Stress is defined by the Health and Safety Executive (HSE) as ‘the adverse reaction people have to excessive pressures or other types of demand placed on them’. Stress can be impacted by poor training, the wrong match between job and their skills or experience, and other external factors, such as a change in circumstances. Employers can proactively prevent and respond to stress through the right training, supports, and management. 

Causes of Stress

  • Long hours
  • Heavy workloads
  • Changes to role or responsibilities
  • Job insecurity
  • Financial insecurity or debt
  • Lack of autonomy 
  • Lack of skills or experience 
  • Micro-management 
  • Inadequate or unhealthy work environment
  • Harassment and discrimination 
  • Conflict
  • Relationship problems 
  • Moving house, getting married, or bereavement
  • Crisis incidents

Sign and Symptoms of Stress

  • Taking time off for unknown reasons
  • Higher levels of sickness and sickness absence
  • Presenteeism (when someone is sick, but present at work)
  • Arriving for work late, or working excessively long hours
  • Agitation or increased anxiety
  • Mood swings
  • Being withdrawn from colleagues
  • Loss of motivation, commitment and confidence
  • Tearful, sensitive, or aggressive
  • Argumentative with colleagues
  • Increased smoking, drug, and alcohol use
  • Problems with sleeping 
  • Mental health problems, such as depression or anxiety

How is stress diagnosed and treated? 

Stress is not a medical term or a medical diagnosis. However, GPs can and do sign off people from work for periods due to stress that has become unmanageable and is harming somebody’s health. This is often to prevent the stress causing other health conditions, or to reduce the impact it may already be having (such as sleeping disorders, anxiety, or stomach problems).

Often, a break from the source of the stress, where this is work, can help somebody to rest and return to work with their physical symptoms of stress reduced. However, employers should always explore the sources of an employee’s stress and take steps to address these so that the stress does not become a long term health issue or come back when they return to the workplace. 

Somebody experiencing high levels of stress may also require support with alcohol or drug addiction, which may have been taken to excess to mitigate the feelings arising from stress. 

Therapy can help somebody to understand and respond to the sources of stress, and to try and find healthy ways to manage stress (such as cognitive behaviour therapy).  

Stress is a precursor to many serious health issues and should never be ignored. Employers have an additional responsibility in Health and Safety Law to take steps to risk assess and reduce the negative impacts of stress on employees. 

What can employers do to prevent and address stress? 

The HSE provides a framework for preventing and addressing workplace stress. These are the six areas of workplace design: 

  • Demands – is their workload and the expectations placed on them reasonable and within the boundaries of their experience, skills, and time available?
  • Control – what control does the employee have over the way in which they do their work? 
  • Support – does the employee have the right level of support for their role and level of responsibilities (not over or under supervised)?
  • Relationships – are there any relationship difficulties at work? Are there any conflicts that need resolving? 
  • Role – Is their role clearly defined? 
  • Change – is there significant change happening in the organisation or in their personal life? 

Any of these areas could apply to the employees external, private life – such as changes in their own relationships or circumstances. Whilst employers are not responsible for an employees private life, being aware and responsive to these pressures with understanding and adjustment where possible, is more likely to prevent the stress getting to the point of mental health problems and/or sickness absence. 

The HSE has published a stress risk assessment toolkit which employers can use to plan for and address stress at work. Alongside this are talking toolkits, which are designed to help a manager speak with an employee about stress at work. 

Employers can also help to improve the way employees manage their stress levels, by developing stress awareness sessions and resilience training. 

What reasonable adjustments are possible for employees with an acquired brain injury?

Employers have a legal duty to make reasonable adjustments for employees with a diagnosed mental health condition – which may include stress as a symptom of that condition –  if they know, are aware of, or could ‘reasonably be expected to know’ that the employee is experiencing unhealthy levels of stress. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of stress:

  • Extra time to complete tasks to accommodate difficulties the person may have juggling work tasks and intrusive or anxious thoughts.
  • A structured working day to allow the employee to concentrate more easily and to become less distracted by their stress.
  • Providing regular, sensitive feedback and reassurance, so that an employee with high levels of unhealthy stress who may come across particularly vulnerable to criticism, or stressed in a work environment, can stay abreast of what they are doing well, or what they could improve on.
  • Time off to attend appointments, so that the person can work on recovery while staying in work.
  • Flexibility regarding working from home if the employee struggles with their stress when in public or around other people, which may affect their commute.
  • Raising awareness so that colleagues understand the employee’s stress and can help ensure the employee feels comfortable at work. This might involve learning more about the condition to gain a better understanding of what the employee might be facing day-to-day.

Stress Signposting

Health and Safety Executive – provides oversight of health and safety for workplaces, and a wide range of resources to help employers identify, plan for, and address stress at work. 

Mind– provides advice and support groups for people struggling with their mental health. 

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