How to be mentally healthy at work

Work and mental health

Being in paid employment is generally considered to be a good thing. It’s more than just a way of earning a living: it provides identity, contact and friendship with other people, a way of putting structure in your life, and an opportunity to meet goals and to contribute. 

And while it's possible to embrace an alternative point of view, and thrive without paid work, unemployment is linked with poor physical and mental health, and poverty. However, paid employment brings its own pressures on your mental health. 

The Health and Safety Executive (HSE) estimates that every year around 2 million people experience a health problem that they believe to have been caused by their current or past work: stress being the largest cause of work-related illnesses. Stress and bullying are the two main causes of mental distress at work, and we tackle these in the following pages.

If you already have a mental health problem, maintaining paid employment can itself be a challenge: the usual pressures of work may sometimes make you feel worse, or you may feel that you can’t be open about your condition to your boss or colleagues. However, with understanding and support from your employer, and a little bit of flexibility, work can be a positive experience.

Only at its very worst has my mental health adversely affected my work. In general, I feel better when I am actually at work – being distracted and feeling valued for what I do

Note: Not all work is paid work. People work and gain skills in many ways, e.g. through bringing up children, caring for relatives, maintaining the home and garden, or doing voluntary work. While these are all important, the focus of this booklet is on paid employment, which has distinct pressures, rules and expectations.

Work stress

What are the signs of stress?

These are some of the typical signs of stress:

What causes stress at work?

While stress sometimes has its roots outside work, it is the most common cause of work-related illness. If you are experiencing some of the symptoms above, you may want to think about why. Here are some of the common causes of stress at work:

• having too much or too little to do
• work that is too difficult or too easy
• the pressure of deadlines
• shift work
• physically demanding work
• lack of control over what you do and how you do it
• poor working conditions, e.g. high noise levels; bad lighting, furniture or equipment
• poor communication from your employer about changes
• unclear expectations and conflicting messages
• lack of managerial support
• feeling trapped in the wrong job, e.g. with poor pay, poor status, limited opportunities for promotion and training; or with high pay because of financial commitments
• uncertainty about the future, e.g. threat of redundancy, a fixed-term contract
• poor relationships at work
• working in isolation, e.g. at home
• bullying
• an unsupportive work culture, e.g. where needing help is seen as being weak
• conflicting demands of managing your home and work life, especially if you have a personal crisis going on
• trapped in a cycle of working harder and harder because you feel you can’t get enough done; leading to exhaustion, poor sleep and lack of concentration.

How can I deal with stress at work?

Taking action, however small, can improve your life at work or prevent stress developing in the first place. You may be free to do some things without reference to anyone else, but some things you will need to negotiate, formally or informally, with colleagues or managers.

Take control

• Develop good relationships with colleagues so you can build up a network of support.
• Talk to someone you trust, at work or outside, about what upsets you or makes you feel stressed.
• Say if you need help.
• Be assertive – say no if you can't take on extra demands.
• Be realistic – you don't have to be perfect all the time.
• Write a list of what needs to be done; it only takes a few minutes and can help you to prioritise, focus and get things in perspective. It can also feel satisfying to tick items off once they have been done.
• If everything starts to feel overwhelming, take a deep breath. Try and get away from your desk or situation for a few minutes.

I arrange to meet a friend for lunch every day. Just 30 minutes away from the office having a chat and sharing a laugh works wonders. I share my worries and get a 'sense' check from friend

• Try and take a walk or get some fresh air during the day. Exercise and daylight are good for your mental health as well as physical health.
• Work regular hours and try to take the breaks and holidays you're entitled to. If things are getting too much, book a day off or a long weekend.
• Try not to work long hours or take work home with you. This may be alright in the short term, if the work has a specific purpose and is clearly defined – a team effort to complete an urgent project may be very satisfying. However, working longer hours on a regular basis does not generally lead to better results.
• If you are provided with opportunities to have some input, particularly in decisions that may impact you, then take advantage of those opportunities.
• If you are working from home, make the most of opportunities for contact.
• Maintain a healthy work-life balance – nurture your outside relationships, interests, and the abilities your job does not use.
• Make sure you drink enough water and that you eat during the day to maintain your energy levels.
• Learn some relaxation techniques (see Mind’s information about How to manage stress).

Bullying

What is workplace bullying?

Workplace bullying is more than someone being bossy and occasionally having an angry outburst about work targets. It is when someone persistently acts towards you in a way that hurts, criticises or victimises you. They can be quite obvious – shouting or swearing or humiliating you in front of colleagues; or more underhand – constantly criticising you,isolating you from colleagues, spreading malicious rumours about you or blaming you whenever things go wrong.

