Supporting mental health at work: Practical guidance

Mental wellbeing describes our ability to cope with the day-to-day stresses of life, work productively, interact positively with others and realise our own potential. When we talk about wellbeing, we are referring to mental wellbeing. Our wellbeing can fluctuate day-to-day, hour-by-hour and is influenced by many things in our lives, personal or professional. Those with mental health problems can still have high levels of general mental wellbeing, while those without mental health problems can still experience periods of low levels of mental wellbeing.

The crucial thing to remember is that experiences of poor mental health vary. Two people with the same condition may have entirely different symptoms and coping mechanisms. That’s why working with people on an individual basis is so important.

Mental health challenges range from more commonly experienced issues, such as depression and anxiety, to relatively less common conditions, such as schizophrenia and bipolar disorder.

The terms used to diagnose conditions are sometimes words that are in everyday use, such as ‘depression’ or ‘anxiety’. Although this can make them seem easier to understand, their familiarity may lead to confusion. For example, be aware of the difference between clinically diagnosed depression and the use of ‘depressed’ to describe feeling a bit down.

There are many different mental health conditions. Some have similar symptoms, so people may experience the symptoms of more than one, or be given several diagnoses at once. Or people might not have a particular diagnosis, but could still be finding things very difficult. Everyone’s experiences are different and can change at different times. When offering support, it’s important not to label someone by focusing on the diagnosis. Instead, talk to them about how it impacts on their work and any support they would find helpful.

We all know what it’s like to feel stressed, but it’s not easy to pin down exactly what stress means. When people say things like ‘this is stressful’ or ‘I’m stressed’, they might be talking about:

• situations or events that put pressure on them (for example, times where they have lots to do and think about) 
• the reaction to being placed under pressure (the feelings they get when they have demands placed on them that they find difficult to cope with).

There’s no medical definition of stress but the UK Health and Safety Executive (HSE) defines stress as “the adverse reaction people have to excessive pressure or other types of demand placed upon them”. Of course, a certain level of pressure in a business environment can be positive. Pressure can help to motivate people and may boost their energy and productivity levels.

With little or no pressure on us, we can feel unchallenged and experience boredom, leading to very low or poor performance. 

As pressure increases, performance can improve within what we might call our ‘comfort zone’. Beyond this, new challenges stretch us, enhancing performance. However, sustained pressure without recharging leads to strain, impacting concentration, effectiveness and decision-making, potentially causing stress. 

When stress becomes unmanageable it can have physical, psychological and behavioural symptoms that, if not addressed, can lead to or worsen mental health problems. Stress can also be linked to physical ill health, including heart disease and back pain.

More detailed information on the signs and symptoms of stress is available from Mind.

Managing stress effectively is a crucial part of a preventative approach to supporting mental health in the workplace, and organisations need to develop an organisational framework for managing the risks to people’s health from stress. This should include carrying out a stress risk assessment or audit.

Further guidance is also available in the CIPD’s guide on managing and preventing stress at work.

There is also information on stress in the workpace in our factsheet.

Use our range of practical tools to help you spot the signs of stress and take steps to manage and reduce workplace stress.

See the HSE’s tools and resources to take a systematic and risk-based approach.

People's mental health can be affected by work and non-work issues. For example, CIPD research  shows a quarter of UK employees say that work negatively impacts their mental health. 

It’s difficult to disentangle the impact of various factors on mental health but employers have a duty to protect people from the impact of work-related factors on their mental health.

There is also useful information on mental health in the workplace in our factsheet.

In the UK, the Equality Act 2010 ('the Act') gives protection to those who can show that their mental health condition counts as a ‘disability’ within the special meaning under the Act.

Poor mental health can be a non-visible or 'hidden' disability and as many people are often reluctant to disclose their condition, it is good practice for an employer to make adjustments for those experiencing poor mental health even if the definition of a disability under the Act may not be met and to take account, within reason, of those who might not recognise or want to disclose that they are experiencing poor mental health. For example, a fluctuating or episodic mental health condition may not meet the Act’s definition of a disability requiring the condition to be ‘long term’, meaning 12 months or more, but the employee may still need appropriate support and adjustments at work.

Organisations that are public authorities also have special legal obligations under the public sector equality duty. More information on the duty is available from the Equality and Human Rights Commission (EHRC).

Employers also have duties under health and safety legislation to assess the risk of stress-related poor mental health arising from work activities and to take measures to control that risk. The UK Health and Safety Executive’s (HSE) Management Standards are designed to facilitate this.

See also our resource on employers' legal obligations to reduce work-related stress and increase employee wellbeing.

How people are treated and managed on a day-to-day basis is central to their mental health and engagement, as well as the level of trust in the employment relationship. Good line management is key to initiating early intervention, while poor line management may exacerbate or even cause poor mental health.

When managers can manage well and build trust-based relationships with their team, it helps to create an environment that is open and respectful, in which people feel ‘psychologically safe’. This means people are more likely to feel able to speak up about a health or work issue without fear of any negative consequences, confident they’ll be listened to and receive support and understanding.

