Mental health in the workplace: towards evidence-based practice

Updated: Oct 14, 2019

There is a growing interest in workplace mental health programs which has created an unprecedented opportunity for those who work within the profession.

Like many of us, if I had a physical health issue or I hurt myself physically I would be able to access a comprehensive list of healthcare interventions as part of our well-loved NHS (granted it may come with a slight wait).  In addition, I will use these resources without a second thought and could reasonably expect that my colleagues and employers will support me on my journey back to health. 

Some of you are luckier than me, and you may also have access to additional employee healthcare benefits, therefore know your access will be immediate and your healthcare will be paid for.

The prevalence rate of mental health issues continues to be on the increase in the UK. If you develop signs and symptoms of a mental health issue, once again your employer is there for you with a comprehensive set of benefits that often include the availability of an employee assistance program (EAP), provision of short and long-term sickness leave if required, and of course, payment for psychological services. However, if you’re like most employees you will probably not access these services.  When it comes to mental health issues, the resources which are provided by organisations are typically underutilised.  For example, EAP programs are often under accessed and underutilised. Moreover, the people who would often benefit the most from these resources are also the least likely to use them.

Researchers suggest several potential reasons for this underutilisation of organisational resources: (a) individuals may not recognise that they require program, service, or resource; (b) individuals may not be aware what resources are available; or (c) individuals may not use available resources because of other concerns or fears (e.g. stigma). Positively, there are signs that some of these conditions are changing and, indeed, I go far as to claim that we currently have an unprecedented opportunity to substantially change the mental health of all for the better.  A variety of policy and economic factors have resulted in a ‘perfect storm’ that has changed the organisational landscape with regard to mental health issues. In short organisations in the UK are getting involved with mental health issues to a unprecedented extent, provides not only a great opportunity and also a significant challenge for mental health as a profession.

The perfect storm

On a policy front, the storm is been brewing for a considerable time. Along with the emerging policy agenda, economic considerations have increasingly pointed towards the need to focus on workplace mental health. The potential economic consequences of mental health problems in organisations are well documented and include consideration of absenteeism, presenteeism, reduce productivity, increased turnover, and a host of other organisational behaviours. The convergence of economic and policy considerations has resulted in what I would argue as an unprecedented concern for issues related to workplace health. Organisations, as never before in my memory, are looking for solutions, interventions, and programs focusing on mental health 'issues'. Consultants and experts of all types have rushed in to fill this void and there is a danger that ‘doing something’ is been confused with ‘doing what is effective’.  Despite extensive research into the causes and correlates of occupational stress and mental health problems, many of the intervention programs being implemented are, at best, weakly supported by empirical data and are heavily concentrated on symptomatology and the over-medicalisation of mental health.

Furthermore, the standard has been to focus the attention almost exclusively on identifying and, eventually, changing organisational conditions such as the environment, workplace conditions, psychological support, workplace demands, work-life balance, recognition and feedback and so forth. Whilst many organisations efforts are well intended, there is not a strong evidence base that provides guidance as to what is the most effective workplace strategies. In essence, we have convinced organisations to act but are not well-positioned to advise them as to what action to take. The ultimate goal of course, is to improve well-being, and I believe this is a laudable goal as the workplace is well suited to address issues of mental health. However, it must be acknowledged, that not all mental health conditions originating in the workplace.

By the very nature of the over-commercialisation of mental health interventions, and the rise of the ‘expert’ what can be seen is not only confusion but the dilution of mental ill-health. The truth is, mental health is complex and whilst we as individuals are similar, we have many differences. In addition, in the bid to encourage the de-stigmatisation of mental health we are dangerously close to increasing internal stigma due to the often negative narrative around mental health. 

Many of the common issues which we face in modern day society, which contribute negatively to our mental health are going undiscussed and are not mentioned in the daily narrative, nor are we taking active steps to address such problems.  Issues such as low self-esteem, the increase in approval seeking behaviour, all are nothing thinking, rumination and worry, increased fear of making mistakes, and the increasingly high expectations and critical nature of the human condition, continue to go unmeasured, unreported, and untreated. Moreover, many are simply unmeasurable, which is why they are often missed due to the constant pressure from organisations which are striving for ROI. As organisations and professionals we also need to deal with our own internal version of what mental health actually is - often this is a distorted view also based on fantasised imagery and wording.

These issues go deeper than just the symptom, and fundamentally we fail to realise that that the things we believe are, to a significant extent, a combination of beliefs, stories, philosophies, superstitions, lies, mistakes, and struggles which affect each and every one of us differently. Without the self-acceptance, the knowledge, and the understanding of our individual mental health, we risk externalising these unhelpful human behaviours with the labelling of the symptomatology in response to such concerns, and our inability to accept we are fallible as we strive to be 'perfect'.   It is a community threat, and I cannot exaggerate the danger and the level of panic such externalisation including illusions of perception, fallacies, fantasy creation, and social conformity in the creation of a mass delusion that we are all mentally ill. 

To the extent to which mental health professionals can help organisations create better or healthier work environments, we should certainly do so.  However, we must also recognise and educate organisations that not all employee concerns originate in the workplace and a sole focus on workplace conditions is not likely to have the kind of effects we're hoping for. Rather, I suggest that there is considerable value in seeing the workplace as a site for intervention because this is where most adults spend their days. In addition, if we are to understand the age of perfectionism, we need to understand two separate things - the self that wants to become perfect, and our culture that tells us what perfect actually is.

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About the author: Stacy Thomson is the founder of The Performance Club, she is a self described Mental Wealth Generator, Educator & Speaker.

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