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
Your employee is struggling. What can you do? Occupational health specialist Nancy Monk walks line managers and employers through Workplace Needs Assessments, the mistakes that can be made, and how to build a workplace where support is more than policy.
It usually begins with small things.
Someone reliable starts missing details. Emails take longer to answer. A person who was once calm becomes irritable or withdrawn. Deadlines slip. They look exhausted by midday. Or perhaps they are still performing, technically, but everything suddenly seems to require far more effort than before.
Managers may assume they are looking at a performance issue. Occupational health specialists often see something else.
After 17 years and more than 6,000 Workplace Needs Assessments, Nancy Monk has learned that mental health problems at work rarely arrive dramatically. There is usually no cinematic collapse in the boardroom. No warning siren. More often, difficulties emerge gradually until day-to-day functioning becomes harder than it should be.
In the first article in this series, The Invisible Crisis, we explored the occupational health “flag” system used to identify barriers affecting recovery and performance.
Blue Flags relate to the workplace itself: workload, management style, relationships, and pressure.
Yellow Flags relate to behaviour and psychology: stress, fear, avoidance, and overwhelm.
In reality, people rarely arrive carrying only one flag.
The employee with neck pain may be sleeping badly because of stress. The person struggling with concentration may have not taken a proper lunch break in six months. The employee labelled “difficult” may be working through exhaustion, sensory overload, or chronic pain that nobody has noticed because they have become very good at hiding it.
The visible problem is not always the real problem. Beneath the symptoms, there is often a hidden barrier – something in the individual, the role, or the environment that is making work harder than it needs to be.
This is where Workplace Needs Assessments can make a significant difference. Early recognition, combined with practical adjustments, often helps reduce the friction between a person and the environment they are trying to function in.
We spoke with Nancy to understand what actually helps when an employee is struggling, how Workplace Needs Assessments work in practice, and why the most effective adjustments are often smaller, more practical, and more individual than employers expect.
Nancy’s assessments usually begin with a referral from HR or management. Someone reports neck pain, back pain, headaches, wrist discomfort or another musculoskeletal problem. The physical complaint is real. But it is often only the visible part of a much larger picture.
Once the conversation begins, other factors frequently emerge: stress, poor sleep, overwhelming workload, anxiety, tension with colleagues, cognitive exhaustion, or difficulties at home. Sometimes it is someone quietly working until midnight because tasks that once took an hour take three.
When you’re talking to them about these musculoskeletal issues,” Nancy explained, “very often they also open up about other struggles they might be having. Maybe outside of work, maybe inside of work.
This is why the assessment cannot be reduced to a checklist about equipment.
Nancy explores how the person actually works and functions day to day. How many hours are they working? Do they take breaks? Are they sleeping well? Can they concentrate? What part of the day feels most difficult?
The answers often reveal patterns managers never see: someone who has not taken a proper break in months, someone living in a constant state of stress, or someone who is physically present but mentally exhausted by mid-afternoon. Presenteeism in its purest form.
Physical and psychological pressures rarely exist in isolation. Stress increases muscular tension. Poor sleep lowers resilience and pain tolerance. Fatigue affects concentration. Chronic discomfort drains energy. By the time someone reaches assessment, several issues are often reinforcing one another.
The goal is not simply to address symptoms. It is to understand what is preventing that individual from working comfortably, effectively, and sustainably.
The setting may vary. Nancy conducts assessments in offices, warehouses, factories, vehicles, and home-working environments where the workstation may consist of a dining chair and a laptop balanced on a coffee table.
The adjustments differ. The principles do not.
Whether someone spends their day analysing spreadsheets, operating machinery, driving long distances, or managing customer calls, the same question sits at the heart of every assessment: What is making work harder for this person than it needs to be?
The most common mistake Nancy sees is managers deciding on the solution before they have fully understood the problem.
She recalls assessing a senior team leader, Helen, at a large bank. It was a high-pressure role involving significant financial responsibility. A previous DSE assessment had recommended a private office: fewer distractions, greater concentration, a quieter environment. On paper, it made perfect sense.
