A review of good workplace practices to support individuals experiencing mental health problems : research review.
Date: 2024-08-14
Institutions: European Agency for Safety and Health at Work
Subjects: labour market, mental health, mental stress, occupational health, occupational psychology, report, risk management, social well-being, socioeconomic conditions, working conditions, workplace

A review of good workplace practices to support individuals experiencing mental health problems 

European Agency for Safety and Health at Work 

A review of good workplace practices 
to support individuals experiencing 
mental health problems  

Research Review  

 
 
 
 
A review of good workplace practices to support individuals experiencing mental health problems 

Authors: Marianna Virtanen, Kirsi Honkalampi, Petri  Karkkola, Maija Korhonen (University of Eastern 
Finland). 

Project management: Sarah Copsey - European Agency for Safety and Health at Work (EU-OSHA). 

Additional good practice resources were provided by experts nominated by the EU-OSHA network of 
National Focal Points. 

This report was commissioned by the European Agency for Safety and Health at Work (EU-OSHA). Its 
contents, including any opinions and/or conclusions expressed, are those of the authors alone and do 
not necessarily reflect the views of EU-OSHA.  

Neither  the  European  Agency  for  Safety  and  Health  at  Work  nor  any  person  acting  on  behalf  of  the 
agency is responsible for the use that might be made of the following information. 

Luxembourg: Publications Office of the European Union, 2024 

PDF     ISBN 978-92-9402-331-5               doi: 10.2802/380241                  TE-02-24-736-EN-N 

© European Agency for Safety and Health at Work, 2024 

Reproduction is authorised provided the source is acknowledged. 

For any use or reproduction of photos or other material that is not under the copyright of the European 
Agency for Safety and Health at Work, permission must be sought directly from the copyright holders. 

European Agency for Safety and Health at Work – EU-OSHA 

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A review of good workplace practices to support individuals experiencing mental health problems 

Table of Contents 

Executive Summary .............................................................................................................................. 4 

1 Introduction ......................................................................................................................................... 9 

2 The workplace as a supportive setting for mental health ............................................................ 10 
2.1  Workplace mental health policy to support workers to continue working or return to work .... 11 

2.2  Addressing mental health-related stigma ............................................................................... 11 

2.3  Legislation ............................................................................................................................... 12 

2.4  Work accommodations ........................................................................................................... 13 

2.5  Inclusive workplaces ............................................................................................................... 14 

3 Aims and methods of the present project ..................................................................................... 14 
3.1  Aims and objectives ................................................................................................................ 14 

3.2  Analytic methods ..................................................................................................................... 15 

4 Results ............................................................................................................................................... 15 
4.1  Workplace policies and practices supporting mental health in general .................................. 16 

4.2  Workplace policies and practices targeted to specific mental health conditions .................... 18 

4.3  Return-to-work programmes ................................................................................................... 22 

4.4  Work accommodations ........................................................................................................... 22 

4.5  Practical tools and guides ....................................................................................................... 22 

4.6  Support for SMEs .................................................................................................................... 23 

5 Concluding remarks and policy pointers ....................................................................................... 24 

6 References ........................................................................................................................................ 28 

Appendices .......................................................................................................................................... 36 

Appendix A – Resources for workplace practices .......................................................................... 36 

Appendix B – A list of work accommodations retrieved from a scientific literature review ............ 71 

List of Tables and Boxes 
Table 1: Policies and practices to support vulnerable groups in the workplace……………………… 16 

Table 2: Three principles of work capacity management in the workplace, applied to SMEs………. 23 

Table A1: Resources for workplace practices ....................................................................................... 36 

Table B1: List of work accommodations ................................................................................................ 71 

Box 1: Elements of a comprehensive workplace mental health policy ................................................. 11 
Box 2: Policy pointers ............................................................................................................................ 26 

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A review of good workplace practices to support individuals experiencing mental health problems 

Executive Summary 

Introduction 

Mental health conditions are a leading cause of disability in high-income countries, and in Europe, more 
than 125 million people live with a mental health condition.1  

The EU has now elevated mental health alongside somatic diseases to among its first priorities. In 2023, 
the European Commission adopted a new, comprehensive, multi-stakeholder approach to mental health, 
which is prevention-oriented and aims to tackle the mental health challenges in Europe,2 while in 2022 
the European Commission set out actions on return-to-work and work accommodations in its Disability 
Employment Package.3 

There is a particular focus in the ‘Comprehensive approach to mental health’ on psychosocial risks at 
work and supporting people with mental health conditions to continue working and when returning to 
work after a period of sickness absence, as acknowledged also in the ‘EU strategic framework on health 
and safety at work 2021-2027’.4 European Agency for Safety and Health at Work (EU-OSHA) activities 
contributing to this comprehensive approach include this report and a resource for workplaces based 
on the findings5. The overarching aim was to find and share good practices for workplaces on how to 
support individuals who experience a mental health issue, to stay in work or successfully return to work 
following sickness absence. 

Key concepts and methods of support 

A  mental  health  policy  in  the  workplace  is  a  comprehensive  approach  for  addressing  mental  health 
issues in the workplace. It defines the workplace’s vision on what procedures and practices will be used 
to prevent mental health problems. The overall goal is to promote good mental health, take preventive 
action to remove psychosocial risks for all workers, support workers to deal with work stress, encourage 
early intervention for any work stress or mental health problem, and support workers who have a mental 
health problem — including by making reasonable adjustments to enable people with a mental health 
problem to work and providing effective rehabilitation and return-to-work plans. 

Return to work is a concept that involves all procedures and initiatives that aim to facilitate the workplace 
reintegration of individuals with a reduced work capacity.6 A return-to-work programme can be part of a 
disability management programme, which is further integrated into a wider safety and (mental) health 
policy. 

This  report  builds  on  previous  work  on  psychosocial  risks  at  work,7,8 which  have  been  found  to  be 
associated  with  mental  health  problems  among  workers.  Psychosocial  risks  include,  for  example, 
excessive workloads, conflicting demands and lack of clarity, lack of involvement in decisions that affect 
the worker, lack of influence on the way the job is done, poorly managed organisational change, job 

1  WHO  (2023)  The  Pan-European  Mental  Health  Coalition.  https://www.who.int/europe/initiatives/the-pan-european-mental-

health-coalition  

2 Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee 
(2023)  298. 

the  Regions  on  A  Comprehensive  Approach 

to  Mental  Health  COM 

and 
https://health.ec.europa.eu/system/files/2023-06/com_2023_298_1_act_en.pdf 

the  Committee  of 

3 See: https://ec.europa.eu/social/main.jsp?catId=1597&langId=en  
4 Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee 
and the Committee of the Regions: EU strategic framework on health and safety at work 2021-2027 Occupational safety and 
health in a changing world of work COM (2021) 323. eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52021DC0323  

5  EU-OSHA – European Agency for Safety and Health at Work, Guidance for workplaces on how to support individuals 

experiencing mental health problems, 2024. Available at: 
https://osha.europa.eu/en/user/login?destination=/en/publications/guidance-workplaces-how-support-individuals-experiencing-
mental-health-problems  

6 EU-OSHA  – European  Agency  for  Safety  and  Health  at  Work,  Rehabilitation  and  return  to work:  Analysis  report  on EU  and 
Member States policies, strategies and programmes, 2016. Available at: https://osha.europa.eu/en/publications/rehabilitation-
and-return-work-analysis-report-eu-and-member-states-policies-strategies  

7 EU-OSHA  –  European  Agency  for  Safety  and  Health  at  Work,  Psychosocial  risks  and  mental  health,  2023.  Available  at: 

https://osha.europa.eu/en/themes/psychosocial-risks-and-mental-health  

8 EU-OSHA – European Agency for Safety and Health at Work, Return to work after MSD-related sick leave in the context of 
psychosocial risks at work, 2021. Available at: https://osha.europa.eu/en/publications/return-work-after-msd-related-sick-leave-
context-psychosocial-risks-work  

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A review of good workplace practices to support individuals experiencing mental health problems 

insecurity,  ineffective  communication,  lack  of  support  from  management  or  colleagues,  psychosocial 
and  sexual  harassment,  and  third-party  violence.  When  supporting  a  worker  to  continue  working  or 
return  to  work,  it  is  highly  important  that  psychosocial  risks  are  assessed  and  their  adverse  effects 
minimised. 

Mental health-related stigma refers to negative attitudes, beliefs and stereotypes about mental health 
issues,  which  lead  to  discrimination  of  people  who  experience  mental  health  conditions.  Typical 
stigmatised characteristics  are gender, race,  socioeconomic status, disability and health.  Addressing 
mental  health-related  stigma  in  the  workplace  is  crucial  for  creating  a  supportive  and  inclusive  work 
environment,  as  stigma  and  its  consequences  may  become  severe  barriers  to  safely  disclose  one’s 
mental  health  condition  and  to  have  work  accommodations  needed  to  continue  working  or  return  to 
work.9 For employers, it is important to create an atmosphere in the workplace that promotes inclusion, 
diversity, equal treatment and non-discrimination. They can signal their commitment by ensuring that 
necessary  resources  are  targeted  towards  mental  health  promotion  at  all  levels  and  by  providing 
resources to work accommodations for those in need. Specific education and training can be provided 
to employees and supervisors on mental health at the workplace and mental health literacy.  

Disclosing a mental health condition by an employee is necessary to implement work accommodations. 
However,  employers  should  be  aware  of  the  difficulties  around  disclosure  due  to  a  threat  of  stigma, 
which  is  real,  because  mental  health  conditions  are  among  the  most  stigmatised  conditions  in  the 
workplace.  In  the  OSH  Pulse  survey,  50%  of  respondents  answered  that  they  thought  disclosing  a 
mental health condition would have a negative impact on their career.10 Training managers for creating 
a  supportive  workplace  climate,  recognising  an  individual’s  uniqueness  in  their  needs,  and  open 
dialogue (e.g. leaders speaking openly about their own mental health challenges) are important aspects 
when encouraging employees to disclose a mental health condition. 

Work (or job) accommodations refer to modifications of job or work environment to fit an individual’s 
work ability so that they can perform their job duties. Work accommodations are categorised into four 
broad  groups:  scheduling  accommodations  (e.g.  reduced  working  hours,  changes  in  the  shift  work 
schedule); job description modifications (e.g. modified tasks, change to a different position); physical 
space  accommodations  (e.g.  access  to  a  private  area,  reduction  of  noise);  and  communication 
facilitation (e.g. added supervision, a co-worker ‘buddy’, written instructions). Some accommodations 
may only be needed on a temporary basis, such as reduced hours as part of a gradual return to work. 
The advantages of work accommodations include the possibility for a worker to work while recovering 
from a mental health problem or to manage a long-term mental health problem while continuing to work. 
For employers, the accommodation policy may be beneficial by being a low-cost solution, decreasing 
turnover rates, reducing  long-term sickness absenteeism, and creating a  mentally healthy workplace 
with a culture of mental health awareness and commitment to good mental health policy in the workplace.  

Aims and methods  

The  overarching  aim  of  this  report  was  to  provide  information  to  produce  a  practical  resource  on 
workplace  support  for  workers  experiencing  mental  health  problems.  Existing  guidance  and 
recommendations  on  workplace  support  for  workers  experiencing  mental  health  problems  to  stay  at 
work or successfully return to work following sickness absence were identified. Advice for micro and 
small enterprises (MSEs) was also identified.  

Some  of  the  mental  health  conditions  covered  are  purely  work-related,  for  example,  occupational 
burnout and work stress, some of them can be either work-related or non-work-related, for example, 
sleep problems,  depression, post-traumatic  stress  disorder,  and some  of them  are mainly  non-work-
related  in  nature  (e.g.  schizophrenia,  bipolar  disorder).  In  addition,  some  conditions  are  based  on 
medical diagnoses whereas others represent symptomatology that does not necessarily involve medical 
diagnoses, such as sleep problems and cognitive problems.  We used reliable sources of information 
from  ‘grey  literature’,  patient  support  organisations  and  disability  organisations,  the  websites  of 
occupational safety and health national and intermediary organisations, employers and trade unions, 

9 WHO (2022). Guidelines on mental health at work. https://www.who.int/publications/i/item/9789240053052  
10 EU-OSHA – European Agency for Safety and Health at Work, OSH Pulse - Occupational safety and health in post-pandemic 
workplaces,  2022.  Available  at:  https://osha.europa.eu/en/publications/osh-pulse-occupational-safety-and-health-post-
pandemic-workplaces 

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A review of good workplace practices to support individuals experiencing mental health problems 

rehabilitation/return-to-work  organisations,  and  relevant  institutions  such  as  EU-OSHA,  Eurofound, 
WHO,  the  ILO  and  the  OECD.  We  completed  the  searches  with  peer-reviewed  international  articles 
based on scientific databases (PubMed and Cochrane Database of Systematic Reviews). 

Results 

The  review  found  a  total  of  278  relevant  documents,  and  of  these,  113  were  scientific  studies  or 
policy/practice documents and 165 were websites. The review found several review articles and reports 
in which the information on workplace policies and practices was systematically collected and reviewed. 
Sections 4.1 to 4.4 cover scientific literature-based knowledge on interventions and good practices to 
support individuals with mental health conditions to stay in employment or return to work after a period 
of disability. Section 4.5 and Appendix A cover informative websites, practical guides and tools that have 
been developed in different countries, Appendix A contains a brief summary of these resources, with 
web links, and section 4.6 provides guidance for SMEs. Chapter 5, concluding remarks, includes some 
policy pointers. A list of different types of work accommodations retrieved from the scientific literature is 
provided in Appendix B. 

Guidance for the workplace 

The  workplace  is  an  important  arena  for  mental  health  promotion  and  there  are  various  ways  to 
implement  support  and  become  an  inclusive  workplace.  Good  practices  found  in  this  report  are 
applicable  to  mental  health  issues  irrespective  of  their  origin;  more  than  the  type  of  mental  health 
condition,  workers’  unique  needs, capabilities and job demands determine which types  of  workplace 
practices are helpful in supporting mental health and capacity for work. 

As mentioned above, and in line with previous reports on work-related stress,11 mental health issues 
are highly stigmatised. Therefore, the most important starting point is the willingness and commitment 
of  the  employer  to  raise  awareness  of  mental  health  issues,  address  stigma,  train  supervisors  and 
workers to talk about and address mental health issues, and, eventually, develop an open, inclusive and 
non-discriminative workplace.  

The findings of this report are also in line with a previous article that suggested that interventions that 
are not only targeted to the individual but also include, for example, active support from the supervisor, 
contact with the workplace and early gradual return to work, can be effective in returning to work after 
sickness absence due to common mental health conditions.12 We add to this evidence the component 
of work accommodations by providing a catalogue of mental health conditions and a comprehensive list 
of  possible  work  accommodations  that  can  be  applied  in  the  workplaces.  In  practice,  many 
accommodations are simple and inexpensive.  

The findings of this report suggest that irrespective of the mental health condition, the following principles 
apply when supporting workers to stay in work or return to work after an episode of sickness absence: 

▪  a  culture  of  awareness  and  inclusion  enabling  disclosure  of  the  mental  health  condition  and 

developing a sense of psychologically safe workplaces; 
▪  acceptance and support from co-workers and supervisors; 
▪  early intervention, i.e. contact with the worker at an early phase of the sickness absence; 
▪  established mental health and return-to-work policy, i.e. there are steps to take that are tailored 

to each case; 

▪  good access to health services, professional multidisciplinary support; 
▪  work accommodations, based on an analysis of work tasks in relation to the  worker’s current 

work capacity; and 
follow-up of progress. 

▪ 

11 EU-OSHA – European Agency for Safety and Health at Work, Safer and healthier work at any ages: Final overall analysis report, 

2016. Available at: https://osha.europa.eu/en/publications/safer-and-healthier-work-any-age-final-overall-analysis-report  

12 EU-OSHA – European Agency for Safety and Health at Work, Return to Work after sick leave due to mental health problems, 

2020. Available at: https://oshwiki.osha.europa.eu/en/themes/return-work-after-sick-leave-due-mental-health-problems 

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In  addition,  supported  employment  initiatives,  with  vocational,  educational  and  clinical  support,  have 
been found to be effective in enabling individuals experiencing severe mental health conditions to find 
a job and remain in employment.13  

The following steps can be followed to apply work accommodations: 

1.  Prevent and manage work-related psychosocial risk factors and promote health and wellbeing. 
2.  Ensure workers are encouraged to report psychosocial risk factors at work and that this leads 
to  early  intervention  at  the  workplace  to  address  work-related  factors  and  workers  being 
encouraged to seek treatment.  

3.  Some  information  about  the  worker’s  health  and  functional  status  is  needed  to  compare  the 
worker’s current work capacity with the demands of the current job. For this, consent from the 
employee  and  collaboration  between  the  employee,  employer  and  health  professionals  is 
essential. 

4.  Psychological job analysis: a description of the essential tasks and demands of the current job 
is  important  to  compare  whether  there  is  a  mismatch  between  current  job  demands  and  the 
worker’s work capacity. 

5.  For work accommodations, it is important to identify job practices and factors in the psychosocial 

and physical work environment that are modifiable. 

6.  Follow-up: develop a holistic plan  that includes all important aspects of support  at follow-up; 
work  accommodations,  therapeutic  and  medical  support,  self-management  and  relapse 
prevention. Evaluate each support factor and make changes when needed. 

Few good practices and tools developed for the needs of SMEs regarding mental health issues were 
found.  For  them,  access  to  multidisciplinary  external  support  services  is  needed  and  healthcare 
treatments should include return to work as a treatment goal. Given the stigma around mental health 
and  the  lack  of  awareness  of  how  to  act,  giving  support  and  tools  for  workplaces  to  support  worker 
mental health is even more important than for other, physical health conditions. In this way, it is possible 
to have coverage of good practices for all workers, irrespective of where they work.  

Finally, it is important to note that the more a workplace is inclusive and takes account of diversity, the 
less  need  there  will  be  for  individual  accommodations  and  the  stigma  involved  in  asking  for  them. 
Focusing on preventing risks at source, incorporating adaptability and promoting wellbeing is also part 
of making a workplace inclusive. Having specific policies for all workers and flexible work arrangements, 
such as adaptable working hours and teleworking, can support continued working while experiencing a 
mental health problem or other health conditions.   

Policy pointers 

Key takeaways for policymakers and decision-makers include: 

▪ 

Interventions to support individuals should be implemented within the context of organisational 
interventions that address psychosocial risks factors for all workers. 

▪  Regarding  return  to  work  and  workplace  support,  the  same  approach  should  be  applied  to 

mental health problems as is taken with physical health conditions. 

▪  More needs to  be done  to  raise awareness of  mental health  in the workplace and to  reduce 

stigma. 

▪  All employers and their workers, especially MSEs, would benefit from access to multidisciplinary 
return-to-work  services.  The  self-employed  also  need  access  to  services.  Examples  and 
experiences  of  good  practices  regarding  multidisciplinary  support  programmes  should  be 
shared. 

▪  Return to work should focus on an individual’s capabilities not their disabilities. 
▪  National sickness insurance and benefit schemes should allow a gradual return to work. 
▪  Employment  should  be  part  of  all  healthcare  policies  on  mental  health:  health  practitioners 
should have return-to-work as a treatment objective for patients with mental health problems 
and therapies, such as cognitive behavioural therapy, should be work focused. 

13 WHO & ILO (2022). Mental health at work: policy brief. https://www.who.int/publications/i/item/9789240057944 

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▪  Workers may often have a physical and a mental health condition. These physical and mental 

health conditions need to be addressed together within a work-focused approach. 

▪  Social partners should incorporate the issue of integration and retention of workers with chronic 

disease into social dialogue at all levels14.  

▪  Social partners should engage in policies for return-to-work at the workplaces. 
▪  More evidence-based tools and resources need developing, including ones tailored to different 
sectors, and including how to support workers with episodic conditions (where the person has 
periods of wellness and short periods of being unwell). 

14  Eurofound,  How  to  respond  to  chronic  health  problems  in  the  workplace?  Publications  Office  of  the  European  Union, 
Luxembourg,  2019.  Available  at:  https://www.eurofound.europa.eu/en/publications/2019/how-respond-chronic-health-
problems-workplace 

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1  Introduction 
In Europe, the proportion of people with sickness absence due to illness or disability within a year rose 
from 3.6 to 5.2 million (by 44%) between 2006 and 2020 (Antczak & Miszczynska, 2021), and in 2019, 
more than 125 million people lived with a mental health condition  (WHO, 2023). Mental health issues 
do not only increase personal suffering and decrease quality of life, they also have substantial financial 
implications, with the total costs being more than 4% of GDP in Europe (European Commission, 2018). 
The  global  COVID-19  pandemic,  Russia’s  war  against  Ukraine  (e.g.  Eurofound,  2024),  energy  and 
climate crises, inflation and the increase in interest rates have further increased mental ill health globally. 
For example, 44% of EU workers responding to a European Agency for Safety and Health at Work (EU-
OSHA) survey (OSH Pulse) replied that their work stress had increased as a result of the COVID-19 
pandemic  (EU-OSHA,  2022a),  and  a  number  of  Eurofound  reports  underline  the  impact  that  the 
pandemic had on mental health (Eurofound, 2020, 2022; Eurofound  et al., 2021). These crises have 
also affected the labour market, with increasing turbulence, insecurity and unemployment. The crises 
have proportionally affected young people, as a recent health report revealed that the share of young 
people  who  report  depressive  symptoms  has  more  than  doubled  in  several  EU  countries  (European 
Commission, 2022).  

Work can also impact mental health. According to the findings of the EU  Labour Force Survey (LFS) 
ad hoc module 2020 (Eurostat, 2021), ‘stress, depression or anxiety’ are the second most common type 
of  work-related  health  problems.  The  proportion  of  workers  who  reported  facing  risk  factors  for  their 
mental wellbeing at work was nearly 45%.  According to another survey, work intensity has remained 
high over the years (Eurofound, 2019a) and an increased prevalence of high work intensity (reported by 
four in 10 workers) was seen in the European Working Conditions Telephone Survey (EWCTS) in 2021 
(Eurofound,  2023).  The  European  OSH  Pulse  survey  conducted  by  EU-OSHA shows  that  27%  of 
workers experience stress, anxiety or depression caused or made worse by work (EU-OSHA, 2022a). 
Just as they have for physical risks, employers have a duty to assess factors that could cause work-
related  stress  (psychosocial  risk  factors)  and  prevent  the  respective  risks.  While  according  to  EU-
OSHA’s third  European Survey of Enterprises on New and  Emerging Risks (ESENER) conducted in 
2019,  only  a  third  of  organisations  had  action  plans  to  prevent  work-related  psychosocial  risks  (EU-
OSHA, 2020b). 

Although mental health has been acknowledged for a long time, the EU has now elevated mental health 
alongside  somatic  diseases  to  among  its  first  priorities.  In  2023,  the  Commission  adopted  a  new, 
comprehensive, multi-stakeholder approach to mental health, which is prevention-oriented and aims to 
tackle the mental health challenges in Europe (European Commission, 2023). There is a particular focus 
on psychosocial risks at work and supporting people experiencing mental health problems to continue 
working and when returning to work after a period of sickness absence, as acknowledged also in the 
‘EU strategic framework on health and safety at work 2021-2027’ (European Commission, 2021a). This 
report  contributes  to  this  comprehensive  approach.  It  also  supports  the  aims  of  the  Commission’s 
Strategy for the Rights of Persons with Disabilities (2021-2030) (European Commission, 2021b) and the 
related Disability Employment Package.15 

Considerable  stigma  and  discrimination  surround  mental  health  problems  at  work.  However,  many 
individuals with mental health problems can continue to work or successfully return to work if they are 
provided with the right support and work accommodations. Employers need guidance on how to provide 
this support.  

This report was carried out to provide background information that was used to compile a resource for 
employers to help them provide such support16.  

