IOSH
Mental health
How to control work-related factors and best support workers
Find out about how occupational safety and health professionals can support workers with mental health problems.
"Mental health is a state of mental wellbeing that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their community."
Definition of mental health
- Job role
- World Health Organization
Mental health can describe both positive and negative mental states. These can be short (acute) or long-term (chronic). Changes may happen suddenly, or progressively over a long time. These changes can be unpredictable.
Mental health can be healthy, stable, adaptable, strong and resilient. Sometimes, changes can lead to mental health problems.
What causes mental health problems?
Mental health is affected by lots of different things, both in and out of work.
There is no single cause of mental health problems. People are affected differently but problems often come from a combination of:
- environment, at home and work
- fears or threats
- genetics
- other illnesses (including short and long-term pain)
- physical and mental abuse
- traumatic events.
There are some specific work-related factors that can cause or make an existing mental health problem worse. These include:
- change and threat of change
- excessive job demands and workload
- lack of control over work
- lack of support and communication
- leadership style and organisational culture
- poor workplace relationships
- work pattern.
This is not always the case. Sometimes a mental health problem has no recognisable cause.
The most common mental health problems for workers are:
Anxiety
It is natural to feel emotionally strained, worried, nervous or fearful at times.
These emotions stimulate the body’s survival mechanisms to prepare us for action against anticipated danger and misfortune.
These mental responses are collectively known as ‘anxiety’ and can change brain processes and behaviour.
Anxiety can become a mental health problem when it becomes uncontrollable, unexpected and unhelpful. It can seriously affect life, work and health.
Depression
Depression can be described as a ‘lowering of feelings’ that affects emotional states, thoughts, self-esteem, happiness and self-worth.
It can last for short or prolonged periods. When depression becomes more developed, it can be described as feeling like a physical disease that has overwhelmed the body and the brain. The psychological condition can feel like it has become a physical condition.
It is normal to feel ‘down’ or ‘low’ at times in response to traumatic, difficult or emotionally demanding ordeals.
If someone is unable to make a change from this temporary negative state to a more positive coping state, they may have depression.
Post-traumatic stress disorder (PTSD)
Those who are exposed to traumatic events such as workplace incidents, accidents, bullying, harassment, violence or abuse, or other stress-inducing events may develop PTSD.
Those with PTSD are unable to eliminate thoughts and emotions associated with injury, loss, danger, anger or grief that then influence their behaviour.
Many associate PTSD with military combat experiences but PTSD extends much further than this and can be caused by varying traumatic experiences. For example, events that include a threat to life such as the death of a relative or witnessing a severe injury in a workplace.
Symptoms can develop within three months (approximately) of a traumatic (trigger) event, or they can develop many years later.
The symptoms interfere with work, everyday life and social relationships.
Vicarious trauma and secondary traumatic stress
This type of mental health problem can occur in individuals due to indirect exposure to emotional trauma that somebody else has experienced.
It can also occur when someone is exposed to graphic media or information such as disturbing news accounts and traumatic stories (audio or visual).
Those who work in high-stress or traumatically exposed sectors of work such as child abuse investigators, judges and public services could be more likely to experience this mental health problem.
There's many other types of mental health problems, sometimes with similar symptoms.
Mental health problems and the workplace
Mental health problems do not start and end in the workplace. Mental health is also affected by factors outside of work.
Learning more about the mental health of their workers and causes of mental health problems is important. It allows organisations to prevent or limit the impact of mental health problems on the workplace.
Understanding what is happening to a worker with mental ill-health helps organisations be more empathetic to what they are experiencing.
Organisations who provide appropriate support for workers’ mental health are likely to experience:
- improved productivity, innovation, efficiency and morale
- reduced sickness absence, presenteeism (working despite being unwell) and improved worker retention
- improved organisational reputation
- satisfaction in meeting the duty of care towards workers
- financial savings in legal and regulatory.
Education
People with mental health problems sometimes experience discrimination and exclusion from others. This can happen at work and in wider society.
This often makes it more difficult for workers to seek support and tell their organisation about a mental health problem.
Managers and workers need to be educated about mental health and wellbeing. Changing workplace culture takes time and requires:
- commitment and good leadership from senior managers
- effective communications, including training
- development of suitable preventative methods
- supportive intervention when needed.
