Understanding health and wellbeing in the workplace
Causes of stress at work
Workplace stress commonly arises from excessive workloads, unrealistic deadlines, poor management, lack of support, unclear job roles, workplace bullying or harassment, job insecurity, and organisational change. Additional factors include lack of training, toxic work environments, and personal issues such as bereavement or financial worries, which may exacerbate work-related stress. Employers should proactively identify these stressors through risk assessments and employee feedback to mitigate risks and foster a healthy work environment.
Spotting the signs of stress
Managers should be vigilant for behavioural and physical changes in employees, such as irritability, reduced productivity, tearfulness, excessive tiredness, withdrawal from social situations, low mood, poor concentration, absenteeism, and changes in appearance or hygiene. Early intervention is crucial; a significant change in an employee’s demeanour or performance should prompt a supportive, informal conversation to explore underlying causes.
Legal obligations of employers
Employers have a statutory duty under the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999 to ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees—including mental wellbeing. This requires conducting regular risk assessments, identifying and controlling workplace stressors, and taking appropriate action to prevent harm. Employers must also ensure compliance with the Equality Act 2010, particularly where stress leads to a disability, and maintain written records of risk assessments if employing five or more staff.
Stress and disability under UK employment law
While stress alone is not classified as a disability, it can lead to mental health conditions such as anxiety or depression, which may qualify as a disability under the Equality Act 2010 if the impairment has a substantial and long-term adverse effect on the employee’s ability to carry out normal day-to-day activities. Employers must not discriminate against disabled employees and are required to make reasonable adjustments, such as modifying duties, adjusting hours, or providing additional support, to ensure the employee is not substantially disadvantaged.
Managing stress through disciplinary or grievance procedures
Disciplinary or grievance procedures can be particularly stressful for employees. Employers should balance the need to follow procedures with the employee’s wellbeing, considering adjustments such as rescheduling meetings, allowing accompaniment, or seeking medical advice on how to proceed. If the employee is disabled, reasonable adjustments must be made to the process. Employers should avoid unnecessary delays but must ensure the process is fair and supportive, in line with the ACAS Code of Practice.
Keeping in touch and supporting an employee off with work-related stress
Employers should maintain regular, empathetic contact with employees absent due to work-related stress, focusing on wellbeing and recovery rather than work tasks. The frequency and method of contact should be agreed with the employee to avoid overwhelming them. Support may include signposting to Employee Assistance Programmes, providing access to occupational health, and discussing adjustments for a return to work. A return-to-work meeting should be held to review support needs and update risk assessments, ensuring the employee is not exposed to the same stressors upon their return.
Legal obligations and rights
Legal requirements for employers to address workplace stress
Employers are legally required to assess and manage risks related to workplace stress under the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999. This includes identifying stressors such as excessive workload, poor management, or bullying, and taking reasonable steps to mitigate these risks through regular risk assessments, staff surveys, and implementation of appropriate controls. Failure to address workplace stress can result in legal claims for personal injury, breach of contract, or constructive dismissal, as well as enforcement action by regulators if statutory duties are breached. Employers must also ensure that stress risk assessments are documented, especially in organisations with more than five employees, and reviewed following significant changes or when concerns are raised.
Is mental wealth a disability under UK law?
Mental health conditions can be classed as a disability under the Equality Act 2010 if they have a substantial and long-term adverse effect on an individual’s ability to carry out normal day-to-day activities. “Substantial” means more than minor or trivial, and “long-term” means lasting or expected to last at least 12 months. The definition applies regardless of whether the condition is constant or fluctuating, and includes conditions such as depression, anxiety, bipolar disorder, and schizophrenia if the statutory threshold is met. Stress alone is not automatically a disability, but long-term stress may contribute to a qualifying disability depending on its impact and duration.