15 See: https://ec.europa.eu/social/main.jsp?catId=1597&langId=en  
16 EU-OSHA – European Agency for Safety and Health at Work, Guidance for workplaces on how to support individuals 

experiencing mental health problems, 2024. Available at: 
https://osha.europa.eu/en/user/login?destination=/en/publications/guidance-workplaces-how-support-individuals-experiencing-
mental-health-problems  

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2  The workplace as a supportive setting for mental health 
Although being employed is associated with better mental health than being unemployed (Milner et al., 
2013), psychosocial risks at work are increasingly recognised as a major issue in occupational health 
as  the  above  listed  figures  indicate.  Many  epidemiological  studies  have  examined  the  relationship 
between psychosocial risks at work and the onset of sickness absence due to mental health problems 
(Duchaine et al., 2020), however, less is known about good practices to help individuals with mental 
health conditions stay at work or successfully return to work after a period of sickness absence. A few 
reviews have collected scientific evidence on this issue (Cullen et al., 2018; Nieuwenhuijsen et al., 2020; 
Salomonsson  et  al.,  2018;  Williams-Whitt  et  al.,  2015).  A  comprehensive  review  is  lacking  about 
practical solutions that workplaces apply when, for example, making work accommodations, as well as 
real examples of individual experiences and company practices. Nevertheless, from the experiences of 
many organisations offering practical advice and support, including patient support groups and national 
return-to-work support programmes, it is possible to see common opinions of what kinds of support can 
work in practice.  

This report builds on previous activities of EU-OSHA (EU-OSHA, 2023a) and other authorities. Previous 
EU-OSHA  projects  have  highlighted  that  stress  is  a  common  phenomenon  in  European  workplaces, 
although often misunderstood and stigmatised (e.g. EU-OSHA, 2022d). Focusing on workplaces rather 
than individuals would make psychosocial risks more manageable and further disabilities preventable. 
Psychosocial  risks  include  excessive  workloads,  conflicting  demands  and  lack  of  clarity,  lack  of 
involvement  in  decisions  that  affect  the  worker,  lack  of  influence  on  the  way  the  job  is  done,  poorly 
managed  organisational  change,  job  insecurity,  ineffective  communication,  lack  of  support  from 
management or colleagues, psychosocial and sexual harassment, and third-party violence (EU-OSHA, 
2023a). The overall goal is to create workplaces that promote good mental health, take preventive action 
to remove psychosocial risks for all workers, support workers to deal with work stress, encourage early 
intervention  for  any  work  stress  or  mental  health  problem,  and  support  workers  who  have  a  mental 
health problem — including by making reasonable adjustments to enable people with a mental health 
problem to work and providing effective rehabilitation and return-to-work plans. This report focuses on 
providing support for workers who experience a mental health condition. This includes both work-related 
and non-work-related conditions.  

This report also builds on previous EU-OSHA reports on sustainable working life and returning to work 
among  special  groups  of  workers,  such  as  ageing  workers,  workers  with  chronic  musculoskeletal 
disorders, cancer or mental health problems (EU-OSHA, 2016a, 2016b, 2016c, 2017a, 2021c, 2021d), 
as well as a report on workers with mental disorders in a digitalised world (EU-OSHA, 2023b). These 
analyses acknowledge that policies and practices must take account the ageing of the workforce and 
workers who need to manage chronic health conditions. An integrated approach is advocated in the EU 
countries, which means that there is a broader view on different societal and policy areas. Research 
also shows that due to improved medical treatment, most cancer survivors can continue working (EU-
OSHA, 2017a). However, cancer is associated with a substantial risk of mental health issues, such as 
depression or anxiety, and therefore it is important to have a holistic approach to rehabilitation in cancer. 
Likewise, there is a strong psychological component in chronic musculoskeletal disorders (EU-OSHA, 
2021c, 2021d). Research has also shown that return to work after sickness absence due to common 
mental health conditions can be enhanced by interventions that are targeted to the individual, but also 
include  a  link  to  the  workplace,  for  example,  active  support  from  the  supervisor,  contact  with  the 
workplace and early gradual return to work (EU-OSHA, 2020b).  

A  report  on  musculoskeletal  disorders  identified  the  following  principles  of  returning  to  work  after 
sickness absence: early intervention, an established return-to-work policy in the organisation, a culture 
promoting health and good communication, incentives (e.g. quick access to interventions), awareness, 
professional  multidisciplinary  support,  social  support,  competence  building,  workplace  adjustments, 
gradual  return  to  work,  right  timing,  customisation  of  the  return-to-work  process  with  a  standard 
procedure, and reviewing  and  performance tracking  (EU-OSHA, 2021c). These  principles  apply very 
well to the management of other health conditions in the workplace, such as mental health conditions. 

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2.1  Workplace mental health policy to support workers to continue 

working or return to work 

A  mental  health  policy  in  the  workplace  is  a  comprehensive  approach  for  addressing  mental  health 
issues in the workplace. It defines the workplace’s vision on what procedures and practices will be used 
to prevent mental health problems and support employees at risk and those who already have a mental 
health condition, to stay in work or return to work after a period of absence. In addition, a good mental 
health  policy  includes  information  on  how  to  create  a  work  environment  that  facilitates  promotion  of 
mental health in the workplace.  

The key elements of a workplace mental health policy are given in Box 1. 

Box 1: Elements of a comprehensive workplace mental health policy  

A workplace mental health policy should cover: 

1.  Prevention of work-related psychosocial risk factors. 
2.  Supporting groups of workers more exposed to work-related psychosocial risk factors. 
3.  Supporting workers with a mental health problem or work-related stress. 
4.  Promoting mental health and wellbeing in the workplace. 
5.  Consulting and involving workers and their representatives over policies and actions. 

Items 1, prevention, and 5, consultation, are perquisites for the success of the other items.  

WHO  and  ILO  guidelines  recommend  three  types  of  interventions  to  support  individuals  with  mental 
health conditions at work (WHO & ILO, 2022): 

1.  Reasonable  accommodations  at  work  (defined  as  adapting  work  environments  to  fit  the 

employee’s current needs and work capacity). 

2.  Return-to-work  programmes  (programmes  that  are  designed  to  enhance  the  ability  of 
employees  to  return  to  work  and  remain  in  employment  after  a  sickness  absence  period, 
involving  a  combination  of  medical  care,  rehabilitation,  and  work-focused  interventions  and 
support).  

3.  Supported employment initiatives to enhance individuals with severe mental health problems to 

find a job and remain in employment, with vocational, educational and clinical support.  

EU-OSHA has further defined return to work as a concept  that involves all procedures and initiatives 
that aim to facilitate the workplace reintegration of individuals with a reduced work capacity (EU-OSHA, 
2016a,  2016b).  Some  organisations  integrate  the  return-to-work  programme  into  a  specific  disability 
management programme, which is further integrated into a wider safety and health policy. 

Considerable  challenges  may  arise  during  the  return-to-work  process.  Recovery  from  mental  health 
conditions  is  usually  gradual  rather  than  based  on  an  on-off  principle,  and  therefore,  some  work 
accommodations  may  be  needed  to  support  return  to  work.  Partial  sickness  absence  is  one  of  the 
flexible methods that can be used to integrate the employee back into the workplace, however not all 
Member States have a social security policy that allows this (EU-OSHA, 2021d). Unsuitable working 
conditions and excess workload can lead to a relapse and new sickness absence.  

Work  accommodations  have  been  applied  to  return  to  work  with  musculoskeletal  disorders,  but  to  a 
lesser extent in relation to mental health conditions. However, due to their high prevalence as a cause 
of work disability, these groups should both be high priorities in workplace mental health policies (EU-
OSHA, 2016b). In fact, many accommodations that can help someone continue working are simple and 
inexpensive. 

2.2  Addressing mental health-related stigma 

Mental health-related stigma refers to negative attitudes, beliefs and stereotypes about mental health 
conditions, which lead to discrimination against people with mental health conditions. According to the 
theory on stigma (Goffman, 1963), stigma is based on characteristics of an individual that other people 
perceive as socially undesirable and which bring about punitive reactions from them. Self-stigma is a 
condition where a stigmatised individual has internalised the negative attitudes and attributions as part 

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of their identity. Typical stigmatised characteristics are gender, race, socioeconomic status, disability 
and health. These negative attitudes, beliefs and misconceptions are common in the workplace, too. It 
is often believed that mental health problems are a sign of weakness or flaws, or that people with mental 
health problems are unpredictable, violent or dangerous (EU-OSHA, 2023b). However, they are more 
likely  to  be  victims  than  perpetrators  of  violence.  Many  people  also  believe  that  it  is  not  possible  to 
recover from a mental health problem.  

Addressing  mental  health-related  stigma  in  the  workplace  is  crucial  for  creating  a  supportive  and 
inclusive  work  environment,  as  stigma  and  its  consequences  may  become  severe  barriers  to  safely 
disclosing  one’s  mental  health  condition  and  to  having  work  accommodations  needed  to  continue 
working or return to work from a period of sickness absence (WHO, 2022). However, 37% of workers 
would not feel comfortable speaking to their manager or supervisor about their mental health and 50% 
of workers think that disclosing a mental health condition would have a negative impact on their career. 
Source: OSH Pulse 2022 (EU-OSHA, 2022a). 

For employers, it is important to create an atmosphere in the workplace that promotes inclusion, diversity, 
equal treatment and non-discrimination. They can signal their commitment by ensuring that necessary 
resources  are  targeted  towards  mental  health  promotion  at  all  levels  and  by  providing  resources  for 
work accommodations for those in need. Specific education and training can be provided to  workers 
and supervisors on mental health at the workplace and mental health literacy. There should be zero 
tolerance for all forms of discrimination in the workplace and a safe environment for discussion about 
topics that might be perceived as difficult or sensitive. Everyone in the workplace should have an insight 
into their own attitudes towards mental health issues and how they react to other people. Key principles 
when addressing mental health-related stigma in the workplace are dignity and respect towards other 
people.  

2.3  Legislation 

The basic principle of all occupational safety and health (OSH) legislations is that work should not cause 
injury or ill health or make existing conditions worse. The OSH Framework Directive (89/391/EEC)17 laid 
the  foundations  for  employers’  obligation  to  evaluate  the  safety  and  health  risks  of  workers, 
environmental,  physical  and  psychosocial,  and  to  implement  protective  measures.  The  priority  is  to 
eliminate risks at source and take collective measures to make work safer and healthier for all workers. 
This is important, as measures to make work easier for all workers could enable someone with a chronic 
health  condition  to  continue  working.  Particularly  sensitive  groups,  such  as  workers  with  chronic 
conditions, must be protected against hazards that specifically affect them.  

Under  the  EU  directive  on  equal  treatment  at  work, 18 employers  have  a  responsibility  to  arrange 
reasonable  work  accommodations  for  employees  with  disabilities.  These  may  include  adapting  the 
physical work environment, working time, the distribution of tasks, or the provision of training and other 
resources. However, the requirement depends on a Member State’s definition of disability, not on an 
individual’s health status.  

Some countries have more detailed requirements, including regarding return to work following sick leave 
and provide specific support programmes.  

A work accommodation is reasonable when it is not too costly, disruptive or difficult to implement for the 
employer. In practice, many accommodations are simple and inexpensive.  

According to the EU-OSHA reports on ageing and work life (EU-OSHA, 2016a, 2016b), all EU Member 
States  provided  some  form  of  rehabilitation  to  people  with  disabilities  or  permanent  work  incapacity 
although there were notable differences in the level of support provided. Some countries have adopted 
a  positive  approach  by  moving  from  the  concept  of  disability  to  remaining  capacity  for  work.  All  EU 
Member States have rules on the management of sickness absence.  

17 Council Directive 89/391/EEC: https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=celex%3A31989L0391 
18 Directive 2000/78/EC – Equal treatment: https://osha.europa.eu/en/legislation/directives/council-directive-2000-78-ec  

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Practice tip – Inclusive workplaces minimise the need for accommodations 

Making workplaces more inclusive for all workers, taking account of diversity, and providing flexibility 
and  adjustability,  for  example,  when  buying  equipment,  planning  tasks,  workspaces  and  working 
hours, reduces the need to make adjustments for individuals. 

2.4  Work accommodations 

2.4.1  Disclosing a mental health condition 

A  mental  health  condition  is  invisible  unless  the  person  reveals  it  to  other  people.  Disclosure  of  the 
mental health condition to some degree is necessary to receive work accommodations. However, this 
might be difficult, as there is always a threat of stigma, which is real, because mental health conditions 
are among the most stigmatised conditions in the workplace (Bonaccio et al., 2019; EU-OSHA, 2023b). 
In the OSH Pulse survey, 50% of respondents answered that they thought disclosing a mental health 
condition  would  have  a  negative  impact  on  their  career  (EU-OSHA,  2022a).  Individuals  may  be 
concerned about confidentiality as well as unfair treatment. 

There are several ways to encourage disclosure of a mental health condition in the workplace. First, 
abandoning a dichotomous view of disclosure (yes-no) can be beneficial. This means that the person 
can choose how much information they reveal and to whom it will be revealed in the workplace (Brohan 
et al., 2012). The second important aspect is workplace climate — whether it is open, inclusive and non-
discriminative. In addition, managers in the workplace should understand that a supporting workplace 
climate involves recognising an individual’s uniqueness in their needs. Therefore, a simple one-size-fits-
all procedure is not enough (Bonaccio et al., 2019). 

Practice tip – Open conversations 

A  worker’s  needs  will  become  clearer  through  good  communication.  A  conversation  between  an 
individual and their manager about a health condition could cover the following: 

the condition; 
the symptoms experienced; 
if the symptoms vary, how they feel on a good or bad day; 
the effects of medication; 

▪ 
▪ 
▪ 
▪ 
▪  what tasks or factors in the work environment they find challenging and need help with; and 
▪  what support they need or might need to do their job now and in the future. 

A voluntary approach leads to the best conversation and cooperation.  

Note:  workers  are  not  obliged  to  disclose  a  medical  diagnosis,  and  confidentiality  must  be 
guaranteed  under  data  protection  legislation.  They  should  not  experience  any  negative 
consequences because of disclosure. 

Source: EU-OSHA (2021d) 

2.4.2  Implementing work accommodations 

Work (or job) accommodations refer to modifications of the job or work environment to fit an individual’s 
work ability so that they can perform their job duties. Work accommodations are categorised into three 
broad groups (Zafar et al., 2019):  

▪ 

scheduling accommodations (e.g. reduced working hours, changes in the shift work schedule), 
job description modifications (e.g. modified tasks, change to a different position); 

▪  physical space accommodations (e.g. access to a private area, reduction of noise); and 
▪ 

communication facilitation (e.g. added supervision, a co-worker ‘buddy’, written instructions). 

Some accommodations may only be needed on a temporary basis, such as reduced hours as part of a 
gradual return to work.  

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Recent WHO guidelines on mental health at work were based on a review of scientific evidence. The 
authors  concluded  that  reasonable  work  accommodations  should  be  implemented  for  workers  with 
mental health conditions, including psychosocial disabilities, even though the few conducted intervention 
studies on their effectiveness were evaluated as providing low-certainty evidence (WHO, 2022).  

The advantages of work accommodations include the possibility for a worker to work while recovering 
from  a  mental  health  condition  or  maintaining  it.  Work  accommodations  can  be  either  temporary  or 
permanent  because  the  course  of  the  condition  may  vary  between  individuals.  For  employers,  the 
accommodation  policy  may  be  beneficial  by  being  a  low-cost  solution,  decreasing  turnover  rates, 
reducing long-term sickness absenteeism, and creating a mentally healthy workplace with a culture of 
mental health awareness and commitment to good mental health policy in the workplace.  

Supportive workplace accommodations are more likely in workplaces where individuals feel they can 
voice their concerns and where they experience high levels of support from managers and colleagues 
(EU-OSHA, 2021d; Eurofound, 2014, 2019b). 

Practice tip – Early disclosure 

The earlier a mental health problem is reported, the easier it is to deal with; an employer cannot 
take action if they are not aware of the issue. This means encouraging and enabling  workers to 
disclose health  problems as soon as they arise, assuring them that they will be  listened to and 
supported. If someone has a persistent mental health problem that affects their work, they should 
be  encouraged  to  seek  medical  advice  as  soon  as  possible.  Medical  advice,  if  shared  with 
permission,  can  help  the  employer  to  understand  what  support  the  worker  needs  (EU-OSHA, 
2021d). 

2.5  Inclusive workplaces 

Inclusion  at  work  means  having  an  environment  where  all  people  feel  welcomed,  heard,  respected, 
supported, valued and able to reach their full potential (HSE, 2023). The more inclusive workplaces are 
for  the  needs  of  a  diverse  workforce,  the  less  likely  individual  accommodations  will  be  needed  for 
individuals, for example by providing options for flexible working hours or teleworking for all workers. 
The  starting  point  to  support  inclusion,  including  persons  with  disabilities,  such  as  mental  health 
conditions,  is  management’s  commitment,  which  should  be  clearly  stated  and  communicated  (EU-
OSHA,  2021d).  Workplace  inclusivity  should  be  visible  in  all  policies  and  activities,  ranging  from 
recruitment to performance management and job redesign, and, finally, to monitoring the current state 
and progress of policies and practice (see Table 1). 

3  Aims and methods of the present project 

3.1  Aims and objectives 

The  overarching  aim  of  this  report  was  to  identify  practical  information  to  produce  a  comprehensive 
report on workplace support practices for workers with different types of  non-work-related  and work-
related mental health problems. We identified  existing guidance and recommendations on workplace 
support for workers with mental health problems to stay at work or successfully return to work following 
sickness absence. This information was compiled into a separate report. We also included advice to 
micro and small enterprises (MSEs) in the latter report.  

The review addressed the following specific objectives: 

▪  To identify information to be used to compile a catalogue of good practices and guidance on the 
steps that can be taken to provide support in the workplace regarding the most common mental 
health conditions covering a) non-work-related conditions, and b) work-related stress/work-related 
mental health conditions, in particular: 

o 

o 

to identify practical information on workplace accommodations and support for individuals 
with different types of work-related or non-work-related mental health conditions to stay at 
work or successfully return to work following sickness absence; and 
to identify real examples of individual experiences and organisational policies and practices. 

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▪  To provide guidance and workplace examples on the additional steps needed. 

Some of the mental health conditions are purely work-related, for example, occupational burnout and 
stress  from  work,  some  of  them  can  be  either  work-related  or  non-work-related,  for  example,  sleep 
problems,  depression  and  post-traumatic  stress  disorder,  and  some  of  them  are  mainly  non-work-
related in nature (e.g. schizophrenia, bipolar disorder). In addition, some of the analysed conditions are 
based  on  medical  diagnoses  whereas  others  represent  symptomatology  that  does  not  necessarily 
involve  medical  diagnoses,  such  as  work-related  stress.  Sleep  disorders  and  comorbid  pain  were 
included because individuals experiencing mental health problems may also need support to manage 
them.  Work  accommodations  for  cognitive  problems  were  also  covered,  because  mild  cognitive 
symptoms may be experienced by individuals experiencing a mental health disorder or sleep problems. 

3.2  Analytic methods 

The review used reliable sources of information from ‘grey literature’ (e.g. Overton and OpenGrey), and 
for  example,  from  patient  support  organisations  and  disability  organisations,  the  websites  of  OSH 
national  and  intermediary  organisations,  employers  and  trade  unions,  rehabilitation/return-to-work 
organisations, and relevant institutions such as EU-OSHA, Eurofound, WHO, the ILO and the OECD. 
Google was used as the main search engine to find these databases. We completed the searches with 
peer-reviewed international articles based on scientific databases (PubMed and Cochrane Database of 
Systematic Reviews).  

The literature was analysed from several viewpoints: 

▪  Support  from  the  workplace:  good  practices  emerging  from  the  literature  and  company  / 
individual  examples  may  include  job  accommodations  and  adjustments,  working  hour 
arrangements, reorganising tasks, partial sickness absence arrangements, shared work tasks, 
and support from managers and co-workers.  

▪  Support  from  OSH  services:  good  policies  and  practices  may  include  assessment  of 
psychosocial  risks  at  work  and  identification  of  vulnerable  groups,  recommendation  of  job 
accommodations,  graded  support  for  workers  on  sickness  absence  due  to  mental  health 
problems, collaboration with employers and employees in every step and level of prevention, 
and providing tools for support. 

▪  Contextual  factors:  these  include  national-level  good  policies  and  practices,  for  example, 

legislation on partial sickness absence and disability retirement policies.  

Good practices may vary depending on the condition of the  worker and the level of prevention; early 
identification requires different support and management practices than those for prevention of recurrent 
sickness absence, support of return to work after a long-term absence period or suicide prevention. In 
the present project, we focused on support to employees experiencing a mental health condition, thus, 
we did not consider general workplace wellness programmes. 

4  Results 
The  review  found  a  total  of  278  relevant  documents,  and  of  these,  113  were  scientific  studies  or 
policy/practice documents and 165 were websites. The review found several review articles and reports 
in which the information on workplace policies and practices was systematically collected and reviewed. 

Sections 4.1 to 4.4 cover scientific literature-based knowledge on interventions and good practices to 
support individuals with mental health conditions to stay in employment or return to work after a period 
of disability. Sections 4.5 and Appendix A cover informative websites, practical guides and tools that 
have been developed in different countries, Appendix A contains a brief summary of these resources, 
with web links, and section 4.6 provides guidance for SMEs. Chapter 5, concluding remarks, includes 
some  policy  pointers.  A  list  of  different  types  of  work  accommodations  retrieved  from  the  scientific 
literature is provided in Appendix B. 

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4.1  Workplace  policies  and  practices  supporting  mental  health  in 

general 

It is easiest to support individuals with mental health problems in workplaces that promote inclusion and 
that have policies and practices that support mental health.  

In a scientific review paper (Kersten et al., 2023), the concept of ‘vulnerable’ workers was introduced. 
The review included studies on employers’ perspectives of management policies and practices in the 
workplace. In addition to  persons with socioeconomically disadvantaged  positions (e.g.  persons  with 
migrant  background,  unemployed),  persons  with  disabilities,  such  as  mental  health  conditions,  are 
among the vulnerable workers. In the review, most studies focused on workers with physical disabilities. 
The review  identified seven themes from studies that concerned the employers’ perceptions of  good 
practices to support inclusion of vulnerable workers, as listed in Table 1. The key starting point is senior 
management commitment, which should be clearly stated and communicated. An inclusive workplace 
is visible in all activities, ranging from recruitment to performance management and job redesign, and, 
finally, to monitoring the current state and progress of policies and practices. 

Table 1: Policies and practices to support vulnerable groups in the workplace 

Senior 
management 
commitment 

Recruitment  
and 
 selection 

Performance 
management 
 and 
 development 
practices 

▪  Inclusion of disability in the organisation’s policies and mission statement. 
▪  Strategic plan for normalising disability. 
▪  Policy of non-discrimination and openly addressing stigma against disability. 
▪  Internal and external promotion of disability-inclusive programmes. 
▪  Involvement and commitment of (senior) management to inclusion with a vision. 

▪  Inclusive recruitment and selection strategy. 
▪  Collaboration  with  external  parties  in  recruitment,  such  as vocational  rehabilitation 

agencies. 

▪  Internship programmes for people with disabilities or participation in job fairs. 
▪  Diverse recruitment team. 
▪  Accommodations in the recruitment process (e.g. different communication format). 
▪  Open communication in the recruitment process. 

▪  Disability–human  resource  management  fit  with  disability-inclusive  (performance 

management) practices. 

▪  On-the-job training for people with disabilities. 
▪  Career advancement opportunities based on merit for people with disabilities. 
▪  Fair compensation and flexible benefits. 
▪  Regular performance reviews. 
▪  Wellness programmes and healthcare support, tailored for people with disabilities. 
▪  Inclusion of work and disability in all relevant human resources (HR) policies. 