Bullying can often:

• undermine your ability, causing you to lose your self-confidence and self-esteem
• intimidate you in a way that makes you feel very vulnerable, alone,angry and powerless
• cause you stress
• lead to anxiety and/or depression.

What can I do if I’m being bullied?

If you are being bullied, you have three choices: putting up with it; standing firm and taking action; or leaving your job. Putting up with it is likely to be damaging in the long term, but the alternatives may also be a challenge.

Taking action

Taking action usually means speaking out, but not necessarily confronting the bully directly. It may seem the right thing to do, but how confident you feel about doing it may depend on whether you think your employer and colleagues will support you.

• Seek advice and support from your human resources department, your health and safety or welfare officers, or your union representative, if you have one. You might also find it helpful to contact ACAS.
• Find out if your employer has a policy on bullying and harassment, and what their grievance procedure is.
• Seek support from friends and colleagues, as well as from those in authority. But be aware that people may be nervous of providing support in case they end up being targeted by the bully too.
• Avoid situations where you are alone with the bully.
• Record what is happening to you and keep relevant documents in case you should need them for any formal complaints procedures.

Protecting your mental health

Because the effect of bullying is often to damage your self-esteem and self-confidence, it is important to get help in dealing with this.

Learning some basic self-assertiveness skills can help you to feel better about yourself. It can help you to deal with awkward situations that may arise and any anger you may be feeling (see Mind’s information about How to deal with anger). Your employer may offer assertiveness training – or look for classes on the internet or at your library.

You may wish to try counselling. It can help to have someone objective to talk to, who has the time to listen to how you are feeling, with no distractions. A counsellor will not offer you advice on what to do, but explore how you are feeling and suggest ways to cope better with difficult situations. Counselling can often be accessed through your GP, privately, or through a voluntary organisation. Some workplaces offer counselling, either in-house or by referral to an employee assistance programme (EAP). (See Mind’s information about talking treatments.)

Leaving your job

You may decide that leaving your job is the best option for your mental health. If so, you don’t have to see this as defeat, but as a positive decision, taken to keep yourself well and because things are stacked against you. If you tell your employer why you are leaving, this may help you feel more in control and may help others in the future.

Telling your employer and getting support

Should I tell my employer if I have a mental health problem?

If you have an ongoing mental health problem you may be unsure of who to tell about it, when to tell them and how much to tell. You may be worried about how they may react and the consequences.

More often than not I just ‘put on a brave face’ and make sure at all costs that no-one notices if I'm struggling

Many employers now have positive policies on disability and equality at work and take a more positive view of mental health problems, which ought to mean that being open about your mental health is less of a risk. There are also laws in place to protect you at work if you are considered to be disabled because of a mental health problem (see ‘Rights at work’). However, you may still want to think about the risks and benefits before making a decision.

The potential risks of disclosing something about your mental health include:

• being teased or harassed by other employees
• being assumed to be a less productive member of the team
• having fewer opportunities for career development
• being treated as more vulnerable than other employees, or as having everything (anger, excitement, time off sick, or a grievance) associated with your mental health problem
• being monitored more than other employees, and having to work harder to gain the same respect
• giving your employer a reason to manage how you act and interact with colleagues.

The potential benefits of disclosure are:

• being open about it can encourage others in the same situation
• keeping it secret may be too stressful, or against your beliefs
• it gives you a stronger basis for requesting adjustments to your job or work environment (see Disability discrimination for more information on adjustments)
• it could give you the opportunity to involve an outside adviser or support worker, who could see you at work or speak directly with your employer
• it could make it easier to go into work at times when your symptoms are more visible
• it enables you to get the support of colleagues.

If you do decide to tell your employer, think about how and when to do it, how much information you want to give, and who to share it with. For example, the human resources department may know your diagnosis, but they don't have to tell your supervisor or colleagues.

You don't have to go into personal details; focus on what you need for the job. Employers want to know if you can do the job and will get along with the customers or clients and the rest of the team. If you can show that your intention is to get the job done, this should go a long way to reassuring them. Being straightforward and unembarrassed about your history will help them get it in to perspective.

If you simply want your employer to understand your needs, disclosing your mental health problem may prompt your employer to treat you in a more constructive and supportive way. From a legal point of view, an employer only has to make adjustments for needs that they know about. Therefore, if you are disabled and want the protection of the Equality Act (see Rights at work), you will have to make sure that someone in a responsible position knows what they are.

What adjustments can I ask for at work?

