For a long time, mental health at work was treated as a personal matter: if you couldn't handle the pressure, you "needed to take care of yourself". Research and regulation have changed that conversation. We now know that the way work is organized (workload, autonomy, leadership, clarity, respect) matters as much as each person's resilience, and that caring for it is also a business decision.
In short
- The WHO and the ILO estimate that 12 billion working days are lost every year to depression and anxiety, costing about US$1 trillion in productivity.
- Many countries now require employers to assess and manage psychosocial risks: Mexico (NOM-035), Brazil (NR-1), Chile, Peru, Spain, France and others.
- What works best is changing how work is organized, not only offering individual perks.
- Trained leaders make the difference: for the first time, the WHO recommends training managers in mental health.
- It pays off: Deloitte estimates around £4.70 back for every £1 invested in employee mental health.
Why it matters to the business
The WHO estimates that 15% of working-age adults were living with a mental disorder in 2019. At work this shows up as sick leave, but also as presenteeism: people are there, but performing far below what they could. Add turnover, conflict, mistakes and accidents, and the cost of ignoring the issue becomes clear.
The good news is that the reverse is also true. Teams that feel safe to speak up, understand what is expected of them and have some control over their work tend to make fewer mistakes, innovate more and stay longer.
What the rules require, country by country
- Mexico: NOM-035-STPS-2018 requires every workplace to identify and prevent psychosocial risk factors, with duties by size and official questionnaires (Reference Guides I, II and III).
- Brazil: NR-1 (MTE Ordinance 1,419/2024) brought psychosocial risks into occupational risk management; since 26 May 2026 they must be identified, assessed and covered by an action plan.
- Chile: under Law 16,744, the Psychosocial Risk Surveillance Protocol uses the CEAL-SM/SUSESO questionnaire; the Karin Law (21,643, 2024) strengthened the prevention of harassment and violence at work.
- Peru: Occupational Safety and Health Law 29,783 includes psychosocial risks in risk assessment.
- Spain: Law 31/1995 on Occupational Risk Prevention requires assessing all risks, including psychosocial ones.
- France: the single occupational risk assessment document (DUERP) must include psychosocial risks.
- International standard: ISO 45003 (2021) is a voluntary standard with guidelines for managing psychological health and safety at work.
The rules differ from country to country, but the logic is the same: assess, act, document and follow up.
The most common psychosocial risks
- Workload and pace: more work than time allows, impossible deadlines, long hours.
- Low control: no say in how, when or in what order to do one's own work.
- Unclear roles: not knowing what is expected, or getting conflicting requests.
- Leadership: lack of support, recognition or feedback; perceived unfairness.
- Violence and harassment: humiliation, shouting, bullying or sexual harassment, discrimination.
- Work–life balance: always-on connection, after-hours messages, trouble switching off.
- Insecurity: constant fear of losing one's job, or unexplained changes.
A practical five-step program
1. Listen anonymously. Use a validated questionnaire (or your country's official one), with results only by group, so people answer honestly.
2. Prioritize. Look at results by department and by factor. Pick a few issues with the highest risk and impact instead of trying to fix everything at once.
3. Change the work, not just the person. Rebalance workloads, clarify roles, agree on response times, review targets. Perks such as meditation apps help, but they don't replace organizational change.
4. Prepare your leaders. Teach them to spot signs of overload, talk with empathy, adjust demands and refer people to professional support when needed.
5. Measure again. Repeat the assessment (at least once a year, or as your country's law requires) and compare. Showing what changed builds trust.
What a leader can do tomorrow
- Start meetings by asking how people are doing, and actually listen.
- Make clear what is a priority and what can wait.
- Protect rest: no after-hours messages as a norm.
- Recognize effort, not only results.
- Act quickly on any sign of harassment.
- Know your own style: understanding how you react under pressure helps you avoid passing that pressure on to the team.
How it improves performance
The link between wellbeing and performance is one of the most consistent findings in organizational psychology. Gallup found that managers account for about 70% of the variance in team engagement. A study in The Lancet Psychiatry (Chisholm and colleagues, 2016) estimated that every dollar invested in scaling up treatment for depression and anxiety returns about four dollars in better health and productivity. And Deloitte UK calculated an average return of about £4.70 for every pound invested in workplace mental health, higher when the investment is preventive.
Common mistakes
- Wellness theater: fruit in the kitchen and a yearly talk, without touching workload or leadership.
- Treating it as individual weakness: putting all the weight on the person's resilience.
- Using personality tests as hiring filters: they are for self-knowledge and team development, not for selecting or excluding people.
- Surveys with no follow-up: asking and then showing no action erodes trust.
Frequently asked questions
How can I support employees' mental health? Combine three things: fix the main work-related risks (workload, control, clarity, respect), train managers to notice and respond, and make professional support easy to access.
What is ISO 45003? It is an international, voluntary standard with practical guidelines for managing psychological health and safety within an occupational health and safety system.
Does every company need a psychologist? It depends on the country and company size. In general, assessments can be done with validated instruments, and formal reports are usually signed by licensed professionals.
How do I help an employee who is struggling? Talk privately, listen without judging, temporarily adjust their demands if possible and suggest professional support. If there is an immediate risk, seek emergency help.
Where should we start on a small budget? With an anonymous assessment and manager training. They offer the best cost-benefit ratio.
If you want to start with the assessment, Ethea runs anonymous psychosocial diagnostics with results by department at ethea.me/en/business. And if you'd rather look at yourself first, the burnout test helps you spot the signs early.
References
- World Health Organization and International Labour Organization (2022). Guidelines on mental health at work; Mental health at work: policy brief. https://www.who.int/news/item/28-09-2022-who-and-ilo-call-for-new-measures-to-tackle-mental-health-issues-at-work
- World Health Organization (2024). Mental health at work (fact sheet).
- Chisholm, D. et al. (2016). Scaling-up treatment of depression and anxiety: a global return on investment analysis. The Lancet Psychiatry, 3(5), 415–424.
- Deloitte UK (2024). Poor mental health costs UK employers £51 billion a year for employees. https://www.deloitte.com/uk/en/about/press-room/poor-mental-health-costs-uk-employers-51-billion-a-year-for-employees.html
- Gallup (2015). State of the American Manager.
- ISO 45003:2021. Occupational health and safety management — Psychological health and safety at work.
- Mexico, Secretaría del Trabajo y Previsión Social. NOM-035-STPS-2018 (DOF, 23 Oct 2018).
- Brazil, Ministry of Labour and Employment. MTE Ordinance No. 1,419/2024 (NR-1).