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 £56 billion per year (Deloitte/Mind, 2022) — 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 £5.30 for every £1 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:

1. Demands — workload, hours, pace
2. Control — how much say employees have
3. Support — from managers and colleagues
4. Relationships — including bullying and harassment
5. Role — clarity of responsibilities
6. Change — 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

1. Produce, implement, and communicate a mental health at work plan
2. Develop mental health awareness among employees
3. Encourage open conversations about mental health and the support available
4. Provide good working conditions
5. Promote effective people management (managers trained and supported)
6. Routinely monitor employee mental health and wellbeing

Enhanced Standards (for larger employers)

1. Increase transparency and accountability through internal and external reporting
2. Demonstrate accountability (senior sponsor, board-level reporting)
3. Improve the disclosure process
4. 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 — 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 6–8 sessions)
• Legal and financial advice
• Health and wellbeing support

Uptake: The average EAP utilisation rate is 3–5% annually. High-performing employers achieve 15–20% through active promotion.

Cost: £25–£80 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:

Access to Work Mental Health Support Service can fund up to 9 months of professional support — 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