This is one of three mental health awareness articles:
Article 1: The Invisible Crisis — The problem
Article 2: The Hidden Barrier — Employer’s guide to solutions
Article 3: The First Conversation — Individual’s guide to getting help at work
Struggling with your mental or physical health at work? Learn how to ask for support, request workplace adjustments and understand your rights.
You’ve been managing. Just about.
Some days are better than others. But increasingly, work feels harder than it should. You are exhausted by mid-afternoon. Concentration slips. Tasks that once came easily now require significant effort. You are working longer hours to produce less.
And when you are in the middle of it, it can be difficult to see the wood for the trees — especially when you’re the one being chopped down. The missed deadline is one problem. The sleepless night another. The inability to concentrate, the growing anxiety about work, the exhaustion by three o’clock: each becomes something else to manage. What is harder to see is the bigger picture, and what might need to change.
Perhaps you know why. Anxiety, depression, grief, chronic stress. Perhaps you suspect something but have no diagnosis. Perhaps you simply know that you are not functioning the way you were, and you can’t continue like this indefinitely.
What most people don’t realise is that mental and physical health at work are handled together. The same assessment system that addresses a bad back or chronic neck pain also addresses exhaustion, anxiety, and the inability to concentrate. The same legal framework that protects someone with a physical disability protects someone whose mental health is affecting their ability to work. The same practical adjustments, a different desk, a change in hours, a quieter environment, can serve both.
This matters because it means the route to support is more accessible than most people assume. You don’t need to wait until things are serious. You don’t need a diagnosis. You also don’t need to frame your difficulty as a mental health crisis to be entitled to help.
We spoke with Nancy Monk, an occupational health specialist who has conducted over 6,000 workplace assessments across 17 years, to understand what that support looks like in practice, and what you can realistically expect if and when you ask for it.
The hardest part is often the first conversation.
It’s nobody’s business. You don’t want to appear weak. You don’t want to damage your career prospects. You don’t want to be seen as unable to cope. These are understandable concerns. There are still workplaces where raising a difficulty is treated as a performance issue rather than a health one.
Increasingly, employers understand the business case for supporting people who are struggling. Supporting an employee costs far less than losing them. Many line managers genuinely want to help but don’t know what you need unless you tell them.
The conversation doesn’t have to be dramatic. You are not necessarily requesting radical accommodation. You’re identifying barriers and asking whether there are adjustments that would allow you to do your job well. That is a reasonable professional request.
If you work somewhere where raising a health concern could cost you a promotion, a project, or your manager’s confidence in you, the law may offer protection. We’ll set out exactly what that means in Part Three, Knowing Your Rights. Most workplaces, however, are not like this, and the conversation you may be avoiding is usually easier than you expect.
Everything in this article depends on you being willing to have it.
When the environment is the problem
Nancy Monk has assessed thousands of people, but one case has stayed with her as a clear example of how reasonable adjustments can change a person’s working life.
Joy loved her job. She was good at it. There was nothing wrong with her work, her attitude, or her commitment. But the team at the bank of desks beside her was loud: laughing, talking, constantly active. Joy simply wanted to get on. The noise made it impossible.
She wasn’t ill. She didn’t have a diagnosis. She had a mismatch between how she worked best and the environment she was working in. She hadn’t told anyone. Nobody had named it. Nobody had asked. And so she kept trying to function in conditions that were draining her, every single day.
A small change, a different desk location, access to a quiet zone, permission to use a private pod when she needed to concentrate, would have resolved it entirely. Sensitivity to noise is not fixed, and it is not a character flaw. Nancy has noticed the same shift in herself over the years.
So, for instance, as I’ve got older, if there’s noise when I’m writing reports, I can’t concentrate,” she said. “Whereas when I was doing my degree, I could have rock music on in the background and be writing my dissertation, and I could do that while multitasking. However, we all morph and we all change and age, and our abilities also morph and change. The modern office environment needs to cater for all these different preferences and needs, and adapt to changes.