Support and strategic leadership from the top are critical to create organisational cultures that are inclusive and compassionate. To achieve this, senior leaders need to role model a management style based on inclusivity and empathy. They should ensure that line managers appreciate the value of people’s wellbeing and understand their people management responsibilities.  

Managers need to have a clear appreciation of the link between corporate and team objectives, as well as day-to-day people management in areas such as: 

• communication and consultation 
• training and development 
• performance and attendance management 
• workplace conflict.

Managers also need to be familiar with all HR policies to ensure consistent people management practice across the organisation. They should receive training on the key people management skills needed for the role. Those supporting people with mental health issues may also need extra support, as they might experience additional strain as a result.

Often it is about good people management and common sense. If managers regularly ask staff how they are, they are more likely to build trust and prevent stress at work. Conversely,  if managers are indecisive and inconsistent, give mostly negative feedback and set unrealistic deadlines they are more likely to cause or exacerbate work-related stress. Managers need to have the confidence and self-awareness to flex their management style to suit each employee’s preferred working style. 

The CIPD has created a range of support materials to help line managers adopt a management approach that supports good health and engagement in their teams.

It’s important that managers create the right culture so that they: 

Lead by example: Actively encourage healthier working habits by working sensible hours, taking full lunch breaks, taking annual leave and switching off out of work hours. 

Develop confidence on mental health: Become familiar with the organisation’s mental health policies and practices and how staff can seek confidential advice and support. 

Normalise mental health: Regularly check in with employees to see how they are. Create space for them to raise concerns and give them permission to talk about home as well as work issues if they wish. 

Take stock: Include an agenda item at team meetings to discuss everyone’s wellbeing together, and what factors are affecting this. If the organisation runs a staff survey, giving feedback on the results could form the basis of the discussion. 

Be available for staff: Regular catch-ups can help to maintain good working relationships and build mutual trust. If staff are working remotely, ensure they’re familiar with when and how best to communicate. 

Treat people as individuals: Treat employees with respect, praise good work and use a coaching management style. Ask for feedback about the support provided and what support individuals need to help them achieve their goals. 

Embed employee engagement: Promote open dialogue and involve employees in decisions about how the team collaborates. Make sure employees understand their role as part of the bigger picture and make clear their contribution to the organisation’s goals. 

Create opportunities for coaching, learning and development: Make sure employees are well equipped and supported to enable them to do their job to their full potential. 

Promote positive work relationships: Support a culture of teamwork, collaboration and information-sharing, both within the team and across the organisation, and model these positive behaviours to staff.

Employers can help employees cope with pressure and adversity in the workplace by focusing on building resilience and using stress management techniques. Resilience can be defined as the ability to recover or bounce back in the face of adverse conditions, change or pressure. Successful approaches focus on building individual, team and organisational resilience, which are all interconnected. An organisational focus on building resilience can help employees understand how they can manage and withstand pressure more effectively and also ensure that employers are taking steps to identify and prevent stress.

See the CIPD’s guides on how HR professionals and line managers can support resilience. 

A key part of spotting the signs is managers being alert to the potential workplace triggers, such as:

• people working long hours and not taking breaks 
• unrealistic expectations or deadlines 
• high-pressure environments 
• unmanageable workloads or lack of control over work 
• negative relationships or poor communication 
• an unsupportive workplace culture or lack of management support 
• job insecurity or poor change management 
• high-risk roles 
• lone working.

External and/or more personal triggers may also affect an employee’s mental health, such as: 

• social isolation or loneliness 
• experiencing discrimination and/or stigma 
• social disadvantage, poverty or debt 
• bereavement 
• having a long-term physical health condition  
• homelessness or poor housing 
• being a long-term carer for someone 
• drug and alcohol misuse 
• domestic violence, bullying or other abuse

Managers who know their staff and hold regular one-to-ones to discuss work and wellbeing are well placed to spot any potential signs of stress or poor mental health at an early stage. Often the key is a change in typical behaviour, although it's important not to make assumptions and a manager's job is not to diagnose but to sensitively encourage a conversation with the individual. Symptoms will vary, as each person’s experience of poor mental health is different, but there are some potential indicators to look out for. People professionals can use this scenario-based exercise to train managers in spotting the signs of stress in others.

Table 1 is not exhaustive, but it also offers some useful pointers. However, if one or more of these signs is observed, this does not automatically mean the employee has a mental health problem – it could be a sign of another health issue or something else entirely. It’s important not to make judgements, and to be led by the employee. Always take care to talk to the person directly.

Use our range of practical tools to help you spot the signs of stress and take steps to manage and reduce workplace stress

Table 1: Indicators of poor mental health 

If poor mental health is suspected or disclosed, managers should facilitate an early conversation about the person’s needs, to identify and implement appropriate support and/or adjustments. Good people management and the use of empathy and common sense are needed to effectively manage mental health in the workplace. If an individual does not trust their manager, they’re unlikely to want to discuss a sensitive issue such as mental health. Managers need to be approachable and listen when staff ask for help, supported by a workplace culture that’s open and inclusive about mental health.

While mental health conditions are a sensitive and personal issue – like any health problem – most people prefer honest and open enquiries over reluctance to address the issue. Shying away from the subject can perpetuate fear of stigma and increase feelings of anxiety. Often employees will not feel confident in speaking up, so a manager making the first move to open up a dialogue can be really helpful. However, it’s important that managers don’t make any assumptions.