Work 
accommodations 
and  
redesign of work 

▪  Flexible work schedules, locations and leave arrangements. 
▪  Modified or partial work duties. 
▪  Accessibility of the workplace. 
▪  Adapted furniture or equipment. 
▪  Accommodations officer and system for accommodations request. 
▪  Budget reserved for accommodations. 

Supportive culture 

▪  Inclusive culture (e.g. fairness, cooperativeness, empowerment, encouragement). 
▪  Inclusion in social opportunities and customs. 
▪  Support in socialisation. 
▪  Management support (e.g. inclusive leadership, mentoring systems). 
▪  Co-worker support (e.g. buddy systems, peer modelling, worker resource groups). 
▪  Disability (awareness) training. 

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External 
collaborations 
(excluding 
recruitment) 

Monitoring 

▪  Strategic  alliances  with  experts,  other  organisations  or  vocational  rehabilitation 

agencies. 

▪  Employer networks for inspiration and visibility. 
▪  Requirements for subcontractors or suppliers. 

▪  Annual targets for disability management and the number of people with disabilities. 
▪  Corporate analysis of costs related to disability management. 
▪  Mechanism to assess the number of people with disabilities. 
▪  Involvement of people with disabilities in decision-making. 
▪  Employee surveys aimed at feedback from minorities. 

Source: Kersten et al. (2023) 

‘What  constitutes  a  mentally  healthy  workplace?’  was  the  question  in  another  review  (Harvey  et  al., 
2014). The identified research-informed workplace strategies were similar to those reported above: 

▪  designing and managing work to minimise harm (e.g. flexible work, employee participation, anti-

bullying policies);  

▪  promoting  protective  factors  at  team  and  organisational  levels  to  maximise  resilience  (e.g. 

providing manager training, managing change effectively); 

▪  enhancing personal resilience (e.g. stress management training, coaching/mentoring); 
▪  promoting  and  facilitating  early  help-seeking  (e.g.  Employee  Assistance  Programmes, 

appropriate responses to traumatic incidences);  
supporting workers’ recovery from mental health problems (e.g. supervisor support and training, 
partial  sickness  absence,  return-to-work  programmes,  work-focused  exposure  therapy,  and 
individual  placement  and  support  methods  for  workers  with  severe  mental  health  problems); 
and 
increased awareness of mental health and stigma.  

▪ 

▪ 

To  support  a  worker  to  recover  from  a  mental  health  problem,  early  and  regular  contact  from  the 
manager during sickness absence seems to be beneficial. In this communication, the focus should be 
on  the  worker’s  wellbeing  and  a  detailed  plan  on  return  to  work  to  be  developed.  Partial  sickness 
absence is one of the flexible methods that is helpful for integrating the worker back into work. Not all 
Member States allow for this.  

Another  review  highlighted  demand-side  employment  interventions  (Bauer  &  Gewurtz,  2022). 
Traditional approaches target individuals and aim to improve individuals’ skills and work capacity to help 
them better fit into their existing job or to a wider labour market. The demand-side approach emphasises 
the  workplace  as  the  target  of  intervention.  These  interventions  modify  the  work  environment  and 
working conditions to better meet the needs of diverse workers, such as workers with physical or mental 
health conditions. A scoping review  identified six intervention studies, of which one focused on  work 
accommodations,  three  focused  on  mental  health  awareness  and/or  mental  health  knowledge  and 
communication  among  leaders,  one  focused  on  support  from  a  workplace  coach,  and  one  was  a 
comprehensive programme for health promotion. Although the interventions reported promising positive 
results, more studies are needed in this research line (Bauer & Gewurtz, 2022). 

An expert panel opinion was published by the EU on how to support mental health of health workforce 
and other essential workers in the context of the COVID-19 pandemic (European Commission, 2021b). 
The  pandemic  put  this  workforce  under  high  stress  and  mental  health  risks  in  addition  to  the  risk  of 
COVID-19  infection.  A  comprehensive  review  identified  the  following  characteristics  of  effective 
workplace interventions for workplaces in crisis: 

▪  management of basic safety needs (e.g. food, water, information); 
▪ 
▪ 
▪ 

social and societal (e.g. financial) support; 
communication and training; 
infection control (in the case of the COVID-19 crisis or other pandemics); 

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▪  workload  management,  e.g.  reducing  shift  lengths  and  workloads,  and  providing  adequate 

periods of rest and recuperation; and 

▪  personal support, for example, from the Employee Assistance Programmes (EAP). 

However, these interventions focused on all healthcare workers, and the authors noted that few studies 
had differentiated workplace support for those with pre-existing mental health conditions.  

One Mind at Work19 is a global coalition of  employers  who collaborate to implement evidence-based 
workplace  approaches  to  mental  health.  Based  on  a  variety  of  the  member  companies’  policies,  the 
following eight pillars were set as a framework for an effective mental health policy in the workplace: 

▪  Long-term commitment to continuous improvement. 
▪  Promotion of mental health through comprehensive policies, education and resources. 
▪  Elimination of stigma, social prejudice and discrimination. 
▪  Adoption  of  a  proactive  prevention  approach  by  reducing  psychosocial  risk  factors  and 

increasing protective factors. 

▪  A coordinated response, including access to mental health treatment, services, resources and 

support. 

▪  Early  and  effective  workplace 

interventions  by  performance,  absence  and  disability 

management systems that involve supportive conversations with the worker. 

▪  Utilising innovative practices, approaches and concepts, including new technologies. 
▪  Continuous evaluation of the policies and practices. 

4.2  Workplace  policies  and  practices  targeted  to  specific  mental 

health conditions 

Psychosocial risks and work-related stress and mental health problems 

Psychosocial  risks  at  work  are  a  consequence  of  problems  in  work  design,  organisation  and 
management. They may also be associated with poor social relationships at work. Psychosocial risks in 
the work environment may increase the risk of work stress, burnout, and mental health problems, such 
as  anxiety  and  depression.  Working  conditions  that  lead  to  psychosocial  risks  include,  for  example, 
excessive workload, high or conflicting job demands, poor role clarity, low possibility of decision-making, 
poor leadership, job insecurity, ineffective communication, lack of support, and psychological and sexual 
harassment and violence (EU-OSHA, 2023a). 

Within  the  frame  of  the  Healthy  Workplaces  Manage  Stress  (2014-2015)  Campaign,  a  report  was 
developed  on  good  workplace  practices  to  tackle  psychosocial  risks  (EU-OSHA,  2015),  which  is 
available in several languages. In the report, there are descriptions of good practices that were awarded 
in the campaign, for example, the case of Deutsche Post DHL Group, which implemented a new Health, 
Safety and Well-Being Strategy. The implementation included training of managers, a discussion forum 
with experts, flexible working arrangements, worker check-ups with a procedure to respond, and events 
that increased group spirit and engagement. 

At the same time an e-guide Managing stress and psychosocial risks was published (available in several 
languages,  see  Appendix  A).  It  includes  practical  examples  on  how  to  prevent  and  deal  with 
psychosocial  risks  at  work.  When  adverse  psychosocial  working  conditions  have  been  detected,  the 
following actions are recommended: 

▪  Changing  work;  work  accommodations:  for  example,  reducing  workload  or  responsibilities, 

providing support in major changes at work. 

▪  Training, decision-making and roles: ensuring that the workers have appropriate competences 

▪ 

to perform their duties and participate in decision-making, and clarifying their roles. 
Involving others and providing support: whether there are other workers involved in the stress 
situation (e.g. harassment or bullying); help and support with non-work issues. 

19 One Mind at Work: https://onemindatwork.org/  

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▪  Health promotion: regarding psychosocial risks, it is likely that the interventions will reduce but 
not completely remove all such risks; therefore, a comprehensive approach to psychosocial risk 
prevention includes overall health promotion, including a healthy lifestyle. 

A Cochrane Review on prevention  of  occupational stress in healthcare  workers  (Ruotsalainen et al., 
2015)  found  that  organisational  interventions  typically  consisted  of  changes  in  working  conditions, 
organising support, changing the availability and content of care, increasing communication skills and 
changing  work  schedules.  Keeping  in  mind  that  the  studies  were  small  in  scale,  changing  work 
schedules provided the most convincing evidence on its effectiveness to reduce stress. 

Occupational burnout 

Burnout is defined as an individual’s psychological response to chronic work stress that has not been 
successfully  managed.  There  are  three  components  identified  in  the  burnout  syndrome:  emotional 
exhaustion, cynicism, and lowered professional efficacy (EU-OSHA, 2022b; WHO, undated). According 
to  a  systematic  review  and  meta-analysis  on  the  effect  of  interventions  on  burnout  symptoms  and 
employment outcomes among workers with burnout, only four of 18 interventions included workplace or 
occupational aspects in their intervention, such as meetings with the supervisor or labour experts (Ahola 
et al., 2017). The results of these small-scale studies were mixed. Another systematic review on burnout 
interventions  (Pijpker  et  al.,  2019)  concluded  that  interventions  that  aimed  to  enhance  worker’s  job 
control  (i.e.  possibility  to  have  impact  on  decision-making  in  their  job  and  workplace),  social  support 
(e.g. positive feedback from supervisors), and reducing workload could facilitate recovery and return to 
work among workers with burnout. 

Interventions  targeted  to  prevent  burnout  in  high-risk  individuals,  such  as  those  experiencing  mental 
health problems or stress symptoms, were evaluated in a systematic review (Bagnall et al., 2016). The 
authors suggested that organisational-level interventions could be more effective in the prevention of 
burnout  than  individual-level  approaches,  such  as  psychotherapy  or  counselling.  Another  Cochrane 
Review (Naghieh et al., 2015) examined organisational interventions that aimed to reduce stress and 
improve  wellbeing  among  teachers.  The  interventions  consisted  of  redesigning  work  (e.g.  modifying 
tasks), flexible work schedules, making accommodations to the work environment, performance bonus 
pay,  improving  promotion  opportunities,  coaching  and  mentoring.  Improvements  were  observed  for 
some aspects of wellbeing, such as retention rates only, and the assessed interventions studies were 
small. 

Depression 

A  Cochrane  systematic  review  and  meta-analysis  examined  the  effectiveness  of  work-directed 
interventions  to  reduce  sickness  absence  days  and  speed  up  return  to  work  (Nieuwenhuijsen  et  al., 
2020). Work-related interventions were defined as modifying the work environment or supporting the 
individual to reach a better fit between the work capacity of a worker with depression and the workplace 
requirements, for example, by modifying work tasks or working hours, by a gradual return to work, or by 
providing  coaching  to  help  the  employee  learn  new  skills  to  cope  with  work  challenges.  The  review 
indicated  that  a  combination  of  work-directed  intervention  and  a  clinical  intervention  (psychotherapy, 
medication) may shorten the sickness absence period, reduce depressive symptoms and improve work 
capacity.  

Anxiety 

A meta-review appraised the results of existing reviews and included a wide variety of interventions at 
all three levels of mental health promotion (prevention, support for groups at risk, support for individuals 
with  a  mental  health  problem)  (Joyce  et  al.,  2016).  For  tertiary-level  interventions  (targeted  at  those 
experiencing a mental health problem), there was evidence on the effectiveness of exposure therapy 
(in  real  life  or  imaginary)  that  provided  the  employee  an  opportunity  to  gradually  deal  with  anxiety 
experiences in certain work situations. Exposure therapy is always guided by a skilled mental health 
professional. The interventions did not include other work-related aspects. 

Sleep problems 

A  systematic  review  analysed  studies  on  workplace-based  interventions  to  improve  sleep  duration 
among  shift  workers  (Robbins  et  al.,  2021).  The  most  common  interventions  were  shift  timing,  light 

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exposure (in the mornings), and education on sleep hygiene (basic principles to manage regular sleep 
rhythm). The authors concluded that these types of interventions can be beneficial for sleep among shift 
workers, especially when combined with individual-focused approaches, such as cognitive behavioural 
therapy (CBT) targeted to insomnia. 

Trauma and post-traumatic stress disorder (PTSD) 

There  are  specific  workplace  practices  to  support  workers  after  a  crisis,  disaster  or  an  event  that 
increase the risk of employees to become traumatised and develop PTSD. Occupations susceptible to 
traumatic  events  are,  for  example,  defence  forces,  security  services  (police,  fire  department,  coast 
guard), social, healthcare and retail occupations. 

There are several important principles to consider in a trauma-informed approach in the workplace: 

▪  Everyone in the workplace has a basic awareness and knowledge on trauma and its effects on 
individuals,  families  and  communities.  This  awareness  includes  also  understanding  of  how 
traumatic experiences affect people’s behaviours. 

▪  Everyone  can  recognise  signs  and  symptoms  of  trauma.  In  workplaces  where  traumatic 
experiences  are  likely  to  occur,  screening  and  assessment  may  be  beneficial  to  recognise 
symptoms of trauma. 

▪  The organisation has a procedure of how to respond to different trauma-related situations and 

events.  

▪  The organisation has the means to resist re-traumatisation among employees and customers 

(SAMHSA’s Trauma and Justice Strategic Initiative, 2014). 

Psychological First Aid (PFA) is a method recommended by  WHO, to be used  in serious crises  and 
disasters  (see  also  Appendix  A).  PFA  is  an  initial  disaster  and  crisis  response,  aiming  at  promoting 
safety,  stabilising  survivors  and  connecting  people  to  help.  PFA  is  delivered  by  mental  health 
professionals,  such  as  psychologists  or  psychiatric  nurses,  but  it  is  not  a  therapy-based  approach. 
Mental  Health  First  Aid  (MHFA)  is  an  educational  method  for  workers,  with  the  aim  to  increase 
knowledge on how to help a co-worker in crisis or in the early stages of a mental health problem (see 
Appendix A). MHFA is therefore not limited to a crisis or disaster situation. This method has, for example, 
improved mental health knowledge and reduced stigmatising attitudes among employees (Hadlaczky et 
al., 2014). This method has been successfully applied to, for example, public security workplaces.  

Severe mental health problems (including schizophrenia) 

The most convincing practice to support individuals experiencing severe mental health conditions, such 
as schizophrenia, is supported employment, a tailored intervention that helps individuals experiencing 
severe mental health problems to find a job and gain sustainable employment (WHO & ILO, 2022). A 
Cochrane systematic network analysis on this issue suggested that supported employment programmes 
could  be  augmented  with  other  vocational  training  programmes,  such  as  social  skills  training 
(Suijkerbuijk  et  al.,  2017).  Individual  Placement  and  Support  (IPS)  is  an  evidence-based  supported 
employment  method  that has been developed to help people with severe mental health  problems  to 
obtain  and  succeed  in  competitive  employment  (Bond  et  al.,  2020).  There  is  an  EU  organisation, 
European  Union  of  Supported  Employment  (EUSE),  which  is  an  organisation  for  promotion  and 
development of employment opportunities for people with significant disabilities to access and stay in 
employment (see Appendix A). 

Substance abuse 

A systematic review evaluated workplace-level interventions to prevent or reduce the adverse effects of 
substance abuse (Akanbi et al., 2020). The quality of studies was generally low, and the results were 
mixed.  Typical  interventions  were  a  combination  of  employee  education,  drug  testing  and  Employee 
Assistance  Programme  sometimes  also  supervisor  training  or  a  written  policy  on  a  substance-free 
workplace. In another review, all interventions were targeted to individuals and included screening with 
a brief intervention, psychosocial interventions and lifestyle interventions (Morse et al., 2022). 

The Team Awareness programme is a workplace-focused intervention, with the aim to have an impact 
on workplace culture (Bennett et al., 2004). The method includes reviewing group risks, strengthening 
responsiveness  to  problems  and  providing  alternatives  to  social  drinking.  The  basic  principle  in  the 

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intervention is that there are drinking cultures, social norms and attitudes also in the workplaces, which 
need to be addressed when attempting to introduce an effective intervention programme. The training 
programme typically consists of a couple of group sessions with lectures, discussions, interactive group 
work, video, role plays, communication skills practice and homework. Another workplace culture-based 
model describes workplace characteristics that have an impact on employee drinking behaviours, such 
as  stress,  job  satisfaction,  alienation  experiences,  social  control,  alcohol  availability,  and  social  and 
cultural norms. This approach has been applied, for example, in a project among young United States 
Air  Force  personnel  by  reducing  availability  of  alcohol,  with  a  media  campaign  in  the  local  air  force 
community, and by offering alternatives to drinking, such as sports activities (Ames & Bennett, 2011). 

Comorbid pain 

A  previous  EU-OSHA  report  (EU-OSHA,  2021d)  listed  the  following  recommendations  for  managing 
chronic musculoskeletal conditions in the workplace: 

▪  The workplace environment should be designed to be as inclusive as possible for all, so that 

there is no or little need for individual accommodations. 

▪  For workers who are on sick leave, there should be an effective return-to-work plan available. 
▪  There  should  be  collaborative  coordination  of  the  management  of  chronic  musculoskeletal 

disorders at the organisational level. 

▪  Organisational  culture  should  be  supporting,  aware  and  understanding,  including  training  for 

managers and workers. 

The general recommendations included avoiding static postures and prolonged sitting, providing specific 
tools and equipment, changing working hours and tasks, and task rotation. Specific attention should be 
paid  to  employees  in  driving  occupations.  Separate  reports  have  been  published  by  EU-OSHA  on 
prolonged constrained standing and static sitting at work (EU-OSHA, 2021a, 2021b).  

Cognitive problems 

A  systematic  review  explored  available  documents,  both  scientific  and  non-scientific,  to  examine 
employers’ perspectives, experiences and needs when managing workers who develop dementia while 
in employment (Thomson et al., 2019). Three major themes emerged from the literature:  

▪  Early presentation and identification of dementia in the workplace, which also emphasised the 
fact  that  many  people  are  not  aware  of  their  cognitive  deficits  at  work  and  when  having 
difficulties, try to hide them. Co-workers and supervisors play an important role in recognising 
the difficulties and encouraging the employee to seek professional advice. Clinical observations 
have shown that symptoms of early-onset dementia may be more varied than those in later-
onset  dementia,  including,  for  example,  changes  in  personality  and  risk-taking  behaviours. 
Various memory and cognitive function-related symptoms are actualised in a decline in work 
ability  compared  to  previous  standards.  Here,  it  is  vitally  important  that  the  managers  and 
supervisors are sensitive and respectful when they ask the worker about difficulties with memory 
or concentration issues. 

▪  Reasonable accommodations, which could help the worker with dementia to continue working. 
This theme concerned the content of accommodations and security issues to be accounted for, 
regarding both the worker and the co-workers. 

▪  Providing  information.  This  third  theme  concerned  the  importance  of  raising  awareness  of 
working-age dementia and facilitating informed choice among those affected. For example, the 
employees should be informed on where they can get support from, as well as about clinical 
examinations and benefits when having cognitive problems at working age. Unfortunately, many 
workers have experienced lack of support and even a quick job loss after they were diagnosed 
with dementia. 

However,  the  situation  should  also  be  reviewed  frequently,  and  the  employer  must  be  honest  in  the 
number of accommodations that can be reasonably made. At some point, there is a need for a retirement 
decision.  Becoming  a  dementia-friendly  employer  has  many  benefits:  there  is  a  strong  message  of 
justice, the employer image will become more positive, and the workers will feel that they are cared for 

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and  not  discriminated  against  whatever  health  issues  they  may  have  in  the  future.  It  is  important  to 
acknowledge that cognitive problems in people of working age are typically due to reasons other than 
dementia, such as depression, anxiety or occupational burnout. 

4.3  Return-to-work programmes 

A  review  of  best  sickness  absence  management  and  return-to-work  practices  for  employees  with 
musculoskeletal or common mental health problems (Durand et al., 2014) identified a six-step process 
of return to work from the employer’s perspective: 

time off and recovery; 
initial contact with the worker; 

▪ 
▪ 
▪  evaluation of the worker and their job tasks; 
▪  a return-to work plan with work accommodations; 
▪  work resumption; and 
▪ 

follow-up of the return-to-work process. 

In addition to support from healthcare professionals, the stakeholders involved in the workplace include 
supervisor,  senior  management,  return-to-work  coordinator,  co-workers,  union  representatives  and 
sickness absence manager. 

A  NICE  guideline  from  the  United  Kingdom  (UK)  (National  Institute  for  Health  and  Care  Excellence, 
2019)  reviewed  evidence  on  how  to  facilitate  return  to  work  and  reducing  risk  of  recurrence  among 
workers  on  long-term  sickness  absence.  According  to  the  guidelines,  providing  graded  activity  and 
workplace environment modifications could facilitate the return-to-work process although the scientific 
evidence is limited. According to another review (Nielsen et al., 2018), there is need for an integrated 
framework for sustainable return to work. This integration includes resources at five levels: the individual, 
the  group,  the  leader,  and  the  organisational  and  the  overarching  contextual  levels.  In  addition,  it  is 
important to develop a holistic framework that also includes resources outside work. 

4.4  Work accommodations 

There is a growing literature on work accommodations, including some review papers  (Lindsay et al., 
2019; McDowell & Fossey, 2015). Many chronic conditions, such as cancer, chronic pain, mental health 
problems  and  musculoskeletal  disorders,  are  ‘invisible’.  Thus,  there  is  discussion  on  the  barriers  to 
disclosure  and  request  for  work  accommodations,  how  these  accommodations  could  be  measured 
(Gignac et al., 2023) and categorised (MacDonald-Wilson et al., 2003), and what would be the optimal 
timing  of  such  a  request  (Ameri  &  Kurtzberg,  2022).  A  study  on  supportive  employment  for  workers 
experiencing severe mental health problems suggested that in this group of workers, cognitive deficits 
and  interpersonal  problems  were  the  most  reported  limitations  for  which  there  were  accommodation 
needs (MacDonald-Wilson et al., 2002). The most often used accommodations were a job coach and 
modified  job  duties.  There  were  also  discussions  about  the  challenges  that  workplaces  face  with 
episodic disabilities, such as mental health conditions, when balancing between privacy legislations and 
benefits  of  a  disclosure  to  obtain  work  accommodations  (Gignac  et  al.,  2021).  One  study  examined 
whether  there  is  a  downside  in  work  accommodations  and  found  that  the  accommodations  process 
resembles  organisational  change,  with  similar  risks  to  discrimination,  maltreatment  and  bullying 
(Kensbock et al., 2017). The article provides guidance on how to manage the potential risks involved in 
work accommodations. WHO suggested in their review that reasonable work accommodations should 
be implemented for workers experiencing mental health conditions, even though the few intervention 
studies on their effectiveness were evaluated as providing low-certainty evidence (WHO, 2022).  

A comprehensive list of work accommodations found  In the scientific literature, grouped according to 
the accommodation type, is available in Appendix B. 

4.5  Practical tools and guides 

A total of 165 examples were identified of informative websites, guides and practical tools developed to 
enhance  employment  or  return  to  work  for  employees  experiencing  mental  health  conditions.  A 
comprehensive description of the tools with links to the respective websites is available in Appendix B. 

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These tools and guides are grouped according to the following focal points: general workplace mental 
health and return-to-work support, workplace accessibility and accommodations, SMEs, depression and 
burnout, psychosocial risks and work stress, trauma and PTSD, sleep and recovery, chronic pain, eating 
disorders, suicide and substance abuse. 