Helen rejected the idea immediately.
Absolutely not,” she told Nancy. “Because I want my right-hand man and my left-hand man with me so that we can collaborate and make decisions and have all the information.
The recommendation would have removed the very thing that allowed Helen to function well under pressure.
This is where generic workplace wellbeing approaches often fall short. Employers can assume that a condition has a standard solution. Anxiety means quiet space. ADHD means movement. Stress means a reduced workload.
People are rarely that predictable.
One employee with anxiety may need a quieter environment. Another may become more anxious when isolated from colleagues. One person may need movement and stimulation to concentrate; another may need reduced sensory input and rigid structure simply to get through the day.
That is why Workplace Needs Assessments examine three interconnected elements: the individual, the task, and the environment. The focus is not solely on what condition, difficulty, or diagnosis someone may have, but on how that person functions in that particular role and setting.
Nancy applies the same framework everywhere: offices, warehouses, factories, vehicles, and home-working setups balanced somewhere between a kitchen table and a laundry basket.
A warehouse manager may correctly identify that someone needs task rotation and still get the intervention wrong. The crucial questions remain: which tasks, for how long, and why? Is the issue physical fatigue, cognitive overload, chronic pain, sensory stress, or some combination of all four?
Because the answer is usually found in the details.
Not every assessment ends with a new chair or a better monitor arm.
Sometimes the assessment reveals something much harder: an employee can no longer safely continue in their current role.
Sarah’s situation began with changes in her medical circumstances that gradually affected both her physical and mental health. Her productivity declined. Concentration became more difficult. Colleagues could see she was struggling, even if they could not always explain why. What managers saw was someone physically present but increasingly unable to perform consistently.
Eventually, Nancy was asked to conduct a Functional Capacity Assessment – a more detailed evaluation used to determine whether someone remains capable of carrying out a role safely and sustainably.
Unlike a Workplace Needs Assessment, these higher-level assessments often involve ongoing discussions with HR, line managers, and the employee over an extended period. Adjustments may be introduced, reviewed, and refined before the situation is reassessed months later.
Over several months, Nancy worked with Sarah, HR, and management through a process of review and reassessment. The conclusion gradually became unavoidable. Sarah could no longer continue in the physically demanding role she loved.
Many organisations treat this as a binary choice: keep the employee or lose them.
Nancy approached it differently.
She was still able to sit within the company,” Nancy explained. “Due to her experience, she would be useful in a different area. So she couldn’t do the job that she loved, which was exceptionally physical. But she was able to continue working.
The focus shifted from what Sarah could no longer do to where she could still contribute and succeed.
That required far more than recommending equipment. Nancy became a bridge between employee and employer, balancing medical realities with operational needs.
It’s almost being a mediator and having an overview,” Nancy said, “working with the employer and the employee in that middle pivotal position to try and find what’s going to work best for the business and for the individual.
The result benefited both sides. Sarah remained in employment, and the company retained an experienced member of staff whose knowledge and skills still had considerable value.
Sarah’s case illustrates an important principle. Employers often assume reasonable adjustments mean equipment. Sometimes they do. But adjustments can also be structural: altered responsibilities, flexible hours, hybrid working, phased returns, task redistribution, or redeployment into a different role.
Sometimes the most valuable outcome of an assessment is not a product recommendation, but a different way of seeing the problem.
In Sarah’s case, the solution was not helping her stay in the same job. It was helping her remain in work. For Nancy, that represents the best outcome an assessor can hope for: a solution that supports the individual while allowing the employer to retain valuable experience and knowledge.
As she puts it, “it’s a win for everybody.”
If Nancy could give employers one wellbeing recommendation that costs nothing, it might be this:
Let people move.
Modern office culture still quietly rewards immobility. The employee who remains welded to the desk for eight uninterrupted hours is often treated as diligent, whilst the person regularly getting up, stretching, walking, or changing posture risks appearing distracted.