Regular catch-ups or supervisions are an opportunity to start the conversation, which should always be in a private, confidential setting where the employee feels equal and at ease. Questions should be simple, open and non-judgemental to give the employee ample opportunity to explain the situation and their feelings in their own words. If there are specific grounds for concern, such as poor performance, it’s important to sensitively address these at an early stage. A good starting point is asking someone how they are.

Questions to ask 

• How are you doing at the moment? 
• You seem to be a bit down/upset/under pressure/frustrated/angry. Is everything okay? 
• I’ve noticed you’ve been arriving late recently and I wondered if you’re okay. 
• I’ve noticed the reports are late when they're not usually. Is everything okay? 
• Is there anything I can do to help? 
• What would you like to happen? How? 
• What support do you think might help? 
• Have you spoken to your GP or looked for help anywhere else? 

 Questions to avoid 

• You’re clearly struggling. What’s up? 
• Why can’t you just get your act together? 
• What do you expect me to do about it? 
• Your performance is really unacceptable right now – what’s going on? 
• Everyone else is in the same boat and they’re okay. Why aren’t you? 
• Who do you expect to pick up all the work that you can’t manage?

Managers should explore how to address any difficulties which are work-related if an employee shares concerns about their mental health. Encourage the employee to see their doctor as a first step and ensure they’re aware of any support available. This could either be from the organisation, for example a confidential employee assistance helpline, or from credible external sources.

Employers need to communicate clearly through policies on stress management and/or mental health that anyone experiencing challenges with their mental health will be supported. Employers need to signpost what help is available. 

When someone shares information about their mental health, it’s essential to have a sensitive and supportive conversation with them about their needs. This will help to discuss appropriate support or adjustments. 

Choose an appropriate place 

• It’s important to make people feel comfortable and so hold the conversation somewhere private and quiet. 
• Sometimes a neutral space outside the workplace will help the person to feel more at ease. 
• For remote workers, where feasible, ask if they would like to meet for a walk, or a neutral place where they feel comfortable. If they prefer, arrange to have a chat virtually. If meeting remotely, ensure they have appropriate notice of the topic of conversation; they might want to take the call in a private space away from other members of their household if working from home. 

Avoid making assumptions 

• It can be difficult for people to disclose information relating to their mental health, so make it easier by keeping an open mind and giving them space to talk it out. 
• Actively listen and show that you are receiving the information with empathy and understanding. 
• Avoid trying to guess what symptoms an employee might have and how these might affect their ability to do their job. 
• Remember, many people are able to manage their condition and perform their role to a high standard but may require support when going through a difficult period. 

Embed confidentiality 

• People can understandably be anxious about sharing details about their health, so be prepared to take responsibility for confidential and sensitive information. 
• Understand your organisation’s policies about who should be made aware of the person’s situation. This might be outlined in a safeguarding policy or mental health policy. As a rule, it should involve as few people as possible. 
• When beginning a discussion about mental health, it is best to ensure people understand the circumstances under which information they disclose might be shared. 
• Reassure the person that any private information they disclose will not be shared with their colleagues without their prior consent. 
• Discuss with the person any information they would like shared with team colleagues and how, as this can be very supportive for some people. 
• To fulfil the duty of care to keep staff members safe at work, employers are obliged to break confidentiality if someone is experiencing a crisis or could be unsafe. If an employer or manager becomes aware that someone is at serious risk of harm, call the emergency services.  

Encourage people to talk 

• Remember, everyone’s experience of poor mental health is different, and how managers and employers deal with a disclosure should be entirely dependent on the individual. 
• Follow the conversation checklist below to explore how the condition manifests itself, what the implications are and what support they need. 
• People may not always be ready to talk straight away so it's important to give them the space and time to share when they feel ready.
• Reassure the individual that the door is always open and they can speak to their manager or someone in the HR team at any time.

Respond flexibly 

• Mental distress affects people in different ways and at different times in their lives, so be prepared to adapt support to suit the individual. 
• If it works for both, work with the employee to develop an individual wellness action plan.
• Remember, workplace adjustments for poor mental health need not be costly nor require huge changes – they can be simple, as shown below. 
• Be aware of the steps to take when there’s concern the employee may be having suicidal feelings – guide them to seek help from their GP or the Samaritans, and consult  Mind’s advice or the CIPD’s guide on how to support people.

Develop a wellbeing plan 

• Work with team members to develop an individual wellbeing plan. (See also our factsheet on health and wellbeing at work).
• It’s important that the plan identifies the signs of the person’s mental health problem, triggers for stress, the possible impact on their work, who to contact in a crisis, and what support they need. 
• The plan should include an agreed time to review the support measures to check if they have been effective or whether any further adjustments are needed. 
• Include a date to follow up on the wellbeing plan and set up a subsequent meeting. 

• Encourage the individual to speak to their doctor about available support, such as talking therapies. 
• If the organisation has an employee assistance programme, it may be possible to arrange counselling. The organisation might also have a range of additional support services available; familiarise yourself with how accessible these are to remote workers. 
• The Mind Infoline can signpost people towards support, and the network of local Mind hubs across the UK can also help source advice and support. 