4.6  Support for SMEs 
More than two-thirds of the European labour force is employed by SMEs. While workplace size appears 
not  to  be  a  factor  determining  whether  workplaces  are  likely  to  make  adaptations  (Eurofound,  2014, 
2019b),  SMEs  may  have  specific  challenges  when  trying  to  address  mental  health  issues  in  the 
workplace, as there often is no HR department or established teams to support employee wellbeing. 
The self-employed are their own employers and they may neglect to take care of themselves. In a small 
enterprise, there might not always be a culture of speaking about mental health. According to a recent 
survey carried out by EU-OSHA (EU-OSHA, 2022c), MSEs were still facing acute OSH management 
challenges,  such  as  lack  of  risk  assessments  and  monitoring.  Moreover,  awareness  of  psychosocial 
risks was lower than that of physical risks. National legislation seems to play a role in influencing the 
management of psychosocial risks in SMEs.  SMEs perform worse in managing psychosocial risks in 
EU Member States with poor OSH services and they often lack a systematic approach to prevention, 
instead initiating improvements only when an incident has occurred or if it is externally demanded (EU-
OSHA, 2017b, 2018, 2022d). The WHO guidelines on mental health at work suggest that the support 
for SMEs is arranged by the public sector services, and those services can help in providing reasonable 
accommodations for the workers (WHO, 2022). It is important that workers and employers have access 
to  those  occupational  health  services  and  employment  services,  which  should  preferably  be 
multidisciplinary. EU-OSHA reports also stress the importance of providing support for small businesses 
in terms of return-to-work documents (EU-OSHA, 2021d). 

A  similar  integrated  approach  to  workplace  mental  health  applies  to  SMEs  as  to  other  workplaces, 
including  the  three  levels  of  psychosocial  risk  prevention:  primary  prevention  (preventing  harm  by 
reducing overall work-related psychosocial and physical risks), secondary prevention (focusing on the 
health  risk  reduction  among  those  having  elevated  psychosocial  or  physical  risk  levels),  and  tertiary 
prevention (preventing the worsening of disease, improving and supporting the remaining work capacity 
among those with health issues). However, there are very few intervention studies with the focus on 
SMEs’  occupational  health  and  the  scientific  literature  lacks  guidance  on  the  best  OSH  practices  in 
SMEs (EU-OSHA, 2016d).  

A Finnish qualitative study identified challenges in OSH practices in SMEs (Heikkilä et al., 2014). These 
included the lack of education and nomination of representatives who are responsible for OSH-related 
practices, such as risk assessment. Clear, easy-to-use risk assessment and monitoring methods should 
be tailored to the workplace’s needs and implemented on a regular basis, with written reporting. Work 
capacity management should be included in the OSH practices. Workers should be allowed to actively 
participate in the decision-making process regarding OSH practices, such as risk management, early 
support, work accommodations and return-to-work practices. Table 2 shows the three principles of work 
capacity  management  (Confederation  of  Finnish  Industries,  2011),  which  are  useful  stepping  stones 
when planning a comprehensive approach to support mental health and work capacity in SMEs. 

Table 2: Three principles of work capacity management in the workplace, applied to SMEs 

▪  How is your personnel doing? 

o Job satisfaction, competence, health, work capacity 

The principle of 
awareness 

▪  What are the risks for work capacity in your workplace? 
▪  What are the risks for health in your workplace? 
▪  At what level are physical and psychosocial risks in your workplace? What are the 

target levels in your workplace? 

▪  What are the costs associated with work incapacity? 
▪  etc. 

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The principle of 
preparedness 

The principle of 
participation 

▪  Do you have means to address the identified risks? 
▪  Do you have preventive OSH practices? 
▪  Do you have early support practices in case of mental health issues? 
▪  What types of work accommodations are agreed? 
▪  Do you have a return-to-work policy? 

▪  Do your workers participate in the planning of policies and practices? 
▪  Do your workers participate in the planning of the provision of Employee Assistance 

Programmes and OSH? 

Although few documents retrieved from our searches were developed specifically for SMEs, the practical 
guides  and  tools  provided  in  this  report  are  applicable  to  them  as  well,  keeping  in  mind  that  every 
workplace is unique, and some effort is needed to create an organisational specific solution. Building on 
general good practices, as provided in this report, could be a good point of departure. General principles 
on approaching mental health issues include: an open attitude towards diversity, so that the  workers 
feel that they are respected; open, creative ways of finding solutions; listening to the worker’s wishes 
and opinions; relying on OSH providers, NGOs and other sources of information; and making a return-
to-work plan (EU-OSHA, 2020a). 

However, there are some solutions developed for SMEs. For example, a practical tool for SMEs by the 
EU-funded H-WORK project was launched in the Mental Health at Work Platform. It includes interactive 
tools for mental health, and benchmarking, especially for SMEs and public sector organisations. A UK-
based website has a collection of information and tools for SMEs. For example, as part of their campaign 
It’s okay to talk about mental health, the Federation of Small Businesses (FSB) has published a guide 
to help small businesses navigate workplace mental health (find all resources provided in Appendix A). 

Small  businesses  often  struggle  with  the  lack  of  time  and  resources  to  implement  a  comprehensive 
workplace health promotion approach. However, they do not have to do it all at once. It is possible to 
begin with small steps, starting with awareness raising, to enhance a work environment where mental 
health can be discussed. Similarly, measures to manage identified psychosocial risks can be divided 
into those to be implemented in the short, immediate and long term, starting with some things to put 
right (EU-OSHA, 2018a). The article ‘Developing an integrated approach to workplace mental health: A 
hypothetical conversation with a small business owner’ (LaMontagne et al., 2018) is useful reading that 
gives practical tips to SMEs on how to start with mental health support in the workplace. 

5  Concluding remarks and policy pointers 
Mental health problems are one of the leading causes of disability and years lost globally, and therefore, 
policies  and  practices  need  improving  to  reduce  the  global  burden.  The  starting  point  for  supporting 
mental health at work is the prevention of work-related psychosocial risk factors. Support for groups at 
risk  and  individuals  experiencing  mental  health  problems  should  be  provided  within  the  context  of  a 
good prevention approach.  

The  overarching  aim  of  this  report  was  to  examine  the  third  element,  and  provide  comprehensive 
information on workplace support practices for workers experiencing different types of non-work-related 
and work-related mental health problems to  be used  to produce practical  advice for workplaces. We 
identified  and  compiled  existing  guidance  and  recommendations  on  workplace  support  for  workers 
experiencing mental health problems to stay at work or successfully return to work following sickness 
absence. We focused on the tertiary-level prevention, that is, supporting workers experiencing a mental 
health condition to continue in employment or return to work after a period of work disability. This report 
indicates  that  the  workplace  is  an  important  arena  for  support  and  that  there  are  various  ways  to 
implement support and become an inclusive workplace. Good practices found are applicable to mental 
health  issues  irrespective  of  their  origin;  some  issues  are  work-related,  some  issues  are  non-work-
related and some issues are both.  

Building on a previous EU-OSHA report that showed that stress is often misunderstood and stigmatised 
in European workplaces (EU-OSHA, 2016b), our literature review confirmed that mental health issues 
are highly stigmatised. Therefore, the most important starting point is the willingness and commitment 

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of the employer to raise awareness of mental health issues, address stigma, and, eventually, develop 
an open, inclusive and non-discriminative workplace.  

A previous report suggested that interventions that are not only targeted to the individual but also include 
changes  at  the  workplace  level,  for  example,  active  support  from  the  supervisor,  contact  with  the 
workplace and early gradual return to work, can be effective in return to work after sickness absence 
due to common mental health conditions (EU-OSHA, 2020b). Our literature review found however that 
interventions as well as the research available are most often focused on individuals; there is excessive 
literature  on  different  types  of  psychotherapies  and  stress  reduction  techniques  to  strengthen  the 
individual’s coping capacity at work. Only recently have work environment-focused interventions been 
developed, although the scientific evidence on their effectiveness is still modest. However, the review 
found several review articles on work accommodations as a promising practice to support employees 
whose work capacity has changed and their use is a strong recommendation of the WHO (WHO, 2022).  

It seems that Irrespective of the mental health condition, the following principles apply when supporting 
employees to stay in work or return to work after an episode of sickness absence: 

▪  A  culture  of  awareness  and  inclusion  enabling  disclosure  of  the  mental  health  condition;  to 

develop a sense of a psychologically safe workplace. 

▪  Early intervention, that is, contact with the worker at an early phase of the sickness absence. 
▪  Established mental health return-to-work policy, that is, there are steps to take that are tailored 

to each case. 

▪  Good access to health services, professional multidisciplinary support. 
▪  Acceptance and support from co-workers and supervisors. 
▪  Work accommodations; based on an analysis of work tasks in relation to the worker’s current 

work capacity. 

▪  Follow-up of progress. 

While suitable individual accommodations may differ between mental health conditions (and in any case 
should always be tailored to the individual and their workplace (EU-OSHA, 2021d, 2023b)), the general 
approach and steps are the same as identified as good practice in previous EU-OSHA reports regarding 
rehabilitation in general and for specific conditions such as musculoskeletal disorders, cancer or Long 
COVID (EU-OSHA, 2017a, 2020b, 2021c).  

A psychologically safe workplace is a useful concept here. In today’s turbulent working life, employees 
and teams need psychological safety, which is defined as the belief of employees that the workplace is 
safe for expression of ideas and opinions, and that employees will not be punished or humiliated if they 
speak up (Edmondson, 1999; Frazier et al., 2017). Many of the retrieved methods and guides in this 
report reflected the idea of psychological safety at work, by emphasising good management practices, 
encouraging  open  and  honest  communication,  listening  to  workers,  making  sure  that  workers  feel 
supported, and showing appreciation and humility when people speak up. Raising awareness of mental 
health, reducing stigma, and training supervisors and workers to talk about and address mental health 
issues in the workplace were the most common activities that emerged in the retrieved material. These 
are excellent starting points from which organisations can continue their development and lay the basis 
for a psychologically safe workplace. 

Important further steps towards a workplace supporting mental health were presented by Kersten et al. 
(2023), with a conceptual framework to support all vulnerable workers. The Mentally Healthy Workplace 
concept (Harvey et al., 2014) included similar elements, highlighting practical solutions, such as work 
accommodations  and  EAP  support.  The  presented  principles  and  practices  started  from  senior 
management  commitment  and  ranged 
to  performance 
management, work accommodations and job design, supportive culture and external collaboration (e.g. 
EAP).  A  mental  health-supporting  workplace  is  always  inclusive.  Equality,  non-discrimination  and 
disability should be included in all the policies and activities  of the organisation, and should include a 
disability strategy that summarises all important aspects, such as disability management, return-to-work 
and work accommodation practices. 

from  personnel  recruitment  policies 

Regarding workplace accommodations for mental health conditions, it seems that they are not yet widely 
used in the workplaces and the scientific research on their effectiveness is in its infancy (Lindsay et al., 

European Agency for Safety and Health at Work – EU-OSHA 

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A review of good workplace practices to support individuals experiencing mental health problems 

2019; McDowell & Fossey, 2015; WHO, 2022). In the future, more research is needed to examine the 
impact  of  work  accommodations  in  various  contexts  and  to  investigate  what  works  in  practice.  The 
guides and toolkits were in most cases quite general, focusing on overall mental health.  

Of  the  specific  conditions,  PTSD  and  substance  abuse  received  most  attention  while,  for  example, 
anxiety-related  conditions,  such  as  panic  disorder  or  obsessive-compulsive  disorder,  were  rarely 
mentioned.  However,  awareness  of  the  usefulness  and  low  costs  of  work  accommodations  may 
increase their interest, as well as the resource that has been produced based on this review that includes 
descriptions of different mental health conditions, practical solutions and real-life examples.  

As described in the methodology, there are some limitations of this research. However, while this report 
is not exhaustive nor a systematic review, we basically followed the principles of a scoping review, we 
could form a good overall picture of the subject, and clearly see a consensus regarding what constitutes 
good practices. Although the websites, guides and tools provided in this report were carefully selected 
from reliable sources, it is not known how  effective these resources are to support change. It is also 
possible that it is only the most motivated companies that seek information from these types of sources. 
These issues would be important topics for future research, as well as finding out the most effective 
means to share and distribute good practices. 

It was heartening to see how various companies around the world have come together and established 
networks around an important issue, mental health in the workplace. However, as those companies are 
typically  large  international  companies,  we  need  to  find  ways  for  more  workplaces  to  act,  including 
SMEs. For SMEs, we found that there are very few good practices and tools developed for their needs, 
especially  regarding  mental  health  issues.  Particularly,  for  small  businesses  and  their  employees, 
access to multidisciplinary external support services is needed. Healthcare treatments should include 
return to work as a treatment goal, and access to occupational health services (OHS) is needed for all 
employers and employees (the provision of OHS could include through primary care). Given the stigma 
around  mental  health  and  the  lack  of  awareness  of  how  to  act,  support  for  organisations  to  support 
workers experiencing mental health conditions return to and stay in work is even more important than 
for other, physical health conditions. In that way it is possible to have coverage of good practices for all 
workers, irrespective of where they work.  

The more a workplace is inclusive and takes account of diversity, the less need there will be for individual 
accommodations and the stigma involved in asking for them. Focusing on preventing risks at source, 
incorporating adaptability and promoting wellbeing is also part of making a workplace inclusive. Having 
specific policies that cover all workers on flexible work arrangements, such as adaptable working hours, 
and teleworking, can support continued working with a mental health or other health condition. HR and 
OHS/those  responsible  for  safety  and  health  need  to  work  together,  both  on  the  prevention  of 
psychosocial  risks  and  support  for  groups  of  workers  at  risk,  and  for  those  in  need  of  support  when 
returning to work.  

Policy pointers that are suggested by the review are summarised in Box 2.  

Box 2: Policy pointers 

Based on the work, key takeaways for policymakers and decision-makers include: 

▪ 

Interventions  to  support  individuals  should  be 
organisational interventions that address psychosocial risk factors for all workers. 

implemented  within  the  context  of 

▪  Regarding return to work and workplace support, the same approach should be applied to 

mental health problems as is ideally already taken with physical health conditions. 

▪  Return to work should focus on an individual’s capabilities not their disabilities. 

▪  Workers may often have a physical and a mental health condition. These physical and mental 

health conditions need to be addressed together within a work-focused approach. 

▪  All  employers  and  their  workers,  especially  MSEs,  would  benefit  from  access  to 
multidisciplinary  return-to-work  services.  The  self-employed  also  need  access  to  services. 
Examples and experiences of good practices regarding multidisciplinary support programmes 
should be shared. 

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A review of good workplace practices to support individuals experiencing mental health problems 

▪  Employment should be part of all healthcare policies on mental health: health practitioners 
should have return-to-work as a treatment objective for patients with mental health problems 
and therapies, such as CBT, should include a work focus. 

▪  National sickness insurance and benefit schemes should allow a gradual return to work. 

▪  More  needs  to  be  done  to  raise  awareness  about  mental  health  in  the  workplace  and  to 

reduce stigma. 

▪  Social  partners  should  incorporate  the  issue  of  integration  and  retention  of  workers  with 

chronic disease into social dialogue at all levels (Eurofound, 2019b).  

▪  Social partners should develop guidelines for return-to-work at workplaces. 

▪  More  evidence-based  tools  and  resources  need  developing,  including  ones  tailored  to 

different sectors, and including how to support workers with episodic conditions. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Appendix A - Resources for workplace practices 

Table A1: Resources for workplace practices 

Appendices 

General workplace mental health and return-to-work support 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

Mental Health 
Platform 

H-WORK – 
Multilevel 
Interventions to 
Promote Mental 
Health in SMEs and 
Public Workplaces 

EU 

Eurofound’s website  Eurofound 

Eurofound: Absence 
from work 

Eurofound 

EU 

EU 

https://www.mentalhealth-
atwork.eu/  

H-WORK Innovation Platform is an outcome of the EU-funded H-WORK 
‘Multilevel Interventions to Promote Mental Health in SMEs and Public 
Workplaces’. It includes analytical, decision-making, intervention and evaluation 
tools to promote wellbeing in the workplace. 

https://www.eurofound.europa.
eu/en/topic/health-and-well-
being-work  

Eurofound’s research reports, data and other information on health and 
wellbeing at work can be found at this link.  

https://www.eurofound.europa.
eu/sites/default/files/ef_files/do
cs/ewco/tn0911039s/tn091103
9s.pdf 

This study addresses patterns of absence from the 27 EU Member States and 
Norway, the costs involved, policies for dealing with absence, and general 
developments in relation to promoting health and wellbeing. It includes national 
examples of best practice for sickness absence management.  

Eurofound: Disability 
and chronic diseases 

Eurofound 

https://www.eurofound.europa.
eu/topic/disability-and-chronic-
disease 

Eurofound’s research reports, data and other information on disability and 
chronic diseases can be found at this link. 

EU 

ENWHP website 

European Network 
for Workplace 
Health Promotion 
(ENWHP) 

https://www.enwhp.org/?i=port
al.en.home 

EU 

A guide to employers 
to promote mental 
health in the 
workplace 

European Network 
for Workplace 
Health Promotion 
(ENWHP) 

https://www.enwhp.org/resourc
es/toolip/doc/2018/04/23/menta
lhealth_broschuere_arbeitgebe
r.pdf  

The European Network for Workplace Health Promotion (ENWHP) conducts 
research and training for improving workplaces and occupational health. Its 
online publications and resources include material related to healthy working 
and chronic illnesses, good practices for promoting healthy working, good 
practices in the prevention of psychosocial risks, and guidance on healthy 
ageing and healthy lifestyles.  

A practical guide for employers published in a European campaign Work in 
Tune with Life as the initiative to help promote mental health in workplaces. 

A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

EU 

EU 

EU 

EU 

EU 

EU 

Work in Tune with 
Life: Mental Health at 
the Workplace 
guidance 

European Network 
for Workplace 
Health Promotion 
(ENWHP) 

https://www.enwhp.org/?i=port
al.en.8th-initiative-work-in-tune-
with-life  

This page links to resources aimed at helping employers and employees to 
implement measures to promote good mental health at work and to convince 
European stakeholders and companies that it is necessary and worthwhile to 
invest in programmes that help improve employees’ mental health. 

Promoting healthy 
work for workers with 
chronic illness: A 
guide to good 
practice (available in 
various languages) 

Healthy Workplaces 
Campaigns 

Healthy Workplaces 
Lighten the Load 

European Network 
for Workplace 
Health Promotion 
(ENWHP) 

European Agency 
for Safety and 
Health at Work (EU-
OSHA) 

European Agency 
for Safety and 
Health at Work (EU-
OSHA) 

Healthy workers, 
thriving companies – 
a practical guide to 
wellbeing at work 

European Agency 
for Safety and 
Health at Work (EU-
OSHA) 

https://www.enwhp.org/?i=port
al.en.european-guide-to-good-
practice-guidelines  

https://healthy-
workplaces.osha.europa.eu/en  

https://healthy-
workplaces.osha.europa.eu/en/
previous-
campaigns/musculoskeletal-
disorders-2020-22/campaign-
summary  

https://osha.europa.eu/en/publi
cations/healthy-workers-
thriving-companies-practical-
guide-wellbeing-work 

Workforce diversity 
and risk assessment: 
ensuring everyone is 
covered, Factsheet 
87 

EU-OSHA Factsheet 
53 

European Agency 
for Safety and 
Health at Work (EU-
OSHA) 

https://osha.europa.eu/en/tools
-and-
publications/publications/factsh
eets/87/view  

European Agency 
for Safety and 
Health at Work (EU-
OSHA) 

https://osha.europa.eu/en/publi
cations/factsheet-53-ensuring-
health-and-safety-workers-
disabilities/view 

Guidance on promoting healthy work for workers with chronic illness. 

Healthy Workplaces Campaigns aim to raise awareness, provide practical 
resources and bring stakeholders together around different workplace health 
issues, such as musculoskeletal and mental health, risk assessment and 
digitalisation. 

The campaign raised awareness of work-related musculoskeletal disorders and 
the need to manage them and promote a culture of risk prevention. The 
campaign was structured around eight priority areas: prevention, facts & 
figures, chronic conditions, sedentary work, worker diversity, future generations, 
psychosocial risks, and telework. 

Tackling psychosocial risks and musculoskeletal disorders in small businesses. 

Workforce diversity and risk assessment: ensuring everyone is covered – 
summary of an Agency report, providing practical advice. 

Ensuring the health and safety of workers with disabilities – factsheet providing 
simple advice on risk assessment. 

European Agency for Safety and Health at Work – EU-OSHA 

37 

 
A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

EU 

Rehabilitation and 
return to work report 

Ill health, disability, 
employment and 
return to work 

European Agency 
for Safety and 
Health at Work (EU-
OSHA) 

European Agency 
for Safety and 
Health at Work (EU-
OSHA) 

https://osha.europa.eu/en/tools
-and-
publications/publications/rehabi
litation-and-return-work-
analysis-eu-and-member-
state/view  

https://oshwiki.osha.europa.eu/
en/themes/ill-health-disability-
employment-and-return-work  

EU 

Mental Health 
Europe website 

Mental Health 
Europe 

https://www.mhe-sme.org/  

EU 

EU 

Mental Health: The 
Power of Language’ 
– A glossary of terms 
and words 

A position paper on 
psychosocial 
accessibility 

Mental Health 
Europe 

https://www.mhe-sme.org/mhe-
releases-glossary/  

Mental Health 
Europe 

https://www.mhe-sme.org/new-
reflection-paper-accessibility/  

Rehabilitation and return to work: Analysis report on EU and Member States 
policies, strategies and programmes. 

This OSHwiki article presents EU-OSHA’s resources related to returning to 
work and working with an ill-health condition or disability; it also features key 
resources from other organisations. It includes a section on mental health and 
work-related stress. 

Mental Health Europe (MHE) is a European NGO network committed to the 
promotion of positive mental health, the prevention of mental distress, the 
improvement of care, advocacy for social inclusion and the protection of the 
rights of (ex)users of mental health services, persons with psychosocial 
disabilities, their families and carers. MHE represents associations and 
individuals in the field of mental health and together with its members, MHE 
formulates recommendations for policymakers to develop mental health-friendly 
policies. A specific section is devoted to workplace mental health. 

By being mindful of the terms and words we use about mental health, this 
publication can contribute to the elimination of stigma and discrimination related 
to mental health. It was developed in co-creation by people with lived 
experience, supporters, care professionals, service providers, and human rights 
and health experts.  

‘More than a ramp: rethinking accessibility for people with psychosocial 
disabilities’ is a position paper on accessibility on a psychosocial perspective. 
The position paper can be used by stakeholders (e.g. the EU institutions and 
the Member States), as a working document and baseline for the initial 
discussions around accessibility and what barriers persons with psychosocial 
disabilities can encounter. 

EU 

Frontex Mental 
Health Strategy 

Frontex 

https://op.europa.eu/en/publicat
ion-detail/-
/publication/89c168fe-e14b-
11e7-9749-
01aa75ed71a1/language-en 

Frontex is the European Border and Coast Guard Agency that supports EU 
Member States and Schengen-associated countries to manage the external 
borders of the EU, including cross-border crime prevention and intervention. 
The strategy is tailored to operational conditions, and it includes topics on 
occupational health and safety (OSH), mental health promotion and 
rehabilitation/return-to work. 

European Agency for Safety and Health at Work – EU-OSHA 

38 

A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

Australia 

Developing a return 
to work plan 

Work Safe Australia 

Australia 

Return to work 
websites and toolkits 

Melbourne School of 
Population and 
Global Health, 
University of 
Melbourne 

Australia 

Mental Health First 
Aid education 

Mental Health First 
Aid (MHFA) 

https://www.safeworkaustralia.
gov.au/sites/default/files/2023-
12/202311-FINAL-
Developing%20a%20return%2
0to%20work%20plan%20-%20
guide%20and%20template_0.p
df  

https://returntowork.workplace-
mentalhealth.net.au/tools-
downloads/ 
https://mhfa.com.au/sites/defau
lt/files/8671_return-to-
work_guidelines.pdf 

This resource is a guide and template for anyone responsible for developing a 
return-to-work plan in collaboration with the injured or ill worker.  

