Mental health problems are often 'invisible' - undisclosed by individuals, under estimated and unrecorded by employers, under funded by health services and few statistics. That may be set to change.

A recent report from the Sainsbury Centre for Mental Health estimated the cost of mental health problems to UK business alone at £26 billion per annum: an average of over £1000 per employee. While the cost of straightforward absenteeism because of mental health problems is significant - £8 billion per year, and a total of 70 million days - presenteesim - i.e. being there but not able to work well - is nearly twice as costly - £15 billion per annum.

A new organisation - Stand to Reason - has been set up to challenge stigma and support people with mental ill health. The difference from other organisations is the high profile stance they are taking and the image of the people involved - the founder is a successful city banker.

Publicity may gradually be shifting attitudes and reducing fear and stigma. Stephen Fry recently fronted a series of programmes on UK TV about mental ill health - the problems and the benefits it brings to life. The Hollywood film A Beautiful Mind profiled the mathematician John Nash and the hero of the best selling book The Curious Incident of the Dog in the Night Time had Asperger Syndrome.

New ways of supporting people using reading and book clubs may reduce individual concern about taking drugs and provide cost effective alternativs.

Why is this important?

Sadly, the old adage 'what gets measured counts' almost certainly applies. If the real costs of inaction are better understood, the cost-benefits of action become clearer. Work is often a significant motivator for people with mental ill health, but addressing it will not only need statistics, but a change of attitude and new approaches to management to address prejudice, long hours cultures and a 'bums on seats' philosophy all of which contribute significantly to presenteeism.

We are short of workers, and as the population ages will increasingly be so. The one million people on incapacity benefit because of mental ill health represent a valuable resource, which at present is primarily a huge cost in care and incapacity benefit as well as the personal cost.

In the past, social stigma and insecurity, among other things, have often prevented people from speaking out or acting to address discrimination they have experienced. Now, backed up by tougher legislation as well as attitudinal change, people may speak out more. As Corporate Social Responsibility takes a higher profile, companies which profess responsibility in one area but are found severely wanting in another are likely to suffer the consequences. They could begin to experience large legal and compensation costs, not to mention poor publicity.

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