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
Mental health issues in UK workplaces have increased 45% in 30 years. Occupational health specialist Nancy Monk explains what changed, why younger workers are most affected, and how to spot the warning signs before crisis hits.
Roughly one in four working adults in the UK now experiences anxiety, depression, or stress-related mental health issues. That figure has increased 45% over the last three decades.
The statistics become starker when you look at age. Conditions that once appeared primarily in middle age now affect people in their twenties and thirties. Seven and a half percent of UK adults have been diagnosed with general anxiety disorder. Twenty percent will, at some point in their working lives, be diagnosed with anxiety, depression, or another stress-related condition.
These are not small numbers. They represent a fundamental shift in how work affects mental health.
We sat down with Nancy Monk, an occupational health specialist who has conducted over 6,000 workplace assessments over 17 years, to understand what changed and why the crisis arrived when it did.
The most common question Nancy hears is whether mental health issues are actually increasing, or whether we are simply better at recognising them now that stigma has reduced.
The answer appears to be both.
Stigma has decreased. People are more willing to name their struggles, seek diagnoses, and ask for support. Awareness campaigns have made mental health a topic of public conversation rather than private shame.
But something else has changed as well. The structure of work itself.
‘Job security is not what it used to be,’ Nancy explained. ‘Economic pressures, family pressures, people are often overworked. Maybe doing a job that would previously have been done by two people because of budgets and finances.’
The always-on culture compounds the problem. Phones blur the boundary between work and home. Remote work, which some people find liberating, leaves others unable to mentally clock off. The place where you should relax has become the place where deadlines live.
Unemployment rates, competition for roles, the rising cost of simply living. It accumulates.
Just living is pretty stressful,’ Nancy said. ‘So the mental health movement becoming easier to talk about is happening at a time when it’s on the increase anyway. It’s a mixture of all those things into the melting pot at one time.
One of the more surprising aspects of Nancy’s work is how often mental and physical health issues arrive together, each feeding the other.
‘The more pain you’re in physically, that feeds into your mental health,’ she explained. ‘And mental health feeds back into the physical.’
When someone is stressed, their breathing changes. They hyperventilate. Neck muscles shorten. Head position shifts. Blood chemistry alters. What begins as mental strain becomes physical tension, which becomes pain, which worsens the mental strain.
Chronic pain is exhausting. Exhaustion can lead to depression. Depression often manifests as physical fatigue, changes in appetite, disrupted sleep. The cycle reinforces itself.
This is why Nancy’s assessments for physical complaints often uncover mental health struggles, and vice versa.
We’re currently in a bit of a transition period,’ she said, ‘where DSE now needs to incorporate not only your desk and your computer, but the whole environment, the tasks you’re doing, and the individual. Those three pillars have always been there. But they’re getting chunkier.
The pillars she refers to—individual, task, environment—form the foundation of occupational health assessment. Historically, assessments focused on whether the chair was adjusted correctly and the monitor positioned properly. Now the assessment must also ask: is this person burning out? Are they sleeping? Do they feel supported?
The tools for answering those questions are still being built.
It is worth understanding what a workplace assessment actually involves, because it rarely looks the way people expect.
Around 70 to 75 percent of the referrals Nancy receives come in as physical complaints. Someone has neck pain, or shoulder problems, or chronic headaches. She is called in to assess the workstation. What happens next is instructive.
Take Adam. He was referred because of neck and shoulder pain. In the course of a private conversation, he mentioned fatigue. Then that he had been to the doctor feeling very down. That he could not cope with his workload. That he had recently lost a family member.
It just seems to be everything’s all happening at once for Adam,’ Nancy recalled. ‘Quite often when you have these clinical chats with people about their musculoskeletal issues, very often they also open up about other struggles they might be having.
From there, Nancy looked at how Adam worked. The hours, the breaks, whether he ate lunch at his desk. She noted the blue flags — a flag system used in occupational health to categorise risk — including the workplace pressures that were feeding into his mental state. His employer did not yet know any of this. Before it could be shared, Adam’s consent was needed.
The recommendations addressed both layers.
Physically: a laptop stand, separate keyboard and mouse, a supportive chair. ‘Multiple different adjustments to make sure that the equipment is coming to him rather than him going to the equipment,’ Nancy said.
For the mental health: a sit-stand desk, movement breaks every 45 minutes. ‘Any movement and any exercise, even just stretching at your desk — it increases the endorphins, the dopamine, the serotonin. It enhances mood, reduces the perception of pain, decreases stress.’
The assessment also flagged a need for a Specialist Neurodiversity Assessment. From that came software changes, voice dictation, the ability to listen rather than read. Adam’s workload, on paper unchanged, became manageable.