Return to work is a comprehensive website on all aspects of return to work 
developed by University of Melbourne. According to information and guidance, 
it includes several toolkits on mental health and return to work. 

https://www.mentalhealthfirstai
d.org/wp-
content/uploads/2023/07/23.07.
16_MHFA-at-Work-marketing-
one-pager-v1.pdf 

MHFA is a course for employees on how to identify, understand and respond to 
signs of mental health problems and substance abuse. The training gives skills 
that are needed to reach out and provide initial help and support to someone 
who may be developing a mental health or substance use problem or 
experiencing a crisis. 

Australia 

Mentally Healthy 
Workplace platform 

Australian 
Government 
National Mental 
Health Commission 

https://beta.mentallyhealthywor
kplaces.gov.au/about-mentally-
healthy-workplaces 

The Mentally Healthy Workplace platform was developed as part of the national 
Workplace Initiative, and it includes information, materials and case stories of 
the companies creating mentally healthy workplaces across Australia. 

Austria 

Fit2Work website 

Fit2Work 

https://fit2work.at/ 

Fit2Work is an Austria-wide programme based on the Labour and Health Act, 
with the key objectives to reintegrate employees after long periods of sick leave 
and to preserve their workability on a long-term basis. This is to be done by 
taking adaptive measures at organisational level and supporting the individual’s 
efforts (integration schedule for the company and the individual). 

Austria 

Fit2Work practical 
examples 

Fit2Work 

https://www.fit2work.at/artikel/e
rfolgreiche-faelle-aus-der-
praxis  

Summaries of return-to-work cases assisted by Fit2Work. 

European Agency for Safety and Health at Work – EU-OSHA 

39 

 
 
 
 
 
 
 
A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

Austria 

Wiedereingliederung
steilzeit 
Arbeitsrechtlicher 
und 
sozialversicherungsr
echtlicher Leitfaden / 
Reintegration part-
time work guide 
to labour law and 
social security law 

BM für Arbeit und 
Wirtschaft 
Österreich- 
Federal Ministry of 
Labour and 
Economic Affairs 
Austria 

https://www.bmaw.gv.at/dam/jc
r:369f4770-83ea-4f92-ae3c-
75c459d8d167/20220719_Wie
dereingliederungstz.pdf 

This brochure contains all the important information on labour and social 
security law as well as an overview of the most important regulations, concrete 
examples, checklists and step-by-step instructions. 

Belgium 

Checklists: 
Reintegration at 
Work 

Belgium FPS 
Employment, Labour 
and Social Dialogue 

https://werk.belgie.be/nl/publica
ties/checklists-re-integratie-op-
het-werk 

This resource includes four checklists. The first three each relate to a phase of 
reintegration (incapacity for work - risk prevention, during incapacity for work - 
maintaining contact, effective reintegration); the fourth checklist indicates 
transversally what the actors should pay attention to during the entire 
reintegration process (promote communication between actors). 

Bulgaria 

ПОДКРЕПА ЗА 
ТРУДОВАТА 
РЕАЛИЗАЦИЯ НА 
ХОРА С 
ИНТЕЛЕКТУАЛНИ 
ЗАТРУДНЕНИЯ / 
Support for people 
experiencing mental 
health problems 

Bulgarian Center for 
Non-Profit Law and 
the “World of Maria” 
Foundation with the 
support of Active 
Civil Fund of 
Iceland, 
Liechtenstein and 
Norway 

https://bcnl.org/uploadfiles/doc
uments/%D0%A0%D0%B5%D
0%B7%D1%8E%D0%BC%D0
%B5_%D0%9F%D1%80%D0
%B0%D0%B2%D0%B5%D0%
BD%20%D0%B0%D0%BD%D
0%B0%D0%BB%D0%B8%D0
%B7_%D0%9F%D0%BE%D0
%B4%D0%BA%D1%80%D0%
B5%D0%BF%D0%B0%20%D0
%B7%D0%B0%20%D1%82%
D1%80%D1%83%D0%B4%D0
%BE%D0%B2%D0%B0%20%
D1%80%D0%B5%D0%B0%D0
%BB%D0%B8%D0%B7%D0%
B0%D1%86%D0%B8%D1%8F
%20%D0%BD%D0%B0%20%
D0%9B%D0%98%D0%97.pdf  

Possible forms of employment, legislative requirements for rehabilitation and 
support are described, as well as the challenges for providing these actions. 

Bulgaria 

Психично-здравен 
сайт на България / 
Mental Health 
Website of Bulgaria 

Mental Health 
Website of Bulgaria 

https://psihichnozdrave.com/ 

Association “Adaptation Society” – an NGO of relatives of people experiencing 
mental health issues. 

European Agency for Safety and Health at Work – EU-OSHA 

40 

A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

Canada 

ACED website 

ACED 

https://aced.iwh.on.ca/  

Canada 

CCOHS guidance 
and 
recommendations 

CCOHS 

https://www.ccohs.ca/topics/we
llness/mentalhealth/  

Accommodating and Communicating about Episodic Disabilities (ACED) is a 
research partnership developing evidence-based workplace tools, resources 
and training programmes to support the sustained employment of people with 
episodic disabilities. 

CCOHS (Canadian Centre of Occupational Health and Safety) mainly provides 
guidance and recommendations on how to achieve a healthy workplace. It 
covers a range of occupational-related topics such as mental health, gender 
and health in the workplace. Its pages on mental health cover topics such as 
active listening, conversations, providing support, PTSD and burnout. 

Canada 

Guide on return to 
work, workplace 
mental health 
information 

Workplace 
Strategies 

https://www.workplacestrategie
sformentalhealth.com/resource
s/return-to-work-response-for-
leaders  

Workplace Strategies and the partners, the Canadian Standards Association 
(CSA Group) and the Bureau de normalization du Québec (BNQ) have 
developed the Workplace Strategies for Mental Health website, including a 
guide for line managers on return to work. 

Canada 

IWH website 

IWH 

https://www.iwh.on.ca/topics/m
ental-health-in-the-workplace  

IWH carries out research projects and provides practical tools. Its materials on 
mental health can be found on this web page.  

Canada 

Tools and guides 

IWH 

https://www.iwh.on.ca/tools-
and-guides/supporting-return-
to-work-among-employees-
with-musculoskeletal-or-
mental-health-conditions-
evidence-based-practical-
resource  

This resource synthesises the research evidence on the practical solutions that 
workplaces can implement – in conjunction with workers’ compensation, 
insurance and healthcare authorities – to support the return to work of 
employees with musculoskeletal disorders or mental health conditions. This 
two-page guide emphasises that the most effective return-to-work strategies 
package together interventions from more than one of three areas of return-to-
work support: health services, case coordination and work modification. 

Croatia 

Center for Vocational 
Rehabilitation 
“Zagreb” 

Center for 
Vocational 
Rehabilitation 
“Zagreb” 

https://cprz.hr/ 

Denmark 

En af os – One of Us 

Danish Health 
Authority 

https://www.sst.dk/da/en-af-os  

Initiatives, examples of good practice, projects or other activities on the topic of 
Supporting workers experiencing a mental health problem to return to 
work/continue working. Center for Vocational Rehabilitation “Zagreb” organises 
and performs vocational rehabilitation of persons with disabilities, including 
persons experiencing mental health difficulties. 

The main purpose of One of Us is to end stigma related to mental health issues. 
In cooperation with different actors within the labour market, One of Us has run 
several initiatives targeting the workplace. One long-term goal is to create more 
awareness about mental health, which may contribute to reducing sick leave 
caused by the problem and providing better conditions for the inclusion of 
people experiencing mental health problems. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

Denmark 

The ABCs of Mental 
Health 

University of 
Copenhagen 

https://psychology.ku.dk/abc/  

Estonia 

Vaimne tervis 
töökohal / Mental 
health in the 
workplace 

MTU Peaasjad 

https://peaasi.ee/tookohal/ 

The ABCs of Mental Health partnership cooperates across different academic 
and organisational disciplines (public, private and civil society) to promote 
mental health on a research-based foundation. The initiative focuses on: 1) 
increasing the knowledge and understanding of what people can do to 
strengthen their own and other’s mental health, and 2) creating the best 
possible conditions for mental health and wellbeing for the entire population 
across life conditions and situations in Denmark. 

This web page on mental health in the workplace includes a dropdown section 
on mental health issues in the workplace, where there are subsections on 
anxiety disorders and the workplace, depression, traumatic events, and 
managing retention and return to work. The sections contain advice and links to 
further information and resources. The section on depression includes a plan 
for a work discussion on depression with video clips. 

Finland 

FIOH Mental Health 
Toolkit 

Finland 

FIOH Hyvän mielen 
työpaikka / Toolkit for 
good mental health in 
the workplace 

Finnish Institute of 
Occupational Heath 
(FIOH) 

Finnish Institute of 
Occupational Heath 
(FIOH) 

https://hyvatyo.ttl.fi/en/mental-
health-toolkit 

The FIOH Mental Health Toolkit includes practical material and toolkits for 
supervisors and a recovery calculator, resilience test and substance abuse 
programme (available in Finnish, Swedish and English). 

https://www.ttl.fi/oppimateriaalit
/hyvan-mielen-tyopaikka  

A website that includes educational materials for supervisors about how to 
support mental health at work and develop a workplace with good mental 
health. 

Finland 

MIELI Mental Health 
Finland 

MIELI 

https://mieli.fi/en/  

MIELI Mental Health Finland is a mental health organisation whose mission is 
to promote mental health, provide crisis support and prevent mental health 
issues. “We want to build a society in which people can talk about mental health 
safely and without stigma.” Materials are available in several languages. 

France 

Website Travail, 
parcours et 
prévention de l’usure 
professionnelle / 
Work, career paths 
and preventing 
occupational attrition 

Agence nationale 
pour l’amelioration 
des conditions de 
travail (ANACT) 

https://www.anact.fr/travail-
parcours-et-prevention-de-
lusure-professionnelle 

This series of articles seeks to understand the organisational phenomena at the 
root of the professional attrition experienced by certain employees, and identify 
possible courses of action for those involved in prevention. 

France 

Psycom website 

Psycom 

https://www.psycom.org/  

Psycom is an NGO in France that provides information and tools to handle 
mental health issues for everyone. 

European Agency for Safety and Health at Work – EU-OSHA 

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A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

Germany 

Germany 

Germany 

Collaborative 
practice of returning 
to work – 
reintegration after a 
mental health 
condition 

Umgang mit 
psychisch 
beeinträchtigten 
Beschäftigten - 
Handlungsleitfaden 
für Führungskräfte / 
Dealing with 
employees 
experiencing mental 
health problems – 
Guidance for 
managers 

Rückkehr an den 
Arbeitsplatz nach 
psychischer 
Erkrankung – 
Leitfaden für 
Betriebsärztinnen 
und -ärzte / 
Returning to work 
after mental health 
issues – Guidance 
for occupational 
health physicians 

Bundesanstalt fur 
Arbeitschutz und 
Arbeitsmedizin 
(BAuA) 

https://www.baua.de/DE/Angeb
ote/Publikationen/Praxis/A106.
html 

The brochure is based on studies examining the return-to-work process of 
employees with common mental health problems. It includes two exemplary 
cases with insights into the experience, behaviour and action in the return-to-
work process from the perspective of returning employees. See First and 
Second lessons learned in the English translation. 

Deutsche 
Gesetzliche 
Unfallversicherung 
(DGUV) 

https://publikationen.dguv.de/wi
dgets/pdf/download/article/373
2  

This guidance aims to raise awareness and provide information to managers on 
the issue of mental health problems. The guideline intends to encourage 
managers/supervisors and support them in approaching mental health aspects 
at work. It includes information on how to talk to employees experiencing 
mental health problems and provides practical guidance on steps to take.  

UKD – University of 
Düsseldorf (Institute 
for Occupational 
Health, Social and 
Environmental 
Medicine) 

https://www.uniklinik-
duesseldorf.de/fileadmin/Fuer-
Patienten-und-
Besucher/Kliniken-Zentren-
Institute/Institute/Institut_fuer_A
rbeits_Sozial_und_Umweltmedi
zin/Materialien/Downloads/Han
dlungsleitfaden_RTW_nach_ps
ychischen_Krisen_final.pdf 

This guide on the implementation of the reintegration process of workers 
experiencing mental health problems was developed and tested in the 
framework of a study. The main objective of the guide is to empower the 
occupational physician in his/her position as a facilitator of reintegration after 
mental health crises. The guide provides assistance in communication with 
other internal and external stakeholders and in their involvement. It includes 
various scenarios with options for action by the occupational health physician. 

Germany 

Initiative Neue 
Qualität der Arbeit - 
New Quality of Work" 
(INQA) website 

Bundesministerium 
für Arbeit und 
Soziales 

https://www.inqa.de/DE/themen
/gesundheit/psychische-
gesundheit-am-
arbeitsplatz/uebersicht.html  

INQA supports companies and institutions on their way to an economically 
sustainable and at the same time humane working environment. The initiative 
unites all the important social forces and contributes new know-how about the 
design of the working environment to companies. The aim is to improve the 
quality of work, to maintain employees’ health and to increase the innovative 
power and competitiveness of the German economy. The main themes include, 
for example, health and diversity management. 

European Agency for Safety and Health at Work – EU-OSHA 

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A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

Greece 

IASIS website 

IASIS (external 
support 
organisation) 

https://www.iasismed.eu/  

Greece 

HR case study series 
of workers with 
mental health 
problems 

University of Athens 

https://issuu.com/hrm_aueb/do
cs/24_hr-case-study-
series_issue 

IASIS is an NGO that provides psychosocial support and promotes mental 
health. It has a day centre for workers and the unemployed – IASIS at Work – 
that also provides education and training on mental health issues relevant to the 
workplace. 

HR case study series 24: Mental health at work / Ψυχική Υγεία και Ευζωία στην 
Εργασία. Experts examine case examples of teleworkers experiencing mental 
health problems and work stress during the COVID-19 pandemic, discussing 
factors such as using the preconditions, the commitment of leadership, the role 
of HR in educating, designing and implementing policies, and the use of 
employee support programmes as well as the help of psychologists and 
coaches. 

Pan-Hellenic 
Association for 
Psychosocial 
Rehabilitation and 
Professional 
Reintegration 
(PEPSAEE, external 
support 
organisation)  

“Thalpos-Mental 
Health” Agency 
External support 
organisation) 

https://www.pepsaee.gr/  

PEPSAEE is a scientific not-for-profit organisation whose main purpose is to 
support the social and labour market integration of people experiencing 
psychosocial difficulties. It has day centres and operates an Employment & 
Social Entrepreneurship Support Office. 

https://thalpos.org.gr  

The “Thalpos-Mental Health” Agency is an NGO with an active role in 
intervention and information on mental health and in the management of social 
care programmes. 

Health and Safety 
Authority (HSA) 

https://www.hsa.ie/eng/publicati
ons_and_forms/publications/sa
fety_and_health_management/
hsa_disability_guidelines_2021
.pdf  

Guidelines for employers on disability that includes case studies. 

Greece 

PEPSAEE website 

Greece 

“Thalpos-Mental 
Health” Agency 
website 

Ireland 

Employees with 
Disabilities An 
employer’s guide to 
implementing 
inclusive health and 
safety practices for 
employees with 
disabilities 

Ireland 

Mental Health Ireland 
website 

Mental Health 
Ireland 

www.mentalhealthireland.ie 

A national NGO for mental health promotion. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

Ireland 

Shine website 

Shine 

https://shine.ie/ 

Ireland 

Practical guidance 

NDA (National 
Disability Authority) 

The 
Netherlands 

Effectieve 
interventies / 
Effective 
interventions 

Trimbos institute 

The 
Netherlands 

Blijven werken met 
psychische klachten 
/ Keep working with 
mental health 
problems  

HAN University of 
Applied Sciences 

The 
Netherlands 

Good practices 

Commissie Werk 
Gezondheid 

https://nda.ie/uploads/publicatio
ns/retaining-employees-who-
acquire-a-disability-a-guide-for-
employers.pdf  

https://www.trimbos.nl/kennis/
mentale-gezondheid-
preventie/expertisecentrum-
mentale-gezondheid/arbeid-en-
mentale-gezondheid/effectieve-
interventies/ 

https://www.han.nl/projecten/bli
jven-werken-met-psychische-
klachten/ 
https://www.han.nl/projecten/ta
keover/interventies-en-
diensten/ 

https://centrumwerkgezondheid
.nl/wp-
content/uploads/2018/02/Overv
iew_Good_Examples_work_ch
ronic_conditions_31jan2018.pd
f 

Shine is an NGO that supports individuals and groups experiencing mental 
health problems to enhance their recovery and challenge negative attitudes and 
behaviours, and delivers a variety of programmes and services. 

Practical guidance for employers about how to help employees who have 
acquired a disability to stay in work. 

This web page describes a number of interventions aimed at promoting the 
mental health of employees that have been found effective in the scientific 
literature or recognised by Dutch intervention databases. They cover return to 
work and mental health in the workplace. 

Practical tips and information on supporting employees with mental health 
problems aimed at employers. The website offers general advice for employers 
and links to diverse support options both for staying at work but also preventive 
approaches. 

Results of an exploration of European initiatives for stay at work with a chronical 
condition and job opportunities for (young) people with a chronic condition. 

The 
Netherlands 

The 
Netherlands 

Werk en inkomen / 
Op zoek naar werk - 
Work and income / 
Seeking employment 

MIND 

Mind Your Business  MIND 

https://mindplatform.nl/thema/w
erk-en-inkomen-1 
https://wijzijnmind.nl/op-weg-
naar-werk/op-zoek-naar-werk 

MIND is an independent advocacy organisation for people experiencing mental 
health issues and their families. These web pages contain practical tips and 
information on finding, maintaining and going back to work with mental health 
problems. There are links to different support programmes. 

https://wijzijnmind.nl/mind-your-
business 

This web page contains information on how to stay mentally health at work. A 
self-test and so called challenges where you can sign up for 7-10 days of 
educational emails with information and small tasks for the day. 

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Country 

Resource 

Organisation 

Web link 

Summary 

Norway 

Open Mind 

Telenor 

https://www.telenor.no/openmin
d/english/ 

Poland 

“Leczenie 
psychiatryczne a 
praca” / “Psychiatric 
treatment and work” 

Grupa Pracuj 

https://porady.pracuj.pl/zycie-
zawodowe/leczenie-
psychiatryczne-a-praca/ 

Telenor’s Open Mind programme offers work to people experiencing different 
work disabilities, such as physical handicaps or mental health issues, and to 
immigrants from non-European countries. During the one-year programme, 
Open Mind can strengthen the participants’ chances to gain employment 
through relevant on-the-job practice and training. 

Grupa Pracuj is a platform that supports and equips companies with 
technological solutions to automate HR processes. This web page includes 
information on the following topics: Concealing a mental health issue from an 
employer - is it a bad thing?; Sick leave from a psychiatrist and return to work; 
Mental health treatment and work - how does work activity affect the healing 
process?; Mental health treatment and work - what is the situation?; How to 
support a colleague experiencing mental health issues. 

Poland 

“Wsparcie osób 
chorujących 
psychicznie na rynku 
pracy. Analiza i 
zalecenia” / 
“Supporting people 
who experience 
mental health 
problems in the 
labour market. 
Analysis and 
recommendations” 

Biuro Rzecznika 
Praw 
Obywatelskich/Com
mission for Human 
Rights 

https://bip.brpo.gov.pl/sites/def
ault/files/Wsparcie_osob.pdf 

The purpose of this handbook is to identify and define and compare the 
specificity of the functioning of the institutions of socio-professional activation of 
people in Poland who experience mental health issues from the perspective of 
the employees of the Regional Centres for Social Policy, managers and 
employees of the rehabilitation centres, and people affected by mental health 
problems, and identify good practices.  

Spain 

Design for All 
Foundation website 

Design for All 
Foundation 

http://designforall.org/design.ph
p 

The Design for All Foundation promotes knowledge around the concept of 
design tailored to human diversity. Design for All projects aim to improve quality 
of life, solidarity, dignity, sustainability and equal opportunities. The website 
contains guidance for various sectors, such as the tourism, education and 
museum sectors, and companies, but also for individuals. There is a special 
section regarding news in the sector, where there is information regarding new 
trends of inclusive design and award-winning initiatives in the sector. 

Sweden 

SWEA website 
(available in various 
languages) 

Swedish Work 
Environment 
Authority (SWEA) 

https://www.av.se/halsa-och-
sakerhet/#  

This website provides information for the workplace on work adaptations and 
rehabilitation. It includes information on legal obligations and good practice. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

Sweden 

Sweden 

Sweden 

Sweden 

Plan för återgång i 
arbete efter 
sjukskrivning / Plan 
for return to work 
after sick leave 

Arbetsplatsdialogen - 
upptäck tidiga tecken 
på ohälsa / The 
workplace dialogue - 
detect early signs of 
ill health 

Social Insurance 
Office 

https://www.forsakringskassan.
se/arbetsgivare/att-forebygga-
sjukfranvaro-bland-
medarbetare/friskare-
medarbetare-med-
rehabiliteringsbidrag/plan-for-
atergang-i-arbetet 

Advice for employers on their legal responsibility to make a return-to-work plan 
for an employee on sick leave. 

Prevent 

https://www.prevent.se/jobba-
med-
arbetsmiljo/osa/arbetsplatsdialo
gen/  

ArbetsplatsDialog för arbetsåtergång, ADA (Workplace Dialogue for return to 
work, ADA), is a method developed and evaluated by the Occupational and 
Environmental Medicine Clinic in Lund. The manual can be found at 
www.fhvmetodik.se 

Krav- och 
funktionsschema 
(KOF) / 
Requirements and 
Functionality 
Schedule (KOF) 

Arbets- och 
miljömedicin i 
Uppsala / 
Occupational and 
environmental 
medicine in Uppsala 

https://ammuppsala.se/arbetsfo
rmaga/krav-och-
funktionsschema-kof/ 

The Requirements and Functionality Schedule (KOF) is a method for 
collaboration around an employee’s work ability, which is based on a meeting 
between the employee and their immediate manager. 

Riktlinjer vid psykisk 
ohälsa på 
arbetsplatsen / 
Guidelines for mental 
health problems in 
the workplace 

Swedish Agency of 
Work Environment 
Expertise 

https://mynak.se/publikationer/r
iktlinjer-vid-psykisk-ohalsa-pa-
arbetsplatsen/ 

These research-based guidelines for occupational health and employers focus 
on preventing, investigating and remedying work-related mental health issues. 
The guidelines also include guidance on measures for the workplace when 
someone has experienced mental health issues. 

Sweden 

Mind website 

Mind 

https://mind.se/  

Sweden 

Work Integration 
Social Enterprise 
(WISE) 

WISE Gävleborg 

https://pubmed.ncbi.nlm.nih.go
v/37187968/  

Mind is an NGO in Sweden that aims to promote mental health in the society in 
various ways. The website includes information on mental health, sources of 
help and possibilities for interaction. Part of the material is available in several 
languages. 

This is a case study (Macassa et al., 2023) of a social enterprise that operates 
in a small region in mid-Sweden. With a total of 40 employees, the WISE 
provides services, such as home and office cleaning, gardening, snow 
ploughing, rehabilitation, and lunch and cafeteria services, with flexible working 
hours. The interviewed employees reported that working in a WISE provided 
them a sense of safety, belongingness, freedom and improved self-esteem, and 
that they felt that their work contributed to the wider community.  