Seek advice

• Seek advice from expert organisations and encourage the employee to do the same. If available, employee assistance programmes (EAP) can also help. 
• Involving occupational health services, if available, can be very helpful, as they can support the employee and recommend effective support and/or adjustments. 
• Remember that once aware of health or disability information, the employer also has a legal duty to consider making reasonable adjustments as well as a general duty of care and responsibility for employee health and safety.

The below checklist and this infographic, which outlines ten tips, will help you have effective conversations about stress.

Conversation checklist 

• Avoid interruptions – switch off phones, ensure colleagues can’t interrupt. 
• Ask simple, open, non-judgemental questions. 
• Avoid judgemental or patronising responses. 
• Speak calmly. 
• Maintain good eye contact. 
• Listen actively and carefully. 
• Encourage the employee to talk. 
• Show empathy and understanding. 
• Be prepared for some silences and be patient. 
• Focus on the person, not the problem. 
• Avoid making assumptions or being prescriptive. 
• Follow up in writing, especially agreed actions or support.

A Wellness Action Plan is a personalised, practical tool (that can be used whether someone has a mental health problem or not) to help identify what keeps people well at work, what causes people to become unwell, and the support they would like to receive to boost wellbeing or support a recovery. 

A Wellness Action Plan gives people ownership of the practical steps needed to help them stay well at work or manage a mental health problem. It can also open up a dialogue with team members, to help managers better understand their needs and experiences and therefore better support their wellbeing. This in turn can lead to greater productivity, better performance and increased job satisfaction. 

Wellness Action Plans are also particularly helpful during a return-to-work process as they provide a structure for conversations around what support and/or reasonable adjustments might be useful. 

By giving people an opportunity to draw up a Wellness Action Plan, they’ll be able to gain an awareness of what works and what doesn’t work for them. A Wellness Action Plan can help employees to develop approaches to support their mental wellbeing, leading to a reduced likelihood of problems such as work-related stress. 

What should a Wellness Action Plan cover? 

• approaches the staff member can adopt to support their mental wellbeing 
• early warning signs of poor mental health to look out for 
• any workplace triggers for poor mental health or stress 
• potential impact of poor mental health on performance, if any 
• what support they need from you as their manager 
• actions and positive steps both managers and staff members can take if they’re experiencing stress or poor mental health 
• an agreed time to review the Wellness Action Plan and any support measures that are in place 
• anything else that the person feels would be useful in supporting their mental health.  

You can find Mind’s template Wellness Action Plans in addition to a manager’s guide in their use on the Mind website.

Various aspects of work and the workplace can cause substantial disadvantages for people with disabilities. The UK Equality Act 2010 says that employers must take reasonable steps to remove the disadvantage. The purpose of the law is to place a duty on employers to address the disadvantages encountered at work by people with disabilities, and the starting point for any consideration of reasonable adjustments should be what challenges someone is experiencing in the workplace.

‘Reasonable adjustments’ for people with disabilities or health needs are commonly perceived as adaptations to the physical environment. In relation to mental health, more often the obstacles are less tangible and relate to negotiating the social, rather than the physical, world of work. A requirement to work set hours, for example, or the practice of only having occasional supervision might cause a substantial disadvantage for someone with certain mental health problems.

Effective adjustments can be simple, low-cost and can include offering flexible working hours, increasing one-to-one supervision or making small adjustments to working practices. Examples of recent cases where simple adjustments have been made have included providing an employee with noise cancelling headphones and allowing an employee to stay 'off camera' during online meetings.

An employer is only under a duty to make adjustments that are reasonable and this will depend on the circumstances of the case. Potential adjustments should be considered on a case-by-case basis, but factors that may be helpful to consider include:

• the effectiveness of the adjustment in preventing the disadvantage 
• the practicability of making the adjustment 
• the extent to which making the adjustment would impact on service delivery 
• financial and other costs – and any financial assistance, for example available under the Access to Work scheme (see below) 
• the potential impact on colleagues.

It can be useful for managers to discuss the practical implications of any reasonable adjustment request with the employee, including:

• what has been done before
• the ease/difficulty of accommodation
• any service delivery and team implications

The manager and the employee need to be clear about the factors that will be taken into account when reviewing whether an adjustment is reasonable and practicable to implement. It may also be useful to involve occupational health professionals.

However, the organisation should follow a flexible and responsive approach to ‘reasonable adjustments’. Allowing staff flexibility in how and when they perform their role, where possible in line with business needs, can reap rewards in terms of loyalty, increased productivity and reduced absence, and can help normalise mental health and disability issues in the workplace.

The key point to remember is that individual experiences of poor mental health can vary significantly – so two people with the same diagnosis may have very different symptoms and need different adjustments. Typically, the individual themselves will be the expert on their condition and understand their own support needs. In essence this means managing the person as an individual and making adjustments with their collaboration, rather than imposing measures on the person.

Below are some adjustments that may help to mitigate symptoms of poor mental health and the impact on the employee’s interaction with work. It’s important to always be guided by what the person says. The following list could act as a prompt for managers and team members to explore together.

