“When did it become acceptable for what should be an uplifting, creative, cerebral career to become life threatening?” That was the opening question from public relations talent consultant Jane Fordham on a panel at the ICCO Global Summit in Lisbon last week, talking about workplace stress and mental ill heath now being the number one cause of absence in the industry. And, far from this question being met with raised eyebrows and dismissed as melodramatic, there were nods and murmurs of assent from many of the senior practitioners in the room, from agencies around the world.

There’s now no doubt that PR is facing a mental health crisis. The latest figures from the Public Relations and Communications Association and research company Opinium, published to coincide with World Mental Health Day on October 10, show that a shocking 89% of practitioners have struggled with mental wellbeing.

The report – ‘Opening The Conversation: Mental Wellbeing In Public Relations’ – found that the overall mental wellbeing score in the industry, rated on the established Warwick-Edinburgh Mental Wellbeing Scale, is lower than the UK average. The report was initiated after the PRCA Census this spring found that 32% of the industry had suffered or been diagnosed with poor mental health.

Around a third – 31% – of PR professionals say they find their job very stressful, compared to 19% of UK workers overall, and 59% of PR workers (increasing to 62% in agency) say this stress is caused by their workload. Ironically, workload is the main reason why PR professionals don’t take time off for their mental health (43%). For those working in agency, demands from clients and deadlines were the main cause of stress, while in-house, unclear expectations were the main factor.

In response to the findings, Opinium CEO James Endersby said: “When three in ten PR professionals who struggle with their mental health tell us that they avoid telling people for fear it might jeopardise their career (versus a fifth of the general workforce), there is a serious problem. The PR industry needs urgent cultural change. And it needs it now.”

Maybe, as well as the workload, there’s also something about the kind of people who are attracted to the industry that contributes to the figures: for every cold, hard operator in PR there are probably a dozen creative, emotional, sensitive types. The trope of the “tortured artist” has being around as long as creativity itself; with several research studies appearing to provide evidence of certain aspects of this connection, often known as the “Sylvia Plath Effect.”

The same may well be true of the best PR people, plus the high-pressure environment of working in a creative industry may also mean that those in roles that wouldn’t necessarily be viewed as “creative” in themselves – from data analysts to CFOs – may also experience more mental wellness challenges than those in these positions in other sectors. Perhaps it’s time to place a bulk industry order of the retro “You don’t need to be mad to work here, but it helps” office poster.

I’m being flippant, but I’m allowed to be: the rule is you can only make jokes about this stuff if you’re in the Crazy Gang yourself. In the spirit of transparency (and as one of those “creative, sensitive, emotional” types), I left a great job in journalism aged 27 purely because the panic attacks I’d been having since I was 15 got so debilitating I could barely leave the house. Being “freelance” was, initially at least, just running away and hiding. And I had barely sorted all of that out, with help from the miracle of cognitive behavioural therapy and 'the good drugs', when I had my first baby and plunged straight into post-natal depression. I’ve been fine for years, apart from the odd day when the old black dog trails me around, but I accept that my brain chemistry and moods are always going to be delicately balanced, and, if I’m honest, I’d rather feel everything than feel nothing.

But here’s a recipe for potential disaster: take one particular type of creative soul, give them a job in PR, then chuck deadlines, demanding clients (who are often under their own intense pressures), financial and budget squeezes, a 24/7 global news cycle, the tenth circle of hell that is personal and professional social media, always-on tech, the lack of concrete validation in the industry, the pervasive notion of human beings as assets or commodities, plus not enough sleep and too much of the inevitable self-medicating gin into the mixer.

Boom. Multiply this by an entire industry, and you get the kind of numbers the PRCA and Opinium have dug up.

Talking about mental health is very on-trend, but it’s not so long ago that there was literally no conversation around wellness at work, when it was still completely unheard of to describe what you were going through as anything other than the catch-all “stress”. The lifting of this heavy taboo in PR (and I would argue this is still very much partial rather than complete, especially in certain company cultures) has brought mental health out of the darkness and precipitated a large measure of destigmatisation, a broadening of language, and a more open dialogue within teams, businesses and the wider industry.

This shift could mean one of two things: that the numbers in the research are high because people are finally being honest, or they are actually even higher than the study suggests because it’s unfeasible that everyone with mental health challenges is suddenly comfortable talking about it.

Indeed, the PRCA/Opinium research found that there is still a reluctance among those who are struggling to make their feelings known, with 36% saying they didn’t take time off because they “just wanted to keep it to themselves,” higher than the 30% of UK workers who felt the same. This is higher amongst those working in-house (45%) compared to agency side (33%).

