Mental health at work: the employers’ role in supporting disclosure and tackling taboo topics

Blog posts

16 Nov 2023

Jonathan Buzzeo, Senior Research Fellow

Content warning: this blog references suicide and suicidal feelings

I wanted to write a blog about men’s mental health at work for International Men’s Day. That was the idea. That was the plan. I wanted to write about some of the ways in which men more often (I assumed) deal with mental health challenges (e.g. through substance abuse and self-harm) and what employers can do to help support and destigmatise these issues in the workplace. But when I looked at the data it challenged what I thought I knew about gendered differences in mental health and the prevalence of these coping strategies.[1]

In Nuffield Health’s most recent healthier nation index, 44% of respondents said that work had a negative impact on their mental health over the past 12 months. Breaking this down by gender almost half of women surveyed said their job had a negative impact on their mental health, compared to two-fifths of men.

The reasons for this are extensive – women face greater psychosocial and physical risks in society, which are harmful to their mental health and make them much more likely to experience certain mental health conditions. This is a result of structurally embedded gender norms, inequalities and gender-based violence.  These factors also feed into and permeate women’s working lives through pay inequality, discrimination, balancing work with caregiving (and gender inequities in this unpaid work) and sexual harassment. Women may also be less likely to expose the negative impact of these issues on their mental health to their employer and risk further discrimination, resulting in higher levels of presenteeism compared to men, with women less likely to call in sick and more often to go into work when their mental health was not good.

In an ideal world, disclosure of a mental health condition to an employer could offer a way for employees to better manage these challenges, through emotional support, workplace adjustments and better job design, as well as signposting to mental health and wellbeing services. This is vital in the context of NHS mental health services in England being “overwhelmed”, and private services being prohibitively expensive to those facing cost of living pressures.  But a fear of discrimination (among all genders) risks pushing people to a crisis point.

As mental health problems spiral, an individual’s way of coping with these challenges can become progressively more harmful to themselves and others around them. In writing this blog, I wanted to explore the coping strategies that it’s often taboo to talk about in workplace cultures. That includes patterns of addiction and suicidal thoughts and behaviours.

Again, I wrongly presumed that these coping strategies were heavily gendered. In some ways they are. Men far outnumber women in estimates of ‘problem’ drug use and disclose higher rates of alcohol dependency. Men are also three times as likely to take their own lives than women. However, women are more likely to have attempted suicide and are more likely to self-harm, compared to men. Research has shown that this ‘gendered-paradox’ exists due to the different methods by which men and women attempt suicide, alongside differing risk factors, differing functions of self-harm and gendered-stigmas around seeking help. Suicide is a concern among trans and non-binary people too, with specific risk factors and experiences that may challenges these norms, though further careful research is needed on this topic.

All of this is to say that, in order to respond more effectively, employers need a nuanced understanding of how mental health conditions and coping strategies might manifest for different employees within the workplace. There is no one size fits all approach and every individual’s experience is different, but societal risks and norms will always colour our experiences.

Since I started work ten years ago, there’s been a marked change in how mental health is talked about in the workplace – it seems like we actually talk about it now, although some sectors and occupations fare better than others. And there’s still a long way to go.

Individuals reserve the right to decide what they do and do not disclose to their employer, and employers should be promoting access to specialist support services where serious mental health problems are discussed. But as part of their duty of care, employers need to recognise the detrimental impact that work can have on an individual’s mental health and be prepared to talk about and take steps to address this at an organisational level to encourage personal disclosure. 

We also need to get better as a society at destigmatising the ways in which individuals cope with emotional distress through substance use, self-harm and suicide. This includes greater understanding around substance use, viewing it as a response to psychosocial and environmental factors, as opposed to an individual moral failing.

With self-harm and suicide, there are often concerns and worries about opening up these conversations. Some even fear that talking about these feelings with someone they’re concerned about could make things worse or risks putting these thoughts into someone’s head. However, studies have shown that recognising these feelings and taking them seriously can help reduce feelings of distress. It’s important that this is done in a sensitive and gradual way, picking up on key trigger lines (‘I don’t feel like I can cope’, ‘it’s all too much’) and asking open questions to help clarify these experiences and the thoughts going through someone’s head.

Employers can be part of the solution in supporting this, and there are many good resources available on how to support employees who may experience these types of issues in the workplace. Ultimately, employers need to do their bit to help develop a culture of acceptance around different mental health conditions and how their employees cope with them (while still maintaining safe working conditions).

Employees need to trust that there will not be any negative consequences resulting from disclosure, that they will be met with empathy and understanding, and that they will be supported in the process of finding greater stability in their lives. But ignoring these topics is not really an option, and will only perpetuate patterns of harm.