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A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

UK 

UK 

UK 

UK 

UK 

UK 

UK 

A Healthy Return 
guide 

Institution of 
Occupational Safety 
and Health (IOSH) 

Occupational Health 
Toolkit 

Institution of 
Occupational Safety 
and Health (IOSH) 

Several toolkits to 
support inclusive 
workplace and 
mental health of 
employees 

Business in the 
Community (BITC) 

HSE Guide on 
sickness absence 
management 

Health and Safety 
Executive (HSE) 

https://www.cambridgesafety.c
o.uk/wp-
content/uploads/2019/08/B1-
Vocational-rehabilitation-
IOSH.pdf  

https://iosh.com/resources-and-
research/our-
resources/occupational-health-
toolkit/ 

Various toolkits: 
https://www.bitc.org.uk/toolkit/
mental-health-for-employers-
toolkit/  
Ethnically diverse women: 
https://www.bitc.org.uk/toolkit/
mental-health-and-wellbeing-
for-ethnically-diverse-women/  
Inclusive remote working: 
https://www.bitc.org.uk/toolkit/in
clusive-remote-working/  

https://www.hse.gov.uk/disabilit
y/assets/docs/sickness-
absence-return-to-work.pdf  

This is a guidance document for a healthy return to work and rehabilitation. It 
provides practical examples and guidance on good practice for returning to 
work after several causes of long absence, including mental health conditions. It 
defines the criteria for the main actors in occupational health and information on 
relevant reasonable adjustments, managing sensitive medical information and 
other helpful tools such as return-to-work plans with case examples.  

The toolkit is a free resource that provides useful information to help employers 
tackle occupational health issues in the workplace, including psychosocial risks, 
mental health and return to work. 

BITC is the UK’s responsible business network to support fairer, greener and 
more inclusive workplaces. The website includes various toolkits for mental 
health, for example, Mental Health for Employers, Drugs, Alcohol and Tobacco, 
Musculoskeletal Health, Sleep and Recovery, Crisis Management in the Event 
of Suicide, and a Toolkit for Mental Health for Ethnically Diverse Women. 

The guide includes HSE’s best practice on sickness absence management and 
return to work. 

CIPD guide on return 
to work 

The Chartered 
Institute of 
Personnel and 
Development (CIPD) 

https://www.cipd.org/en/knowle
dge/guides/manager-guide-
managing-return-to-work-after-
long-term-absence/  

The guide, produced in partnership with Bupa, is designed to support line 
managers to manage instances of long-term absence and return to work. 

Wellness Action Plan 
by Mind 

Mind 

The Influence and 
Participation Toolkit 

Mind 

https://www.mind.org.uk/workpl
ace/mental-health-at-
work/wellness-action-plan-sign-
up/  

Mind is the national mental health charity in the UK. Local Minds support people 
in communities across England and Wales. Their range of services includes 
supported housing, crisis helplines, drop-in centres, employment and training 
schemes, counselling and befriending. The toolkit has been developed for 
discussion and planning in the workplace. 

https://www.mind.org.uk/workpl
ace/influence-and-participation-
toolkit/ 

Mind is the national mental health charity in the UK. Toolkit for enabling 
workplaces to involve people with mental health conditions to participate in the 
development of the organisation. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

UK 

Ten Steps for Mindful 
Employer guide 

Mind Leeds – 
Mindful Employer 

https://www.mindfulemployerte
nsteps.co.uk/steps  

UK & USA 

This is Me 

Barclays 

https://home.barclays/who-we-
are/our-strategy/diversity-and-
inclusion/disability/this-is-me/ 

USA 

Center for Workplace 
Mental Health 
website 

American 
Psychiatric 
Association 
Foundation 

https://www.workplacementalh
ealth.org/  

USA 

Workplace Mental 
Health Toolkit 

USA 

PEAT website 

Employer 
Assistance and 
Resource Network 
on Disability 
Inclusion (EARN) 

The Partnership on 
Employment & 
Accessible 
Technology (PEAT) 

https://askearn.org/page/menta
l-health-toolkit  

General resources: 
https://www.peatworks.org/emp
loyer-topics/ 
Advice in case of mental health 
conditions on audio-only 
meetings: 
https://www.peatworks.org/why
-employers-should-allow-audio-
only-status-on-calls/ 

Mindful Employer is a national initiative supporting employers to take a positive 
approach towards mental health at work. The guide includes guidance on 
managing stress, mental health and return to work. 

The This is Me campaign was launched at Barclays to challenge the stigma 
around mental health and to create a workplace where people feel confident to 
talk about mental health. The campaign encourages colleagues to tell their 
personal stories and, in this way, create an open environment for everybody. 
The number of colleagues sharing their story about a disability, a neurodiversity 
or a mental health condition has increased from nine to over 250 within a 
couple of years. 

The Center for Workplace Mental Health exists to help employers create a more 
supportive workplace environment for their employees and advance mental 
health policies at their organisations. Includes resources to create a mentally 
healthy workplace. 

EARN’s Workplace Mental Health Toolkit aims to provide employers with the 
knowledge, skills and resources necessary to create a supportive work 
atmosphere for those living with mental health conditions. It provides advice on 
creating a mental health-friendly workplace. 

The mission of PEAT is to foster collaborations in the technology space that 
build inclusive workplaces for people with disabilities. Their vision is a future 
where new and emerging technologies are accessible to the workforce by 
design. 

USA 

Several Toolkits for 
Workplace Mental 
Health 

Mind Share Partners 

https://www.mindsharepartners
.org/toolkits 

Mind Share Partners is a national NGO that aims to change the culture of 
workplace mental health so that both employees and organisations can thrive. 
The toolkits include advice and information on various topics of workplace 
mental health, such as a mentally healthy workplace, mental health awareness, 
peer listening groups and suicide prevention. 

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Country 

Resource 

Organisation 

Web link 

Summary 

International 

WHO Guidelines on 
Mental Health at 
Work web link 
(available in various 
languages) 

World Health 
Organisation (WHO) 

https://www.who.int/publication
s/i/item/9789240053052 

International 

The Global Business 
Collaboration for 
Better Workplace 
Mental Health 

The Global Business 
Collaboration for 
Better Workplace 
Mental Health 

https://betterworkplacemh.com/  

Recommendations to promote mental health, prevent mental health conditions, 
and enable people experiencing mental health conditions to participate and 
thrive in work. The recommendations cover organisational interventions, 
manager and worker training, individual interventions, return to work and 
gaining employment.  

The Global Business Collaboration for Better Workplace Mental Health is a 
business-led initiative to advocate and enable an evidence-based action for a 
positive change for mental health in the workplace. To date, 100 companies 
from 62 countries in six continents, with a total of 1,600,000 employees, have 
signed the Pledge. The website resources include webinars and case stories 
from participating companies on how they had improved mental health in their 
workplaces and how they are building up their roadmap for change.  

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Small and medium-sized enterprises (SMEs) 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

Mental Health 
Platform 

H-WORK – 
Multilevel 
Interventions to 
Promote Mental 
Health in SMEs and 
Public Workplaces 

https://www.mentalhealth-
atwork.eu/  

H-WORK Innovation Platform is an outcome of the EU-funded H-WORK 
‘Multilevel Interventions to Promote Mental Health in SMEs and Public 
Workplaces’. It includes analytical, decision-making, intervention and evaluation 
tools to promote wellbeing in the workplace. 

EU 

MENTUPP Platform  MENTUPP project 

https://www.mentuppproject.eu/  

The MENTUPP project involves the development, implementation and 
evaluation of a multi-level intervention targeting both clinical and non-clinical 
mental health issues and combating the stigma of mental health problems, with 
a specific focus on SMEs. The used framework is a mentally healthy workplace, 
informed by several systematic reviews and a consultation survey with key 
experts in the area. The intervention is facilitated through the MENTUPP Hub, 
an online platform that presents interactive psychoeducational materials, 
toolkits and links to additional resources. A pilot study will be carried out in eight 
EU countries and Australia. 

EU 

Business Europe 
website 

Business Europe 

https://www.businesseurope.eu
/  

Business Europe’s website includes information and advice ranging from 
legislation and European-wide events to OSH issues. 

Australia 

Business in Mind 
website 

University of 
Tasmania 

https://www.utas.edu.au/busine
ssinmind 

A website resource with information, support and a resource kit specifically 
developed for SMEs. Brief video clips and testimonies from SME 
owners/operators. 

UK 

It's okay to talk 
about mental health 

Federation of Small 
Businesses (FSB) 

https://www.fsb.org.uk/knowled
ge/fsb-infohub/it-s-okay-to-talk-
about-mental-health.html 

The Federation of Small Businesses (FSB) campaign ‘It's okay to talk about 
mental health’ provides various resources for SMEs on its website including a 
guide to help small businesses navigate workplace mental health 

UK 

Mind – Mental health 
for small workplaces 

Mind 

https://www.mentalhealthatwor
k.org.uk/toolkit/mental-health-
for-small-workplaces/ 

This UK-based website has a collection of information and tools for SMEs. For 
example, as part of their campaign ‘It’s okay to talk about mental health’, the 
Federation of Small Businesses (FSB) has published a guide to help small 
businesses navigate workplace mental health. The toolbox includes practical 
examples on how to begin talking about mental health and what to do if there is 
a mental health issue in the workplace. 

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Country 

Resource 

Organisation 

Web link 

Summary 

International 

Developing an 
integrated approach 
to workplace mental 
health: A hypothetical 
conversation with a 
small business owner 

LaMontagne et al., 
2018 

https://academic.oup.com/ann
weh/article/62/Supplement_1/S
93/5096681 

This article from an academic journal provides practical tips to SMEs on how to 
start with mental health support in the workplace. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Self-employed 

Country 

Resource 

Organisation 

Web link 

Summary 

UK 

Practical tips for the 
self-employed  

Mental Health at 
Work website 

https://www.mentalhealthatwor
k.org.uk/toolkit/practical-tips-
for-the-self-employed/ 

This advice for the self-employed was produced together with a business 
organisation and is based on a survey of self-employed people. Topics include 
mental health, social anxiety, dealing with feeling overwhelmed 

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A review of good workplace practices to support individuals experiencing mental health problems 

Workplace accessibility and accommodations 

Country 

Resource 

Organisation 

Web link 

Summary 

Canada 

Northwest ADA 
Centre website 

Northwest ADA 
Centre 

https://nwadacenter.org/audien
ce/employers  

Canada 

ACED website 

ACED 

https://aced.iwh.on.ca/  

Canada 

Job Demands and 
Accommodation 
Planning Tool 
(JDAPT) 

The Institute for 
Work & Health 
(IWH) 

https://aced.iwh.on.ca/jdapt 

This website contains advice for businesses, government, architects and people 
with disabilities. This section contains advice on making workplaces accessible 
and making individual accommodations. 

Accommodating and Communicating about Episodic Disabilities (ACED) is a 
research partnership developing evidence-based workplace tools, resources 
and training programmes to support the sustained employment of people with 
episodic disabilities. 

Accommodating and Communicating about Episodic Disabilities (ACED) is a 
five-year research project bringing together researchers and community 
partners to develop evidence-based workplace tools. The JDAPT helps workers 
with chronic and episodic conditions, and the workplace parties who support 
them, identify accommodations tailored to job demands that allow workers to 
successfully stay in their jobs.  

Canada 

Guide on workplace 
accommodations 

Workplace 
Strategies 

https://www.workplacestrategie
sformentalhealth.com/resource
s/accommodation-strategies  

Workplace Strategies and the partners, the Canadian Standards Association 
(CSA Group) and the Bureau de normalization du Québec (BNQ) have 
developed the Workplace Strategies for Mental Health website, including a 
guide on workplace accommodation strategies. 

Finland 

Website and guide 
on work 
accommodations 

Sweden 

Arbetsanpassning 
(AFS 2020:5), 
föreskrifter / Work 
adaptation (AFS 
2020:5), regulations 

Mielenterveyspooli 
(Mental Health Pool) 
and Ministry of 
Social Affairs and 
Health 

https://mielenterveyspooli.fi/mat
eriaalipankki/tyon-
muokkauksen-keinot-kun-
mielenterveyden-hairio-
vaikuttaa-tyokykyyn/  

Swedish Work 
Environment Agency 

https://www.av.se/arbetsmiljoar
bete-och-
inspektioner/publikationer/fores
krifter/arbetsanpassning-afs-
20205-foreskrifter/ 

Website and guide on how to help employees to stay in work or return to work 
with flexible workplace accommodations. 

Guidance on Sweden’s workplace adaptation regulations for workers with a 
reduced ability to perform their usual work, to continue working or to return to 
work. 

Sweden 

The Prehab Guide at 
Sunt Arbetsliv 

Sunt Arbetsliv 

https://prehabguiden.suntarbet
sliv.se/  

With the help of the Prehab Guide, work adaptation and rehabilitation can be 
easier. The prehab guide helps to fulfil the Swedish Work Environment 
Authority’s regulations for work adaptations. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Country 

Resource 

Organisation 

Web link 

Summary 

UK 

Reasonable 
Adjustment Toolkits 

Business in the 
Community, Public 
Health England, and 
Mind 

https://www.mentalhealthatwor
k.org.uk/toolkit/understanding-
reasonable-adjustments-in-
your-workplace/  

UK 

UK 

UK 

USA 

USA 

NHS guide on 
workplace 
adjustments 

National Health 
Services (NHS)  

Workplace 
Adjustment Passport 

College for Policing 

HSE Best practice 
work adjustments 
guide 

Health and Safety 
Executive (HSE) 

https://www.nhshealthatwork.c
o.uk/images/library/files/Govern
ment%20policy/Mental_Health
_Adjustments_Guidance_May_
2012.pdf  

https://www.college.police.uk/s
upport-forces/diversity-and-
inclusion/workplace-
adjustments-passports  

https://www.hse.gov.uk/disabilit
y/best-practice/workplace-
adjustments.htm  

Job Accommodation 
Network website 
(JAN) 

JAN 

https://askjan.org/ 

Accommodations for 
employees 
experiencing mental 
health conditions 
website 

Office of disability 
Employment Policy, 
US Department of 
Labor 

https://www.dol.gov/agencies/o
dep/program-areas/mental-
health/maximizing-productivity-
accommodations-for-
employees-with-psychiatric-
disabilities  

A toolkit for reasonable adjustments to support mental health at work. Business 
in the Community and Public Health England have developed a total of eight 
toolkits to help every organisation support the mental and physical health and 
wellbeing of its employees. Each addresses a different aspect of workplace 
wellbeing, with a common thread of mental health running through them all. 
They’re freely available and designed to be relevant to employers across all 
sectors. 

The guidance is intended to help employers think through the kinds of 
adjustments at work that they can make for people experiencing mental health 
conditions. They include practical advice and links to other resources that might 
help them to support job retention and return to work. 

A tool for recording an individual’s agreed workplace adjustments. 

This practical guide is part of the HSE’s comprehensive guide on principles to 
support disabled workers with long-term conditions in work. 

The Job Accommodation Network (JAN) provides practical information for 
workplace accommodations free of charge. The website contains a database 
with practical examples of accommodations divided by category and type of 
disability. There are solutions covering almost all health conditions and their 
problematic symptoms (not only disabilities) at work.  

Provides examples of accommodations that have helped employees 
experiencing mental health conditions to more effectively perform their jobs.  

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A review of good workplace practices to support individuals experiencing mental health problems 

Workplace accessibility and accommodations – assistive technologies 

Country 

Resource 

Organisation 

Web link 

Summary 

USA 

USA 

Assistive 
Technology for 
Supporting People 
with Mental 
Health Conditions: 
Part 1 
Assistive 
Technology for 
Supporting 
People with Mental 
Health Disabilities: 
Part 2 

Job-Driven 
Technical 
Assistance Center 
(JD-VRTAC) 

https://www.explorevr.org/sites
/explorevr.org/files/files/AT%2
0MH%20Part%201%20FINAL.
pdf  

This presentation provides advice on understand how assistive technology can 
help improve employment outcomes, the process for making a choice and 
implementing solutions.  

Job-driven Technical 
Assistance Center 

https://www.explorevr.org/sites/
explorevr.org/files/files/AT%20
MH%20Part%202%20FINAL.p
df  

This presentation provides advice on identifying specific assistive technologies 
that can be used as accommodations for people with 
mental health conditions. For example it provides information the pros and cons 
of mental health apps, and different types of aids for cognitive support, self-
management apps, symptom tracking, calming/arousal devices etc.  

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A review of good workplace practices to support individuals experiencing mental health problems 

Talking to your employee/employer about a mental health problem 

Country 

Resource 

Organisation 

Web link 

Summary 

UK 

How to support staff 
who are 
experiencing a 
mental health 
problem 

Mond Cymru 

UK 

Telling my employer  Mind 

EU 

Conversation 
starters for 
workplace 
discussions about 
musculoskeletal 
disorders 

EU-OSHA 

https://www.mind.org.uk/media-
a/4806/how-to-support-staff-
who-are-experiencing-a-
mental-health-
problem_wales_v2.pdf 

https://www.mind.org.uk/inform
ation-support/legal-
rights/discrimination-at-
work/telling-my-
employer/#ShouldITellMyEmpl
oyerAboutMyMentalHealthProb
lem  

This guide sets out simple, practical and inexpensive steps that any 
organisation can take to support staff at every stage of the mental health 
spectrum. It includes a section on ‘How to have a conversation with someone 
about their mental health’. 

This webpage provides guidance to individuals on deciding whether to tell an 
employer about a mental health problem, and how to ask for accommodations, 
etc. There is a template for drafting a letter to ask for accommodations. There 
are links to other webpages that provide advice for individuals about applying 
for jobs and challenging discrimination.  

https://osha.europa.eu/en/publi
cations/conversation-starters-
workplace-discussions-about-
musculoskeletal-disorders 

These conversation starters can facilitate group discussions in the workplace or 
during vocational training. The resource contains activities and annexes on 
having a conversation about an ill health condition. While the resource is 
focused on musculoskeletal disorders, the activities and advice on speaking 
about health conditions can be applied to mental health. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Depression and burnout 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

EU 

Belgium 

Burnout in the 
workplace: A review 
of data and policy 
responses in the EU. 

Understanding and 
Preventing Worker 
Burnout 
Fedris Burnout Pilot 
Project Federal 
Agency for 
Occupational Risks - 
Burnout support 
programme 

Eurofound 

EU-OSHA 

https://www.eurofound.europa.
eu/publications/report/2018/bu
rnout-in-the-workplace-a-
review-of-data-and-policy-
responses-in-the-eu 
https://oshwiki.osha.europa.eu
/en/themes/understanding-
and-preventing-worker-burnout 

The report includes information on relevant national strategies and policies and 
some example of workplace actions.  

Article that describes work-related burnout, work risk factors, and managing 
and preventing work-related burnout.  

Fedris 

https://www.fedris.be/nl/pilootp
roject-burn-out 

A pilot programme to support workers with burnout, aimed at banking and 
health care sectors. It offers a psychological support pathway for workers, 
suffering from early signs of burnout, in terms of their retention and/or return to 
work. Results expected end of 2023. 

Canada 

Practical guide 

IWH 

Canada 

Several guides 

Workplace 
Strategies 

https://www.iwh.on.ca/tools-
and-guides/evidence-
informed-guide-to-supporting-
people-with-depression-in-
workplace  
https://www.workplacestrategi
esformentalhealth.com/resourc
es/burnout-response-for-
leaders  

Ireland 

Aware’s website 

Aware 

https://www.aware.ie/ 

Ireland 

Employees with 
disabilities – an 
employer’s guide 

The 
Netherlands 

Guide on preventing 
or solving overvoltage 
and burnout 

Health and Safety 
Authority 

Ministerie van 
Sociale Zaken en 
Werkgelegenheiden 
/ Ministry of Social 
Affairs and 
Employment 

https://www.hsa.ie/eng/publica
tions_and_forms/publications/s
afety_and_health_manageme
nt/employees_with__disabilitie
s.html  
https://www.arboportaal.nl/ond
erwerpen/werkdruk/documente
n/publicatie/2021/10/22/voorlic
htingsfolder-overspanning-en-
burn-out-voorkomen-of-
oplossen 

The guide is designed for anyone in the workplace who supports workers with 
depression as they cope with their symptoms while working, or when they are 
returning to work following an episode of depression. 

Workplace Strategies and the partners, the Canadian Standards Association 
(CSA Group) and the Bureau de normalization du Québec (BNQ) have 
developed the Workplace Strategies for Mental Health website, including a 
guide for managing stress and burnout. 
This NGO aims to raise awareness about people affected by stress, 
depression, bipolar disorder and mood-related conditions and provide 
education and support. 

An employer’s guide to implementing inclusive health and safety practices for 
employees with disabilities, including mental health issues (a practical example 
is provided). 

Brochure providing tips and advice on preventing or solving work-related 
stress and burnout, provided by the Dutch Association for Occupational and 
Occupational Medicine (NVAB) and the Dutch Association of Insurance 
Medicine (NVVG). 

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A review of good workplace practices to support individuals experiencing mental health problems 

UK 

Depression after 
childbirth 

NCT 

https://www.nct.org.uk/life-
parent/work-and-
childcare/returning-
work/returning-work-after-
postnatal-depression 

A guide about returning to work after having experienced depression following 
childbirth (postnatal depression). 

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A review of good workplace practices to support individuals experiencing mental health problems 

Psychosocial risks and work stress 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

EU 

EU 

EU 

Occupational health 
and safety risks in 
the healthcare sector 

European 
Commission 

Healthy workers, 
thriving companies - 
a practical guide to 
wellbeing at work, 

Managing Stress 
and Psychosocial 
Risks e-guide 

European Agency 
for Occupational 
Safety and Health 
(EU-OSHA) 
European Agency 
for Occupational 
Safety and Health 
(EU-OSHA) 

How to reduce 
employee stress and 
prevent burnout. 

 EURopean 
Employment 
Service (EURES) 

https://op.europa.eu/en/publica
tion-detail/-
/publication/b29abb0a-f41e-
4cb4-b787-4538ac5f0238 

https://osha.europa.eu/en/publi
cations/healthy-workers-
thriving-companies-practical-
guide-wellbeing-work 

https://osha.europa.eu/sites/de
fault/files/Eguide_stress_ENG
LISH.pdf  

https://eures.ec.europa.eu/how
-reduce-employee-stress-and-
prevent-burnout-2023-06-
12_en 

This practical guidance on risk prevention in the healthcare sector includes 
detailed sections on the prevention of psychosocial risks covering stress and 
burnout, long working hours and drug abuse. Although focused on the 
healthcare sector, much of the advice is relevant or adaptable to other 
workplaces. Available in various languages. 

A practical guide for employers about managing psychosocial risks in the 
workplace. 

A comprehensive e-guide for employees and employers about understanding 
more about stress and psychosocial risks, taking steps to address them. 

Advice giving practical tips for employers/managers on how to tackle employee 
burnout in the workplace. 

Canada 

Several guides 

Workplace 
Strategies 

Ireland 

Healthy Workplace 
Framework website 

Government of 
Ireland 

Ireland 

The 
Netherlands 

Ireland Code of 
practice for 
employers and 
employees on the 
right to disconnect 

Handige tools en 
instrumenten / 
Useful tools and 
instruments 

Workplace 
Relations 
Commission 

Ministerie van 
Sociale Zaken en 
Werkgelegenheiden 
/ Ministry of Social 
Affairs and 
Employment 

https://www.workplacestrategi
esformentalhealth.com/resourc
es/burnout-response-for-
leaders  

Workplace Strategies and the partners, the Canadian Standards Association 
(CSA Group) and the Bureau de normalization du Québec (BNQ) have 
developed the Workplace Strategies for Mental Health website, including a 
guide for managing stress and burnout. 

https://www.gov.ie/en/publicati
on/445a4a-healthy-workplace-
framework/#  
https://www.workplacerelations
.ie/en/what_you_should_know/
codes_practice/code-of-
practice-for-employers-and-
employees-on-the-right-to-
disconnect.pdf 

Information and links to guidance on how to develop a workplace with the 
Healthy Workplace Framework. 

Code of Practice to give guidance on best practice to organisations and their 
employees on the Right to Disconnect. 

https://www.arboportaal.nl/ond
erwerpen/werkdruk/handige-
tools-en-instrumenten 

Collection of tools and instruments that can be used to tackle work-related 
stress, such as factsheets, checklist, questionnaires and self-tests, tips – e.g. 
about having a conversation about work stress. 