Employers’ duty of care: health, safety and wellbeing
Employers have a statutory and common law duty of care to ensure the health, safety, and welfare of employees, which explicitly includes mental health and wellbeing. This duty requires employers to provide a safe working environment, carry out regular risk assessments (including psychosocial risks), and take prompt action when employees show signs of stress or mental ill health. The duty also extends to making reasonable adjustments for disabled employees and preventing harassment or victimisation. Breaches of this duty can result in claims for negligence, breach of contract, or regulatory penalties.
Overview of mental health in the UK
Mental health issues are widespread in the UK workforce, with approximately one in four people experiencing a mental health problem each year. Common conditions include stress, anxiety, and depression, which are leading causes of workplace absence and reduced productivity. The impact of poor mental health is significant both for individuals and businesses, with substantial costs arising from sickness absence, staff turnover, and decreased morale. Employers are increasingly expected to foster open dialogue, provide mental health training, and offer support such as Employee Assistance Programmes and flexible working arrangements to promote wellbeing.
Discrimination against individuals with disabilities in the workplace
The Equality Act 2010 prohibits discrimination against individuals with disabilities, including those with qualifying mental health conditions. Discrimination can be direct (less favourable treatment because of disability), indirect (policies or practices that disadvantage disabled people), harassment, victimisation, or failure to make reasonable adjustments. Employers must take proactive steps to prevent discrimination and respond promptly to grievances. Failure to comply can result in uncapped compensation at tribunal, reputational harm, and orders for reinstatement or re-engagement.
Definition and scope of disability under the Equality Act 2010
A disability is defined as a physical or mental impairment that has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities. The Act covers fluctuating or recurring conditions and does not require a clinical diagnosis for protection to apply. The duty to make reasonable adjustments is triggered when an employer knows or could reasonably be expected to know of the disability. Adjustments must be tailored to the individual and may include changes to working hours, duties, environment, or support arrangements. What is “reasonable” depends on the size and resources of the employer, the effectiveness of the adjustment, and the impact on the business.
Managing mental health in the workplace
How Employees Can Raise Concerns About Their Health and Wellbeing
Employees should be encouraged to speak to their line manager, HR, or a designated mental health first aider if they have concerns about their mental health or wellbeing. Clear guidance on who to approach and how to do so should be included in induction materials and regularly communicated to all staff. Anonymous feedback tools and regular check-ins can provide additional routes for raising concerns, especially for those uncomfortable with direct disclosure.
Employers must ensure that employees know their rights under the Equality Act 2010, including protection from discrimination and entitlement to reasonable adjustments if their mental health condition qualifies as a disability. Employees should also be made aware of any Employee Assistance Programmes (EAPs), counselling services, or external helplines available.
The role of occupational health services
Occupational health services provide specialist advice to both employers and employees regarding the impact of health (including mental health) on work and vice versa. They can assess fitness for work, recommend reasonable adjustments, and support return-to-work plans following absence due to mental health issues.
Referrals to occupational health should be made with the employee’s consent and in line with data protection requirements. Occupational health professionals can also help identify workplace risks contributing to poor mental health and advise on preventative measures.
Creating a supportive environment for health and wellbeing
Foster a culture where open conversations about mental health are normalised and stigma is actively challenged. This can be achieved by discussing mental health in team meetings, sharing personal experiences from senior leaders, and promoting mental health awareness campaigns.
Implement policies that support flexible working, fair and manageable workloads, and regular breaks. Provide access to wellbeing resources such as mindfulness apps, therapy sessions, or group activities, and ensure all staff are aware of these options.
Routinely monitor employee wellbeing through anonymous surveys, regular one-to-ones, and risk assessments. Use the findings to inform ongoing improvements to workplace practices and support systems.
Mental health awareness at work
Deliver regular mental health awareness training to all staff, covering common conditions, how to recognise early warning signs, and where to seek help. Training should be tailored to the workplace and accessible to all employees, including remote and hybrid workers.
Promote awareness through visible campaigns, posters, and information sessions. Appoint mental health champions or first aiders to act as points of contact and advocates for mental health within the organisation.