• Flexible hours or change to start or finish times; change of workspace, for example quieter, more or fewer people around, dividing screens
• working from home at certain times or on certain days in a given period
• changes to break times
• provision of quiet rooms
• lightbox or seat with more natural light
• agreement to give an employee time off for appointments related to their mental health, such as therapy and counselling
• temporarily changing duties, for example changing the balance of desk work and customer-facing work, reducing caseloads, changing shift patterns
• reallocation of some tasks or amendments to the employee’s job description or duties
• redeployment to a more suitable role
• increased supervision or support from manager, buddy or mentor
• extra help with managing and negotiating workload
• debriefing sessions after difficult calls, customers or tasks
• mediation can help if there are difficulties between colleagues
• access to a mental health support group or disability network group
• identifying a ‘safe space’ in the workplace where the person can have some time out or access support
• provision of information to promote self-care
• encouraging employees to work on building up their resilience and doing things that support good mental health, such as exercise, meditation or eating healthily
• providing regular opportunities to discuss, review and reflect on people’s positive achievements – this can help people to build up positive self-esteem and develop skills to manage better their triggers for poor mental health.

The Access to Work scheme is designed to provide advice and financial support for people with health conditions or disabilities that impact on their job. It might provide expert advice for employers and employees or pay towards a support worker or equipment the employee needs at work.

Encouraging employees to apply for Access to Work support can help employers to manage the potential costs of reasonable adjustments.

Their specialist advisers provide:

• tailored, work-focused mental health support for nine months 
• suitable coping strategies 
• a support plan to keep them in, or return to, work 
• ideas for workplace adjustments to help them fulfil their role 
• practical advice to support those with a mental health condition.

An important time in managing and supporting someone with a mental health problem is when they’re off sick. Keeping in touch, providing support and proactively managing absence is central to the effective management of people experiencing poor mental health. The way organisations manage a period of sickness absence is key to shaping how effectively and how quickly people are able to return to work and get back to peak performance.

It’s important that managers agree how often and how to communicate, for example by telephone, email or face-to-face visits. It’s useful to set out the importance of this contact in the absence management policy so that everyone is clear about the need to maintain supportive contact. If the manager is thought to be a source of the person’s distress, another member of staff or someone in HR should be the person that keeps in touch. Such instances may be difficult to navigate and ideally support will be available to help everyone involved to work through the situation. While a clear policy is useful, organisations also need to understand that the duty to make reasonable adjustments mentioned above applies in all aspects of employment, including the operation of any absence management policies. There may be aspects of an organisation's absence policy that will need to be adjusted in the case of an employee experiencing a period of poor mental health to ensure they are not placed at a disadvantage, for example, requiring an absence to be notified by a particular time in the morning.

The CIPD manager guide Managing a return to work after long-term absence sets out the guiding principles for navigating the key steps to managing an effective return to work:

1    maintaining communication while absent 

2    preparing for a return to work 

3    supporting the employee and manager during the immediate return 

4    supporting the employee and manager on an ongoing basis on return.

Return-to-work interviews are consistently identified by CIPD research as an effective intervention for managing absence. An effective return-to-work interview can build trust and engagement and support a smooth and sustainable return to work. When the person is ready to return, managers should arrange to discuss the details of the employee’s return. The employee should be told this meeting will help them make a successful and lasting return to the workplace and address any ongoing health needs.

• Tell the employee they were missed.  
• Ask the person how they’re feeling. 
• Explain the return-to-work process/procedures. 
• Reassure the employee that they aren’t expected to walk straight back into full-time hours, or manage a full-time workload. 
• Use open questions that require more than just a ‘yes’ or ‘no’ answer and give people lots of space and time to talk. 
• Listen and try to empathise with the employee. 
• Ask if there are any problems at work that might be causing them stress. 
• Discuss whether there are any difficulties outside work that might be contributing to their absence. 
• Talk about the person’s mental health issue, if they have disclosed it, and the possible impact on their work. 
• Discuss possible solutions and make sure they’re aware of any sources of available support, whether internal or external. 
• Discuss any worries the person has about returning to work, reassure them that these are normal, and agree how to address their concerns. 
• Help the person to think about how they want to manage their return; for example, what they want to say to colleagues.

The first day back at work is very important, whether the employee is returning to a workplace or working from home. People are often anxious about returning to work, particularly if they have been off for a while. Managers should decide with their team member exactly what colleagues will be told about the situation before the team member returns. If based in a physical workplace, the individual may like to be met at the workplace door or travel in with their manager or a colleague. If the individual is working from home or in a hybrid way, give careful thought to how they’ll be supported remotely, for example by setting up virtual coffee breaks and catch-ups with colleagues. The aim is to gently reintegrate the returning employee into the routine of work while making sure they can catch up on work and organisation developments.

Managers need to be proactive during the first few weeks of the individual’s return, as it's rarely a one-off event. It’s important to remember that an employee is unlikely to be fully fit when they return to work and will need ongoing support as well as possible adjustments to their workload, particularly if the absence has been long term.