Being vulnerable can be oddly empowering – there’s a reason Brené Brown’s TED Talk on The Power of Vulnerability is one of the most-watched of all time, with 44 million views – but I don’t know how easy it actually is to put your hand up in a busy, buzzy office and say “I’m struggling,” let alone “I’m having an anxiety attack,” “I’m clinically depressed and on medication” or “I’m bipolar,” especially if everyone else on your team seems to be coping and even thriving in the maelstrom. Do you want to risk being seen as the recent promotion who can’t stand the heat; a returning mum who can’t handle having it all, after all; the unravelling MD; or the VP who’s definitely losing it?

There also seems to be an overlap in the Venn diagram between mental health in the industry and that other thorny, and preoccupying, issue of diversity: I’ve sat with several PR professionals this year who have spoken to me with real candour about how their firm had supported (or not supported) them in being their true self at work, including those whose mental wellbeing issues were linked with perceived or actual lack of acceptance (such as a gap between diversity and real inclusion, or “fitting in”) from those who identified as LGBTQ, to people from ethnic minority groups or completely different socio-economic and educational backgrounds to the bulk of the industry.

And, in terms of the related problem of talent retention, there’s also the regular scenario of the swan-like parent or carer (smooth on the surface, paddling like fuck underneath) who desperately needs more flexibility if they are to avoid a complete breakdown, dropping all the balls in their daily juggling act.

One agency that is walking the talk on the mental health conversation at all levels of the business is Hotwire, which last week published – also on World Mental Health Day – a digital booklet, Bring Your Whole Self. I was expecting some pretty words and worthy pledges; what I wasn’t expecting was global CEO Barbara Bates opening the show with a frank tale of her own experiences as the “girl who had it all,” including anxiety and depression.

Bates is followed by 18 other Hotwire staffers – directors, strategists and practice heads around the world, including some very familiar industry names – talking about their experiences and being very open about various mental health diagnoses. Even in 2019, this seems remarkably brave, and it’s extremely moving.

When I spoke to Bates about the project, she said it had stemmed from the agency’s annual global boot camp last year: “Our theme was ‘bring your whole self to work,’ so during my keynote addressing all our staff I shared my own personal journey. The feedback was unbelievable – it changed the whole dialogue within our organisation."

And Bates says she hopes more agencies will follow suit: “What’s been really amazing has been the response from the industry. It’s really struck a chord. The more we get people talking about this stuff, the better it will be for business, and our talent.”

She adds: “There’s actually something to do with the core of what we do in our work, especially in the agency world, where there is an always-on culture and we can get into bad habits of feeling we have to be at clients’ beck and call, so we don’t refuel or step away. That not good for the team, and it’s not good for clients.”

Bates is right: it’s extremely hard, in a 24/7 global service business, to take your foot off the pedal, to focus on staff wellbeing, to put curfews around email and messaging time, or insist on holiday being taken to ensure people get a break before they burn out. But thankfully, Hotwire is by no means alone in recognising that mental health is one of the biggest issues facing the industry today.

A new focus on mental health and wellness was one of the clearest trends from the Holmes Report’s Agency of the Year awards this year. As well as written entries, our editors spend weeks holding face-to-face meetings with dozens of agencies of all sizes around the world, and it became clear within a week or two that almost conversations around people, talent and culture were routinely, and notably, referencing mental health and wellness.

Almost every successful agency we’ve spoken to this year has now put some sort of mental health and wellbeing framework in place, from mental health first aid training, to meditation sessions, to counsellors and coaches on hand within employee assistance programmes, to agencies like Frank encouraging screen time limits outside core working hours.

Of course, free lunchtime yoga sessions aren’t going to solve this crisis overnight – and, as every good PR person knows, raising awareness is only ever the starting point, not an end in itself – but at least mental health is now firmly on the agenda of individual agencies and the industry at large. It’s the first step towards shifting cultures and practices so, hopefully, we’ll see a dip in the numbers of those who are struggling in the next round of research.

Returning to Fordham’s original question: it simply isn’t acceptable for a creative profession and a career that should be stimulating, challenging and, dare I say it, fun to feel like it is destroying sanity and lives. The industry may, as our founder Paul Holmes also said at the ICCO Global Summit, “be moving faster than ever, and will never be this slow again,” but there has to be a way of being committed to a job in public relations, and not letting it eat you alive. To misquote the popular phrase, we really don’t want PR to lead to ER.