Workplace & Mental Health – Week 11 · Clinical Psychology Page 1 of 9
HSE DEFINITION OF STRESS & KEY CONCEPTS
"The process that arises when… demands of various types and Stress pathway:
combinations exceed the person's capacity to cope" — HSE Workplace pressures/demands → psychological strain → mental and
physical health consequences
A significant cause of illness and disease
Burnout = a state of exhaustion that prevents individuals from
Linked with high levels of sickness absence and other indicators of
continuing to work — often categorised under depression
organisational underperformance — including human error
Perception is crucial The first thing you experience is stress → if not addressed → chronic
stress → anxiety → depression or both → can lead to burnout
A negative and unpleasant emotional experience when perceived
demands exceed perceived resources
Need to find meaning in the work you do — a protective factor against
work-related stress and burnout
PREVALENCE OF WORK-RELATED MENTAL HEALTH ILLNESSES — HSE LABOUR FORCE SURVEY
New and long-standing cases of work-related ill health (2024–25): Industries with higher-than-average rates (avg. 2020/21–2022/23):
52% stress, depression or anxiety (964,000) Human health / social work
27% Musculoskeletal disorders (511,000) Public admin / defence
21% Other type of illness (392,000) Education
All industries (benchmark)
409,000 workers suffering from a new case of work-related stress,
Avg. 2022/23–2024/25 — notable shift:
depression or anxiety in 2024/25
Public admin/defence — overtaken health/social work for the first
22.1 million working days lost due to work-related stress, time in 20 years
depression or anxiety in 2024/25 Human health/social work — dramatically dropped
Education remains high
Suggests high pressure and emotionally demanding jobs increase risk of
stress, anxiety and depression
CAUSES — BASED ON RESEARCH BY THE HSE LABOUR FORCE
Not able to cope with work demands / high workload and high
Responses to Stress:
pressures
Unable to control the way they do their work Type Examples
Do not get enough information and support to do their job Subjective / Anxiety, worry, panic, depressed mood
Trouble with relationships at work, or bullying emotional
Do not have clear roles and responsibilities Cognition Failures, errors, inability to think logically, forgetting
Not engaged by senior staff when a business is undergoing change Behavioural Avoidance, aggression, alcohol and substance
abuse
Physiological Muscular tension, high blood pressure, sleep loss,
headaches, sweating
PEOPLE WHO CAN ASSIST EMPLOYEES BARRIERS TO SEEKING HELP
Managers Trade union representative Not recognising symptoms
HR staff MH first aider/buddy Stigma & self-stigma
Colleagues General Practitioner Accessibility issues
Occupational health nurses Counsellor / Therapist Organisational policies
Men less likely to seek help
It is important not to label workshops as "stress management" —
people will not come
LEGAL DUTY — RISK ASSESSMENT FOR WORK-RELATED STRESS
Do employers have a legal duty to do a risk assessment for work-related stress? Yes — but not specific to stress; can be part of a wider
assessment.