Access to occupational health services is identified as one of the most effective interventions for long-term absence. Also, NHS England’s Adult Improving Access to Psychological Therapies (IAPT) services – offering cognitive behavioural therapy, counselling and employment advice – may benefit employees, with referral usually through their GP. There is also a wealth of guidance online (see Useful contacts). Whatever support is used, early intervention is vital.

Employing the right person for the job in the first place is key to help prevent work-related stress. A common source of work-related stress is a misfit between the individual and the role, or between the needs and values of the person and those of the work environment.

Selecting new employees based on competence, combined with realistic job descriptions and person specifications, is not only important for performance, but also for managing and supporting mental health.

Recruitment should focus on hiring the most suitable candidate for the job. Therefore, appointment decisions should be objective and based on whether candidates have the necessary competence and potential required for the role. Experience of poor mental health is not an indicator of poor performance, so it’s important that employers do not discriminate (consciously or unconsciously) against people based on prejudiced and unjustified assumptions.

Throughout the application and selection process, reasonable adjustments may need to be made. For example, as well as helping those with a physical disability, recruitment processes might be adapted for neurodivergent people. It’s good practice to be proactive in offering adjustments for anyone who needs them for their health, regardless of whether or not they meet the legal criteria for a disability.

For further information on recruitment, see the CIPD factsheet on recruitment and induction. 

Provide guidelines and training for all staff to ensure that candidates are not discriminated against at any stage, including the risks of unconscious bias.

Make it clear in adverts and interviews that the organisation promotes good mental wellbeing and supports people if they experience poor mental health, as this sends a signal that sharing information about a mental health problem will not lead to discrimination. For example, include a statement such as: “As an employer, we are committed to promoting and protecting the physical and mental health and wellbeing of all our staff.”

State clearly that workplace adjustments are available – for the interview and the job itself – so applicants understand why sharing information about their mental health might be beneficial.

Ensure people can disclose a mental health problem confidentially and that any information about health or disability is kept separate from the application form, so the recruitment panel does not see it.

Many job applicants will be fearful of disclosing information relating to their mental health history because misunderstanding and stigma about poor mental health is still widespread.  

Section 60 of the UK Equality Act 2010 makes it unlawful to ask questions about disability and health before making a job offer, except in defined circumstances. The purpose is to ensure equal access to job opportunities by preventing disability or health information being used to sift out job applicants before they can show they have the skills to do the job. The EHRC can take legal action against employers where these requirements have been breached. If questions are asked before a job offer is made, it is also easier for job applicants to prove that discrimination has taken place as, under the Equality Act, employers will be assumed to have discriminated unless they can prove otherwise.

More information on this is available in the CIPD’s guide on pre-employment checks. 

Many employers do not use health questionnaires at any stage of the recruitment or induction process, instead dealing with any health issues among employees as they arise. However, others find that routinely using health questionnaires following an offer of employment can provide useful information to help support new employees and enable them to do the job effectively. 

If questionnaires are used, they should be applied to all new recruits, rather than singling people out because ill health or disability is suspected, to avoid discrimination claims. Moreover, this approach will help to encourage an inclusive and positive culture from the outset of employment and help people to feel less stigmatised. 

A job offer might be conditional or unconditional, and an employer can make an offer conditional on medical checks and then ask health-related questions without breaking the law, but the questions need to be related to the candidate's ability to perform the functions of the role, or to establish any reasonable adjustments that might be needed to support the candidate once they start work (or to support them to start work). If, following the provision of the information, an employer withdraws the offer, they must be able to show that this is for a legitimate reason related to the candidate's ability to perform the role, or because the adjustments they would need to make for that candidate to perform the work would not be reasonable. It is unlawful to discriminate on grounds of a mental-health-related disability, so if an offer is withdrawn at that stage, an unsuccessful applicant may be able to make a disability discrimination claim, as the withdrawal itself may be seen as evidence of discrimination. 

If employers do use health questionnaires, and there are no required standards of health (physical or mental) that a candidate needs to meet to carry out the functions of the role, it should be emphasised that the purpose of asking these questions is to see whether new staff have any health issues that, without support, could affect their ability to fulfil the duties of their new role or place them at any risk in the workplace. It should also be explicit that the questionnaire will help the employer to ensure any health needs are met and identify reasonable adjustments or assistance to enable the new employee to do the job. Framing the use of the information in a positive way will encourage people to talk about their mental health. It will also help to reflect the right ethos, which should be to provide better support to the employee. The questionnaire should also specify who will see the information.

The template health questionnaire outlined below can help ensure that any health questionnaires don’t ask unnecessarily intrusive questions that might discourage new employees from disclosing important information about their mental health. The recommended questions are deliberately:

• limited to health information in relation to the work/job role – all other details are personal, sensitive and of no concern to the employer 

• open, to enable new employees to describe their health in their own words and give only as much information as they feel comfortable with 

• non-prescriptive, so people are not forced to disclose a particular condition or detail symptoms and treatments.  

Of course, for some specialist roles, specific health questions may be relevant – for example, people working with chemicals may need to disclose any skin conditions – and this would be lawful under the exception which permits questions relating to ‘intrinsic’ job functions. Employers in these sectors will be best placed to determine the types of questions they need to ask, so the template is limited to general questions employers may choose to ask about health following a job offer.

