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A Health and Safety Approach to Mental Health in the Workplace

Author: Xenia Koumi - City of London Corporation

Date: May 2019


Last December, I was kindly invited by St John Ambulance to chair a panel session at its 'Embedding Mental Health Best Practices in the Workplace Summit', focusing on the changing role and responsibility of health and safety in driving better mental health and wellbeing practices.

I work within the City of London Corporation’s Public Health team, focusing on working-age health and leading the Business Healthy programme. Business Healthy is a free network for employers of all sizes in the City of London, which provides them with support to help improve the health and wellbeing of their workforce. It’s a unique offering from a local government organisation and comes as no surprise, especially when you consider that there are half a million people travelling into the Square Mile each day for work. As well as signposting to local free services and advocating the business case for investing in the health and wellbeing of employees, Business Healthy harnesses the wealth of knowledge and expertise among the network’s member organisations, providing opportunities for these practitioners to share best practice, ideas and help with troubleshooting. Ultimately, anyone working in the field of workplace wellbeing has the same goal in mind – no matter the type of organisation, nor its motivations for improving staff health and wellbeing.

In addition to 'carrots' – business and moral drivers for organisations to pay more attention to their workers’ health and wellbeing, there is also the legal case – the 'stick'.


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Since its introduction in the 1970s – and its precursors in the early 19th century – the implementation of health and safety law in the UK has mostly been dominated by the 'safety' aspects and physical safety. Over the past decades UK industry has been looked to as demonstrating a gold standard in this respect; the huge, four-year construction project for the 2012 London Olympics, for example, was completed with zero fatalities – an Olympic first. The Health and Safety Executive’s enforcement powers have played a key role in these achievements, however many employers are not aware of the legal implications of the 'health' side of health and safety, and fewer still that the HSE has the same powers with regards to prosecuting and fining employers that are found to be negligent with regards to staff’s mental health, or who do not adequately address stress in the workplace.

That’s not to say that all stress experienced by employees is caused by the workplace. While poor mental health is common, the causes are extremely varied and can be caused by external factors, such as family life, a chronic physical condition, caring responsibilities and poor sleep hygiene, to name a few. For many, the pressures of the workplace can exacerbate stress and/ or pre-existing mental health conditions (diagnosed or otherwise), but for others, work can provide a relief and a welcome distraction. It’s for these reasons that the HSE advises employers – no matter how big or small – to conduct a stress risk assessment. An assessment can help to identify hazards that could increase the risk of staff experiencing work-related stress, as well as identify any existing controls in place and highlight opportunities to reduce and/ or manage it. Keeping a written record also demonstrates that the employer has fulfilled a legal duty with regards to helping staff to avoid and/ or manage stress in the workplace and to differentiate between stressed caused by work, or by external factors.

For employers that are looking to do more to support the mental health of their workforce, there is a wealth of free resources, such as those listed on the Business Healthy and Mental Health at Work portals, as well as campaigns, such as the Lord Mayor’s Appeal’s 'This is Me'. The range of choice can be overwhelming, especially for businesses for whom this is a first foray into the world of staff wellbeing and may have limited resources, staffing and budget. Allocating budget, no matter how small, sends a powerful message to employees that the business cares about their wellbeing and lends truth to the saying 'put your money where your mouth is'.

Another adage that springs to mind is 'what gets measured gets done'. Start small and use interventions and activities as an opportunity to engage with staff and to find out their needs, wants and interests with regards to mental wellbeing. There’s no need to launch with an all-singing, all-dancing programme of activities (which will no doubt impact on the mental wellbeing of the individual organising it in addition to their 'day job'); test one or two small activities and measure impact and engagement and capture feedback wherever possible (and not just bums on seats). This will provide intelligence and will also help to build a case to deliver future events and allocate budget and staffing, whether the plan is to help facilitate a peer support network, or roll out a programme of training. This collaborative and co-produced approach also helps to secure staff buy-in and identify those who are particularly passionate and may be keen to take on responsibilities to help deliver interventions.


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The organisational approach can then be built up over time and there are many free frameworks available to help with this, including the Mayor of London’s Healthy Workplace Award, the HSE’s Management Standards Approach and the Thriving at Work standards.

Mental and physical wellbeing are strongly interlinked, so interventions to support mental wellbeing in the workplace can also have positive impacts on physical wellbeing, and vice-versa. Don’t forget about other staff working on-site, such as contractors and service staff; are they able to benefit from the measures your organisation is putting in place?

As you can see, there are many ways to peel an orange and this very much depends on the culture of the business and the nature of the work it conducts. Remember that culture is king; if the company culture is not supportive to staff wellbeing and the interventions being delivered are not supported from the top (including financially – see above), they will just be ticking a box and will not lead to effective and sustained support for staff wellbeing in the long run. For example, many organisations will subsidise gym memberships for their staff, but wonder why take-up is low, while at the same time, it’s frowned upon to take a lunch break away from the desk, or leave the office at a reasonable hour in the evening, making it extremely difficult for staff to make time for exercise during the working week.

Stigma attached to mental health – in the workplace and wider society – has been reduced in recent years, thanks to the work of many high-profile individuals and organisations, including the Royal Family, the City Mental Health Alliance and beloved sports personalities, however it is still not given parity of esteem with physical health. Anecdotal insights from City workers show us that while common mental health issues such as stress, depression and anxiety, are more openly – yet still not fully – accepted, those diagnosed with rarer mental health conditions including bipolar disorder and schizophrenia, are still misunderstood and continue to face stigma. There is clearly, therefore, more work to be done.


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About the author:

Xenia leads the Business Healthy programme within the City of London Corporation’s Public Health team, working with employers in the Square Mile to support them in improving their employees’ health and wellbeing. While Business Healthy engages with employers on all aspects of workplace health and wellbeing, mental health and suicide prevention are key areas of focus. Business Healthy has been instrumental in the Square Mile’s first mental health campaign, ‘Release the Pressure’, and also in the Dragon Café in the City pilot programme in 2018, which made a safe and free space promoting mental wellbeing to the City’s workers and residents. Business Healthy supports other local mental health initiatives, including the City Mental Health Alliance and Minds@Work. Xenia is also a member of the Lord Mayor’s Appeal’s ‘This is Me’ steering group.


 Twitter: @bizhealthy            Linkedin: Xenia Koumi            Business Healthy

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