Joy’s situation only became visible when someone asked the right questions.
This is the first thing to hold onto. You don’t need to be in crisis to ask for support. You don’t need a formal diagnosis, a breakdown, or a long history of struggling. You need to notice that something is making work harder than it should be, and be willing to say so.
The exhaustion you feel by Wednesday afternoon. The work you used to finish in two hours that now takes four. The Sunday dread. The persistent tension across your shoulders that never fully releases. These are not character flaws. They’re signals. And there is a system specifically designed to respond to them.
You do not need a formal medical diagnosis to request support at work. If you are struggling, physically, mentally, or both, that is enough to start a conversation.
A formal diagnosis may become important later, particularly for your legal rights, and we’ll come to that. But you don’t need one to ask, and you don’t even need to be able to name what’s wrong.
Knowing that you need to say something does not necessarily make it obvious whom you should tell.
In some workplaces, the route is straightforward. Your line manager may be the natural first point of contact.
In others, there may be a Mental Health First Aider, HR department, Occupational Health service or Employee Assistance Programme.
If your workplace has a Mental Health First Aider, they can be a good starting point. Their role is to notice when people are struggling, approach them, offer support, and signpost to further help. They are not therapists. They are a pivot point, the person you go to when you are not sure who else to go to.
The best workplaces treat this seriously. Mental Health First Aiders are visible, known to the whole team, and accessible without formality. One-to-ones include space to discuss wellbeing alongside deliverables. Flexible working is standard. People take breaks without guilt. If this describes your workplace, the route to support should feel straightforward. You are tapping into systems designed for this purpose.
But not everyone is comfortable approaching a designated first aider. There may be one in your team you do not know well, or trust fully. This is a limitation of any system that relies on named roles.
There is a reason for this beyond personality. Nancy has noticed that people often find it easier to open up to someone with a bit of distance, a GP, an external assessor, someone outside the day-to-day working relationship, than to a colleague they will see again tomorrow.
Yes, it is, and psychologically, if you’re talking to someone more removed from the situation or environment, it’s much easier to open up,” she said.
The buddy system can be a more natural alternative Most people have at least one person at work they would genuinely talk to, not a formal first aider, not HR, just someone they trust. Nancy describes this as something companies are increasingly trying to formalise: a named, low-pressure contact who has had some awareness training and knows who to escalate to if needed.
If your workplace has neither, you can create your own version informally. It may simply be one person you trust to listen without it going further unless you want it to. Starting there is often easier than starting with a formal process.
If your workplace does not describe any of this, legal protections exist regardless of the culture. We’ll get to exactly what those are in Part Three. You may need to navigate it more carefully, but you are still entitled to ask for support.
Once you have decided who to approach, the next difficulty is often finding the words.
It might sound like this:
“I’ve been finding work increasingly difficult recently. I’m exhausted, struggling to concentrate, and I think my health is affecting my performance. I’d like to discuss what support might be available.”
Note: health, not mental health specifically. If the difficulty is physical, pain, fatigue, headaches, the same conversation applies. A Workplace Needs Assessment can look at both.
That is enough. You don’t need to provide a detailed medical history or justify why you’re struggling. You’re stating a fact and requesting a conversation about solutions.
Once you have decided who to approach, the next difficulty is often finding the words.
This is where some caution is useful.
Openness: If this comes naturally to you, be selective about it at work anyway. Office politics are real: loyalty is not universal, and what you share with a colleague in a vulnerable moment does not always stay contained the way you would want it to. Your employer is paying for your work self, and that relationship has limits worth being clear-eyed about.
Privacy: If this is your instinct — and Nancy sees this more often in older employees, and in men in particular — recognise it for what it is rather than automatically deferring to it. Taken too far, though, privacy means support may never reach you.
Neither instinct should decide the outcome for you.
The practical question is not simply how much to share, but how much to share with whom, and for what purpose.