None of it was a diagnosis. ‘These assessments are all about putting solutions in place to help with the symptoms,’ Nancy said. ‘The only diagnosis and medical intervention plans would come from their GP or medical practitioner.’
Joe was 76 years old and working a physically demanding job. He had two new hips and a new knee. Every day he was in significant pain.
Nancy started with a basic assessment. It quickly became clear that something more was needed. She returned to conduct a Functional Capacity Assessment to determine whether Joe was still physically capable of performing his role.
The answer was no.
When she told him, he cried.
Nancy felt horrible, thinking ‘Oh! My job is making older men cry.’ Her job, as she saw it, was to help people stay in work, not force them out. But then Joe gathered himself and explained.
He had been in the army. Stopping was not something he could permit himself to do. He would have kept going until his body gave out entirely, because anything less felt like failure.
‘He was actually really grateful that I’d come and said, ‘you can’t do your job anymore,’’ Nancy recalled. ‘The relief, I think both of us felt at that point. I’d just given him his retirement, which he probably should have had ten years earlier. But he just wouldn’t stop.’
Joe’s case illustrates something Nancy sees frequently. For older workers, particularly men, admitting struggle feels like admitting weakness. Mental health remains a private matter. Something to manage alone.
‘There are people who are a little bit older who maybe think of mental health as being a private, quite intimate conversation,’ Nancy said. ‘Whereas younger people now, sometimes it’s very open.’
The generational divide is stark. Younger employees often discuss their mental health openly, access counselling without stigma, and request adjustments without shame. Older employees, shaped by different social conditioning, are far more difficult to help.
‘This is why there’s this big push on issues like male suicide,’ Nancy explained. ‘Because men tend to feel like they aren’t supposed to cry and they’re not supposed to have these feelings and be weak.’
The stereotype does real damage. It prevents people from seeking support until crisis has already arrived.
Nancy uses a system developed in occupational health research to identify obstacles to recovery. It is called the Flag System, and it provides a practical framework for noticing when someone is struggling.
The flags are colour-coded. Red flags indicate serious physical pathology. Orange flags indicate psychiatric symptoms requiring medical intervention. But the flags that matter most for early intervention are yellow and blue.
Yellow flags include beliefs and behaviours. Someone who avoids tasks because they expect them to be painful. Someone with a persistently negative outlook on treatment. Someone who expects a single piece of equipment to solve everything without changing how they work.
Blue flags involve workplace relationships. Tension with a manager. Conflict with colleagues. A sense that nobody is listening.
Both are warning signs. Both suggest that someone is heading toward crisis rather than recovery.
‘The key,’ Nancy said, ‘is noticing the subtle changes. Difficulty with concentration, motivation. Performance dips. Changes in weight, sleep patterns, fatigue. Increased sensitivity. Mood changes with minimal input. Withdrawal from social involvement.’
These signs are frequently misread.
‘I would say probably the majority are misread,’ Nancy said. ‘Making assumptions is really dangerous. It can negatively impact the individual in terms of their own mental health and their reputation with colleagues.’
The assumptions take predictable forms. Lazy. Entitled. Not working hard enough. Poor attitude.
What actually helps is simpler.
‘Just asking ‘is everything okay? Can I help? Do you need help?’ is the first step.’
The question matters more than the diagnosis. Because by the time formal medical intervention arrives, the person has usually been struggling for months.
When employers ask Nancy what they are legally required to do, the answer surprises them.
The principle is the same as for any physical condition, Nancy explained. Just as a workplace would be adapted for someone with a mobility impairment, employers are now legally required to make adjustments in communication, environment, and equipment for mental health conditions.
The Equality Act is clear. Mental health conditions now have the same legal protections as physical disabilities. Reasonable adjustments are not optional. They are required.
What counts as reasonable depends on the size and resources of the organisation. A multinational bank and a three-person business will not have identical capacity. But the principle is universal.
The obligation applies more widely than many employers assume. Any company with five or more employees is required to have a written health and safety policy in place, and this must cover both physical and mental health. This is not new legislation, but it is being more actively enforced than before. Many small business owners are unaware that their duty of care begins when they take on their very first member of staff.
The adjustments themselves are often modest. Flexible working hours. Clearer written communication instead of verbal instructions. A desk in a quieter location. Regular one-to-ones to check in.
Sometimes the adjustment is as simple as movement.
Nancy frequently recommends sit-stand desks, not for back pain, but because the transition from sitting to standing resets the body. Movement increases oxygenation. Blood flow improves. The brain receives more oxygen. Mood lifts.
