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Understanding the barriers

Why is the mental health of workers not always prioritised by smaller organisations?

Date posted
15 May 2024
Dr Karen Michell
Estimated reading time
3 minute read

Dr Karen Michell, our research programme lead for occupational health, is blogging regularly throughout mental health awareness week (13–19 May). Karen's latest blog looks at factors stopping small and medium sized enterprises (SMEs) from better supporting their workers' mental health.

Today, I'm exploring the perceived barriers to implementing mental health interventions in SMEs from both an organisational and an individual worker perspective.

These barriers were identified in the recently concluded MENTUPP project. This EU funded study examined the promotion of employee wellbeing and prevention of non-clinical mental health problems in SMEs.

Let’s begin with the organisational level.

  • Lack of resources to implement mental health interventions in the workplace is a shared concern for both workers and employers. SMEs usually have limited financial and human resources. In addition to this, workers feel there are insufficient competent people in the workplace who understand how to identify poor mental health and then how to implement interventions.
  • Insufficient knowledge about mental health policies and interventions exists within SMEs. In many cases, this includes a lack of clarity on what interventions could be implemented or how effective these are.
  • Mental health issues are not seen as a priority for SMEs and their management (managers and supervisors). This is evident in the lack of understanding and awareness of mental health concerns and the reported lack of interest from managers.

Time management is a barrier as workers are frequently not given sufficient time to engage with interventions in the workplace as productivity is seen to come first.

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On an individual level, there are also a number of barriers.

  • Fear of stigmatisation and discrimination means workers are often not comfortable engaging with mental health interventions in the workplace. They also express concerns that mental health disclosure at work may hamper their future work prospects as they may be labelled as weak. These concerns extend to fears about lack of confidentiality and discrimination.
  • Work pressure does not allow workers to participate in interventions at work as there is just not enough time. This is compounded by the lack of engagement from workers with these interventions due to the fear of being labelled. Consequently, mental health is not seen as a priority for SMEs.
  • Lack of structure and competent people to implement interventions and lack of management commitment are further factors which discourage participation.
  • General disinterest is also an issue as workers do not see themselves as having a mental health disorder and hence do not see how these interventions could be relevant to them.


A number of these barriers coexist in workplaces. This creates a situation where the limited resources and lack of knowledge and understanding of mental health issues, both positive (how to stay well) and negative (what to do when there is stress, depression or anxiety) create an apathy towards awareness campaigns. For managers, this may well not be a lack of interest but rather a lack of understanding of the value that such interventions can add in the workplace.

As Coppens1 has shown, where managers liaise with other organisations that have successfully implemented mental health interventions, their interest in these programmes improves as they see the value that is added. To prevent failure when implementing interventions in the workplace it is prudent to consider and address these barriers before venturing down the path of mental health interventions.

In my next blog, we will explore the facilitators identified by both the workers and the organisations for whom they work.


  1. Coppens E, Hogg B, Greiner BA, Paterson C, de Winter L, Mathieu S, et al. Promoting employee wellbeing and preventing non-clinical mental health problems in the workplace: a preparatory consultation survey. Journal of Occupational Medicine and Toxicology. 2023;18(1):17.

Last updated: 16 May 2024

Dr Karen Michell

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Research Programme Lead (Occupational Health)

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