Blog: The perfect psychological safety storm

By Kevin Bampton, CEO of The British Occupational Hygiene Society (BOHS).

No-one person who has been in management over the last thirty years will have been immune to the reality that mental illness is one of the most impactful phenomena on business continuity. Poor performance, difficult workplace relationships, absenteeism, bullying, misconduct and employer liability often trace their roots back to psychological issues within the worker. This is obvious. Much of modern efficiency and effectiveness is behaviourally linked, whether it be elementary issues such as conscientiousness, trust and confidence or high-level dimensions such as leadership, interprofessional working or risk appetite. The cost of poor mental health on the balance sheet is probably incalculable, but in a manager’s daily life, the impact is often obvious. If the psychological safety of all staff at all levels is not implicit in the risk management of every organisation, it should be.

Even before the pandemic 13% of sick days related to mental health issues and almost one in seven workers affected by work-related mental health issues, with women twice as likely to be affected as men. Last year’s figures from the HSE that indicated that 50% of workplace illness arises through mental health problems will possibly be of little surprise to and employer. Taken off the back of a lasting mental health crisis in society derived from the lack of mental health support and infrastructure, a legacy from austerity, the impact of social media on younger people, followed by the crisis of collective grief, alienation, insecurity and stress that was the period of COVID lockdowns, it is hardly surprising. As Peter Kelly, Senior Psychologist for HSE warns, the worst is yet to come. He expects a “tsunami” of mental illness paralleled by the experience of the influenza epidemic just over a century ago.

Remote working and the impact of dealing with short staffing, financial insecurity and low wages add to the factors that bring the workplace closer to being a fulcrum upon which stress and mental health is balanced. A viewpoint that sees mental health as part of the personal domain of an individual and classes those who are more overtly psychologically vulnerable as lacking resilience or being “snowflakes” is no longer sustainable by the evidence. Just in the same way as we would not dismiss vulnerabilities on the basis of gender or disability, psychological vulnerability is one that we cannot and should not be blasé about.

It’s 25 years since the first case which allowed a claimant to be given substantial damages for stress at work and since then it has become more common place.

The legal duties have always been there, but as public understanding and clinical practice evolves around this area, the impact of those duties has gradually become more profound. In criminal law, the Health and Safety at Work Act does not exclude psychological safety and the HSE has had in place for a while the Stress Management Standards and at common law, the courts have accepted that psychological injury can give rise to damage, while in employment law, it activates a whole series of rights, giving rise to employer liability.

However, big things are about to happen that will determine the impact of the looming mental health tsunami on businesses. The HSE’s newly published strategy for the first time lists health protection as the first of its priorities and headlining that, the protection of mental health. It seems clear the regulator is now intent on using its collective resources to focus on this problem, to deliver interventions that make a real difference.

The excuse of “too hard to handle” if it was weak when the stress management standards came out, becomes paper thin when we consider the free availability of ISO45003, the psychological safety standard, designed to work around the stress management standard framework.

The regulator now has the mandate, the appetite, the ability and the yardstick to measure employer’s compliance with the legal duty to protect the psychological safety of the workforce, just at the time when the workplace is going to see unprecedented risk in this area.

Other factors make this an area of real focus. As of the beginning of July, it will not only be doctors who can issue fit notes. The power to issue these will extend to pharmacists and some occupational health professionals. It is not unlikely that pharmacists, who will be familiar with regular prescriptions of medication to manage stress and mental health issues will be very much involved in issuing fit notes around stress and mental health.

In every way this brings about a perfect storm: external factors are going to increase risk; understanding of the problem and of rights amongst workers is heightened; the standards expected of businesses are clearer; access to support to sign off work is easier; the regulator focus is more directly on the area and its intent to pursue bad practice is greater, coupled with courts more readily disposed to support criminal and civil claims.

Aside from the moral arguments and the obvious business continuity case, the corporate risk of not addressing psychological safety has never been higher. However, it would be counter-productive to move the focus from physical health to mental health.

People are more conscious than ever about their health. They have access to wearable technology that makes them focus on physical health. Workplace exposures have known health impacts and concern about health is a major stress factor directly. Those involved in industries where there is routine exposure to carcinogens like respirable silica dust in construction, to extremes of heat and to constant noise will directly experience stress and will also potentially experience secondary psychological effects from physical exposure. Exposing people to the risk of physical injury, especially long-term illness, mortality or loss of the ability to work (e.g. through Musculoskeletal Disorders) inevitably creates contexts for poor mental health. The links between back pain and depression, noise and mental illness and the relationship between physical stress and mental stress have long been known.

In many ways, the HSE’s new strategy should be a prompt for all employers to look again at their own human resources strategy. In the current economy, maintaining and promoting the health of employees has never been a better investment in business continuity and neglecting physical and mental health has never come at higher price in terms of corporate risk.

More about Professor Kevin Bampton, (LLB FCMI FRSA FHEA) Chief Executive Officer of the British Occupational Hygiene Society

Kevin has worked as a legal adviser for the British Council and the Overseas Development function of the Foreign and Commonwealth Office and as Special Constitutional and Legal Adviser for the United Nations. Amongst his academic roles, he has been Professor of Public Law, Professor of Comparative Justice, Director of the International Policing and Justice Institute, Research Fellow in Good Government, Research Fellow in Health and Life Sciences, Higher Education Adviser to Trent Postgraduate Medical Deanery and is Visiting Professor at Gloucestershire University. He is an award-winning educator with a focus on interprofessional education and the integration of practical skills into theoretical learning. He has taught across a range of areas, including advanced forensic science, professional ethics, and employment law. As an extension of his 30 years of working in the justice field, he has worked extensively with professional and Chartered bodies with a focus on professionalisation, ethics and educational development. Kevin is representing BOHS in various professional committees and bodies and is the Chair of the BSI HS/1 Occupational health and safety management committee. His life-long emphasis on the relationship between justice, science and health led him to his current role. His belief is that the British Occupational Hygiene Society plays a critical role in ensuring the protection of worker health and scientific independence in the development of occupational health in a post-Brexit Britain and a post-COVID-19 world.

More about BOHS

The British Occupational Hygiene Society (BOHS) is a representative voice of occupational hygiene in the UK. It provides internationally recognised qualifications, scientific conferences, membership services and publications. For more information see