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Why Half of Employees Don't Want to Talk About Mental Health and What to do About it.

Over half of employees do not feel comfortable talking about their own mental health with their line manager. A third of employees lie about the cause of sickness absence, making up physical conditions to hide mental health conditions.


Despite increasing awareness of mental health, there’s been no change in the proportion of employees willing to talk about their mental health at work.


% of Employees That Feel (Quite or Very) Comfortable Talking to Their Line Manager About Their Own Mental Health

Source: Based on Business in the Community (BITC) data, 2016, 2017, 2018, 2019)

More than half of employees don’t want to talk about their mental health at work. Why is this? There are likely to be several reasons.


No legal justification for employers to enquire


Setting the Equality Act 2010 aside, a key legal ruling (Hatton v Sutherland, 2002) states: ‘An employer is generally entitled to take what he is told by his employee at face value, unless he has good reason to think to the contrary. He does not generally have to make searching enquiries of the employee or seek permission to make further enquiries of his medical advisers.’ The employer has no general obligation to enquire about the mental health of employees. If employers do not routinely ask about the mental health of employees, employees may feel their employer is not interested in it, making employees feel less willing to talk about their mental health issues at work.


Employees may have no need


Some employees with mental health issues have their issues under control. They may see their issues as minor and feel they are more than capable of dealing with them by themselves. Some issues may be more severe, but perhaps the employee is getting all the support they need outside of work and does not need their employer’s support. Many employees with poor mental health do not wish to make a big deal out of it, feeling they can manage the situation alone and not wishing to ask for support beyond that which they feel is as absolutely necessary.


Employees may desire privacy


Employees have a right to privacy. Some employees will wish to keep ‘special category data’ such as medical (including mental health) information to themselves. They have no obligation to share this information unless it affects their ability to do their job. Even then, some employees will wish to keep their medical history and any prognosis private. Employees may even lie to do so.


Employees may have no legal right to support


Employees may believe they are not entitled to their employer's support. If employees do not believe they have a ‘protected characteristic’, they may feel there is little point in disclosing a mental health condition if, in law, they are not entitled to support from their employer. Even if employees do have a 'protected characteristic' they may not wish to ask for ‘reasonable adjustments’ to be made to their working arrangements so, again, employees may remain silent.


Employees may fear a negative reaction and becoming stigmatised


A significant proportion of employees with mental health issues worry about the potential reaction of their employer, should they disclose their issues. 20% of employees who disclose a mental health issue at work are disciplined, demoted, dismissed or resign shortly after their disclosure (consider this the ‘disclosure dismissal’ rate). Others remain employed but become stigmatised. An unknown number of people will have their disclosure held against them in some way. It is possible that 1 in 3 or more employees suffer adverse effects from disclosing a mental health issue at work. Why would an employee take a 1 in 3 or worse chance of a negative employer response? Mental health itself and attitudes about it are invisible. Leaders and managers can say one thing, and think and do another. Does a mental health ‘glass ceiling’ operate in the employer organisation? How many Directors and middle managers admit openly to having poor mental health? How many employees with mental health issues are promoted? What is the mental health ‘pay gap’? Leaders can say they are pro-mental health, but their actions and decisions may reveal a different attitude. Employees are likely to sense injustices, just as they are about race, religion, physical disability, gender and so on. It is likely employees will stay silent about their mental health because of the potential for an adverse employer response and becoming stigmatised.


Employees may feel shame and embarrassment


Employees with mental health issues can feel shame and embarrassment. This feeling can prevent employees discussing their mental health with others, especially at work where employees may believe it is necessary to present as a tough, resilient and hardy character, able to cope with the stresses and strains of the workplace.


Employees feel their employer isn't sufficiently prepared


Some employees may wish to ask their employer for help, but they may perceive their employer is not sufficiently prepared to support them. Preparations are about more than training. Employees will assess a number of factors before making any disclosure, including culture and attitudes, policies and procedures, along with how others disclosing mental health issues have been treated. Employees will weigh up employer preparedness which, if they find it to be lacking, will lead to employees keeping their issues to themselves.


Employees are not clear about the employer's role


Employees may not see it as the employer's role to provide mental health support. Traditionally, mental health support has been provided by the national health service. The employer's role in mental health may not be obvious to employees, and even where the employer does offer support, employees may hold doubts about the employer's competence.


Whatever the reasons for holding back, employees appear no more likely to talk about their own mental health than they were previously, despite increasing awareness. Recommendations for employers are obvious:

  • Enquire about the mental health of employees. Make sure they know you’re interested in their mental wellbeing. You’ll probably have to do so in any case when undertaking mental health risk assessments.

  • Make sure employees understand how to access mental health support. You never know who might need it and when, so communicate its availability widely and make access simple and convenient.

  • All too often, employers feel employees have a duty to disclose mental health issues when, in fact, they usually do not. Attempting to force employees to disclose medical information will undermine trust. Respect your employees’ right to privacy.

  • Ensure employees understand the levels of support available, including how those employees legally entitled to workplace accommodations and adjustments can access them. Also communicate what support is available to employees with mental health issues, over and above any legal considerations. What additional support do you provide, above and beyond the basics?

  • Monitor how your organisation treats employees who disclose mental health issues. Measure your organisation’s ‘disclosure dismissal’ rate. Manage the result to ensure your actions match your words.

  • Ensure you develop a non-judgemental culture, where employees can feel comfortable talking about their mental health, without it affecting how they are regarded. THIS is probably the employer's biggest single challenge when managing mental health.

  • Clearly communicate what your role is in the mental health management system, along with how your role as an employer fits into an integrated approach.

  • Properly prepare to support the mental health of your employees. Start with a mental health policy, procedures and programme. Develop your organisation’s culture so it becomes pro-mental health. Research best practice and management standards (eg. ISO 45003, due out in 2021), then implement them.

None of the above recommendations will be effective in isolation. A comprehensive approach must be taken; an approach that is strategic, structured and systematic.


Employee reluctance to speak out about their mental health comes down to trust. Currently, more than half of employees do not trust their employer to act fairly, should employees disclose mental health issues.


By taking a strategic, structured and systematic approach, and when coupled with caring, compassion, kindness and tolerance, employers can improve levels of trust, improving the employee-employer mental health relationship to the benefit of both.

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