You are not obliged to explain yourself fully to everyone involved.
Once you’ve had that first conversation, what follows is a defined process: an assessment, a set of possible changes, and often more support than most people realise is available.
In larger companies, your line manager may refer you to HR, who may arrange an assessment. In smaller organisations, the conversation may happen directly with your manager or business owner.
There are two types of assessment you might be offered, and it is worth knowing the difference.
A DSE Assessment (Display Screen Equipment) is the standard, more routine review of your workstation: chair, screen, keyboard, lighting. It is good practice to have one annually or whenever your job, workstation, or medical situation changes.
A Workplace Needs Assessment is broader. It is used when the difficulty is primarily mental health or neurodivergence-related, or when a DSE assessment would not go far enough to address what is actually going on. In practice the two frequently overlap. Most referrals start out looking physical. Nancy estimates around 70 to 75 percent are for musculoskeletal aches, pains, or medical conditions, but the mental health picture often surfaces once the conversation gets going.
A Workplace Needs Assessment delves deeper by asking: what is preventing you from functioning well at work, and what could remove those barriers?
It looks at three things:
It covers physical and mental health together, because in practice they are rarely separate. Often the problem is not capability but mismatch. Your body or your brain works one way. The environment demands another. Adjustments reduce the friction between the two.
If Nancy were your assessor, she would typically start by asking about your work routine. How many hours do you work? Do you take breaks? Do you eat lunch at your desk? Are you getting enough sleep? Do you have trouble concentrating? What tasks feel hardest? Where in your body do you feel the strain?
The conversation creates space to explain what’s actually happening. Perhaps you’re working until midnight most nights because concentration has become so poor that tasks take three times longer than they should. Perhaps you’re not sleeping well because you are anxious about work or your home situation. Perhaps you have a persistent ache in your lower back that starts at 11 am every day, or find yourself on edge most afternoons without knowing exactly why.
When the problem isn’t what it seems
Take Tom. He was referred for lower back pain that had been getting steadily worse. In the course of his assessment with Nancy, he mentioned he wasn’t sleeping. Then that his concentration had gone. That he was caring for a parent with early-stage dementia, on top of covering a colleague’s workload since a recent restructure.
It was clear it wasn’t just the chair,” Nancy said. “Once you start asking about the physical symptoms, people often tell you what else is going on.
From there, Nancy looked at how Tom worked — his hours, his breaks, whether he was taking any real time away from his desk. She noted the blue flags: the workplace pressures feeding into his mental state, on top of what was happening at home. His employer did not yet know about the caregiving, or the toll it was taking.
Before any of it could be shared, Tom’s consent was needed.
The recommendations addressed both layers. Physically: a footrest, a monitor arm, a chair with proper lumbar support. For the mental load: a later start time to avoid the pressure of the morning commute, and explicit permission to leave promptly at the end of the day rather than absorbing extra hours by default.
The assessment also flagged that his sleep problems were significant enough to warrant a GP referral.
Nancy reviewed his case three months later. The back pain had eased enough that he was no longer thinking about it during the day. He was sleeping close to a full night for the first time in months, and the difference showed in his concentration. Tasks that had been taking him hours were moving faster again.
The caregiving hadn’t gone away, and neither had the workload entirely, but he had the physical and mental space to actually carry both.
You may not have recognised these things as part of the same problem, or known how to explain them.
An assessment gives you a structured way to start addressing them.
It is also not an instant fix. A Workplace Needs Assessment is not a single conversation that fixes everything on the spot. Adjustments are put in place, then reviewed and refined where necessary. Nancy describes cases where changes are made and then checked again three months later to see what is actually working. It can take weeks or months to land on the right combination, and that is normal, not a sign the process has failed.
Beyond the assessment itself, some employers offer more. A number now fund confidential talking therapy as part of their benefits, commonly six to eight sessions with a therapist, arranged through the company but reported back to nobody. The content of the sessions is totally confidential. Some also cover physiotherapy, and private health policies may extend to manual therapy, imaging, and other private medical treatment.
