Mental Health at Work: UK Employer Guide
The Scale of the Issue
Mental health is the leading cause of sickness absence in the UK:
- 1 in 6 workers experience mental health problems in any given week (Mental Health Foundation, 2023)
- Mental ill health costs UK employers ยฃ56 billion per year (Deloitte/Mind, 2022) โ through sickness absence, presenteeism, and staff turnover
- 300,000 people with long-term mental health problems lose their jobs each year (Thriving at Work review, Stevenson-Farmer, 2017)
- Investing in mental health support returns ยฃ5.30 for every ยฃ1 spent (Deloitte, 2022)
Legal Framework
Equality Act 2010
Mental health conditions that have a substantial, long-term (12+ months) adverse effect on day-to-day activities qualify as a disability under the Equality Act. This covers:
- Depression
- Anxiety disorders
- Bipolar disorder
- PTSD
- OCD
- Schizophrenia
- Eating disorders
Employer duties apply: reasonable adjustments, non-discrimination, no direct or indirect discrimination.
Health and Safety at Work Act 1974
Employers have a duty to ensure the health, safety, and welfare of employees, which the Health and Safety Executive (HSE) interprets as including mental health. The HSE's Management Standards for Work-Related Stress provide a framework for risk assessment.
Six key stressors identified by HSE:
- Demands โ workload, hours, pace
- Control โ how much say employees have
- Support โ from managers and colleagues
- Relationships โ including bullying and harassment
- Role โ clarity of responsibilities
- Change โ how change is communicated
The Thriving at Work Standards
The 2017 Stevenson-Farmer review commissioned by the government produced the Thriving at Work framework, with six core standards for all employers and four enhanced standards for larger organisations.
Core Standards
- Produce, implement, and communicate a mental health at work plan
- Develop mental health awareness among employees
- Encourage open conversations about mental health and the support available
- Provide good working conditions
- Promote effective people management (managers trained and supported)
- Routinely monitor employee mental health and wellbeing
Enhanced Standards (for larger employers)
- Increase transparency and accountability through internal and external reporting
- Demonstrate accountability (senior sponsor, board-level reporting)
- Improve the disclosure process
- Ensure tailored in-house mental health support and sign-posting
Mental Health First Aid (MHFA)
Mental Health First Aid England (MHFA England) trains workplace Mental Health First Aiders โ employees who are trained to:
- Recognise signs of mental ill health
- Have a supportive conversation
- Signpost to professional help
- Follow up appropriately
Certification Levels
- MHFA Champion (4 hours): Awareness-raising role
- MHFA First Aider (2 days): Full certification; can respond to mental health crises
- MHFA Instructor: Can deliver MHFA training internally
Government commitment: The government announced in 2023 its intention to require all businesses with 50+ employees to have a trained Mental Health First Aider.
Best practice: One MHFA First Aider per 50 employees; visible, named, and communicated to all staff.
Employee Assistance Programmes (EAPs)
An EAP provides employees with confidential access to:
- Short-term counselling (typically 6โ8 sessions)
- Legal and financial advice
- Health and wellbeing support
Uptake: The average EAP utilisation rate is 3โ5% annually. High-performing employers achieve 15โ20% through active promotion.
Cost: ยฃ25โยฃ80 per employee per year depending on provider and scope.
Popular UK EAP providers: Bupa, Health Assured, Optum, Workplace Options.
Reasonable Adjustments for Mental Health
Common adjustments that make a significant difference:
| Condition | Adjustment |
|---|---|
| Anxiety | Flexible start time, advance warning of meetings, written agenda |
| Depression | Phased return to work, reduced hours during recovery, adjusted targets |
| PTSD | Remote working option, noise-reducing environment, designated safe space |
| Bipolar disorder | Flexible working to manage energy levels, awareness training for manager |
| OCD | Written procedures for tasks, reduced pressure on speed |
| All conditions | Regular 1:1 check-ins, signposting to EAP, Workplace Adjustments Passport |
Access to Work Mental Health Support Service can fund up to 9 months of professional support โ entirely separate from the employer's own adjustments.
Manager Training
Line managers are the most important factor in whether employees with mental health conditions thrive or leave. Recommended training:
- Mental Health Awareness (half day): Understanding common conditions, signs to look for, how to have a supportive conversation
- Managing Wellbeing Conversations (half day): How to ask "how are you?" and mean it; when to escalate
- Return to Work (half day): Supporting employees returning after mental health-related absence
Free resources: Mind (mind.org.uk/workplace), Mental Health at Work Commitment (mentalhealthatwork.org.uk), ACAS Mental Health guidance.
Sources: Mental Health Foundation Workplace Mental Health 2023, Deloitte/Mind Mental Health and Employers 2022, Stevenson-Farmer Thriving at Work Review 2017, HSE Management Standards, MHFA England, ACAS