Why not stress-specific? Stress is subjective and everyone has If you specifically ask about stress and it is high, you have a legal
different abilities to cope obligation to address it — which companies don't like to do
, Workplace & Mental Health – Week 11 · Clinical Psychology Page 2 of 9
WHO HEALTH PROMOTION FRAMEWORK — APPLIED TO WORKPLACE HEALTH: FARMER & STEVENSON (2017)
THRIVING AT WORK REVIEW
In 2017, mental ill health cost employers approximately £33–42 billion annually
Primary Secondary Tertiary
Support for all employees to thrive, Targeted support for those who are Tailored support for those who are ill and
including those who may be thriving with a struggling — people have different levels of possibly off work
long-term MH condition ability to cope Improving treatment and recovery to enable
Taking steps to tackle stress at the source Modify or manage how workers respond to usual/pre-level of functioning
by crafting and shaping the environment risks to reverse or delay progression of ill- Repair damage already done
Identify and eliminate or reduce potential health caused by the risks
risks Developing our skills or psychological
resources to help us cope
WORKPLACE SOLUTIONS EXAMPLES
Employer Examples Occupational Health Examples
Primary Providing good work to support health; developing health and Health screening; identifying health issues; inputting organisational
wellbeing strategies; diversity and inclusion activities strategies
Secondary Awareness raising and education; health promotion activities; Improve health and wellbeing awareness; health promotion activities;
coaching and wellness tools assessments and work adjustments
Tertiary Return-to-work programmes; signposting to support services; EAP Treatment and rehabilitation; referral to specialised services i.e. CBT;
services (employee assistance programmes) support return-to-work
DEI is broader than gender and identity — it should recognise that everyone is different, and no 2 people are the same
OCCUPATIONAL HEALTH IN THE UK — ACCESS & PROVISION
Two ways occupational health is offered in the UK:
Access statistics (Health Foundation, 2024):
Large company = has its own in-house occupational health
Only 45% of workers in Britain had current access to some form of
department or designates professionals
occupational health service (review published 2022–24)
Small company = usually outsourced externally; sometimes support is
28% of employers in Britain offer some form of occupational health,
provided by government initiatives/training schemes
with large employers 3× more likely to do so than SMEs
90% of businesses in the UK are small or medium (SMEs; 50 workers
or less for small), not large (over 500 workers)
FIT NOTE — STATEMENT OF FITNESS FOR WORK
In the workplace, nearly all cases of MH are signed off by a GP who will
Key clinical note: The longer you are signed off, the less likely you are
provide a Fit Note (statement of fitness for work) — it adopts a
to go back into the workforce successfully (Boets et al., 2024)
biopsychosocial approach.
Two outcomes: Why the fit note matters:
Not fit for work — meaning the employee should not work at all for a Biopsychosocial approach — considers psychological, social and
period; max 2 weeks at a time, then back to GP again work factors
May be fit for work, taking into account the following advice… e.g. Encourages sustainable RTW rather than prolonged absence
reduced hours, hybrid/home working, lighter duties, extra breaks Facilitates communication between GP, employer and employee
Helps reduce long-term sickness absence
HSE DEFINITION OF STRESS & KEY CONCEPTS
"The process that arises when… demands of various types and Stress pathway:
combinations exceed the person's capacity to cope" — HSE Workplace pressures/demands → psychological strain → mental and
physical health consequences
A significant cause of illness and disease
Burnout = a state of exhaustion that prevents individuals from
Linked with high levels of sickness absence and other indicators of
continuing to work — often categorised under depression
organisational underperformance — including human error
Perception is crucial The first thing you experience is stress → if not addressed → chronic
stress → anxiety → depression or both → can lead to burnout
A negative and unpleasant emotional experience when perceived
demands exceed perceived resources
Need to find meaning in the work you do — a protective factor against
work-related stress and burnout
PREVALENCE OF WORK-RELATED MENTAL HEALTH ILLNESSES — HSE LABOUR FORCE SURVEY
New and long-standing cases of work-related ill health (2024–25): Industries with higher-than-average rates (avg. 2020/21–2022/23):
52% stress, depression or anxiety (964,000) Human health / social work
27% Musculoskeletal disorders (511,000) Public admin / defence
21% Other type of illness (392,000) Education
All industries (benchmark)
409,000 workers suffering from a new case of work-related stress,
Avg. 2022/23–2024/25 — notable shift:
depression or anxiety in 2024/25
Public admin/defence — overtaken health/social work for the first
22.1 million working days lost due to work-related stress, time in 20 years
depression or anxiety in 2024/25 Human health/social work — dramatically dropped
Education remains high
Suggests high pressure and emotionally demanding jobs increase risk of
stress, anxiety and depression
CAUSES — BASED ON RESEARCH BY THE HSE LABOUR FORCE
Not able to cope with work demands / high workload and high
Responses to Stress:
pressures
Unable to control the way they do their work Type Examples
Do not get enough information and support to do their job Subjective / Anxiety, worry, panic, depressed mood
Trouble with relationships at work, or bullying emotional
Do not have clear roles and responsibilities Cognition Failures, errors, inability to think logically, forgetting
Not engaged by senior staff when a business is undergoing change Behavioural Avoidance, aggression, alcohol and substance
abuse
Physiological Muscular tension, high blood pressure, sleep loss,
headaches, sweating
PEOPLE WHO CAN ASSIST EMPLOYEES BARRIERS TO SEEKING HELP
Managers Trade union representative Not recognising symptoms
HR staff MH first aider/buddy Stigma & self-stigma
Colleagues General Practitioner Accessibility issues
Occupational health nurses Counsellor / Therapist Organisational policies
Men less likely to seek help
It is important not to label workshops as "stress management" —
people will not come
LEGAL DUTY — RISK ASSESSMENT FOR WORK-RELATED STRESS
Do employers have a legal duty to do a risk assessment for work-related stress? Yes — but not specific to stress; can be part of a wider
assessment.