Where these services exist, they sit alongside a Workplace Needs Assessment: the assessment changes how you work, while other services give you access to treatment.
It is worth asking what your employer actually provides. Many people are entitled to more than they realise.
An assessment can result in many different kinds of adjustment, depending on what is actually making work difficult for you.These are some of the adjustments an assessment might recommend. The list is by no means exhaustive.
These are examples, not the limit. Sometimes the adjustment that makes the difference is one you would never have thought to ask for.
Nancy worked with a woman who was struggling significantly, anxious, exhausted, her performance suffering. When the conversation went deeper, the source of the problem was the commute.
A crowded tube, twice a day, was triggering panic attacks before she had even sat down at her desk. By the time she arrived, she was already depleted.
The adjustment was a later start time. Avoiding the rush hour. A modest change to her working hours, compared with what it would have cost the company to lose her, and it changed everything for her.
This is what a good assessment does. It doesn’t assume the problem is the chair or the screen. It asks what is actually making work hard for you, in your specific working environment
For some people, the difficulty at work is not a temporary response to a difficult period. It is ongoing: anxiety that recurs, depression that lifts but never fully clears, chronic physical pain that affects concentration and mood month after month.
This is not a crisis to weather. It is a reality to accommodate.
The adjustments in this case are not a one-off fix. They are a structure: a way of organising your work, your environment, and your day that makes sustained, good-quality work possible over the long term.
You do not owe your employer an explanation of your entire medical history. You owe them good work. If the right adjustments allow you to provide that consistently, everyone benefits.
If you have a recurring or chronic condition, it is worth making that clear in the assessment process rather than framing it as a temporary difficulty. The adjustments that result are then more likely to reflect what you need over the longer term.
Most situations can begin with a straightforward conversation. But it is worth understanding the legal framework behind workplace support, particularly if your condition is long-term or your employer is reluctant to act. Here is what actually applies to you.
EQUALITY ACT 2010: You’re protected under the Equality Act 2010. Both mental and physical health conditions are covered. Where a condition, diagnosed or not, has a substantial and long-term adverse effect on your ability to carry out day-to-day activities, your employer is legally required to make reasonable adjustments. This includes neurodivergent conditions such as dyslexia, dyspraxia and autism spectrum disorders, as well as mental health conditions such as bipolar affective disorder, depression, schizophrenia, anxiety and other mental-health impairments.
MEDICAL DIAGNOSIS: You do not necessarily need a formal diagnosis for a condition to meet the Equality Act definition of disability. What matters is the effect of the impairment and how long that effect has lasted, or is likely to last.
You also do not need to wait for a diagnosis before asking your employer for support. If you are experiencing difficulties at work, you can start that conversation now. Medical evidence may become useful where the nature or effect of a condition needs to be established, particularly if there is disagreement about what support is required.
REASONABLE ADJUSTMENTS: What counts as a “reasonable” adjustment depends on the circumstances. Factors can include how effective the adjustment would be, its practicality and cost, and the employer’s resources. A large corporation and a three-person business may therefore reasonably be expected to respond differently. But where the legal duty applies, the employer must consider what can be done to remove or reduce the disadvantage caused by the disability.
HYBRID WORKERS: If you work from home or on a hybrid basis, your employer’s responsibilities do not simply stop at the office door. Your home-working environment may also need to be considered when identifying reasonable adjustments, particularly where working from home forms part of your normal working arrangement.
If something about either your home or office setup is creating a disability-related disadvantage, raise it as part of the assessment rather than assuming only one location counts.
ACCESS TO WORK SCHEME: The Access to Work scheme can help with costs. This government programme, run by the Department for Work and Pensions, can provide practical and financial support for people with physical or mental health conditions or disabilities, including eligible people who are self-employed.