Training managers on mental health
Managers should receive training on how to spot early signs of mental health issues, have supportive conversations, and respond appropriately. Training must include legal responsibilities under the Equality Act 2010, confidentiality, and how to make or request reasonable adjustments.
Equip managers with practical tools, such as checklists for conversations, guidance on signposting to support, and information on managing performance or absence related to mental health. Ongoing refresher training should be provided to maintain competence and confidence.
How to talk to someone with poor mental health
Arrange conversations in private, at a time and place that suits the employee, and approach the discussion with empathy, patience, and without judgement. Use open-ended questions, listen actively, and avoid making assumptions about the person’s experience or needs.
Reassure the employee about confidentiality and explain any limits (e.g., if there is a risk of harm). Offer information about available support and agree together on next steps, such as adjustments or referrals. Follow up as agreed to maintain trust and support.
How to provide mental health support at work
Offer reasonable adjustments tailored to the individual’s needs, such as flexible hours, changes to workload, remote working, or additional breaks. Adjustments should be regularly reviewed and adapted as circumstances change.
Provide access to support services, including EAPs, occupational health, and external helplines. Ensure employees know how to access these resources and that they are available confidentially.
Maintain clear, up-to-date policies on mental health and wellbeing, and ensure all staff are familiar with them. Policies should outline how to raise concerns, what support is available, and the organisation’s commitment to mental health.
Stress management
Causes of stress at work
Workplace stress commonly arises from excessive workloads, unrealistic deadlines, lack of managerial support, unclear job roles, workplace bullying or harassment, job insecurity, organisational change, poor working conditions, and insufficient training. External factors such as bereavement, personal health issues, financial worries, and caring responsibilities can also exacerbate stress experienced at work. Employers should proactively identify these stressors through regular risk assessments and employee feedback to mitigate risks and foster a supportive environment.
Spotting the signs of stress
Signs of workplace stress may manifest as changes in behaviour, mood, or performance. Indicators include irritability, tearfulness, withdrawal from colleagues, reduced productivity, increased absenteeism, poor concentration, indecisiveness, tiredness, and avoidance of social situations. Managers should be vigilant for such changes and initiate private, supportive conversations with affected employees to explore underlying causes and offer assistance.
Legal obligations of employers
Employers have a statutory duty under the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999 to ensure, so far as is reasonably practicable, the health, safety, and welfare of employees—including mental wellbeing. This requires conducting suitable and sufficient risk assessments for stress, implementing measures to control identified risks, and regularly reviewing these arrangements. Failure to comply may result in legal claims for personal injury, breach of duty of care, or discrimination if reasonable adjustments are not made.
Stress and disability under UK employment law
While stress itself is not classified as a disability, it can lead to or exacerbate mental health conditions such as depression or anxiety, which may qualify as a disability under the Equality Act 2010 if they have a substantial and long-term adverse effect on day-to-day activities. Where an employee’s condition meets this threshold, employers must not discriminate and are required to make reasonable adjustments—such as modifying duties, hours, or providing additional support—to avoid substantial disadvantage.
Managing stress through disciplinary or grievance procedures
Disciplinary or grievance procedures can be particularly stressful for employees. Employers should balance the need to proceed with such processes against the employee’s wellbeing, considering postponements or adjustments where appropriate. Reasonable adjustments may include allowing representation, rescheduling meetings, or seeking medical advice on the employee’s fitness to participate. The Acas Code of Practice should be followed, and any adjustments must be documented. If the employee is disabled, failure to make reasonable adjustments may constitute discrimination.
Keeping in touch and supporting an employee off with work-related stress
Employers should maintain regular, empathetic contact with employees absent due to work-related stress, agreeing on the frequency and method of communication to avoid causing additional pressure. Contact should focus on wellbeing, updates, and planning for a return to work, not on work tasks or disciplinary matters. Support may include referrals to occupational health, Employee Assistance Programmes, or developing a phased return-to-work plan with necessary adjustments. All communications and agreed actions should be recorded to demonstrate compliance and support.
