Mental health at work

What is mental health at work and why does it matter?

The World Health Organization defines mental health as a state of well-being that enables individuals to cope with life’s stressors, develop their skills, learn and work effectively, and contribute to the betterment of their community. Work influences this state in both ways: meaningful, safe, and supportive employment protects mental health, while overload, lack of control, insecurity, violence, harassment, or lack of recognition can harm it. Work-related mental disorders have a high cost in terms of suffering, absenteeism, presenteeism, and productivity.

From an occupational risk prevention perspective, mental health is not addressed as an individual issue, but rather as the result of assessable and modifiable working conditions. Law 31/1995 mandates the assessment and prevention of all risks, including those arising from the organization of work (Article 4.7), and the adaptation of work to the individual (Article 15.1.d). The 2022 WHO/ILO guidelines structure action on three levels: preventing psychosocial risks, protecting and promoting mental health through training and awareness-raising, and supporting workers with mental health problems so they can participate and thrive at work.

The ISO 45003 standard transfers this approach to occupational health and safety management systems, as a complementary guide to ISO 45001 for managing psychosocial risks.

Risk and protective factors

• Work organization. Workload and pace, long working days, shifts and night work, lack of autonomy, role ambiguity or conflict, job insecurity and poorly managed organizational changes.
• Relationships and leadership. Support from managers and colleagues, quality of leadership, recognition, organizational justice, violence, harassment and discrimination.
• Content and meaning. Monotony, underutilization of skills, exposure to emotionally demanding situations (care for people, emergencies) and right to disconnect .
• Work -life balance. Balance between work and personal life, flexibility and remote work managed with preventive criteria.
• Individual and social factors. Personal situations, disability, previous illness, precariousness and stigma, which interact with working conditions and demand attention to particularly vulnerable people.
• Protective factors. Autonomy, participation, social support, recognition, clarity, professional development, and a culture of psychological safety that allows for open discussion of difficulties.

Levels of intervention

• Primary prevention. Assessment of psychosocial risks with validated methods and organizational measures on workload, time, autonomy, support and leadership; policies against violence and harassment.
• Secondary prevention. Management training in healthy leadership and early detection, staff awareness, communication and support channels, and stress management programs as a complement, never as a substitute for action on the organization.
• Tertiary prevention and support. Health surveillance, access to psychological support, job adaptation, planned return to work after leave due to mental health reasons, and protection against stigma and discrimination.
• Management and monitoring. Indicators (absenteeism, turnover, results of the psychosocial evaluation, use of support resources), periodic review and participation of representatives.

Organizational application: how to manage mental health

1. Include mental health in preventive policy with the commitment of management, the participation of representatives and a statement against stigma.
2. Evaluate psychosocial risks using validated methods and plan organizational measures with assigned responsibilities and deadlines.
3. Train managers in healthy leadership, detecting warning signs, supportive conversation, and referral to appropriate resources.
4. Provide accessible and confidential support resources (prevention service, assistance programs, guidance) and communicate them to all staff.
5. Establish protocols for dealing with violence and harassment, conflict management, and return to work after taking leave for mental health reasons.
6. To attend to particularly sensitive people with job adaptations in accordance with article 25 of Law 31/1995.
7. Measure, review and communicate results, integrating mental health into the management system indicators.

Preventive management software allows you to plan the measures derived from the psychosocial assessment, record the training of managers, manage the adaptation and return procedures with confidentiality, and monitor the indicators.

Limits and common mistakes

1. Reducing mental health to individual wellness programs without addressing the organization of work.
2. Treating mental health problems as private matters unrelated to occupational risk prevention.
3. Lack of training for managers, who are the ones who first detect and manage situations.
4. Failure to protect the confidentiality of health information or to prevent stigma and discrimination.
5. Forgetting about the planned return to work after taking leave for mental health reasons.
6. Confusing psychosocial assessment with a clinical diagnosis of people.

This information sheet is for informational purposes only; the diagnosis and treatment of mental health problems are the responsibility of healthcare professionals.

Regulatory and reference framework

• Law 31/1995, articles 4.7, 14, 15, 16 and 25. Working conditions, duty of protection, preventive principles, evaluation and especially sensitive workers.
• WHO Guidelines on Mental Health at Work, 2022. Recommendations on prevention, protection, promotion and support, developed with the ILO.
• ISO 45003. Occupational health and safety management: Psychological health and safety at work, Guidelines for the management of psychosocial risks.
• European Agency for Safety and Health at Work (EU-OSHA) . Psychosocial risks and mental health at work: resources and guidance.
• Technical Criterion 104/2021 of the Labour and Social Security Inspectorate . Inspection actions in matters of psychosocial risks.

The Spanish Strategy for Safety and Health at Work and the European Union’s strategic framework include mental health among their priorities; in Colombia, the Psychosocial Risk Battery and Law 1616 of 2013 on mental health constitute the reference framework.