Importantly, Access to Work does not replace your employer’s duty to make reasonable adjustments, and it will not fund adjustments that the employer is already legally required to make. It can, however, help with additional support and costs, which may include specialist equipment, support workers or help with travel to work.
You can apply for it yourself, though your employer usually supports the application, or your employer can apply on your behalf. Many people who would benefit from it are simply unaware it exists.
If you are struggling, with your mental health, your physical health, or the point where the two have become difficult to separate, the starting point is the same: talk to someone.
1. Speak to your GP: Explain what you are experiencing, physically, mentally or both. Your GP can help establish what may be causing your symptoms, advise on appropriate support or treatment and make referrals where necessary. This also creates a medical record that may become important later.
2. Speak to someone at work: Your line manager, a Mental Health First Aider, HR, Occupational Health or a trusted buddy, whichever feels most accessible to you.
3. Ask what support is available: Your employer may already provide services or benefits you do not know about.
4. Request a formal assessment if you need one: A Workplace Needs Assessment looks at your physical setup, work patterns, tasks, environment and the difficulties you are experiencing, then identifies practical adjustments that could help.
Providing support, equipment, training, adjustments, the invitation to ask, is your employer’s job. But it is only half of it. You also have a responsibility: to raise the issue. Your employer cannot help if they aren’t aware.
“… 50% comes from the employer and 50% from the employee, they have to meet in the middle,”
Nancy said.
An adjustment cannot help if it is not used. Equipment cannot reduce strain if it remains in the box. A scheduled break does nothing if you continue working through it.
Support works when both sides engage with it.
If you’re freelance or self-employed, the usual employer-led support structures may not be available to you. Start with your GP, explain what is happening, physically and mentally, and ask for a referral if appropriate. Your GP can signpost you towards appropriate support.
Build in social contact deliberately, too. Isolation affects both mental and physical wellbeing. Nancy’s advice is specific:
“Try and build social aspects into your day. Going for a coffee, for a face-to-face meeting rather than being on Teams. Even within an office environment, if you work in the same building, meet up in the café and have a meeting over a coffee. Have that face-to-face, conversation rather than through your screen.”
This costs nothing and needs no one’s permission.
Mental health and physical health at work are not separate problems with separate solutions. They are aspects of the same question: does this environment allow this person to function well?
When the answer is no, the next step is finding out what is getting in the way and what can be changed.
You don’t need to manage indefinitely on your own. You don’t need to wait until things become a crisis. And you don’t need to have all the answers before you start the conversation.
It comes back, in the end, to where this article started: the first conversation. Have it, and everything else described here can become available to you.
If something is making work harder than it should be, the first step is understanding why.
An assessment can help identify the specific barriers affecting your ability to work comfortably, effectively and sustainably. Sometimes the answer is a simple adjustment. Sometimes it involves changes to your working environment, the way you work or the support available. The key is understanding what is actually getting in the way and what can be changed.
At OE Group, we provide individual DSE Assessments, Workplace Needs Assessments, and an Access To Work Assessment alongside specialist ergonomic solutions designed around your specific needs. Our approach looks at how you work, the challenges you are experiencing and the practical changes that could make a difference.
If you’re not sure what kind of assessment or support you need, our specialists can help you find the right place to start.
This article was written by Mouna Mounayer, Marketing Consultant & Content Editor at OE Group, and developed from an interview with occupational health and ergonomics specialist Nancy Monk.
Editorial review was provided by the OE Group Editorial Team, including workplace assessment and ergonomics specialists, to help ensure the content reflects current professional practice and real-world workplace experience.
Explore IEA and ILO guidance on applying human factors and ergonomics to create safer, healthier, more effective and sustainable work systems.
Discover Ergotron’s guidance on improving remote working through ergonomic workspaces that support employee comfort, wellbeing and productivity.
Explore the IEA’s practical guide to using human factors and ergonomics to improve employee wellbeing, productivity, quality and business performance.