Your answers to this questionnaire will be CONFIDENTIAL to [HR/occupational health/your manager] and will not be given to anyone else without your written permission. Our aim is to support and maintain the physical and mental health of all people at work. The purpose of the questionnaire is to understand if there are any barriers in our workplace which would make it more difficult for you to undertake the duties of the post you have been offered, or any circumstances we need to be aware of that would put you at any risk in the workplace. We may follow up in consultation with you to understand more fully any of your responses in order to put in place adjustments or assistance to remove or reduce the impact of those barriers. 

 Intrusive or inappropriate questions to avoid 

• Is there any history in your family of mental health issues? 
• Do you suffer from, or have you ever experienced, any of the following? [With an exhaustive tick box list of conditions, for example depression, anxiety, bipolar disorder…] 
• Are you taking any tablets or medications? If yes, please give details. 
• Have you consulted a doctor in the last two years? 
• Are you having or waiting for treatment (including medication) or investigations at present? If yes, please provide details of the condition, treatment and dates.

A good induction programme is vital for all new, promoted or redeployed employees. Starting a new role can be daunting; if the organisation doesn’t provide effective orientation, it can be an unsettling experience. A negative first few days in the job, where people are given insufficient guidance about expectations and processes, can undermine people’s confidence and could trigger new or exacerbate existing problems. It can also lead to early attrition, where an employee leaves within the first year.

An effective induction for all employees includes the following elements:

• orientation (organisational) – how the employee fits into the team and how their role fits with the organisation’s strategy and goals 
• one-to-one meeting(s) between the new starter and their line manager 
• meetings with other key employees (either face-to-face or online) 
• an awareness of other functions within the organisation 
• health and safety information (this is a legal requirement) 
• explanation of terms and conditions, as well as pay and benefits 
• details of the organisation’s history, its products and services, its culture and values 
• a clear outline of the job/role requirements and expectations 
• health and wellbeing initiatives provided by the employer 
• information about ways of working, for example flexitime, homeworking.

If the organisation is operating a hybrid working model, the induction process needs to be adapted accordingly. This includes using induction to guide new starters on how to work effectively in a hybrid and/or remote way. It also means building more time into the process for new employees to build working relationships and ensuring introductory meetings with other colleagues are set up remotely if necessary. New hybrid workers will need additional support in the early stages of their employment to understand the culture. It’s essential that line managers give as much support as possible and regularly check in on the team members to see if they have any questions or concerns. A buddy or mentor can also help. 

Most employers will have policies and procedures in place for performance management, but where there are suspected or known health issues, these should also be explored, prior to any formal processes. If the root causes of poor performance are not addressed, any solutions are unlikely to fully resolve the issue and there can be wider impacts in terms of reduced morale, commitment and attendance.

Performance management should be a positive and supportive process. It is in the organisation’s, as well as the employee’s, interest to discuss potential adjustments and support where appropriate, and help the individual perform to their full potential. People with a mental health condition are capable of performing to a high standard at work and most continue to work and thrive. There may be times when performance could be affected, particularly if someone is afraid to share information about their condition. An effective performance management process should be responsive to people’s needs and take into account any underlying health issues they may be experiencing.

Managers should make it clear that any disclosure of a mental health problem will be handled in a supportive manner and not prompt negative consequences such as disciplinary action.

Discussions or meetings about performance should concentrate on the person’s work and how it is being impacted. However, asking simple, open questions about how the employee is and whether anything is affecting their performance can encourage them to talk about any health issues. It is also useful to explore any other potential workplace issues, such as negative relationships with colleagues, which may be impacting on the employee’s wellbeing and, in turn, their performance. No one should feel pressured to disclose a health issue, but using the conversation tips in this guide can help a manager to explore this area in a way that is not intrusive or judgemental.

An effective performance management system should not consist of a one-off appraisal meeting but should include regular and constructive feedback and discussion. This informal dimension to performance management is crucial to encouraging a two-way dialogue and trust-based relationships. This will make it much easier to address any health issues, identify any extra support or coaching the person may benefit from and set timescales for improvements.

Each employee will need to be managed on a case-by-case basis, but the general rules of thumb are:

• Focus on the person, not the problem – don’t make assumptions about how mental health affects performance, because people with even a serious mental health condition can still thrive at work. 
• Ask simple, open and non-judgemental questions. 
• Consider health-related solutions, not just performance-based approaches. 
• Make it clear that the organisation is prepared to put in place support or adjustments to help the individual perform to their full potential. 
• Allow the employee to be supported in discussions or meetings, for example by an advocate or someone who understands their condition. 
• Use mediation to resolve any conflict if necessary/appropriate.

Acas: free and impartial information, advice, and training to employers and employees, including a range of resources to support good mental health at work 

Business in the Community 

Centre for Mental Health 

CIPD stress tools: a range of practical tools to help you spot the signs of stress and take steps to manage and reduce workplace stress and guide for people managers on managing stress at work

Equality and Human Rights Commission 

• England 
• Wales 

Health and Safety Executive advice on stress 

Mind 

PANDAS HR toolkit for businesses and organisations to support employees who may be affected by perinatal mental health conditions 

Time to Change Wales 

Togetherall: a safe, online community where people support each other anonymously to improve mental health and wellbeing. 