Changing something about your working environment or the way you do your job may help you to stay healthy and work more effectively. You may be able to organise some of these for yourself; others may require action, or at least agreement, from your employer.

Many of the adjustments that can help your mental health are things you might expect an employer to adopt as a matter of good practice, e.g. a quiet workspace or being able to work from home, and you can ask for these even if you don’t consider yourself to be disabled or don’t want to tell your employer that you have a mental health problem.

Reasonable adjustments

However, if you have a mental health condition that is considered to be a disability (see 'Rights at work' for a definition), your employer has a duty under the Equality Act to make ‘reasonable adjustments’. You can ask for such adjustments at the point when you need them, even if you did not volunteer information about your mental health problem earlier.

When thinking about what adjustments to ask your employer for, the key is to think creatively about what will enable you to do your job effectively. You are probably the best judge of what would be most successful for you, but here are some examples:

• using voicemail to take messages (without slowing down the overall response time) if phone calls make you anxious
• using email when face-to-face contact is too stressful
• a quiet workspace or being able to work from home – to avoid distractions and help you concentrate
• changing your manager, if possible, and if another would be more flexible
• restructuring your job or temporarily reallocating some of the duties (for example, 'front-line' work)
• flexible hours to accommodate therapy, medical appointments, rushhour pressures or the morning drowsiness associated with some medicines
• on-the-job support, or permission for a support worker to come in or to be contacted during work hours
• permission to take time out when distressed: this could just be a few minutes away from your workstation, going out for some air, or having a short rest
• a workstation by a window; or a lightbox, if you have seasonal affective disorder.

I will cancel meetings if a panic attack sets in and I really can't face the world – and I am open and honest about it. You may want to think through some of the possibilities with another person before speaking to your employer, or have someone to back up your request. This could be someone involved with your care or treatment, or a disability employment adviser (DEA) from Jobcentre Plus (see 'Useful contacts'). DEAs can give you advice and carry out an employment assessment to find out what help you may need. They may be able to help you get funding – via the Access to Work scheme – for equipment, personal support or assistance, or help with extra costs of getting to work; for example, if you can’t use public transport.

What if my mental health becomes a problem at work?

Anyone can become upset and reveal to their workmates that they are human. But if you have a mental health problem you may have a particular need for a safe space to express your feelings. If you are going through a mental health crisis, whether or not it's caused by work stress, it is likely have an impact on you at work.

If you can learn to identify what triggers your episodes of ill health, this will make it a lot easier to find the right coping strategy. Keep a diary of what happened, how you felt and how you reacted – you may find that a pattern emerges over time. This can help you think about how to deal with the same type of situation next time it arises – or to learn to avoid that type of situation if at all possible.

Ways of coping

• A brief time-out period when you are feeling unwell could restore you and allow you to continue working.
• You may need a quiet place away from colleagues to shout or cry.
• You may prefer someone to be with you to help calm you down or just listen.
• You could learn specific therapeutic techniques using breathing or meditation.

These are just examples, and they may not work for you. It may take a few tries to find out what does. But once you know what you are likely to need, you may be able set up or discuss with your employer, in advance, the things that will allow you to help yourself feel better.

Be honest about what's happening, but don't let people tell you 'you can't'. Instead, tell them what you need, so that you can.

Getting help

If you are worried about your mental health, or other people are expressing concerns, you may want to get professional help.

If you work for a large organisation, they may have an occupational health service, where you can discuss worries about your health and problems you may be facing at work. Someone in the workplace is not only easier to access, but has the advantage of understanding the organisation and being a potential ally. However, if you do not feel secure enough in your job to approach them, or there is no service available, you may want to talk to your GP or a counsellor. You may need time off work – and sickness absence for a mental health problem is just as valid as that for physical health problem.

Returning to work

If you have to take time off with a mental health problem, returning to work can be quite daunting. But it can also be an important part of your recovery, and you don’t have to be a hundred per cent well to go back. You don't have to apologise or justify being unwell, any more than you would if you were recovering from an accident or operation.

In the midst of a mental health crisis, people sometimes say or do things they wouldn't otherwise say or do. If this has happened, then you may feel the need to rebuild relationships. But, very often, other staff will just be glad to see you back at work. People are able to empathise, and are more likely to have been busy with their own lives and work, rather than preoccupied with why you have been off sick or what led up to it.

However, there are some practical things you can do to ease things, before you return completely:

• Keep in touch with colleagues on a social basis.
• Ask to be put on the mailing list for the staff bulletin or house magazine so that you have the opportunity to get up-to-date with developments.
• Drop in to work before starting back, to say hello to colleagues and get re-familiarised.

