor working conditions, low wages and the
banning of trade unions, collapsed with convulsions and
Dr Lipsedge told delegates he believed that
the recent suicides of the Chinese workers in a Shenzhen
electronics factory were an “extreme” form of resistance taken by
employees who could see no other way of changing their terrible
Dr Lipsedge said the disadvantage of the
common pattern of a disgruntled employee consulting a doctor and
being issued with a medical certificate was that the consultation
shifted the focus away from the workplace and into the medical
realm. “It depoliticises workplace conflict, perceived unfairness
and injustice are not remedied, and medicalisation maintains the
He said there was a clear distinction to be
made between involuntary sickness absence because of a major mental
illness, and “elective” absence which was, he said, an overt
expression of resentment.
“Few people are malingerers. However, some
people do react in this way because they have unreasonably heavy
workload, are not consulted in decision-making, are unfairly
treated, feel powerless and don’t have access to trade unions.
Twenty or thirty years ago they would have been on the picket lines
- today they take time off with stress. This is the reason for
the stress epidemic. There is no direct confrontative option.”
Taking time off work because of stress-related
sickness was a way disempowered employees acted out the indignation
and anger at the way they were being treated, said Dr Lipsedge. “Is
at is an oblique form of resistance, a strategic tool to redress
the balance for those employees who feel powerless in the
However, it was a strategy that played into
the hands of some employers, who were all too happy to lose
disruptive and unhappy workers to long-term sick leave.
For further information, please
Anne Ochola or
Deborah Hart in the Communications
Telephone: 0203 701 2544, 0203 701 2538 or 0777 623
International Congress of the Royal College of Psychiatrists, Edinburgh, 21-24 June 2010.