‘That movement causes improved oxygenation through your blood system,’ Nancy explained. ‘More oxygen getting to the brain. Even just stretching at your desk increases endorphins, dopamine, serotonin. It enhances mood, reduces the perception of pain, decreases stress.’
A chair with a built-in movement mechanism allows someone to shift and fidget without conscious effort. For people with anxiety, that unconscious movement can mean the difference between staying focused and becoming overwhelmed.
There is another factor that often goes unnoticed. Monotonous work — the same task, repeated, at the same screen, hour after hour — is a significant contributor to declining mental health. Task rotation, where employees shift between different types of work throughout the day, breaks the cycle. It is a recommendation Nancy makes frequently and one that costs nothing to implement.
The legal obligation exists. The challenge is knowing what to do with it.
Organisations that treat mental health support as optional face consequences on two fronts.
The human cost comes first. Performance issues. Absenteeism. Staff who feel undervalued and unheard. Retention falls. Morale drops. The people who remain carry heavier loads, which worsens their own stress.
‘Workforce effects have knock-on business effects,’ Nancy said.
The legal cost follows. The Health and Safety Executive can audit workplaces. If they find that issues were flagged but not addressed, the penalties are significant. Financial and operational.
But there is a third cost that is harder to quantify. When younger employees burn out and leave, the cost of recruiting and training replacements compounds. When people are supported and stay, that cost is avoided. When morale drops across a team, the effect on those who remain is rarely measured but always felt.
The inverse is also true. When employees feel supported, retention improves. Productivity increases. Morale strengthens.
‘On a human level,’ Nancy said, ‘you feel that you are valued as a member of that team if someone is concerned about your wellbeing. Having that positive, solution-based, person-centred approach is much more likely to produce a productive and motivated workforce.’
The business case and the human case point in the same direction.
Toward the end of our conversation, Nancy returned to a theme that had run throughout.
‘It all boils down to being compassionate,’ she said. ‘We have legislation about how to do that nowadays, which is a sign of the times — it came in 2024. But bringing the human back in is needed.’
Compassion requires putting yourself in someone else’s position. Understanding their pain without needing to fix it immediately. Recognising that the person sitting across from you is dealing with something you may not be able to see.
‘If you’ve got a compassionate leader who’s also leading by example,’ Nancy said, ‘that’s a great place to start.’
Leadership matters. When senior figures acknowledge their own struggles, it gives permission for others to do the same. When managers check in genuinely rather than performatively, it creates space for honesty.
Compassion is not the same as lowering standards. It is recognising that people perform better when the environment supports rather than obstructs them.
The question is not whether someone can do the job. The question is whether the conditions allow them to do it well.
If this article has felt uncomfortably familiar, the first step is simpler than you might expect.
You do not need a formal diagnosis to ask for support. If you suspect you are struggling, a conversation with your line manager about what adjustments might help is a reasonable starting point. Where there is a good working relationship, honesty often works better than waiting for crisis.
A Workplace Needs Assessment can clarify what would actually be useful rather than guessing. The assessment looks at how you work, what drains you, and what small changes might remove friction. It is not a medical diagnosis. It is a practical evaluation of whether the environment encourages the best performance from the person.
For employers, the task is equally specific. Nancy was asked directly what three things a small business owner could do, tomorrow morning, to improve their employees’ mental wellbeing. Her answer was characteristically practical.
First, encourage movement and task rotation. Build breaks into the day. If people are wired to their desks, look at wireless headsets so they can at least move while they work.
Second, bring in plants. Greenery improves oxygen levels, reduces static, and changes the feel of a space at minimal cost.
Third, have one-to-one conversations. Ask people how they are doing. And ask twice.
‘You ask the first time and you just get ‘fine’ or ‘yeah,’’ Nancy said. ‘If you ask again, you can often get a bit of a different answer.’
Ensure that policies do not just exist in a handbook but are actually known and used. Make Mental Health First Aiders visible and accessible. And recognise that mental health support is not an act of charity. It is a legal requirement — one that applies from the moment you employ a member of staff — with significant consequences if ignored.
Small adjustments often produce disproportionate results. A quieter desk. A change in working hours. Permission to take proper breaks. These are not difficult changes. They simply require noticing when someone is struggling and responding as though their wellbeing matters.
Because it does.
Mental Health Awareness Week runs 11 to 17 May 2026. If you are struggling, speak with your line manager or contact your GP. For employers, the question is not whether to act. It is how quickly you can start.
At OE Group, we provide corporate and individual DSE assessments, Workplace Needs Assessments, and specialist ergonomic solutions that support both physical and mental wellbeing. Our assessors work with you to identify practical adjustments that fit your organisation’s needs and budget.
If you would like to discuss assessments or workplace adjustments, our team is available to talk through the options.
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