Employer support

Make use of any support you can from your employer.

• Make a plan for returning to work that focuses on what you can do.
• Ask if you could have a gradual build-up to full hours (just as you might expect after breaking a leg or a major operation).
• Find out if your employer has any specialist support services on offer e.g. occupational health services, or an employee assistance programme (EAP) which may provide services such as free counselling.
• Ask your employer to consider short-term (or even permanent) changes to your job or hours, if you feel this is needed.

Any changes to your working arrangements that might help, whether temporary or permanent, could be considered as ‘reasonable adjustments’ under the Equality Act (see above). In the longer term, a Wellness and Recovery Plan (WRAP) is something you might agree with your employer. It doesn't have legal status, but it could help you plan how to stay well at work, for what might go wrong, and what to do if to does.

For many people, what matters is knowing that they don't have to hide mental health problems and will be allowed to get on with their job without feeling pressurised to continue if they do need to stop or slow down sometimes. If you need feedback from another person to help you recognise when you are overdoing it, you could discuss with a trusted colleague what they need to be aware of, and what kind of support you would welcome.

Rights at work

What are my rights at work?

Health and safety

Whether you have a mental health problem or not, your employer has a duty of care to you under health and safety legislation. All workers have a right to work where risks to their health and safety are properly controlled. Employers also have responsibilities to protect employees after returning to work from sickness absence if they have become more vulnerable because of illness, injury or disability. (See the Health and Safety Executive under ‘Useful contacts’.)

Disability discrimination

If you are considered to be disabled, the law (the Equality Act 2010) says you have a right not to be discriminated against in employment. This means that employers must not treat you less favourably than other people, either as an employee or a job applicant.

Someone with a mental illness that has a substantial and long-term effect (12 months, or more) on their ability to carry out day-to-day activities is considered disabled. You would still be covered if these effects are controlled by treatment, if you have recurrent episodes, or if you have met the definition of 'disabled' in the past.

The Equality Act makes it clear that it is not lawful for an employer to ask health questions in the recruitment process before a job offer is made. It is still relevant for an employer to ask these questions after the offer, so making job offers conditional on references and health assessments is allowed.

Employers must make 'reasonable adjustments'; in other words take reasonable steps to change work environments or arrangements that put a disabled person at a substantial disadvantage. The law applies to training and promotion, and the Act also outlaws victimisation of people bringing complaints. (See Mind's online legal briefing Disability Discrimination under the Equality Act 2010 for more information.)

If you have a complaint under the Equality Act, or any other law related to employment, you can take it to an employment tribunal. Get advice from your trade union, local Citizens Advice or the Equality and Human Rights Commission. (See 'Useful contacts’ for more information.)

Note: the employment sections of the Equality Act apply to all employers, except the armed services.

Useful contacts

Useful contacts

Mind Infoline
tel: 0300 123 3393 (Monday to Friday, 9.00am to 6.00pm)
email: info@mind.org.uk
web: www.mind.org.uk
Details of local Minds and other local services, and Mind's Legal Advice Line.  Language Line is available for talking in a language other than English

Acas
web: acas.org.uk
Promotes employment relations. See 'bullying and harrassment' in A-Z

British Association for Counselling and Psychotherapy (BACP)
tel: 01455 883 300
web: itsgoodtotalk.org.uk
For practitioners in your area

Citizens Advice
advice lines: 08444 111 444 (England); 0844 477 2020 (Wales)
TextRelay service: 08444 111 445
web: citizensadvice.org.uk with online advice from their adviceguide.org.uk
Confidential advice on a range of issues, including employment

Employment Tribunal Guidance
tel: 0845 795 9775
web: justice.gov.uk/tribunals/employment
Gives guidance on the tribunal system

Equality and Human Rights Commission
Equality Advisory Support Service tel: 0800 444 205
textphone: 0800 444 206
web: equalityhumanrights.com
Information and advice on equality and rights issues

GOV.UK
web: gov.uk
Information about employment rights and help for disabled people

Health and Safety Executive
web: hse.gov.uk
The national independent watchdog for work-related health, safety and illness

Jobcentre plus
web: gov.uk/contact-jobcentre-plus
For help finding a job.

The Stress Management Society
tel: 0203 142 8650
web: stress.org.uk
Helps people tackle stress

The Work Foundation
web: theworkfoundation.com
Independent foundation looking at work issues

Working Families
tel: 0300 013 0312
web: workingfamilies.org.uk
Information on achieving work-life balance

Published 2013
To be revised 2015
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