Mental health in the workplace

Employers should:

• provide managers with training, tools and protected time to hold regular one-to-one wellbeing conversations with their staff. Read our guidance on supporting effective health and wellbeing conversations with staff
• ensure managers understand how workplace factors such as workload, discrimination, exclusion, workplace relationships and organisational change can affect wellbeing
• establish clear escalation routes and access to specialist support where concerns are identified
• encourage regular follow-up and consistent support.

Employers should:

• provide managers with workforce data, training and organisational support to identify workload pressures early
• ensure job expectations and objectives are clear and realistic
• support managers to involve staff in decisions about how work is organised and delivered
• provide timely information about organisational changes so managers can communicate openly with their teams
• ensure staff have safe working environments, appropriate equipment and access to learning and development. 

Employers should: 

• provide clear policies and guidance on supporting mental health at work
• ensure managers can access HR, occupational health and wellbeing expertise when considering workplace adjustments
• promote consistent and equitable approaches to mental health adjustments
• ensure staff can access appropriate adjustments, including temporary changes to duties, hours or working arrangements where appropriate.

Use Acas’ guidance on ‘reasonable adjustments for mental health’ at work to support employers and employees and NHS Employers’ Understanding workplace adjustments’ infographic. 

Employers should:

• maintain clear and accessible wellbeing pathways 
• ensure managers receive regular information about available support services 
• promote services such as occupational health, employee assistance programmes and wellbeing resources 
• ensure managers understand the role and boundaries of mental health first aiders and wellbeing champions 
• make support easy to access and communicate consistently across the organisation.

Employers have a legal duty to assess the risk of stress-related ill health arising from work activities. The Health and Safety Executive (HSE) has produced the HSE Management Standards, which provide information on how to assess and control the risk of stress. They have also developed guidance on how to implement the management standards. 

Use the HSE Management Standards and implementation guidance to assess and manage work-related stress.

• Create a culture where staff can discuss morally distressing experiences without blame or judgement. 
• Explain what moral injury is and how to access confidential support through staff communications and workplace wellbeing spaces.
• Agree a board-level approach to preventing and responding to moral injury, including clear accountability for implementation and oversight.
• Make staff aware of the support available through mental health hubs and your organisation’s wider health and wellbeing offer.
• Help staff make sense of morally distressing experiences by enabling them to access appropriate psychological support. Signpost clearly to the support available and make sure staff can use it confidentially and without fear of judgement.

• Ensure suitable and sufficient risk assessments are undertaken on psychosocial hazards/causes of work-related stress. This should be done in partnership with trade unions.
• Monitor organisational data such as sickness absence and NHS Staff Survey data to identify any potential issues or areas of concern.
• Prepare staff who may be exposed to potentially morally injurious experiences, including those working in intensive care, A&E and trauma services. Explain the risks associated with these settings and help staff understand the reactions they may experience.
• Hold regular open and honest conversations about the nature of the tasks people face and how they may respond, ideally before they are exposed to potentially morally injurious events (PMIEs).
• Ensure all leaders role-model compassionate behaviour, including acknowledging that moral injury may occur in difficult circumstances.

In response to an event where moral distress or moral injury may be a concern, organisations can support managers and leaders to take the following actions:

• access support themselves (if needed) and share experiences
• provide compassionate support in response to difficult experiences at work
• acknowledge potential moral challenges openly and honestly with the whole team, including ancillary/support staff who may have witnessed or been involved, including your bank/agency/student staff
• signpost to sources of further help and advice, including occupational health services, mental health hubs, trade unions and professional bodies
• encourage conversations outside of the organisation, such as with friends and family
• be open about the difficulties they have had, which can lead to honest discussions and reparation. Support for senior leaders can be found via the NHS Leadership Academy and the Association of Clinical Psychologists
• organise reflective practice sessions led by appropriately trained facilitators, focusing on the impact of the event and what support staff need rather than attributing blame or reviewing operational performance.