Reasonable adjustments and disability rights
Reasonable adjustments for mental health and disabilities
Employers must make reasonable adjustments for employees with disabilities, including mental health conditions, where these have a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. Reasonable adjustments may include changes to working hours, job duties, workplace environment, policies, or providing auxiliary aids, and must be tailored to the individual’s needs. The duty applies when the employer knows, or could reasonably be expected to know, of the disability, and is triggered by requests, observed difficulties, or disability-related absence records. Employers should not ask employees to pay for adjustments, and must consider practicality, cost, effectiveness, and impact on others when deciding what is reasonable. Failure to provide reasonable adjustments can result in claims for disability discrimination with uncapped compensation for injury to feelings and loss of earnings under the Equality Act 2010 and supporting ACAS guidance.
Responding to changes in mental health condition or impairment
When an employee’s mental health condition or impairment changes, employers must review existing adjustments to ensure they remain effective and appropriate. This includes situations where symptoms worsen, fluctuate, or improve, or where the employee’s job role or working environment changes. Employers should have open, sensitive discussions with the employee to identify new or different support needs, and may need to seek updated medical or occupational health advice. Adjustments should be regularly reviewed, at least every six months or sooner if circumstances change, and changes should be confirmed in writing. Failing to review and adapt adjustments as needs change can amount to unlawful discrimination.
Time off for medical appointments and treatment
Allowing paid or unpaid time off for medical appointments, therapy, or treatment related to a disability is recognised as a reasonable adjustment. This includes time off for GP, hospital, or specialist appointments, counselling, rehabilitation, or assessments. Such leave should be recorded separately from standard sickness absence to ensure employees are not unfairly penalised under absence management policies or redundancy selection criteria. Employers should communicate clearly with employees about how to request time off and ensure policies reflect this entitlement. Adjustments to absence triggers or thresholds may also be necessary to avoid discrimination.
Managing disability-related absence
Disability-related absence, including both sickness absence and disability leave (time off for treatment, assessment, or rehabilitation), must be managed distinctly from ordinary sick leave. Employers should record and discount disability-related absences from absence triggers, disciplinary procedures, and redundancy selection criteria. Policies should make clear how disability-related absence is identified and managed, and employees should be encouraged to flag if an absence is disability-related. Employers must consider reasonable adjustments to absence management, such as modifying trigger points or allowing additional time off, and should keep clear records of all decisions and communications. Dismissal for disability-related absence should only be considered as a last resort after all reasonable adjustments have been explored and documented.
Documentation and record-keeping
Employers should keep detailed records of all requests for reasonable adjustments, meetings, agreed actions, reviews, and communications. This includes using reasonable adjustment passports or similar tools to ensure continuity if the employee changes roles or managers. Records should be kept confidential and only shared with those involved in implementing adjustments, in line with data protection laws. Proper documentation is essential for legal compliance and to defend against potential claims.
Legal risks and compliance
Failure to make or review reasonable adjustments, or to manage disability-related absence appropriately, exposes employers to claims for disability discrimination under the Equality Act 2010. There is no cap on compensation for injury to feelings, and employers may also face reputational damage. Employers should ensure HR and line managers are trained in disability and mental health awareness, and that policies are regularly reviewed for legal compliance.
Specific workplace conditions and policies
Capability or performance assessment
Employers must ensure that any capability or performance assessment is conducted fairly, objectively, and in line with both the Equality Act 2010 and current best practice. If an employee’s performance may be affected by health conditions such as menopause or stress, employers should consider reasonable adjustments and seek medical or occupational health advice before proceeding with formal action. Failure to consider relevant health factors or reasonable adjustments can result in claims for discrimination or unfair dismissal, as highlighted in recent tribunal decisions (e.g., Merchant v BT plc). Assessments should be evidence-based, with clear communication and opportunities for the employee to respond to concerns.
