Mental Health in the Workplace

24th April 2015

Mental health and resilience in the workplace, for many years a taboo subject avoided or at least rarely discussed openly, has become an increasingly important subject in recent years. Studies show that 1 in 4 people suffer frommental health difficulties. The true figures might be much higher and can often go undetected, until a serious problem emerges.

What are the common issues surrounding mental health that employees experience. Here we look at the different types of mental health and aspects of resilience in the workplace.

Mental Health and Resilience in the Workplace

Employees are humans, and all humans can experience mental health difficulties at one time or another. There are many different mental health conditions recognised worldwide, but some of the conditions most likely to be experienced by employees are:

  • Depression

  • Post-Traumatic Stress Disorder (PTSD)

  • Schizophrenia

  • Eating disorders


Depression is one of the most common mental health conditions. Our modern way of life is incredibly fast paced, and can place great demands on our wellbeing. Employees may find themselves struggling to juggle work with a whole host of potential social and personal difficulties. These can lead to depression. It is very important to note that many issues can lead to depression, and that no two people are the same, so symptoms and causes may vary.

Depression can take shape in many forms, but there are some key points to look out for:

  • continuous low mood or sadness

  • feeling hopeless and helpless

  • having low self-esteem

  • feeling irritable and intolerant of others

  • having no motivation or interest in things

  • finding it difficult to make decisions

  • not getting any enjoyment out of life

  • having suicidal thoughts or thoughts of harming yourself

A key fact to remember with depression is that these issues will be ongoing and long lasting. Everyone has bad days where they may experience one or more symptoms of depression, but it is the repeated and continual occurrence of them that signals cause for concern.

There are also particular cases such as post-natal depression, which can be triggered in women who have recently given birth, (and can require extra attention in order to safeguard the new-born from potential side effects or infanticide in extreme cases) and Seasonal Affected Disorder (SAD) which strikes people in the winter months, or in places with limited natural light (i.e. above the Arctic Circle).

As an employer, it will depend on your role as to how easily you may spot the warning signs of depression. Obviously it will be easier for someone who regularly interacts with an employee on a close level to identify any significant changes than for someone who meets an employee less directly. If you suspect an employee is at risk of harm from themselves you should talk to your manager regarding your concerns.

Employees may also disclose to you directly that they are not feeling well or stable of mind. This can be a very challenging situation but you must always take the employee’ s comments seriously. However, you must never take action without their consent.

Post-Traumatic Stress Disorder (PTSD)

PTSD is well known, but generally not well understood. A common misconception is that it is a soldier’ s disease’ many people may have heard about it through the press or media reports on military personnel returning from active service in warzones but it can be caused by a huge variety of incidents. The key is in the word Traumatic’ .

Some incidents that can cause the onset of PTSD are:

  • Severe injury as a result of accident, or being involved in a severe accident

  • Combat, or exposure to combat conditions

  • Violent assault, such as muggings, sexual assault etc.

  • Sexual abuse, especially if the victim is subjected for a prolonged period of time

This is by no means an exhaustive list and what is traumatic to an extreme level will vary from person to person.

PTSD can be very difficult for a non-sufferer to understand. A good way to start would be to consider it the outward manifestation of the body’ s normal response to an abnormal situation.

It has been suggested that PTSD is a side effect of the body’ s natural defence mechanism being permanently activated. The Fight or Flight mechanism that is designed to keep us vigilant of danger and ready to respond closes down most non-essential systems to redirect the energy to those needed for survival.

This is fine, in limited doses, e.g. running from a man-eating tiger, or fighting an assailant. If this system is left running constantly, the body will run out of resources, become exhausted, and will not be able to cope. Neither will the mind. This is essentially what PTSD is.

PTSD can cause numerous problems. Some of the main ones are:

  • Hyperarousal the person experiences numbed emotions and massively increased adrenaline production this can lead to an inability to relax and aggressive behaviour.

  • Flashbacks the person experiences vivid dreams and/or daydreams of the traumatic incident, or of something related. These can severely affect a person’ s normal functioning.

  • Anxiety this is possibly one of the most common and problematic effects. Panic attacks, hyperventilation and avoidance are all common side effects of an increased state of anxiety.

It is important to remember that PTSD can also cause additional mental health conditions, or exacerbate existing ones, such as depression.


Schizophrenia is another common, yet misunderstood condition. It is NOT having a split personality or increased risk of violent outbursts. Schizophrenia is a condition that causes people to have hallucinations, delusions and confusion. It can also be the cause of behavioural changes.

Some of the symptoms of schizophrenia are:

  • Hallucinations, such as hearing voices.

  • Delusions, such as an unshakeable conviction in an unusual or misguided view, e.g. a belief that aliens are trying to kill them.

  • Confusion (also known as thought disorder) people with schizophrenia often have difficulty concentrating, holding a conversation etc.

  • Behavioural changes people with schizophrenia may suddenly act very irrationally or angrily.

  • Social interactions decreasing the sufferer may lose interest in social events, become reclusive and or withdraw from society.

Schizophrenia is very difficult to diagnose, and a diagnosis is usually made by a mental health specialist. Patients are usually referred to their Community Mental Health team by their GP if the GP suspects schizophrenia may be present. It can be very hard for people with schizophrenia to accept that they have any problems, so the main issue initially may be trying to get the employee to visit their GP.

In most cases, an employee with schizophrenia will be treated by the local Community Mental Health Team. This will be a specialist team that comprises of psychiatrists, counsellors, community mental health nurses and social workers. This team will assess and monitor the care of the employee, including moving to more invasive and or secure treatment if deemed necessary.

Schizophrenia is a very complicated condition, and as such the vast majority of decisions will be made outside of a workplace setting. However, if you have concerns you should speak to your manager or HR team.

Eating Disorders

Eating disorders are one of the most prevalent mental health issues that affect employees. An eating disorder is described as the situation where a person has an abnormal attitude towards food which influences their behaviour and eating habits.

People with eating disorders may be unhealthily preoccupied with notions of appearance, weight and body shape. These views may lead them to make unhealthy or ill-informed decisions about food, which may cause harm to their health and wellbeing.

Some of the more common eating disorders are:

  • Anorexia Nervosa: This is the condition where someone tries to keep their weight as low as possible through excessive exercise, eating a starvation diet, or both.

  • Bulimia: This is the medical condition where a person uses a binge and purge strategy of overeating followed by inducing vomiting or using laxatives to control their weight.

The exact causes of eating disorders are usually blamed on the media for portraying an idealised and often unrealistic image of how people should look. However this is a very simplified explanation, and in almost all cases there will be more factors present than simply this.

Around one in 250 women and one in 2,000 men will experience anorexia nervosa at some point. Bulimia is around five times more common than anorexia nervosa and 90% of people with bulimia are female.

Eating disorders can cause serious problems for the people who suffer them, as well as those around?them. Eating disorders can and do kill, as people who are malnourished will have a weaker immune system, and there is also the risk of death from starvation.

Eating disorders are treatable, however in order for the treatment to be successful, the patient must actually want to get better. The treatment process can take a long time.

This has been just a small overview of mental health and resilience in the workplace. There is a lot more detail about dealing with mental health issues in the workplace and how you can train your staff to recognise the signs.

For example, the NHS have commissioned a customised version of Marshall ACM’s personal resilience course. This is a new product available to Marshall ACM clients.

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