Mind Infoline 
Telephone: 0300 123 3393 
Email: info@mind.org.uk 
www.mind.org.uk/information-support/helplines 
Mind provides confidential mental health information services. With support and understanding, Mind enables people to make informed choices. The Infoline gives information on types of mental distress, where to get help, drug treatments, alternative therapies and advocacy. 

Side by Side, Mind’s online community 

Samaritans 
Telephone: 116 123 
Whatever you’re going through, Samaritans are there to listen – 24 hours a day, 365 days a year. Samaritans offer a safe place for you to talk any time you like, in your own way about whatever’s getting to you. They won’t judge or tell you what to do; they’ll listen to you. 

Shout, text support 
Text: SHOUT to 85258. 
Shout is a free, confidential 24/7 text messaging support service for anyone who is struggling to cope. The service is anonymous and won’t appear on any phone bill. 

CALM helpline 
Telephone: 0800 58 58 58 
The CALM helpline is there for anyone who needs to talk confidentially about a tough time they’re experiencing. Calls are taken by trained staff who are there to listen, support, inform and signpost you to further information. The helpline is open from 5pm to midnight every day, 365 days a year. 

SANEline 
Telephone: 0300 304 7000 
SANEline is a national out-of-hours mental health helpline offering specialist emotional support, guidance and information to anyone affected by mental illness, including family, friends and carers. It is normally open every day of the year from 4pm to 10pm. 

We won’t give up until everyone experiencing a mental health problem gets support and respect. We believe no one should have to face a mental health problem alone. We’ll listen, give you support and advice, and fight your corner.

When you’re experiencing a mental health problem, supportive and reliable information can change your life. That’s what we do. We empower people to understand their condition and the choices available to them through the following:

• our Infoline, which offers callers confidential help for the price of a local call 
• our Legal Line, which provides information on mental-health-related law to the public, service users, family members/carers, mental health professionals and mental health advocates 
• our award-winning information, certified by the PIF Tick.

Our local Minds provide help and support directly to those who need it most. There’s a network of more than 100 local Minds across England and Wales that offer specialised support and care based on the needs of the communities they support.

We believe everyone with a mental health problem should be able to access excellent care and services. We also believe you should be treated fairly, positively and with respect.

We campaign on a range of issues that could affect anybody with a mental health problem. This includes health services, legislation, protection of legal rights, and employment. Join us to campaign for change.

Whether you’re an employee worried about your or a colleague’s mental health, a company looking for professional training or consultancy, or an HR professional who wants to improve mental wellbeing in your organisation, we’re here to help. 

Mind’s workplace wellbeing services include: 

• training 
• e-learning 
• Employee ‘Snapshot’ survey 
• consultancy. 

We also offer a range of free resources and information for employers and employees.

Mental health: We all have mental health, just as we all have physical health. How we feel can vary from good mental wellbeing to difficult feelings and emotions, to severe mental health problems. 

Mental wellbeing: Mental wellbeing is the ability to cope with the day-to-day stresses of life, work productively, interact positively with others and realise our own potential. When we talk about wellbeing, we are referring to mental wellbeing. 

Poor mental health: Poor mental health is when people are struggling with low mood, stress or anxiety. This might mean we’re also coping with feeling restless, confused, short-tempered, upset or preoccupied. We all go through periods of experiencing poor mental health – mental health is a spectrum of moods and experiences, and we all have times when we feel better or worse. 

Mental health problems: We all have times when we struggle with our mental health. A mental health problem is when difficult experiences or feelings go on for a long time and affect our ability to enjoy and live our lives in the way we want. You might receive a specific diagnosis from your doctor, or just feel more generally that you are experiencing a prolonged period of poor mental health. 

Common mental health problems: These include depression, anxiety, phobias and obsessive-compulsive disorder (OCD). These make up the majority of the problems that lead to one in four people experiencing a mental health problem in any given year. Symptoms can range from the comparatively mild to very severe. 

Less common mental health problems: These include conditions, such as schizophrenia and bipolar disorder.. They can have very varied symptoms and affect everyday life to different degrees and may require more complex and/or long-term treatments. 

Work-related stress: Work-related stress is defined by the UK Health and Safety Executive as the adverse reaction people have to excessive pressure or other types of demand placed on them at work. Stress, including work-related stress, can be a significant cause of illness. It is known to be linked with high levels of sickness absence, staff turnover and other issues such as increased capacity for error. Stress is not a medical diagnosis, but severe stress that continues for a long time may lead to a diagnosis of depression or anxiety, or other mental health problems. 

Burnout: Burnout is a term used to describe a collection of experiences caused by long-term, unmanageable stress at work. Burnout can make people feel exhausted or unmotivated. People may start to feel distanced from or negative about their job. And they may worry that they’re not achieving enough at work. Burnout can affect mental and physical health. It can also impact work performance. 

Stigma: Stigma is the perception that a certain attribute makes a person unacceptably different from others, leading to prejudice and discrimination against them. 

Self-stigma: Self-stigma is where a person with a mental health problem becomes aware of public stigma, agrees with those stereotypes and internalises them by applying them to the self.