Stress and mental health at work: half a decade in policy and practice
10 Oct 2018
My first memory of hearing about stress at work was as a psychology undergraduate at the University of Nottingham in the early 90s. My lecturer was Professor Tom Cox – I didn’t fully appreciate at the time that I was learning about stress first-hand from a global expert (he had written a seminal book on workplace stress in the 70s and founded the first academic journal on the topic), but it definitely made an impression. At the time I was unfamiliar with the reality of the labour market, before those lectures I assumed the best solution to finding your job difficult was to find another one. I was genuinely surprised that the topic merited a whole journal dedicated to it and never thought that the word ‘stress’ would come to dominate everyday conversation about work. Similarly, it didn’t cross my mind that I could end up researching it myself.
Fast forward fifteen or so years and I found myself on a team at IES running focus groups in organisations that had implemented the Health and Safety Executive’s (HSE’s) new Management Standards for work-related stress. Research conducted by my former lecturer had been instrumental to the development of the Standards and HSE had ambitious aims for them. The intention was to establish good practice principles that would enable employers to manage stress in much the same way as they would approach physical and chemical work hazards. This represented an important and controversial shift; ie holding employers responsible for psychosocial as well as physical risks to health.
The Standards called into question the acceptability of bullying cultures, unmanageable workloads, inflexible working patterns and overly-controlling bosses. However, they were not intended to be legally enforceable; the HSE’s aim was that they would ‘enable organisations to effectively tackle work-related stress, and subsequently reduce both its incidence and prevalence’.
While the Standards were welcomed by many, it‘s worth noting that some quarters were more sceptical fearing that regulatory interference in this area would create a ‘work stress epidemic’. Indeed, my colleague Stephen Bevan (then at the Work Foundation) urged caution on approaching workplace stress as primarily a matter of health and safety, saying that this could result in the ‘medicalisation of dissatisfaction’ and subsequent ‘catastrophisation’ of workplace stress. Other critics challenged the idea of drawing parallels between risks to physical and mental health. For example, Wainwright and Calnan argued that it is ‘difficult, if not impossible, to establish a relationship of cause and effect between a set of objective work characteristics and symptoms of stress’. They also warned that ‘reconceptualization of workplace problems in terms of stress and the individual’s inability to cope with it’ ultimately lead to ‘proposed cures that have the effect of lowering our expectations regarding human resilience’. More on resilience later.
Despite their doubters, nearly 15 years since they were piloted, HSE’s Standards live on and are widely respected. However, and arguably more significantly, the need to manage psychosocial workplace risks is now acknowledged by national (eg NICE and the cross-government Work and Health Unit) and international policy bodies (EU-OSHA, WHO).
Stress management is now seen as part of a broader mental health and wellbeing agenda which also encompasses equality rights of people with longer-term conditions, access to occupational health, and absence management. Applied and academic research on workplace wellbeing and successful campaigning led by mental health charities has raised the profile of all of these aspects.
Elsewhere, there is increasing recognition that all determinants of employee mental wellbeing should be of concern to employers, not just those linked to the workplace. For example, many employee assistance programmes (EAPs, commonly offered by occupational health providers) now offer support in areas like relationships, informal care and debt.
Terms that would not normally have been associated with occupational settings twenty years ago, such as mindfulness, resilience and cognitive behavioural therapy, have become part of the mainstream language. Also, interest in the topic now spans most UK industries: IES has undertaken mental health research work in a diverse range of sectors, including the emergency services (Mind’s Blue Light campaign), the rail industry, Defence and higher education . There is more recognition that different jobs have different stressors and require a bespoke approach. For example, in the latest phase of their Blue Light initiative, Mind developed training specifically for new recruits transitioning into their roles: See our evaluation of this work which has just been published.
Lately, there has also been acceptance that some demographic groups are more vulnerable than others, and that difficult topics like self-harm, substance misuse and suicide need to be named and tackled. This is exemplified in the work that the construction and manufacturing sectors have done to address the disproportional suicide risk among young adult males in lower-paid jobs.
Despite (or perhaps because of) the range of information available, management of mental health is a difficult thing for employers to get right. The evidence base is currently riddled with gaps and it is not clear what well-intentioned employers should do to improve the wellbeing of their workforce, or whether they will get a return on any investment.
There are also new areas of controversy. For example, should people be helped at work to become more resilient or is the implication that some people are lacking in it, akin to victim-blaming? Likewise, what role does Mental First Aid play in workplace wellbeing and who should be trained? Also, there are increasing pressures on employers to equip line managers with better pastoral communication skills and to consider this carefully when recruiting to people-managing roles.
Due to the complexity and sensitivity of these questions, there is an increasing appetite for evidence-based research in this area. IES is well placed to respond with its breadth of research experience on workplace mental health and wellbeing. Needless to say, these are interesting times to be a workplace wellbeing researcher.
 O’Donnell M and Bevan S, ‘Stress at work: time for a rethink?’, Occupational Health At Work, Vol.1 No.3,
Any views expressed are those of the author and not necessarily those of the Institute as a whole.