Embed connection and belonging in organisational values, leadership and wellbeing initiatives. Ensure opportunities for social connection are inclusive and accessible for staff across different roles, working patterns, locations, and backgrounds including those with disabilities, caring responsibilities, faith or cultural needs.

Equip managers with the training, tools and organisational support needed to recognise signs of loneliness and hold wellbeing conversations with staff. Provide clear escalation routes and access to support where concerns are identified. Read our guidance on enabling and supporting staff to work from home. 

Create opportunities for remote, shift, bank and agency staff to connect across locations.  Use staff networks, mentoring, collaborative projects, peer support and regular check-ins to help colleagues build meaningful relationships.

Design work, systems and environments in ways that encourage connection, collaboration and a sense of belonging for all staff, regardless of where or how they work.

Recognise that loneliness can be influenced by factors both inside and outside work. Consider whether organisational policies, including flexible working and work-life balance initiatives, enable staff to maintain relationships and connections beyond the workplace.

• Our Think Flex First NHS toolkit, offering information, tools and resources on flexible working.
• Deloitte UK's Mental health and employers: the case for employers to invest in supporting working parents and a mentally healthy workplace, 2024 report.
• NHS England's Looking after your team’s health and wellbeing guide, designed to help employers and teams explore what being part of a healthy team means and embark on a collaborative improvement journey.
• Mind's The Mental Health at Work Commitment and 6 standards to help employers make a meaningful difference to employee mental health. Note this is not currently accepting new signatories.
• The Society of Occupational medicine's report on the value of occupational health and human resources in supporting mental health and wellbeing in the workplace.
• Stevenson and Farmer's independent review of mental health and employers.

• Our Flexible working toolkit for line managers, designed to help them to support teams to work flexibly.
• Our Sickness Absence Toolkit to empower managers to proactively and supportively manage sickness absence
• Our downloadable Mental health in the workplace infographic featuring statistics and facts to raise awareness of mental wellbeing at work and support a business cases for further action.
• Our Supporting the wellbeing needs of NHS staff guide to support NHS health and wellbeing and staff experience leads to prioritise and meet staff wellbeing needs.
• Acas's Supporting mental health at work practical guide for line managers on recognising concerns, having supportive conversations, and signposting staff to appropriate help.
• Our Hierarchy of NHS staff needs downloadable poster to help employers prioritise staff wellbeing.
• Our Understanding workplace adjustments infographic.
• WHO's End stigma and discrimination in mental health toolkit, offering practical guidance centred around three core principles: leadership or co-leadership by people with lived experience, social contact, and inclusive partnerships.
• The Society of Occupational Medicine's Ten top tips for line managers in tackling work-related mental health.
• The Chartered Institute of Personnel and Development's Health and wellbeing at work factsheet outlining the key domains of a healthy workplace and the role of stakeholders within it.

Use these services alongside your organisation’s occupational health, employee assistance and wellbeing support. Check eligibility and availability before signposting staff.

• Our Flexible working toolkit for individuals working in the NHS, designed to help staff understand their options for flexible working and how to make requests.
• Our Suicide prevention and postvention webpage on the impact of suicide and how employers can best support staff.
• The Access to Work Mental Health Support Service, which provides cost-free support for people struggling with their mental health
• Anxiety UK's website, compiling information about anxiety and how to get help.
• Better Health, Every Mind Matters website highlighting ways adults can look after their mental health. It is supported by the NHS, local authorities and a range of mental health charities, health organisations, as well as other charities and commercial sector partners.
• NHS Practitioner Health, a free, confidential NHS primary care mental health and addiction service with expertise in treating health and care professionals.
• The Everything App, offering free access to a wide range of on-demand and live streamed activities, as well as discounted in-person fitness, sport, and wellbeing services for NHS workers and their families.
• Unmind app mental health platform, which empowers NHS staff to proactively improve their mental wellbeing.
• Northern Health and Social Care Trust's Your wellbeing toolkit to help staff look after their emotional wellbeing.