Prolonged sitting increases fatigue, reduces circulation, stiffens joints and muscles, and gradually affects concentration. The body slows down and, before long, so does the brain.
Movement interrupts that cycle.
Even brief periods of activity can improve mood, reduce stress, and restore focus. The benefits are physical and psychological because the two are closely connected.
Nancy described two organisations that approached this in very different ways.
One was a high-performance automotive company where employees were required to leave the building at lunchtime and walk for at least fifteen minutes.
I had a lot of clinical patients from there who had physical issues,” Nancy said. “But actually they didn’t have the same level of mental health problems at all.
The second took a light-hearted approach. They employed “office angels” whose job was to run through the building every hour and start a Mexican wave. Staff stood, joined in, then sat back down, and carried on working.
Different methods. Same principle.
Managers do not need elaborate programmes to encourage it. They simply need to make it clear that stepping away from a desk is not a sign of disengagement. Sometimes small changes are enough: moving the printer further away, encouraging people to take lunch breaks away from their workstation, or providing wireless headsets so employees can stand and walk while on calls.
The science may be complex. The solution often is not.
Not every solution involves major workplace changes. Sometimes the problem is far simpler than anyone expects.
Nancy recalls assessing a woman whose role was entirely computer-based. She was exhausted, struggling to concentrate, and finding it increasingly difficult to perform her job. At first glance, the situation appeared to require a complex intervention.
The solution turned out to be a blue light filter.
Prolonged screen exposure had been causing eye strain, headaches, and fatigue. The fatigue affected concentration and mood, creating a cycle that gradually undermined her ability to work effectively. Once the source of the problem was identified, the solution was straightforward.
For managers, this is often the challenge: identifying the specific point of friction that is quietly draining someone’s capacity.
The same principle applies to the working environment.
Nancy recalls another employee, Joy, who genuinely enjoyed her job and performed it well. The difficulty was the team seated beside her.
They were rowdy – always laughing and joking,’ Nancy explained. ‘And she just wanted to get on and she really loved what she was doing. But she just felt that it was impossible to do her job in that environment.
Joy did not have a mental health condition. She had an environmental mismatch.
A quieter workspace, a different desk location, or access to a private pod when needed may have been enough to resolve the issue.
Having quiet zones, having private or corner offices or pods, different areas within a space that can be used by different people at different times,” Nancy said, “make a big difference to how you feel about being at work and how productive you are.
That is why Nancy avoids one-size-fits-all solutions. The adjustment that transforms one person’s working day may be completely wrong for somebody else.
The goal is not to implement every possible adjustment. It is to identify and remove the specific barrier preventing that individual from working comfortably and effectively.
Over the years, Nancy has noticed that the same mistakes appear repeatedly, even in organisations that are genuinely trying to support their staff.
Employers often assume that a diagnosis automatically dictates the adjustment. It does not.
One employee with anxiety may benefit from a quieter workspace. Another may become more anxious when isolated from colleagues. One person may need greater flexibility. Another may need more structure and routine.
The condition may be the same. The individual is not.
Reasonable adjustments are not about lowering standards or creating special treatment. They are about removing barriers that prevent someone from performing at their best.
A team member experiencing depression may need flexible start times during a difficult period, yet continue to perform their role to a high standard. The capability has not changed. The obstacle has.
As Nancy points out, most people would not question providing glasses to someone who needs them to see their screen. Workplace adjustments follow the same principle.
This is the mistake Nancy considers most serious.
Wellbeing initiatives can be valuable. Mental health awareness sessions, wellbeing apps, mindfulness programmes, and employee support schemes all have a place.
However, if an employee has a diagnosed condition, general wellbeing support may not be enough.
If somebody has a diagnosis,” Nancy explained, “generalised support may not be appropriate and it also may not stand up if there are any legal issues down the road.
Employees with diagnosed conditions may require an individual assessment carried out by an appropriately qualified practitioner, together with recommendations tailored to their specific circumstances.
