It's enough to drive you mad

A new report links mental illness with pressure at work. But we're far too willing to blame stress for everything that ails us

Ronald Reagan once said: "It's true hard work never killed anybody, but I figure why take the chance?" For him the presidency was a laid-back, high-roller game. In retirement, he was felled by Alzheimer's disease; but as president, he may have been wiser than he's given credit for. Last week the British mental health charity, Mind, published a report in which "work stress" was given as the commonest perceived cause of mental illness.

Ronald Reagan once said: "It's true hard work never killed anybody, but I figure why take the chance?" For him the presidency was a laid-back, high-roller game. In retirement, he was felled by Alzheimer's disease; but as president, he may have been wiser than he's given credit for. Last week the British mental health charity, Mind, published a report in which "work stress" was given as the commonest perceived cause of mental illness.

But this immediately raises as many questions as it answers. Was it really work that caused the trouble? Or were there much deeper roots? Was the wrong person in the wrong job? Think back beyond Reagan to Richard Nixon. In Anthony Summers's scathing new biography, The Arrogance of Power, Nixon is shown as perceiving the presidency to be an all-consuming, obsessive occupation. He ended up barely sane. He'd longed for this stratospheric job all his life. But you could argue he should never have had it.

The Institute for Employment Studies at Sussex University is studying "psycho-social hazards" for the Government's Health and Safety Executive. Jo Rick, principal research fellow at the institute, points out that "stress is a vague and poorly defined concept". The list of factors that cause the things you might feel good about could apparently be almost the same list as those that cause the things you feel bad about.

One person's high excitement is another person's cause of bottomless anxiety. In Employment and Health (British Library, £38), Jennie Grimshaw dispassionately reviews all the research into stress at work: everything from burn-out to bullying. She separates individuals into "type A" and "type B." Type As are impatient and competitive; love long hours and taking work home at weekends; and drive themselves "to meet high, often unrealistic standards". Type Bs take life as it comes. Nixon (or Al Gore) sounds like a classic type A; Reagan (or George Bush junior) a classic type B.

In Britain, some things are certain about the demands of work. The much-predicted Age of Leisure has not arrived. We work longer hours than any other employees in the European Union. Men in full-time work average almost 46 hours a week, and women almost 41 hours. In Belgium, at the other end of the scale, men work about 39 hours, and women fewer than 38. Germans are nearer to the Belgians than to the Brits.

Two years ago, the European working times directive became law in Britain. Employers couldn't have people working more than 48 hours a week - unless those employees wished to. This proviso provides a pretty broad loophole. So does the fact that some sectors are exempt, such as transport. The growing army of the self-employed isn't covered by the regulations. Nor is it easy to pin down the working hours of the multitude of part-timers, many of them taking on more than one job.

Productivity studies, comparing Britain and Germany, have often shown the British working longer for less output. The Employment Studies Institute reckons it's partly that Britain has "a long-hours culture". But it's never been easy to pin down the productivity blame. When the British are given a brand-new plant to work in - as at the Toyota plant in Derbyshire or the Nissan plant on Wearside - they are as productive as anyone else.

What is hard to ascertain is whether they are under any less stress in their newer workplaces. When I went on a visit to the Toyota plant, with its gaggle of robots, pecking at the car bodies like metallic geese, it was the attitude of the people working there that most intrigued me. There were, of course, very few of them by comparison with a traditional industrial plant. There were also, everywhere and all the time, slogans that encouraged consultation and teamwork.

As one man told me, it was the kind of job that required a certain kind of person. You had to accept the ethos of the plant almost as devoutly as if you went to church. Bolshieness was absolutely out. Computer control at the workplace cuts out an entire layer of management. Instead of the foreman walking around with his "spec" sheet, the production director is in immediate touch with the shopfloor. He can see on his own computer screen exactly what each man is doing right or wrong. You could have an argy-bargy with the foreman. You can't have a row with a computer screen.

Once upon a time, work in service jobs was much harder to check on than in industry. A clerk was less glamorous than a miner, but he had more freedom. Now, as the Industrial Society has noted, a call centre is the ultimate in management control. The productivity of those who answer the customers is as fiercely driven by precise timings as Henry Ford's assembly line. Leftist economic analysts have a passion for asserting that we have entered a "post-Fordist" world. They should be forced to take a job at a credit card call centre, where every transaction can be overheard at will by senior managers and timed to the split second.

Research shows that a lack of autonomy - having to dance to the boss's tune - can bring acute unhappiness. Stress at work changes in form. It does not go away. "In the sweat of thy face shalt thou eat bread," God told Adam as he expelled him from Eden. The curse endures, even if it may now be updated: "At risk of repetitive strain injury shalt thou snack on virtually fat-free cottage cheese."

But we must be very careful how much we blame on stress. The Victorians attributed many illnesses to moral failings. Before the discovery of the Koch bacillus, tuberculosis was a classic example. Consider the operatic heroines, with dubious pasts, whom it slew: Verdi's Violetta and Puccini's Mimi. We must beware falling into a modern version of the same trap. "Stress" can be a pseudoexplanation that too readily falls from our lips. Jennie Grimshaw warns that much of the research into cause and effect is flawed. Does a row at home make you see your job as more stressful? Or is it the job that's causing the family row in the first place? Or some elaborate interplay between the two?

The cautionary tale of the peptic ulcer should be pinned up, with appropriately cheery illustrations, as a wall-poster in the offices of all those preoccupied by the problems of "stress". For decades, this ulcer was thought to be the archetype of a stress-related disease. The explanations became ever more complex. At the Tavistock Clinic in London, Dr Elsa Goldberg found that the mothers of ulcer sufferers were "striving, dominant and obsessional in the house", and their fathers were "steady, unassertive and passive". (Sometimes, you just can't win, can you?) But in 1983 Bruce Marshall, a young Australian doctor, discovered a new "curved bacillus" in the linings of stomachs. This was helicobacter pylori. It wasn't "stress" or parental failure that caused the ulcers. It was an infection. Antibiotics cured it.

Paul Barker is a senior research fellow at the Institute of Community Studies