As awareness of mental health issues grows, Debra Hale explores how underwriters and advisers can help those surviving with mental illness
Why are we experiencing so much mental illness? Is life really much more stressful these days or is that we are more engaged with the subject and diagnosis more readily recognised?
The stigma of mental illness is lessening as so many of us are affected by mental health issues, either personally or through family members and peers. Media coverage is wider and awareness is becoming increasingly heightened, giving the advisory community greater opportunity to discuss these issues with clients.
Mental Health Awareness Week takes place this month and as I write, the Duchess of Cambridge and Prince Harry are in the news talking about their charity Heads Together, ITV’s This Morning is running an anxiety helpline and launching an anti-bullying campaign and it is Bipolar Awareness Day.
This timely piece will consider how important it is to have awareness and understanding of the conditions that are affecting many of your clients who are (to use the theme of Mental Awareness Week) surviving with mental illness.
What is mental illness?
There are many mental disorders, too many to discuss in this article, but if you, like me, have been touched by the vast spectrum of mental illness affecting family members, friends and colleagues who are surviving these disorders, understanding the basics is meaningful.
Depression symptoms are varied and can present in many ways such as low mood, reduced energy, lack of enjoyment, sadness and low self-esteem, as well as disturbed sleep patterns and eating habits.
Bipolar disorder, formerly known as manic depression, manifests as depressed episodes with periods of normal mood and manic episodes consisting of abnormally high mood.
These are not just feelings of sadness, stress or fear that most of us can experience from time to time. These are serious health conditions that need support and understanding. The ability to function in normal life activities can be greatly impaired and for some sadly results in suicide.
Anxiety disorders can also interfere with normal functioning. Some of these disorders include phobias, social anxiety, panic, agoraphobia, obsessive compulsive disorder and post-traumatic stress disorder, or PTSD.
PTSD is an anxiety disorder that develops after a person experiences a very stressful, frightening or distressing event. One-third of adults in England report having experienced at least one traumatic event in their lifetime, with slightly more men experiencing PTSD than women.
Who is at risk?
The numbers aren’t just big – they are staggering. Almost half of all ill health for the under 65s is mental illness.
Any age, social status, culture or demographic can be affected by mental illness, but factors like unemployment, bereavement, relationship break-up and physical illness can trigger and exacerbate the illness.
Often it’s a catch 22 situation: those with poor physical health are at higher risk of being mentally ill and those with poor mental health are more likely to have poor physical health. There is also correlation to other major illnesses such as heart disease. Mental illness directly and indirectly impacts on longevity and life quality.
Additionally, longevity dictates that as more of us age, more of us will suffer from old age related mental issues such as Alzheimer’s, but there has been a marked increase in those in their 50s and 60s suffering from other types of mental illness. For many of you, your core client group will consist of the ‘middle aged’, so this is a concern.
Factors driving this increase are varied. The recent recession has left its mark, as has the increasing divorce rate among this age group. It’s proven that those in a stable relationship experience less stress and better physical health. When older people in particular face life on their own, it’s a harsh reality.
And what about our youngsters? We are experiencing more mental disorders than ever before at younger ages. Most mental health problems start in childhood or adolescence and shockingly the average age for anxiety disorder onset is only 11.
The Office for National Statistics reports that being bullied is strongly associated with mental illness. Between 2011 and 2012, one in eight children aged 10-15 reported being bullied at school. Cyber-bullying is a growing problem too.
Mental illness rises dramatically in adolescence as social pressures grow. Self-harming and eating disorders occur more in younger age groups, of both genders.
What can you do?
Supporting your clients is vital. Empathy and understanding the implications of suffering mental illness is perhaps a big ask, but provider support services can alleviate some of the responsibility.
Telephone helplines include counselling services, legal advice, rehabilitation and a raft of other aspects to help you, your clients and their families. One-third of income protection claims are attributed to mental health, so having free access to these areas of expertise makes sense.
What else can you do to make it easier for your clients when considering their protection needs?
Help them through the underwriting process, speak to underwriters up front, manage expectations and understand why providers ask the questions they do.
When we underwrite a client suffering with depression and they are controlling their illness with medication, this is generally deemed to be a sensible risk and we are more likely to offer terms.
Choose comprehensive critical illness cover with strong definitions. Know that your provider will pay out claims sensitively and pragmatically with the help of a dedicated claims handler.
Dealing with illness of any sort is always difficult, but by understanding the challenges of those suffering with mental illness, we can deal with them with sensitivity, providing care and support in these pressured times that we live in.
Debra Hale is a protection specialist at Zurich