Mental health at work

Overview

Almost 60% of the world population is in work (1). All workers have the right to a safe and healthy environment at work. Work can protect mental health. Decent work supports good mental health by providing:

• a livelihood;
• a sense of confidence, purpose and achievement;
• an opportunity for positive relationships and inclusion in a community; and
• a platform for structured routines, among many other benefits.

For people with mental health conditions, decent work can contribute to recovery and inclusion, improve confidence and social functioning.

Safe and healthy working environments are not only a fundamental right but are also more likely to minimize tension and conflicts at work and improve staff retention, work performance and productivity. Conversely, a lack of effective structures and support at work, especially for those living with mental health conditions, can affect a person’s ability to enjoy their work and do their job well; it can undermine people’s attendance at work and even stop people getting a job in the first place.

Risks to mental health at work

At work, risks to mental health, also called psychosocial risks, may be related to job content or work schedule, specific characteristics of the workplace or opportunities for career development among other things.

Risks to mental health at work can include:

• under-use of skills or being under-skilled for work;
• excessive workloads or work pace, understaffing;
• long, unsocial or inflexible hours;
• lack of control over job design or workload;
• unsafe or poor physical working conditions;
• organizational culture that enables negative behaviours;
• limited support from colleagues or authoritarian supervision;
• violence, harassment or bullying;
• discrimination and exclusion;
• unclear job role;
• under- or over-promotion;
• job insecurity, inadequate pay, or poor investment in career development; and
• conflicting home/work demands.

More than half the global workforce works in the informal economy (2), where there is no regulatory protection for health and safety. These workers often operate in unsafe working environments, work long hours, have little or no access to social or financial protections and face discrimination, all of which can undermine mental health.

Although psychosocial risks can be found in all sectors, some workers are more likely to be exposed to them than others, because of what they do or where and how they work. Health, humanitarian or emergency workers often have jobs that carry an elevated risk of exposure to adverse events, which can negatively impact mental health.

Economic recessions or humanitarian and public health emergencies elicit risks such as job loss, financial instability, reduced employment opportunities or increased unemployment.

Work can be a setting which amplifies wider issues that negatively affect mental health, including discrimination and inequality based on factors such as, race, sex, gender identity, sexual orientation, disability, social origin, migrant status, religion or age.

People with severe mental health conditions are more likely to be excluded from employment, and when in employment, they are more likely to experience inequality at work. Being out of work also poses a risk to mental health. Unemployment, job and financial insecurity, and recent job loss are risk factors for suicide attempts.

Action for mental health at work

Government, employers, the organizations which represent workers and employers, and other stakeholders responsible for workers’ health and safety can help to improve mental health at work through action to:

• prevent work-related mental health conditions by preventing the risks to mental health at work;
• protect and promote mental health at work;
• support workers with mental health conditions to participate and thrive in work; and
• create an enabling environment for change.

Action to address mental health at work should be done with the meaningful involvement of workers and their representatives, and persons with lived experience of mental health conditions.

Prevent work-related mental health conditions

Preventing mental health conditions at work is about managing psychosocial risks in the workplace. WHO recommends employers do this by implementing organizational interventions that directly target working conditions and environments. Organizational interventions are those that assess, and then mitigate, modify or remove workplace risks to mental health. Organizational interventions include, for example, providing flexible working arrangements, or implementing frameworks to deal with violence and harassment at work.

Protect and promote mental health at work

Protecting and promoting mental health at work is about strengthening capacities to recognize and act on mental health conditions at work, particularly for persons responsible for the supervision of others, such as managers.

To protect mental health, WHO recommends:

• manager training for mental health, which helps managers recognize and respond to supervisees experiencing emotional distress; builds interpersonal skills like open communication and active listening; and fosters better understanding of how job stressors affect mental health and can be managed;
• training for workers in mental health literacy and awareness, to improve knowledge of mental health and reduce stigma against mental health conditions at work; and
• interventions for individuals to build skills to manage stress and reduce mental health symptoms, including psychosocial interventions and opportunities for leisure-based physical activity.

Support people with mental health conditions to participate in and thrive at work

People living with mental health conditions have a right to participate in work fully and fairly. The UN Convention on the Rights of Persons with Disabilities provides an international agreement for promoting the rights of people with disabilities (including psychosocial disabilities), including at work. WHO recommends three interventions to support people with mental health conditions gain, sustain and participate in work:

• Reasonable accommodations at work adapt working environments to the capacities, needs and preferences of a worker with a mental health condition. They may include giving individual workers flexible working hours, extra time to complete tasks, modified assignments to reduce stress, time off for health appointments or regular supportive meetings with supervisors.

• Return-to-work programmes combine work-directed care (like reasonable accommodations or phased re-entry to work) with ongoing clinical care to support workers in meaningfully returning to work after an absence associated with mental health conditions, while also reducing mental health symptoms.
• Supported employment initiatives help people with severe mental health conditions to get into paid work and maintain their time on work through continue to provide mental health and vocational support.

Create an enabling environment for change

Both governments and employers, in consultation with key stakeholders, can help improve mental health at work by creating an enabling environment for change. In practice this means strengthening:

• Leadership and commitment to mental health at work, for example by integrating mental health at work into relevant policies.
• Investment of sufficient funds and resources, for example by establishing dedicated budgets for actions to improve mental health at work and making mental health and employment services available to lower-resourced enterprises.
• Rights to participate in work, for example by aligning employment laws and regulations with international human rights instruments and implementing non-discrimination policies at work.  
• Integration of mental health at work across sectors, for example by embedding mental health into existing systems for occupational safety and health.
• Participation of workers in decision-making, for example by holding meaningful and timely consultations with workers, their representatives and people with lived experience of mental health conditions.
• Evidence on psychosocial risks and effectiveness of interventions, for example by ensuring that all guidance and action on mental health at work is based on the latest evidence.
• Compliance with laws, regulations and recommendations, for example by integrating mental health into the responsibilities of national labour inspectorates and other compliance mechanisms.
  

WHO response

WHO is committed to improving mental health at work. The WHO global strategy on health, environment and climate change and WHO Comprehensive mental health action plan (2013–2030) outline relevant principles, objectives and implementation strategies to enable good mental health in the workplace. These include addressing social determinants of mental health, such as living standards and working conditions; reducing stigma and discrimination; and increasing access to evidence-based care through health service development, including access to occupational health services. In 2022, WHO’s World mental health report: transforming mental health for all, highlighted the workplace as a key example of a setting where transformative action on mental health is needed. 

The WHO guidelines on mental health at work provide evidence-based recommendations to promote mental health, prevent mental health conditions, and enable people living with mental health conditions to participate and thrive in work. The recommendations cover organizational interventions, manager training and worker training, individual interventions, return to work, and gaining employment. The accompanying policy brief by WHO and the International Labour Organization, Mental health at work: policy brief provides a pragmatic framework for implementing the WHO recommendations. It specifically sets out what governments, employers, organizations representing employers and workers, and other stakeholders can do to improve mental health at work.

1. World employment and social outlook - Trends 2022. Geneva: International Labour Organization; 2022 (https://www.ilo.org/global/research/global-reports/weso/trends2022/WCMS_834081/lang--en/index.htm, accessed 26 August 2022)
2. Women and men in the informal economy: a statistical picture. Geneva: International Labour Organization; 2018 (https://www.ilo.org/global/publications/books/WCMS_626831/lang--en/index.htm, accessed 26 August 2022).