Supporting employees with mental health problems

Employers have specific legal obligations to protect staff from discrimination. Some of these obligations are fulfilled by managers in the organisation. As a line manager, your approach will depend on your organisation’s mental health, recruitment and sickness absence policies. If these policies don’t seem adequate, talk to your own manager about how they could be improved.

Simply meeting your legal obligations is unlikely to be adequate to support your staff fully and help them work to their best. Our information on improving employees' mental health and wellbeing will help ensure you take holistic approach.

“As a manager I would have found it helpful to understand the support mechanisms available to assist employees with mental health issues [to maintain] attendance when they are unwell rather than having to revert to sick leave, which may not be the right solution.” – David A

A woman hugging a cushion, looking sadly at a laptop

What is our legal obligation?

Disability — either physical or mental — is a protected characteristic under the Equality Act 2010.

A problem is a disability if it has a substantial, adverse, and long-term effect on your normal day-to-day activities.

A mental health problem is a disability if (without treatment or medication):

  • it has a medium or large effect on your someone’s everyday life
  • it makes things more difficult for them
  • it has lasted, or is likely to last, 12 months — or is likely to recur

A mental health problem meeting these criteria is legally recognised as a disability, regardless of whether the person actually considers it a disability.

Your organisation has a legal duty to provide reasonable adjustments to the job role or working environment, to help staff overcome any disadvantages resulting from a disability. As a manager, you may be involved in discussing these with your employer and submitting a formal request for the adjustments your employee needs.

It’s illegal to ask questions about health during recruitment. It’s up to candidates to decide whether they want to tell you about a mental health problem – they’re not obliged at any point. If they do, employers must ensure they’re treated fairly during recruitment. CIPD provides detailed guidance on fair recruitment and disclosure.

You’re also legally required to assess the risk of stress-related ill health and take measures to control that risk.

CIPD and Mind recommend that you take a flexible approach to reasonable adjustments. Try and offer reasonable support to all staff, whether they have a formal diagnosis or not.

What are reasonable adjustments for mental health?

A reasonable adjustment is a change to how your employee works to help them overcome any disadvantages they might face. Effective reasonable adjustments can support employees with mental health problems to work to their full capacity.

In this context, ‘reasonable’ is a legal term. Whether an adjustment is ‘reasonable’ or not depends on its effectiveness, practicality, cost, your organisation’s resources, and whether any additional financial help is available. The Equality and Human Rights Commission provides more information on what counts as reasonable, and there are also some examples in this section.

The need to make adjustments is not a legally valid reason not to promote or to dismiss an employee.

It can be difficult to know what kind of reasonable adjustments are appropriate for someone with a mental health problem. Sometimes it isn’t even clear to the employee themselves what might help them.

As a manager it’s important to have an open discussion about possible adjustments, with suggestions from both sides. This can help them think about what might work best for them.

A Wellness Action Plan can help you start and structure this conversation. The better you know your staff, the easier this will be.

Examples of reasonable adjustments

  • Allowing your employee to commute outside of rush hour. This may mean extending or adjusting flexible working hours.
  • Making changes to staff’s working area. This may mean somewhere quieter or somewhere where they have more support around them.
  • Making a quiet room available for staff to take short breaks.
  • Allowing staff to take time off to attend appointments or treatment.
  • Changing someone’s working hours, for example to account for the short-term effects of medication.
  • Allowing staff to work from home sometimes, to avoid travel time or enable them to work in a more familiar environment.
  • Reallocating certain tasks at certain times. This may be a temporary need – for example, allowing staff to have time away from the phones sometimes.
  • Remembering to say ‘thank you’ and offer compliments on good work to prevent increased performance anxiety.
  • Providing written instructions for someone whose mental health problem affects their memory.

It’s important to review reasonable adjustments regularly.

Is our workplace making staff mental health worse and what can we do about it?

Work can cause mental health problems or make mental health problems worse. Issues like bullying, uncertainty, lack of control and a demanding role are all linked to the development of common mental health problems. We have more detailed information on how work can affect your mental health.

What can we do about it?

Have a look at our information on improving staff mental health and wellbeing and how managers can improve working practices within their team.

How should we manage underperformance?

Most organisations have procedures to help them deal with underperformance. But many employees feel unable to disclose a mental health problem and do not receive appropriate support. In these cases, your approach to underperformance may not recognise or deal with health factors.

You should explore health factors in underperformance before any formal processes. It may be that appropriate reasonable adjustments can address the problem. If the underlying causes of poor performance are not addressed, the problem is unlikely to go away through a formal underperformance management process.

Staff should not be forced to disclose any mental health problems. But they should be given space to talk about things they feel may be affecting their performance and asked questions about their health and wellbeing. Our information on dealing with disclosure may help when having this conversation.

If your employee does tell you about a mental health problem that they feel is contributing to their performance, you should set up a WAP and put reasonable adjustments in place before reviewing their performance further.

How should we manage absence as a result of mental health problems?

As with physical health, mental health related absence is sometimes unavoidable.

It’s important to have clear policies and procedures in place. This helps to ensure managers have a consistent approach and staff know what to expect.

Our information on managing time off and supporting return to work has more information on how to support employees during absence.

A BMA logo for highly commended information

Highly Commended in Wellbeing in the 2019 BMA Patient Information Awards

Did our information help you?

We’d love to hear what you think. Our short survey takes just a few minutes to complete and helps us to keep improving our health information.

About our health information

At Bupa we produce a wealth of free health information for you and your family. This is because we believe that trustworthy information is essential in helping you make better decisions about your health and wellbeing.

Our information has been awarded the PIF TICK for trustworthy health information. It also complies with the HONcode standard and follows the principles of the The Information Standard.

The Patient Information Forum tick  This website is certified by Health On the Net Foundation. Click to verify.

Learn more about our editorial team and principles >

    • Stress: management standards. Health and Safety Executive., reviewed March 2017
    • Equality Act 2010. [accessed May 2017]
    • The Equality Act 2010: Guidance for Employers. ACAS. [accessed May 2017]
    • Managing and supporting mental health at work, disclosure tools for managers. CIPD and Mind, December 2011.
    • Management Standards for Tackling Work Related Stress.Health and Safety Executive. [accessed May 2017]
    • Advice and Guidance. What is reasonable? Equality and Human Rights Commission, July 2016 [accessed May 2017]
    • Harvey SB, Modini M, Joyce S, et al. Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems. Occup Environ Med 2017;74:301–310
  • Produced by Clare Foster, freelance health editor, and Nick Ridgman, Head of Health Content, Bupa UK, September 2017
    Next review due September 2020

    Bupa UK expert reviewers:

    • Naomi Humber, Psychology Services Manager, EAP
    • Stuart Haydock, Resilience Lead, Health Clinics
    • Sarah Deedat, Head of Behaviour Change