5.4 Mental Ill Health

How common mental ill health is at work, and how far it reaches

A large share of working-age adults live with a mental disorder. Without effective support, mental disorders and other mental health conditions can affect a person's confidence and sense of identity at work, their capacity to work productively, their absence from work, and how easily they keep or find a job. People with severe conditions are largely excluded from work, even though work matters for recovery. These conditions also affect families, carers, colleagues, communities and society as a whole.

Everyone has the right to work, and every worker has the right to a safe and healthy working environment. Work can protect mental health, but it can also make it worse. Work-related mental health conditions are preventable, and much can be done to protect and promote mental health at work and to help people with mental health conditions take a full and fair part in work.

Mental health conditions vary in severity, duration and support needs. WHO guidance emphasises preventing harmful work conditions, reasonable adjustments and support for participation or return to work. Avoid using an undated prevalence figure or assuming that a condition will be mild or short-lived.

Some employees will already have a physical or mental health condition when they are recruited, or may develop one for reasons unrelated to work.

Common signs of stress, depression, anxiety and panic attacks, and post-traumatic stress disorder

The signs of mental health problems vary enormously with the condition and the person, so it is important to notice any change in how someone thinks, feels and behaves. There are many different mental health problems, many symptoms overlap between diagnoses, and one person may have the symptoms of more than one problem at once. If several of the signs below appear in a worker, it may be time to reach out with help.

• A decline in performance at work. Difficulty coping with daily duties at work, and also at home or in social life.
• Trouble concentrating and thinking. Problems focusing on tasks, difficulty with memory or thinking, or changes in speech patterns.
• Stress. Anxiety, irritability, poor concentration, forgetfulness, headache and fatigue.
• Depression. Usually feelings of flatness or lowness, losing interest in things once enjoyed, including hobbies, often with a change in appetite and more irritability.
• Fear or nervousness. Feeling overly suspicious of others at work or socially, or suddenly nervous and fearful in particular situations.
• Increased sensitivity. Greater sensitivity to sights and sounds, and avoiding over-stimulating situations.
• Unusual behaviour. Feeling detached from surroundings, uncharacteristic or out-of-control behaviour, or seeing or hearing things that are not real.
• Unexplained aches and pains. Headaches, upset stomach or muscle pain.
• Anxiety and panic attacks. Anxiety conditions can affect concentration, sleep and wellbeing. Panic attacks can include intense fear and physical symptoms such as a racing heart, but they are not simply a more physical version of generalised anxiety. Managers should offer support and access to appropriate professional help rather than diagnose from a list of signs. New or severe physical symptoms may need urgent medical assessment.
• Post-traumatic stress disorder (PTSD). A disorder that follows a traumatic event in someone's life. The person may feel they are reliving the event through flashbacks or nightmares, and may have physical reactions such as shaking and sweating.

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