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Vägledning till 
föreskrifterna om 
organisatorisk och 
social arbetsmiljö, 
AFS 2015:4 (H457), 
bok / Guidance to 
the regulations on 
organisational and 
social work 
environment, AFS 
2015:4 (H457), book 

Ten Steps for 
Mindful Employer 

Arbetsmiljöverket / 
The Swedish Work 
Environment 
Agency 

https://www.av.se/arbetsmiljoa
rbete-och-
inspektioner/publikationer/bock
er/vagledning-organisatorisk-
social-arbetsmiljo-h457/  

Mind Leeds 

https://www.mindfulemployerte
nsteps.co.uk/steps  

HSE Management 
Standards 

Health and Safety 
Executive (HSE) 

https://www.hse.gov.uk/stress/
standards/ 

HSE Stress Talking 
Toolkit 

Health and Safety 
Executive (HSE) 

Managing stress and 
mental health at 
work 

Mind – Mental 
Health at Work 

A complementary 
guide to effectively 
manage and support 
remote workers 

The Hartford 

https://www.hse.gov.uk/stress/
talking-toolkit.htm 
https://www.mentalhealthatwor
k.org.uk/toolkit/workplace-
stress-fulfilling-your-
responsibilities-as-an-
employer/  

https://s0.hfdstatic.com/sites/th
e_hartford/files/remote-work-
toolkit.pdf 

Sweden 

UK 

UK 

UK 

UK 

USA 

Guidance on complying with regulations on the organisational and social work 
environment. 

Mindful Employer is a national initiative supporting employers to take a positive 
approach towards mental health at work. The guide includes guidance on 
managing stress, mental health and return to work. 
HSE’s Management Standards is a good practice tool with a step-by-step 
assessment of the current situation, and identification, management and follow-
up of work stress. 
Advice for managers on talking with employees and to prevent and manage 
work-related stress. 

Managing stress and mental health at work toolkit includes several resources, 
such as Stress Risk Assessment, Talking Toolkit, Common Adjustments, 
Thriving at Work, and Mental Health Conditions, Work and the Workplace. 

Managing and supporting remote workers toolkit. 

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A review of good workplace practices to support individuals experiencing mental health problems 

Trauma and PTSD 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

EU 

Italy 

Post-Traumatic 
Stress Disorder 

OSHwiki 

https://oshwiki.osha.europa.eu/
en/themes/post-traumatic-
stress-disorder  

This article on PTSD covers work-related risks, occupations at risk and how to 
handle work-related PTSD. 

Frontex Mental 
Health Strategy 

Frontex 

https://op.europa.eu/en/publicat
ion-detail/-
/publication/89c168fe-e14b-
11e7-9749-
01aa75ed71a1/language-en 

Frontex is the European Border and Coast Guard Agency that supports EU 
Member States and Schengen-associated countries to manage the external 
borders of the EU, including cross-border crime prevention and intervention. 
The strategy is tailored to operational conditions, and it includes topics on OSH, 
mental health promotion and rehabilitation/return-to work. 

Work-related post-
traumatic stress 
disorder: report of 
five cases 

University of Pavia & 
Institute of Pavia 

https://www.ncbi.nlm.nih.gov/p
mc/articles/PMC7708739/ 

This journal article describes five unusual cases of work-related PTSD, 
diagnosed with an interdisciplinary protocol. All patients required psychiatric 
help and pharmacological treatment, with difficulty of varying degrees in 
resuming work. 

UK 

Guides 

Mind – Mental 
Health at Work 

https://www.mentalhealthatwor
k.org.uk/toolkit/helping-staff-to-
cope-with-trauma/  

A toolkit with a focus on helping staff to cope with trauma. Other resources 
provide, for example, response to a traumatic incidence in rail work. 

USA 

USA 

USA 

CTIPP Trauma-
Informed Workplace 
Toolkit 

Campaign for 
Trauma-Informed 
Policy and Practice 
(CTIPP) 

https://www.ctipp.org/post/toolk
it-trauma-informed-workplaces  

NIOSH Guide on 
Traumatic Incidence 
Stress 

National Institute for 
Occupational Safety 
and Health (NIOSH) 

https://www.cdc.gov/niosh/topic
s/traumaticincident/  

SAMSHA’s Guidance 
for a Trauma-
Informed Approach 

Substance Abuse 
and Mental Health 
Services 
Administration 
(SAMSHA) 

https://store.samhsa.gov/produ
ct/SAMHSA-s-Concept-of-
Trauma-and-Guidance-for-a-
Trauma-Informed-
Approach/SMA14-4884  

CTIPP involves representatives from education, mental health, justice, civil 
society and government. CTIPP informs and advocates for public policies and 
practices that incorporate scientific findings on the relationship between trauma, 
health and wellbeing across the lifespan. The toolkit provides educational 
concepts and practical strategies on trauma-informed workplaces to support 
team members. 

NIOSH recommends that all workers involved in response activities help 
themselves and their co-workers and reduce the risk of experiencing stress 
associated with a traumatic incident by utilising simple methods to recognise, 
monitor and maintain health on-site and following such experiences. The guide 
includes the methods of managing traumatic incidence stress. 

The manual introduces a concept of trauma and offers a framework for 
becoming a trauma-informed organisation, offering six key principles and 10 
implementation domains. 

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Sleep and recovery 

Country 

Resource 

Organisation 

Web link 

Summary 

Canada 

Toolkit for Sleep 
Hygiene 

MyWorkplaceHealth 

http://www.myworkplacehealth.
com/uploads/2/1/2/0/21200088/
sleep_hygiene_toolkit_9.pdf  

The toolkit includes resources to help you develop skills and strategies to 
enhance your sleep hygiene. 

UK 

UK 

USA 

Toolkit on Sleep and 
Recovery 

Business in the 
Community (BITC) 

https://www.bitc.org.uk/wp-
content/uploads/2019/10/bitc-
wellbeing-toolkit-sleeprecovery-
jan2018.pdf 

BITC is the UK’s responsible business network to support fairer, greener and 
more inclusive workplaces. The website includes various toolkits for mental 
health. The toolkit has been developed to increase understanding on sleep and 
recovery and taking action to support good sleep. 

Barnsley sleep toolkit 
for employers and 
employees 

Barnsley 
Metropolitan 
Borough Council 

https://www.barnsley.gov.uk/m
edia/17930/barnsley-sleep-
toolkit.pdf 

Toolkit on Fatigue 
among Retail 
Workers 

National Institute for 
Occupational Safety 
and Health (NIOSH) 

https://www.cdc.gov/niosh/docs
/wp-solutions/2019-
102/default.html  

A toolkit for employers and employees about sleep and work. 

By using Total Worker Health® principles, NIOSH has developed solutions on 
how to reduce fatigue among retail workers. 

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Chronic pain 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

Employment and 
pain policy 

European Pain 
Federation (EFIC) 

https://europeanpainfederation.
eu/sip/employment-and-pain-
policy/ 

Position Paper on Workplace Integration and Adaptation, highlighting the 
importance of addressing pain management to support a healthy and 
productive European workforce and society. 

Canada 

AQDC website 

AQDC 

https://douleurchronique.org/m
anagement-of-chronic-
pain/managingpain-at-
work/?lang=en 

The Association Québécoise de la douleur chronique — Quebec Association for 
Chronic Pain (AQDC) is an association aiming to provide information on how to 
deal optimally with chronic pain. The website contains resources on the types of 
diseases related to chronic pain and the treatment and management of chronic 
pain. It gives specific information on managing pain effectively at work.  

UK 

Several toolkits to 
support inclusive 
workplaces and 
mental health of 
employees 

Business in the 
Community (BITC) 

https://www.bitc.org.uk/toolkit/
mental-health-for-employers-
toolkit/  

BITC is the UK’s responsible business network to support fairer, greener and 
more inclusive workplaces. The website includes various toolkits for mental 
health, for example, Mental Health for Employers, Drugs, Alcohol and Tobacco, 
Musculoskeletal Health, Sleep and Recovery, Crisis Management in the Event 
of Suicide, and a Toolkit for Mental Health for Ethnically Diverse Women. 

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Eating disorders 

Country 

Resource 

Organisation 

Web link 

Summary 

Australia 

Guide on eating 
disorders in the 
workplace 

Butterfly Foundation 

https://butterfly.org.au/eating-
disorders-in-the-workplace/  

Butterfly Foundation is the national charity for all Australians impacted by eating 
disorders and body image issues, and for the families, friends and communities 
who support them. The guidance includes information on how to address eating 
disorders in the workplace and develop a Body Kind Workplace. 

UK 

Guide 

Mind – Mental 
Health at Work 

https://www.mentalhealthatwor
k.org.uk/toolkit/creating-
workplaces-that-are-positive-
for-people-with-eating-
disorders/  

A toolkit with a focus on creating workplaces that are positive for people with 
eating disorders. Other resources for people with eating disorders are provided, 
for example, a helpline and how to develop a wellness plan. 

USA 

Guide and toolkit 

The National Eating 
Disorders 
Association (NEDA) 

https://www.nationaleatingdisor
ders.org/learn/help/workplace  

NEDA is the largest NGO dedicated to supporting individuals and families 
affected by eating disorders. The guide and toolkit provide advice on how to 
address eating disorders in the workplace (e.g. screenings) to improve overall 
workplace wellness and to get help to those who need it. 

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Severe mental health conditions 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

European Supported 
Employment Toolkit 

European Union of 
Supported 
Employment (EUSE) 

http://www.euse.org/resources/
supported-employment-toolkit 

Belgium 

Individual Placement 
and Support (IPS) 
pilot project 

National Institute for 
Health and Invalidity 
Insurance 

https://www.inami.fgov.be/nl/pu
blicaties/jv2017/themas/Pagina
s/ips.aspx 

The Supported Employment model was developed to assist people with 
significant disabilities or other disadvantaged groups to access employment in 
the open labour market. The European Supported Employment Toolkit is for 
professionals who are working in supported employment programmes. 

This programme/study focuses on individuals experiencing moderate to severe 
mental health issues. Its goal is rapid and enduring employment, by getting 
people back to work as soon as possible and providing ongoing support within 
the workplace. 

https://schizophrenia-
life.bg/public/living-with-
schizophrenia/professional-life/ 

This web page, from a site dedicated to schizophrenia, includes some key 
suggestions for employers, families, healthcare professionals and institutions to 
improve understanding of the disease. 

Bulgaria 

Шизофрения / 
Schizophrenia 

Gedeon Richter 
Foundation 

Greece 

Panhellenic 
Federation of 
Koi.S.P.E. 
(P.O.Koi.S.P.E.) 
website 

Panhellenic 
Federation of 
Koi.S.P.E. 
(P.O.Koi.S.P.E., 
external support 
organisation)  

Italy 

Individual Placement 
and Support (IPS) in 
Italy 

Emilia-Romagna 
Region, Italy 

The 
Netherlands 

Individuele Plaatsing 
en Steun (IPS) / 
Individual Placement 
and Support 

Kenniscentrum 
Phrenos 

http://pokoispe.gr/  

https://health.ec.europa.eu/syst
em/files/2018-
03/2018_goodpractices_en_0.p
df 

https://www.werkenmetips.nl/e
n/what-is-ips/ 

USA 

Individual Placement 
and Support (IPS) 
method 

IPS Employment 
Center 

https://ipsworks.org/  

POKOISPE is a social cooperative, with the aim to represent and coordinate the 
activities of socioeconomic integration and the professional integration of 
people with psychosocial problems. The social cooperatives are mental health 
units that develop programmes and for people experiencing severe mental 
health conditions. 

A guide published by the 3rd EU Health Programme (2014-2020). 

This web page provides information about the Individual Placement and 
Support (IPS) programme. The programme is an approach to help people with 
severe mental health issues to get and to keep paid employment. They can 
receive guidance from a trained counsellor who helps with looking for, finding 
and keeping a job. People who have problems at work because of their mental 
health issues can also use an IPS programme to keep their job.  

IPS is a model of supported employment for people experiencing severe mental 
health problems, such as schizophrenia, bipolar disorder or severe 
depression. IPS helps them work at regular jobs of their choosing. IPS refers to 
the evidence-based practice of supported employment. Mainstream education 
and technical training are included as ways to advance career paths. 

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Suicide 

Country 

Resource 

Organisation 

Web link 

Summary 

EU 

Preventing and 
managing suicidal 
behaviour. A toolkit 
for the workplace 

Euregenas 

Sweden 

The national action 
programme for 
suicide prevention 

Public Health 
Agency of Sweden 

https://www.euregenas.eu/wp-
content/uploads/2014/11/EURE
GENAS-TOOLKIT-
WORKPLACE-Preventing-and-
Managing-Suicidal-Behaviour-
1.pdf  

https://www.folkhalsomyndighet
en.se/the-public-health-agency-
of-sweden/living-conditions-
and-lifestyle/suicide-
prevention/national-action-
programme-for-suicide-
prevention/  

This resource includes tools to help workplaces prevent suicide, identify and 
interact with suicidal workers, and what to do after suicide  The Euregenas 
(European Regions Enforcing Actions Against Suicide) project was co-funded 
by the European Union.  

National programme on suicide prevention. 

UK 

UK 

Reducing the Risk of 
Suicide: a toolkit for 
employers 

Business in the 
Community and 
Public Health 
England, and Mind 

https://www.mentalhealthatwor
k.org.uk/resource/reducing-the-
risk-of-suicide-a-toolkit-for-
employers/?read=more  

Crisis Management 
in the Event of 
Suicide: a 
postvention toolkit for 
employers in the 
event of suicide 

Business in the 
Community (BITC) 

https://www.bitc.org.uk/wp-
content/uploads/2019/10/bitc-
wellbeing-toolkit-
suicidepostventioncrisismanag
ement-mar2017.pdf 

Reducing the risk of suicide: a toolkit for employers. Business in the Community 
and Public Health England have developed a total of eight toolkits to help every 
organisation support the mental and physical health and wellbeing of its 
employees. Each addresses a different aspect of workplace wellbeing, with a 
common thread of mental health running through them all. They’re freely 
available and designed to be relevant to employers across all sectors. 

A crisis management guide in the event of a suicide in the workplace, with the 
aim to support employers in their response to an employee taking their own life, 
whether that be within a workplace or outside of it – as either scenario can have 
a profound effect on the mental health of colleagues. It covers all stages from 
preparing an appropriate culture, policy and procedures, to the immediate time 
around a suicide, to dissemination of news through an organisation and 
supporting employees through the subsequent days, months and years. 

UK 

The little book of 
minding your head 

Yellowwellies.org 

https://www.yellowwellies.org/w
p-
content/uploads/2024/02/LittleB
ookOfMindingYourHead.pdf  

Poor mental health is not uncommon among farmers. This booklet was written 
to offer support and guidance for those who may be struggling with the 
pressures of farming or recognise that struggle in someone else. It covers 
various issues including suicidal feelings.   

UK 

Suicide Prevention 

Health and Safety 
Executive (HSE) 

https://www.hse.gov.uk/stress/s
uicide.htm  

Employers have a duty of care to workers and to ensuring their health, safety 
and welfare. HSE promotes action that prevents or tackles any risks to workers’ 
physical and mental health, for example due to work-related stress. This guide 
is for prevention of suicide and how to support workers after a suicide incident. 

European Agency for Safety and Health at Work – EU-OSHA 

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Country 

Resource 

Organisation 

Web link 

Summary 

USA 

USA 

Suicide prevention: 
evidence-informed 
interventions for the 
health care workforce 

American Hospital 
Association/HRET 

https://www.aha.org/system/file
s/media/file/2022/09/suicide-
prevention_evidence-informed-
interventions-for-the-health-
care-workforce.pdf  

Healthcare workers are at an increased risk of suicide. This resource is based 
on the results of a project. It suggests interventions for suicide prevention that 
have been developed specifically for the sector.  It contains advice, checklists, 
links to videos. 

Several Toolkits for 
Workplace Mental 
Health 

Mind Share Partners 

https://www.mindsharepartners
.org/toolkits 

Mind Share Partners is a national NGO that aims to change the culture of 
workplace mental health so that both employees and organisations can thrive. 
The toolkits include advice and information on various topics of workplace 
mental health, such as a mentally healthy workplace, mental health awareness, 
peer listening groups and suicide prevention. 

International 

Preventing Suicide: a 
resource at work 

WHO 

http://apps.who.int/iris/bitstrea
m/10665/43502/1/9241594381
_eng.pdf  

This resource provides practical advice on preventing suicide at work and 
helping a suicidal worker. It is aimed at employers, worker representatives, 
providers of employee assistance programmes, human resources and workers. 

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Substance abuse 

Country 

Resource 

Organisation 

Web link 

Summary 

stralia 

Mental Health First 
Aid education 

Mental Health First 
Aid (MHFA) 

https://www.mentalhealthfirstai
d.org/wp-
content/uploads/2023/07/23.07.
16_MHFA-at-Work-marketing-
one-pager-v1.pdf 

MHFA is a course for employees on how to identify, understand and respond to 
signs of mental health issues and substance abuse. The training gives skills 
that are needed to reach out and provide initial help and support to someone 
who may be developing a mental health or substance use problem or 
experiencing a crisis. 

Austria 

WIETZ bei 
Suchterkrankung- 
Checkliste / Checklist 

Canada 

Guide 

Kontakt & co, 
Jugendrotkreuz 
Verein 
“Österreichisches 
Rotes Kreuz - 
Landesverband 
Tirol” / Kontakt &co- 
Red cross Youth, 
Association 

Atlantic Canada 
Council on Addiction 

https://www.kontaktco.at/infoap
p/downloads/pib_checkliste_wi
edereingliederung.pdf 

Checklist on how reintegration into the workplace can succeed in the case of 
addictions. 

https://www.gov.nl.ca/hcs/files/
publications-addiction-
substance-abuse-workplace-
toolkit.pdf 

The guide includes information and a step-by-step guide for workplaces on how 
to address problematic substance use in the workplace. Workplaces come in 
different shapes and sizes, so the steps and tools in the guide can be adapted 
to suit the unique workplace needs. A case study is provided to demonstrate 
how the steps may be applied in the ‘real world’. 

Finland 

FIOH Mental Health 
Toolkit 

Finnish Institute of 
Occupational Health 
(FIOH) 

https://hyvatyo.ttl.fi/en/mental-
health-toolkit 

The FIOH Mental Health Toolkit includes practical material and toolkits for 
supervisors and a recovery calculator, resilience test and a managing 
substance abuse programme. 

Sweden 

UK 

Riktlinjer vid 
alkoholproblem på 
arbetsplatsen / 
Guidelines for 
alcohol problems in 
the workplace 

Toolkits to address 
drugs, alcohol and 
tobacco in the 
workplace 

Swedish Agency for 
Work Environment 
Expertise 

https://mynak.se/publikationer/r
iktlinjer-vid-alkoholproblem-pa-
arbetsplatsen/ 

These guidelines are aimed at occupational health and include guidance, 
methods and working methods for early prevention, identification and 
remediation of alcohol problems among employees. 

Business in the 
Community (BITC) 

https://www.bitc.org.uk/toolkit/d
rugs-alcohol-and-tobacco-a-
toolkit-for-employers/  

BITC is the UK’s responsible business network to support fairer, greener and 
more inclusive workplaces. The website includes various toolkits for mental 
health, for example, Mental Health for Employers, Drugs, Alcohol and Tobacco, 
Musculoskeletal Health, Sleep and Recovery, Crisis Management in the Event 
of Suicide, and a Toolkit for Mental Health for Ethnically Diverse Women. 

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Country 

Resource 

Organisation 

Web link 

Summary 

USA 

NIOSH Opioids in the 
Workplace toolkits 

The National 
Institute for 
Occupational Safety 
and Health (NIOSH) 

https://www.cdc.gov/niosh/topic
s/opioids/  

By using Total Worker Health® principles, NIOSH has developed solutions to 
help workers and employers facing the opioid crisis in their communities.  

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A review of good workplace practices to support individuals experiencing mental health problems 

Appendix B - A list of work accommodations retrieved from a scientific literature review 

Table B1: List of work accommodations 

Author(s), year 

Attridge & Wallace (2010) 
Bolo et al. (2013) 
Corbiere et al. (2014) 
De Rijk et al. (2009) 
Edgelow et al. (2023) 
Gifford & Zong (2017) 
MacDonald-Wilson (2002) 
Mattila-Holappa et al. (2018) 
McDowell & Fossey (2015) 
Pransky et al. (2016) 
Sundar et al. (2017) 
Wang et al. (2011) 

De Rijk et al. (2009) 
Edgelow et al. (2023) 
Gifford & Zong (2017) 
Shaw et al. (2014) 
Sundar et al. (2017) 
McDowell & Fossey (2015) 

Attridge & Wallace (2010) 
Corbiere et al. (2014) 
Doki et al. (2016) 
Mattila-Holappa et al. (2018) 
Pransky et al. (2016) 
Zafar et al. (2019) 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Mental health 
problems, all 
Depression / 
anxiety 
PTSD 

Emotional / 
cognitive 

Mental health 
problems, all 
PTSD 

Emotional / 
cognitive 

Mental health 
problems, all 

Cognitive / 
emotional 

Stamina / getting tired 
Emotional responsiveness 
Reduced decision-making ability 
Concentration limits 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Stamina / getting tired 
Emotional responsiveness 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Stamina / getting tired 
Emotional responsiveness 
Reduced decision-making ability 
Impaired attention 
Concentration limits 
Limitations in executive function 
Mistakes at work 
Forgetfulness 

Job task redefinition / 
modification 

Modified tasks or 
additional support for 
existing or new tasks 

Job task reduction / 
easier tasks 

Modified tasks or 
additional support for 
existing or new tasks 

Gradually increased job 
tasks 

Modified tasks or 
additional support for 
existing or new tasks 

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Author(s), year 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Zafar et al. (2019) 

Mental health 
problems, all 

Cognitive 

Zafar et al. (2019) 
McDowell & Fossey (2015) 

Mental health 
problems, all 

Cognitive 

Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Minimising changes to 
job description over time 

Modified tasks or 
additional support for 
existing or new tasks 

Breaking down tasks 
into smaller tasks 

Modified tasks or 
additional support for 
existing or new tasks 

Attridge & Wallace (2010) 
Corbiere et al. (2014) 
Doki et al. (2016) 
Hamann et al. (2023) 
Mattila-Holappa et al. (2018) 
Pransky et al. (2016) 

Mental health 
problems, all 
Severe mental 
health problems 

Emotional / 
social 

Stamina / getting tired 
Emotional responsiveness 
Communication / social interaction problems 

Graded return to work, 
partial sick leave 

Modified tasks or 
additional support for 
existing or new tasks 

Attridge & Wallace (2010) 
Mattila-Holappa et al. (2018) 
Mellifont et al. (2016) 
Tremblay (2011) 

Mental health 
problems, all 
Anxiety 
Bipolar disorder 

Cognitive / 
emotional 

Stamina / getting tired 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Emotional responsiveness 
Struggling with a previously easy task 

Self-paced workload 

Modified tasks or 
additional support for 
existing or new tasks 

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Author(s), year 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Zafar et al. (2019) 

Mental health 
problems, all 

Cognitive / 
emotional 

Bolo et al. (2013) 
Wang et al. (2011) 

Depression / 
anxiety 

Cognitive / 
emotional 

Attridge & Wallace (2010) 
Bolo et al. (2013) 
Edgelow et al. (2023) 

Attridge & Wallace (2010) 
Bolo et al. (2013) 
Corbiere et al. (2014) 
Wang et al. (2011) 
Zafar et al. (2019) 