Using an occupational safety and health management system
Your organisation needs:
- a general policy that covers all occupational safety and health risks, including mental health
- a proactive mental-health-based strategy.
Your strategy should include mental health objectives, such as:
- promote mental health awareness among all workers
- provide support and access to treatment for those at risk
- welcome and reintegrate people returning to the workplace after a mental health problem.
Mental health action plan
Once you have a strategy, a mental health action plan is the next step.
Your action plan covers:
- any short-term objectives
- initiatives and actions needed, in line with your policies and strategy.
Delegate the leadership, accountability and responsibility for implementing the mental health strategy.
Risk assessments
Risk assessments can help identify mental health hazards at work in the same way as physical hazards.
Use your risk assessments to identify what controls you need to mitigate the risks of creating or worsening mental health problems.
You should consider information on:
- sickness absence
- return to work plans
- staff turnover
- performance appraisals
- exit interviews
- how work is organised:
- conflicting demands and deadlines, for example being asked to provide good customer service but also not spend too much time with each customer
- lack of control over workload
- working with aggressive or distressed people
- shift work and inflexible schedules.
- Social factors:
- poor relationships between managers, workers or clients
- harassment, bullying and victimisation (including through email and social media)
- lack of fairness.
- Surveys and discussions with workers
- Work environment, equipment and hazardous tasks:
- not enough equipment available
- poorly maintained, unsuitable or unreliable equipment
- extreme conditions, such as working in high or low temperatures or working at height
- lack of space, poor lighting and too much noise.
Use your risk assessments to identify what controls you need to mitigate the risks of creating or worsening mental health problems.
A standard five-step risk assessment can be adapted for mental health problems.
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Identify the risk factors
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Identify who might be harmed
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Evaluate the risks
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Record the findings
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Monitor and review
Control measures
It is not enough to just use reactive control measures. Preventative controls need to be introduced before a worker's mental health is negatively impacted. Using preventative controls to avoid harm being caused is a key principle of occupational safety and health.
To identify preventative controls, you need to measure possible workplace causes of mental health problems. This is done through risk assessments.
Controls implemented after this stage are reactive as the worker is already experiencing mental health symptoms. Examples of common reactive controls are employee assistance programmes (EAPs) and mental health first aid.
Provide a private space for workers to rest, talk in private, concentrate and consider their thoughts and emotions.
Temporary adjustments to:
- workloads
- flexible hours
- rest times
- relax absence rules.
Provide employee training on mental health.
Offer flexible working.
Extend paid or unpaid leave during a medical or related absence.
Talk to workers about performance targets and these can be adjusted.
Allow workers to take or make personal phone calls, if reasonable and practical.
Assign mentors, managers, mental health first aiders or mental health champions when required.
Ensure senior management arrange regular one-to-one meetings with managers to discuss progress and prioritise tasks.
Offer extra training and information based on a worker’s duties.
Signpost other supportive services.
Training
Training for managers and workers can help to promote a positive wellbeing culture in the workplace.
Managers should be trained in:
- mental health awareness, and
- their role in the organisation’s strategy and mental health action plan.
The aim of training is giving managers the skills to support workers with mental health problems and to guide them to appropriate care.
Maintaining open and effective communication is crucial. Early intervention with formal and informal conversations can help address potential issues.
For other workers, training should focus on mental health awareness.
Monitoring and reporting
Once your strategy and mental health action and plan are in place, it's important to monitor and measure them. This is done to:
- make sure all agreed actions have been completed
- check everything is working correctly and is effective
- help identify potential updates, such as data gathering or further controls.
Continue to collect and look at the data used in your risk assessments. It supports evidence-based decisions that can help to improve mental health management arrangements.
Comparing to similar organisations can help you understand how you are performing for managing mental health at work.
It is important to report on mental health within and outside your organisation. Keep the board, managers, workers and other stakeholders up to date on progress.
Reporting provides a chance for you to celebrate and promote your organisation's successes in managing mental health in the workplace.
IOSH resources
This guidance page provides an introduction to the subject. IOSH members can access more in-depth resources from Blueprint, our all-in-one package for career and self-development activity. If you're not a member and would like to gain access to these indispensable guides, join IOSH.
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Workplace wellbeing
Workplace wellbeing
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We conducted a survey to get a clearer picture of what is being done in the workplace to support those with mental health problems.