Why not stress-specific? Stress is subjective and everyone has If you specifically ask about stress and it is high, you have a legal
different abilities to cope obligation to address it — which companies don't like to do
, Workplace & Mental Health – Week 11 · Clinical Psychology Page 2 of 9
WHO HEALTH PROMOTION FRAMEWORK — APPLIED TO WORKPLACE HEALTH: FARMER & STEVENSON (2017)
THRIVING AT WORK REVIEW
In 2017, mental ill health cost employers approximately £33–42 billion annually
Primary Secondary Tertiary
Support for all employees to thrive, Targeted support for those who are Tailored support for those who are ill and
including those who may be thriving with a struggling — people have different levels of possibly off work
long-term MH condition ability to cope Improving treatment and recovery to enable
Taking steps to tackle stress at the source Modify or manage how workers respond to usual/pre-level of functioning
by crafting and shaping the environment risks to reverse or delay progression of ill- Repair damage already done
Identify and eliminate or reduce potential health caused by the risks
risks Developing our skills or psychological
resources to help us cope
WORKPLACE SOLUTIONS EXAMPLES
Employer Examples Occupational Health Examples
Primary Providing good work to support health; developing health and Health screening; identifying health issues; inputting organisational
wellbeing strategies; diversity and inclusion activities strategies
Secondary Awareness raising and education; health promotion activities; Improve health and wellbeing awareness; health promotion activities;
coaching and wellness tools assessments and work adjustments
Tertiary Return-to-work programmes; signposting to support services; EAP Treatment and rehabilitation; referral to specialised services i.e. CBT;
services (employee assistance programmes) support return-to-work
DEI is broader than gender and identity — it should recognise that everyone is different, and no 2 people are the same
OCCUPATIONAL HEALTH IN THE UK — ACCESS & PROVISION
Two ways occupational health is offered in the UK:
Access statistics (Health Foundation, 2024):
Large company = has its own in-house occupational health
Only 45% of workers in Britain had current access to some form of
department or designates professionals
occupational health service (review published 2022–24)
Small company = usually outsourced externally; sometimes support is
28% of employers in Britain offer some form of occupational health,
provided by government initiatives/training schemes
with large employers 3× more likely to do so than SMEs
90% of businesses in the UK are small or medium (SMEs; 50 workers
or less for small), not large (over 500 workers)
FIT NOTE — STATEMENT OF FITNESS FOR WORK
In the workplace, nearly all cases of MH are signed off by a GP who will
Key clinical note: The longer you are signed off, the less likely you are
provide a Fit Note (statement of fitness for work) — it adopts a
to go back into the workforce successfully (Boets et al., 2024)
biopsychosocial approach.
Two outcomes: Why the fit note matters:
Not fit for work — meaning the employee should not work at all for a Biopsychosocial approach — considers psychological, social and
period; max 2 weeks at a time, then back to GP again work factors
May be fit for work, taking into account the following advice… e.g. Encourages sustainable RTW rather than prolonged absence
reduced hours, hybrid/home working, lighter duties, extra breaks Facilitates communication between GP, employer and employee
Helps reduce long-term sickness absence