Mental health 
problems, all 
Depression / 
anxiety 
PTSD 

Mental health 
problems, all 
Depression / 
anxiety 

Cognitive 

Stamina / getting tired 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Emotional responsiveness 
Struggling with a previously easy task 

Training needs 
Stamina / getting tired 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Emotional responsiveness 

Stamina / getting tired 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Mistakes at work 
Forgetfulness 

Postponing tasks 

Modified tasks or 
additional support for 
existing or new tasks 

Allowing extra time to 
learn tasks 

Modified tasks or 
additional support for 
existing or new tasks 

Reducing distractions 

Modified tasks or 
additional support for 
existing or new tasks 

Emotional 

Stamina / getting tired 

Job sharing, exchanging 
minor tasks with other 
employees 

Modified tasks or 
additional support for 
existing or new tasks 

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Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Mental health 
problems, all 
Depression / 
anxiety 
PTSD 

Cognitive / 
emotional 

Stamina / getting tired 
Emotional responsiveness 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 

Job change/exchange 
/rotation 

Modified tasks or 
additional support for 
existing or new tasks 

Author(s), year 

Bolo et al. (2013) 
Corbiere et al. (2014) 
De Rijk et al. (2009) 
Edgelow et al. (2023) 
Mellifont et al. (2016) 
Shaw et al. (2014) 
Wang et al. (2011) 
Zafar et al. (2019) 

Doki et al. (2016) 
Mattila-Holappa et al. (2018) 
Mellifont et al. (2016) 

Mental health 
problems, all 
Anxiety 

Emotional / 
cognitive 

MacDonald-Wilson (2002) 
Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Cognitive 

Stamina / getting tired 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Emotional responsiveness 
Training needs 

Meeting deadlines 
Stamina / getting tired 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 

Job trial 

Modified tasks or 
additional support for 
existing or new tasks 

Tailored workday 

Modified tasks or 
additional support for 
existing or new tasks 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Emotional 

Stamina / getting tired 
Emotional responsiveness 
Struggling with a previously easy task 

Job task modifications to 
increase success 
experiences 

Modified tasks or 
additional support for 
existing or new tasks 

Mellifont et al. (2016) 

Anxiety 

Emotional / 
social 

Emotional responsiveness 

Shaw et al. (2014) 

Mental health 
problems, all 

Physical 

Chronic comorbid pain 

Presentation options 
(online presentations, 
substitute to back up) 

Modified tasks or 
additional support for 
existing or new tasks 

Reduce periods of 
prolonged sitting or 
standing 

Modified tasks or 
additional support for 
existing or new tasks 

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Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Mental health 
problems, all 

Mental health 
problems, all 

Mental health 
problems, all 

Physical 

Chronic comorbid pain 

Physical 

Chronic comorbid pain 

Physical 

Chronic comorbid pain 

Specific types of 
accommodation 
/support 

Avoiding twisting, 
bending, pushing, 
pulling and lifting of 
heavy objects 

Avoiding awkward 
postures 

Category of 
accommodation 

Modified tasks or 
additional support for 
existing or new tasks 

Modified tasks or 
additional support for 
existing or new tasks 

Special equipment to 
reduce pain caused by 
work 

Modified tasks or 
additional support for 
existing or new tasks 

Mental health 
problems, all 
Depression / 
anxiety 
Bipolar disorder 

Cognitive / 
emotional / 
physical 

Stamina / getting tired 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Emotional responsiveness 

Working from home 

Modified tasks or 
additional support for 
existing or new tasks 

Author(s), year 

Shaw et al. (2014) 

Shaw et al. (2014) 

Shaw et al. (2014) 

Attridge & Wallace (2010) 
Bolo et al. (2013) 
Corbiere et al. (2014) 
Eurofound (2019) 
Mattila-Holappa et al. (2018) 
Mellifont et al. (2016) 
Tremblay (2011) 
Wang et al. (2011) 
Zafar et al. (2019) 

Eurofound (2021) 

All mental health 
problems 

Emotional / 
cognitive 

Stamina / getting tired 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Emotional responsiveness 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Social / 
emotional 

Emotional responsiveness 

Right to disconnect 

Modified tasks or 
additional support for 
existing or new tasks 

Moving away from client 
work 

Modified tasks or 
additional support for 
existing or new tasks 

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Author(s), year 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Pransky et al. (2016) 

Mental health 
problems, all 

Emotional / 
cognitive 

Stamina / getting tired 
Emotional responsiveness 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Pransky et al. (2016) 

Mental health 
problems, all 

Social / 
emotional 

Emotional responsiveness 

Mattila-Holappa et al. (2018) 
Pransky et al. (2016) 

Mental health 
problems, all 

Social / 
emotional 

Emotional responsiveness 

Pransky et al. (2016) 
MacDonald-Wilson et al. (2002) 

Mental health 
problems, all 

Social / 
emotional 

Stamina / getting tired 
Concentration limits 
Emotional responsiveness 
Struggling with a previously easy task 

NIOSH (2019) 

Sleep problems 

Cognitive 

Sleepiness at work 

Reducing psychological 
job demands 

Modified tasks or 
additional support for 
existing or new tasks 

Assess efforts and 
provide rewards 

Modified tasks or 
additional support for 
existing or new tasks 

Adjust responsibilities, 
for example, away from 
the supervisor role 

Modified tasks or 
additional support for 
existing or new tasks 

Alter policies / 
processes / procedures 

Avoid monotony and 
muscle fatigue 

Modified tasks or 
additional support for 
existing or new tasks 

Modified tasks or 
additional support for 
existing or new tasks 

Attridge & Wallace (2010) 
Bolo et al. (2013) 
Corbiere et al. (2014) 
De Rijk et al. (2009) 
Dunleavy et al. (2020) 
Eurofound (2019) 
Edgelow et al. (2023) 
Gifford & Zong (2017) 
Hamann et al. (2023) 
MacDonald-Wilson (2002a) 
Mattila-Holappa et al. (2018) 
McDowell & Fossey (2015) 
Mellifont et al. (2016) 

Mental health 
problems, all 
Depression / 
anxiety 
Bipolar disorder 
PTSD 
Severe mental 
health problems 
Sleep problems 
Alcohol abuse 

Emotional 

Stamina / getting tired 
Emotional responsiveness 

Reduced work hours, 
from full-time to part-
time 

Scheduling flexibility 

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Author(s), year 

NIOSH (2019) 
Pransky et al. (2016) 
Shaw et al. (2014) 
Sundar et al. (2017) 
Tremblay (2011) 
Wang et al. (2011) 
Zafar et al. (2019) 

Corbiere et al. (2014) 
De Rijk et al. (2009) 
Dunleavy et al. (2020) 
Durand et al. (2014) 
Edgelow et al. (2023) 
Gifford & Zong (2017) 
MacDonald-Wilson (2002) 
Mattila-Holappa et al. (2018) 
McDowell & Fossey (2015) 
NIOSH (2019) 
Mellifont et al. (2016) 
Robbins et al. (2021) 
Shaw et al. (2014) 
Tremblay (2011) 
Zafar et al. (2019) 

Edgelow et al. (2023) 
Mattila-Holappa et al. (2018) 
Robbins et al. (2021) 

A review of good workplace practices to support individuals experiencing mental health problems 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Mental health 
problems, all 
Anxiety 
Bipolar disorder 
PTSD 
Sleep problems 
Alcohol abuse 

Emotional / 
cognitive 

Work scheduling 
Stamina / getting tired 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Emotional responsiveness 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Flexible work hours / 
schedules, possibility to 
have impact on working 
hours 

Scheduling flexibility 

Mental health 
problems, all 
PTSD 
Sleep problems 

Emotional / 
cognitive 

Work scheduling 
Stamina / getting tired 
Reduced decision-making ability 
Impaired attention 
Emotional responsiveness 

Reduced number / no 
night shifts 

Scheduling flexibility 

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Author(s), year 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

NIOSH (2019) 
Robbins et al. (2021) 

Sleep problems 

Emotional / 
cognitive 

Work scheduling 
Sleepiness at work 
Stamina / getting tired 
Reduced decision-making ability 
Impaired attention 
Emotional responsiveness 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Healthy shift work 
schedule 

Scheduling flexibility 

Corbiere et al. (2014) 
Dunleavy et al. (2020) 
Tremblay (2011) 
Zafar et al. (2019) 

Mental health 
problems, all 
Bipolar disorder 
Alcohol abuse 

Emotional / 
physical 

Stamina / getting tired 
Emotional responsiveness 

Paid/unpaid time off 
(e.g. for medical 
appointments) 

Scheduling flexibility 

Attridge & Wallace (2010) 
Bolo et al. (2013) 
Corbiere et al. (2014) 
De Rijk et al. (2009) 
Edgelow et al. (2023) 
Gifford & Zong (2017) 
MacDonald-Wilson (2002) 
Mattila-Holappa et al. (2018) 
NIOSH (2019) 
Robbins et al. (2021) 
Shaw et al. (2014) 
Tremblay (2011) 
Zafar et al. (2019) 
Wang et al. (2011) 

Tremblay (2011) 

Mental health 
problems, all 
Depression / 
anxiety 
Bipolar disorder 
PTSD 
Sleep problems 

Emotional / 
cognitive 

Stamina / getting tired 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Emotional responsiveness 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Reduced pace of work, 
more rest pauses 

Scheduling flexibility 

Mental conditions, 
all 
Bipolar disorder 

Emotional 

Stamina / getting tired 
Emotional responsiveness 

Leaves of absence 
allowed 

Scheduling flexibility 

European Agency for Safety and Health at Work – EU-OSHA 

78 

 
 
 
 
 
 
 
 
A review of good workplace practices to support individuals experiencing mental health problems 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Mental health 
problems, all 
Anxiety 

Social / 
emotional 

Emotional responsiveness 
Communication / social interaction problems 

Positive support / 
recognition / frequent 
feedback from the 
workplace/supervisor 

Communication 
facilitation 

Author(s), year 

Attridge & Wallace (2010) 
Corbiere et al. (2014) 
MacDonald-Wilson (2002) 
Pransky et al. (2016) 
Mattila-Holappa et al. (2018) 
Mellifont et al. (2016) 
Zafar et al. (2019) 

Attridge & Wallace (2010) 
Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Bolo et al. (2013) 
Mellifont et al. (2016) 
Zafar et al. (2019) 
Wang et al. (2011) 
MacDonald-Wilson et al. (2002) 
McDowell & Fossey (2015) 

Zafar et al. (2019) 

Mental health 
problems, all 
Depression / 
anxiety 

Mental health 
problems, all 

Social / 
emotional / 
cognitive 

Social / 
emotional 

Training needs 
Emotional responsiveness 
Limitations in executive function 

Follow-up of progress 

Communication 
facilitation 

Emotional responsiveness 
Concentration limits 
Limitations in executive function 
Communication / social interaction problems 

Increasing/modifying 
supervision; for 
example, weekly 
meetings with supervisor 

Communication 
facilitation 

Social 

Communication / social interaction problems 

Limiting changes in 
supervision/staff 

Communication 
facilitation 

Attridge & Wallace (2010) 
Mattila-Holappa et al. (2018) 
Zafar et al. (2019) 

Mental health 
problems, all 

Cognitive 

Task planning, meeting deadlines 
Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 

Help with task planning / 
management / setting 
priorities (e.g. 
scheduling deadlines) 

Communication 
facilitation 

Edgelow et al. (2023) 
Mattila-Holappa et al. (2018) 

Mental health 
problems, all 
PTSD 

Social / 
emotional 

Emotional responsiveness 

Supporting pet at the 
workplace / service 
animal 

Communication 
facilitation 

European Agency for Safety and Health at Work – EU-OSHA 

79 

 
 
 
 
 
 
 
 
Author(s), year 

Attridge & Wallace (2010) 
Bolo et al. (2013) 
Corbiere et al. (2014) 
Mattila-Holappa et al. (2018) 
McDowell et al. (2021) 
Sundar et al. (2017) 
Tremblay (2011) 
Wang et al. (2011) 
Zafar et al. (2019) 

A review of good workplace practices to support individuals experiencing mental health problems 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Mental health 
problems, all 
Depression / 
anxiety 
Bipolar health 
problems 
Severe mental 
health problems 

Social 

Emotional responsiveness 
Training needs 
Communication / social interaction problems 

Job coach / employment 
specialist 

Communication 
facilitation 

Mattila-Holappa et al. (2018) 
Zafar et al. (2019) 

Mental health 
problems, all 

Social / 
emotional 

Emotional responsiveness 
Communication / social interaction problems 

Permitting calls / positive 
calls to job coaches 

Communication 
facilitation 

Rumrill et al. (2023) 
Sundar et al. (2017) 

Attridge & Wallace (2010) 
Bolo et al. (2013) 
Gifford & Zong (2017) 
McDowell et al. (2021) 
Mellifont et al. (2016) 

McDowell et al. (2021) 

Bolo et al. (2013) 
Wang et al. (2011) 
McDonald-Wilson et al. (2002) 
McDowell & Fossey (2015) 

Corbiere et al. (2014) 
Mattila-Holappa et al. (2018) 
Mellifont et al. (2016) 
Sundar et al. (2017) 
Zafar et al. (2019) 

Cognitive 
problems 
Bipolar disorder 

Mental health 
problems, all 
Depression / 
anxiety 
Severe mental 
health problems 

Mental health 
problems, all 
Severe mental 
health problems 

Cognitive 

Cognitive 

Concentration limits 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Communication / social interaction problems 

Training needs 
Limitations in executive function 
Mistakes at work 
Forgetfulness 

Assisting technologies / 
apps 

Communication 
facilitation 

Work skills training 

Communication 
facilitation 

Social 

Communication / social interaction problems 

Social skills training 

Communication 
facilitation 

Depression / 
anxiety 

Cognitive / 
emotional 

Cognitive limitations 
Emotional responsiveness 
Limitations in executive function 

Individualised courses / 
training 

Communication 
facilitation 

Mental health 
problems, all 
Schizophrenia 

Social / 
emotional 

Emotional responsiveness 
Communication / social interaction problems 

Mentor / co-worker 
buddy 

Communication 
facilitation 

European Agency for Safety and Health at Work – EU-OSHA 

80 

A review of good workplace practices to support individuals experiencing mental health problems 

Author(s), year 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Zafar et al. (2019) 

Mental health 
problems, all 

Social / 
emotional 

Emotional responsiveness 
Communication / social interaction problems 

Orienting co-workers 

Category of 
accommodation 

Communication 
facilitation 

Corbiere et al. (2014) 
Edgelow et al. (2023) 
Gifford & Zong (2017) 
Mattila-Holappa et al. (2018) 
McDowell et al. (2021) 
Shaw et al. (2014) 
Sundar et al. (2017) 

Mental health 
problems, all 
PTSD 
Severe mental 
health problems 

Social / 
emotional / 
cognitive 

Emotional responsiveness 
Communication / social interaction problems 
Limitations in executive function 
Struggling with a previously easy task 

Assistance & help from 
co-workers, ‘back-up’ 
from a colleague 

Communication 
facilitation 

McDonald-Wilson et al. (2002) 
McDowell & Fossey (2015) 

Mental health 
problems, all 

Social / 
emotional / 

Communication / social interaction problems 

Training staff and 
supervisors 

Communication 
facilitation 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Social / 
emotional / 
cognitive 

Emotional responsiveness 
Communication / social interaction problems 
Limitations in executive function 
Mistakes at work 
Struggling with a previously easy task 

Possibility to ask for help 

Communication 
facilitation 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Social 

Concentration limits 
Communication / social interaction problems 

Working in a smaller 
group 

Communication 
facilitation 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Social / 
emotional 

Training needs 
Communication / social interaction problems 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Social / 
emotional 

Bolo et al. (2013) 
Corbiere et al. (2014) 
Mattila-Holappa et al. (2018) 
Wang et al. (2011) 
Zafar et al. (2019) 

Mental health 
problems, all 
Depression / 
anxiety 

Social / 
cognitive 

Communication / social interaction problems 

Concentration limits 
Difficulty following a fast-paced conversation 
Reduced decision-making ability 
Impaired attention 
Limitations in executive function 
Mistakes at work 
Forgetfulness 
Communication / social interaction problems 

Training difficult social 
contacts in a safe 
environment 

Communication 
facilitation 

Possibility to leave 
difficult social contacts 

Communication 
facilitation 

Written / modified 
instructions 

Communication 
facilitation 

European Agency for Safety and Health at Work – EU-OSHA 

81 

 
 
 
 
 
 
 
A review of good workplace practices to support individuals experiencing mental health problems 

Author(s), year 

Mental health 
condition 

Category of 
functional 
limitation(s) 

Specific issues/challenges at work  
to be addressed 

Tremblay (2011) 
McDowell & Fossey (2015) 
McDonald-Wilson et al. (2002) 

Mental health 
problems, all 
Bipolar disorder 

Social / 
cognitive 

Concentration limits 
Difficulty following a fast-paced conversation 
Mistakes at work 
Forgetfulness 
Communication / social interaction problems 

Specific types of 
accommodation 
/support 

Communication 
facilitation / 
communication by 
preferred medium 

Category of 
accommodation 

Communication 
facilitation 

Tremblay (2011) 

Mental health 
problems, all 
Bipolar disorder 

Social / 
emotional 

Concentration limits 
Emotional responsiveness 
Communication / social interaction problems 

Possibility to isolate from 
people 

Communication 
facilitation 

Durand et al. (2014) 
Pransky et al. (2016) 

Mental health 
problems, all 

Social / 
emotional 

Emotional responsiveness 
Communication / social interaction problems 

Return-to-work 
coordinator 

Communication 
facilitation 

Pransky et al. (2016) 

Pransky et al. (2016) 

Mental health 
problems, all 

Social / 
emotional 

Mental health 
problems, all 

Social 

Communication / social interaction problems 

Communication / social interaction problems 

Reducing problematic 
interactions with other 
people 

Communication 
facilitation 

Alter team organisation 
and structure 

Communication 
facilitation 

Attridge & Wallace (2010) 
Corbiere et al. (2014) 
Mattila-Holappa et al. (2018) 
Mellifont et al. (2016) 
Shaw et al. (2014) 
Tremblay (2011) 
Zafar et al. (2019) 
MacDonald-Wilson et al. (2002) 
McDowell & Fossey (2015) 

Corbiere et al. (2014) 
Gifford & Zong (2017) 
Tremblay (2011) 
Zafar et al. (2019) 

Mental health 
problems, all 
Bipolar disorder 

Emotional / 
cognitive 

Mental health 
problems, all 
Bipolar disorder 

Emotional / 
cognitive 

Concentration limits 
Reduced decision-making ability 
Impaired attention 
Mistakes at work 
Forgetfulness 
Struggling with a previously easy task 
Communication / social interaction problems 

Workstation 
modifications, 
workspace modifications 
(to allow own space) 

Physical space 
accommodation 

Concentration limits 
Impaired attention 

Reducing noise (e.g. 
headsets) 

Physical space 
accommodation 

NIOSH (2019) 

Sleep problems 

Cognitive 

Sleepiness at work 

Reducing vibration 

Attridge & Wallace (2010) 

Mental health 
problems, all 

Physical / 
emotional 

Communication, physical constraints 

Improving accessibility 

European Agency for Safety and Health at Work – EU-OSHA 

Physical space 
accommodation 

Physical space 
accommodation 

82 

 
A review of good workplace practices to support individuals experiencing mental health problems 

Author(s), year 

Mental health 
condition 

De Rijk et al. (2009) 
Shaw et al. (2014) 

Mental health 
problems, all 

Category of 
functional 
limitation(s) 

Physical / 
emotional / 
cognitive 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Concentration limits 
Communication / social interaction problems 

Transferring to another 
department / location 

Physical space 
accommodation 

Attridge & Wallace (2010) 
Corbiere et al. (2014) 
Veitch et al. (2011) 
Zafar et al. (2019) 
Robbins et al. (2021) 
NIOSH (2019) 

Mental health 
problems, all 
Sleep problems 

Emotional / 
cognitive 

Sleepiness at work 
Concentration limits 

Changing the lighting 

Physical space 
accommodation 

NIOSH (2019) 

Sleep problems 

Sleepiness at work 

Changing the 
temperature 

Physical space 
accommodation 

Corbiere et al. (2014) 
Gifford & Zong (2017) 
Zafar et al. (2019) 

Corbiere et al. (2014) 
Zafar et al. (2019) 

Tremblay (2011) 
Zafar et al. (2019) 

Zafar et al. (2019) 

Zafar et al. (2019) 

Mental health 
problems, all 

Mental health 
problems, all 

Mental health 
problems, all 
Bipolar disorder 

Emotional responsiveness 
Communication / social interaction problems 

Emotional 

Emotional responsiveness 

Transport 
accommodation (e.g. 
taxi) 

Physical space 
accommodation 

Medication / treatment 
related accommodations 

Physical space 
accommodation 

Emotional / 
physical 

Emotional responsiveness 

Access to water in 
workplace 

Physical space 
accommodation 

Mental health 
problems, all 

Emotional / 
physical 

Stamina / getting tired 
Emotional responsiveness 

Access to rest area 

Mental health 
problems, all 

Emotional 

Stamina / getting tired 
Emotional responsiveness 
Communication / social interaction problems 

Physical / 
emotional / 
cognitive 

Physical 

Durand et al. (2014) 

Mental health 
problems, all 

Emotional 

Stamina / getting tired 
Emotional responsiveness 

Durand et al. (2014) 
Edgelow et al. (2023) 

Mental health 
problems, all 
PTSD 

Emotional 

Stamina / getting tired 
Emotional responsiveness 

Hiring substitutes, 
proper staffing 

European Agency for Safety and Health at Work – EU-OSHA 

Access to private area 

Temporary reduction of 
the department’s 
productivity 
requirements 

Physical space 
accommodation 

Physical space 
accommodation 

Other 

Other 

83 

A review of good workplace practices to support individuals experiencing mental health problems 

Specific issues/challenges at work  
to be addressed 

Specific types of 
accommodation 
/support 

Category of 
accommodation 

Author(s), year 

Edgelow et al. (2023) 

Mental health 
condition 

Mental health 
problems, all 
PTSD 

Category of 
functional 
limitation(s) 

Physical / 
emotional / 
cognitive 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Emotional / 
cognitive 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Emotional / 
cognitive 

Stamina / getting tired 
Concentration limits 
Emotional responsiveness 

Stamina / getting tired 
Concentration limits 
Impaired attention 
Emotional responsiveness 

Concentration limits 
Impaired attention 
Emotional responsiveness 

Mattila-Holappa et al. (2018) 

Anxiety 

Emotional 

Emotional responsiveness 
Communication / social interaction problems 

Mattila-Holappa et al. (2018) 

Mental health 
problems, all 

Social / 
emotional 

Stamina / getting tired 
Emotional responsiveness 
Communication / social interaction problems 

Increasing work 
resources 

Access to gym 

Other 

Possibility for stress 
management & 
relaxation practices 
during the workday 

Listening to music 
during workday 

Exposure in vivo to 
anxiety-provoking work 
situations (e.g. as a part 
of psychotherapy) 

Other 

Other 

Other 

Other 

European Agency for Safety and Health at Work – EU-OSHA 

84 

 
 
A review of good workplace practices to support individuals experiencing mental health problems 

The European Agency for Safety and 

Health at Work (EU-OSHA) contributes to 

making Europe a safer, healthier and more 

productive place to work. The Agency 

researches, develops, and distributes 

reliable, balanced, and impartial safety and 

health information and organises pan-

European awareness raising campaigns. Set 

up by the European Union in 1994 and 

based in Bilbao, Spain, the Agency brings 

together representatives from the European 

Commission, Member State governments, 

employers’ and workers’ organisations, as 

well as leading experts in each of the EU 

Member States and beyond. 

European Agency 

for Safety and Health at Work  

Santiago de Compostela 12 

48003 Bilbao, Spain 

E-mail: information@osha.europa.eu 

https://osha.europa.eu