Ensure all relevant health issues are identified and considered before formal capability procedures.
Consult with occupational health where health is a factor in performance.
Make reasonable adjustments where required under the Equality Act 2010.
Document all meetings, evidence, and decisions thoroughly.
Handling flexible working requests
From April 2024, employees have a statutory right to request flexible working from day one of employment. Employers must follow the statutory process: consider requests reasonably, consult with the employee, and provide a decision within two months. If the request is linked to a disability (including menopause-related conditions), the duty to make reasonable adjustments under the Equality Act 2010 is separate and may require more than the statutory minimum. Failure to consider the impact of health conditions can amount to discrimination or constructive dismissal, as in Johnson v Bronzeshield Lifting Ltd.
Meet with the employee to discuss the request and any underlying health or caring responsibilities.
Consider the request on its merits, including the impact on business and any legal obligations to make adjustments.
Provide a written outcome and allow for an appeal.
Record all communications and decisions.
Pay and time off with stress
Employers must manage stress-related absence in accordance with the Health and Safety at Work Act 1974 and statutory sick pay (SSP) rules. Employees absent due to work-related stress are entitled to SSP if eligible, and may be entitled to contractual sick pay if provided by the employer. Employers should conduct risk assessments for work-related stress and consider adjustments to prevent recurrence. If stress is linked to a disability, the duty to make reasonable adjustments applies. Open communication and support, including access to Employee Assistance Programmes, are recommended.
Conduct risk assessments for stress and implement measures to reduce workplace stressors.
Pay SSP from the fourth day of absence, or contractual sick pay if applicable.
Maintain regular contact and provide support, including referrals to occupational health.
Record all absences and actions taken.
Menopause at work and developing a menopause policy
Employers are strongly advised to develop a menopause policy to ensure legal compliance, support affected employees, and reduce the risk of discrimination claims. The Equality Act 2010 requires employers to consider reasonable adjustments for employees whose menopause symptoms amount to a disability, and to avoid direct or indirect discrimination on the grounds of sex, age, or disability. A best practice menopause policy should include a statement of intent, definitions, legal context, roles and responsibilities, available support, points of contact, and training provisions. Policies should be inclusive of all genders and regularly reviewed.
Engage with staff and consult on policy development.
Provide training for managers and staff on menopause awareness.
Offer practical support, such as flexible working, rest areas, temperature control, and uniform adjustments.
Ensure menopause-related absences are recorded separately from other sickness absence where possible.
Maintain confidentiality and provide multiple support channels.
Reasonable working temperatures and extreme temperatures
Employers must ensure that workplace temperatures are reasonable and do not pose a risk to health and safety, as required by the Health and Safety at Work Act 1974 and the Workplace (Health, Safety and Welfare) Regulations 1992. There is no specific maximum or minimum temperature set by law, but employers must assess risks and take action to mitigate discomfort or health risks, especially during extreme weather. Reasonable adjustments may be required for employees affected by menopause or other health conditions.
Conduct regular risk assessments for temperature and ventilation.
Provide adequate heating, cooling, ventilation, and access to cold drinking water.
Allow for flexible work arrangements or additional breaks during extreme temperatures.
Inform and train staff on recognising and managing temperature-related risks.
Medical suspension from work and pay during suspension
Medical suspension occurs when an employer suspends an employee on health and safety grounds, often following medical advice or risk assessment. During medical suspension, employees are entitled to full pay for up to 26 weeks if the suspension is necessary to protect their health and they are otherwise fit for work, as set out in the Employment Rights Act 1996. Employers must communicate the reasons for suspension clearly, maintain confidentiality, and review the situation regularly.
Notify the employee in writing of the reasons for medical suspension.
Pay the employee their normal pay during the suspension (up to 26 weeks).
Provide access to occupational health and review the suspension as new information becomes available.
Keep detailed records of all communications and decisions.