General wellbeing support can complement that process. It cannot replace it.
One final mistake is trying to solve everything at once.
For someone already struggling, multiple changes introduced simultaneously can create additional stress and make it difficult to identify what is actually helping.
The most effective approach is usually the simplest: introduce an adjustment, review its impact, and build from there.
However, if an employee has a diagnosed condition, general wellbeing support may not be enough.
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There is one limitation Nancy believes every manager should understand. Providing support and ensuring it is available is your responsibility. Using it is the employee’s.
You can provide somebody with all-singing, all-dancing equipment,” she said. “And then as far as the HSE regulations go, you’ve done your bit. If the employee chooses not to use that equipment properly, that’s up to them.
She recalls assessing an employee named Jack who had been working from home in the same setup for six years. He was comfortable, productive, and had no significant physical or mental health concerns. His manager wanted to provide a fully ergonomic chair.
Jack declined.
He did not have the space, felt he did not need it, and had no interest in changing his setup.
From both a practical and legal perspective, that was his choice. The employer had identified a potential improvement and offered support. The employee chose not to accept it.
“You can take a horse to water,” Nancy said, “but not all of them want a drink.”
The same principle applies to mental health support. An employer can offer flexible working, regular check-ins, quiet workspaces, counselling services, or workplace adjustments. None of those measures will help if employees do not feel able to use them.
That is why culture matters as much as policy.
People need to trust that asking for support will not damage their reputation or career prospects. They need to believe that a manager’s concern is genuine rather than a box-ticking exercise.
Providing support is essential. Creating an environment where people feel safe enough to accept it is equally important.
Employers have a legal duty to protect the health, safety, and wellbeing of their staff, including their mental health. Under the Equality Act 2010, mental health conditions that have a substantial and long-term impact on day-to-day activities may be classed as disabilities and are afforded the same legal protections as physical disabilities. In practice, that means employers may need to consider reasonable adjustments and ensure employees are not disadvantaged because of their condition.
But legal compliance is only the starting point.
The organisations that support employees well do more than publish a policy. They create clear pathways for people to access help when they need it.
Employees should know who to speak to if they are struggling, what support is available, and what will happen when they raise a concern. That support may come from a line manager, HR, Occupational Health, an Employee Assistance Programme (EAP), a Mental Health First Aider, or an external specialist. What matters is that people know where to turn and feel comfortable doing so.
Some employers go further by providing practical support directly. Nancy has worked with organisations that fund confidential counselling sessions, physiotherapy, or other specialist services as part of their employee wellbeing programme.
There are companies that have embraced this and have rolled out schemes like that,” Nancy said. “And there are the same policies for musculoskeletal issues — companies that will pay for you to go and see a physiotherapist.
Many organisations already provide support through private health insurance or employee benefits packages but fail to communicate it effectively. Employees cannot use support they do not know exists.
Mental Health First Aiders can also play an important role. Their job is not to diagnose, counsel, or provide therapy. They are trained to recognise when someone may be struggling, start a conversation, and signpost appropriate sources of help.
Most importantly, support must be visible. If employees have to search through an outdated handbook or navigate multiple systems to find help, many simply will not ask for it. The best policies are not the longest. They are the ones people understand, trust, and know how to use.
After all, barriers cannot be removed if nobody knows they exist.
If someone on your team is struggling, the most important step is understanding why.
Workplace Needs Assessments help identify the specific barriers affecting an individual’s ability to work comfortably, effectively, and sustainably. Sometimes the answer is a simple adjustment. Sometimes it involves changes to the environment, working practices, or support available. The key is replacing assumptions with evidence.
At OE Group, we provide corporate and individual DSE assessments, Workplace Needs Assessments, and specialist ergonomic solutions for individuals, employers, and organisations across the UK. Our approach is built around understanding how people actually work, what challenges they face, and what practical changes are most likely to help.
If you would like to discuss support for an employee, a workplace assessment, or potential adjustments for your team, our specialists are available to help.
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.
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