If you see workplace clients, it’s likely that you’ll be pretty familiar with the term ‘the toxic workplace’, but I want to start by clarifying what it means. The Merriam-Webster dictionary defines a toxic workplace as a workplace environment, (culture, work practices and/or workload), that is ‘extremely harsh, malicious, or harmful’ to its employees’, suppliers’ and/or stakeholders’, mental health and/or wellbeing.1 Based on this definition of a toxic workplace, many of us will have either experienced one ourselves or know someone who has worked in a workplace that had a detrimental effect on their mental health and wellbeing.

While employees and employers recognised many years ago that there is a responsibility for workplaces not to cause anyone physical harm, it is only comparatively recently that there has been recognition that this responsibility includes psychological harm. This arguably reflects the historic view of mental health being an individual’s issue, rather than a social/societal one. The focus on the physical aspect of employee health extends to the application of legislation regarding workplace health and safety, with the vast majority of historic action related to physical harm. Indeed, if you had asked many people 10 years ago about the Health and Safety Executive’s (HSE) work, we would probably have envisaged physical injuries and accidents being investigated. We would have expected guidance on workplace accidents, resulting in injuries such as musculoskeletal injury through risks such as falls, slips and trips and/or incorrect manual handling.

Health and Safety Executive

The Health and Safety Executive (HSE) actually provides a wealth of information and research on mental health in the workplace.2 A specific focus of this is workplace stress, which HSE defines as ‘the adverse reaction people have to excessive pressures or other types of demand placed on them’. HSE research has found six main causes of workplace stress:

  • Demands - Employees may say that they are not able to cope with the demands of their jobs.
  • Control - Employees may say that they are unable to control the way they do their work.
  • Support - Employees may say that they don’t receive enough information and support.
  • Relationships - Employees may say that they are having trouble with relationships at work, or are being bullied.
  • Role - Employees may say that they don’t fully understand their role and responsibilities.
  • Change - Employees may say that they are not engaged when a business is undergoing change.2

Employees can and do play an active role in their workplace culture and have agency in some of the six key areas. However, there is a danger that the focus by employers is on the employee’s reaction to stressors rather than reducing the stressor itself.

The Employee Assistance Professionals Association (founded in 1998) cites HSE’s publication of the ‘Stress Management Standards’ in 2005 as fuelling the rapid expansion of employee assistance programmes (EAPs).3 As the number of EAPs increases, more counsellors are providing their services through links with these organisations. While this is positive for employees, who benefit from funded access to psychological therapies through their workplace EAP, the EAPs focus on the individual addressing their mental health, rather than a more systemic perspective.

Ethics and altruism?

Is the increase in EAPs and other mental health-related workplace initiatives, such as Mental Health First Aid courses, purely driven by employers’ ethical and altruistic motives? Or are there other factors driving this desire by employers to address mental health and wellbeing in the workplace? Some of these other factors could include the fact that there is a steady increase in employment tribunals citing disability discrimination,4 with the Ministry of Justice5 figures indicating a 37 per cent increase between 2017 and 2018, a significant proportion of which relate to workplace stress. It would seem that many employees are increasingly calling employers to account for the impact of the workplace on their mental health.

The impact of employee impaired mental health is being felt in the workplace, with 44 per cent of work-related ill health cases in 2017/18 being attributed to stress, anxiety or depression, which results in 57 per cent of all working days lost due to ill health.6 This translates to over half a million affected workers being absent from work for 15.4 million working days. The latest available figures indicate the cost of annual working days lost from 2014/15 is a staggering £5.2 billion.7

The figures above only show part of the impact as they focus on staff absence where stress, anxiety or depression has been stated as the reason for the work absence. In addition to this, is the cost to organisations of the estimated 15 per cent of employees who are in work but whose performance is impaired due to mental health issues, which is calculated to be between £33 and £42 billion.6

Who is responsible?

Whatever the motivation, employers have a responsibility for the mental health of their employees, just as they have for their physical health. There is a range of legislation; for example, Management of Health and Safety at Work Regulations 1999, which state that employers must assess the nature and scale of health risks at work, which includes stress. The Working Time Regulations set out an employer’s responsibilities for hours worked and paid holidays, and the Equality Act 2010 requires employers to make reasonable adjustments to their work or workplace.

Over the years, health and safety at work have evolved and the risks taken with the physical health of employees in the past are shocking when seen from today’s perspective. However, I wonder if we will look back at the cavalier attitude some employers have to their employees’ mental health today as akin to an industrial revolution factory or mine owner’s treatment of their workforce? It is interesting to note the tone of communication from the legal community to employers regarding two legal cases that set a precedent regarding an employer’s responsibility for psychiatric illness caused by workplace stress. The two cases, Hatton versus Sutherland in 20028 and Easton versus B&Q in 20159 both found that if an employer can argue that the employee’s stress is not foreseeable , ie the employee is in work or has returned to work and the employee has not explicitly stated to the employer that they are suffering stress, then the employer will not be found liable. Essentially, the message was that if the employee doesn’t proactively raise an issue with their employer, the employer is off the hook.

Meeting the employers

Let’s look at a couple of examples of the issues faced by counsellors as workplaces address their I recently met with two HR managers from very different companies who wanted to discuss mental health support for their employees. The first was a technological company, let’s call it ‘Techie’ , all exposed brickwork, football tables and the indomitable perky demeanour of an industry that is riding a financial wave. It was less than two years old and had sprung up to meet a customer need that didn’t exist five years ago, essentially not that much different to a shanty town at the mouth of a newly discovered goldmine, and with arguably no deeper foundations. The second was a Welsh Valley survivor, let’s call it ‘Old School’, which had altogether deeper foundations. Old School was founded over 50 years ago. It settled in to its red brick building, now with rusted metal windows and the tired sag that proclaimed it was well past its prime. No clipped verges here. Instead, weeds sprang from the cracks in the uneven concrete entrance and a buddleia looked down triumphantly from its precarious position, wedged in the guttering. This is a family company that has continued manufacturing its products through decades of economic storms, adapting, evolving and surviving as the markets changed, workforces diversified and customers retreated behind their keyboards.

Techie was in an entirely different situation: its financial wave could have crashed at any moment, casting the horde of 20-something employees adrift, displaced from their rented flats, in their summoned Ubers, to destinations unknown. Or back to bemused parents to camp restlessly and reluctantly in disappointed childhood bedrooms and dreams.

Old School had a glossy showroom, which was the latest iteration of its marketing persona, an instagrammable façade as far from the reality of its 1960s-built reality as the other 50-year-old influencers, who also presented their glossy, nipped and tucked, botoxed and photo-shopped faces to their clicking, judging audience.

It felt as if these organisations couldn’t be further apart, but as I sat in their vastly different HR departments, I pondered on how the issue that brought me to them was virtually the same. They had recognised that there was a need to address the mental health issues of their staff. For both organisations there had been a catalyst for getting in touch. For one, an attempted suicide by a staff member had been followed by an increase in issues of stress being reported and an increase in sickness absence. For the other, staff themselves had voiced their struggles with the workload and asked for additional support from managers, due to the resulting stress.

In both organisations, the managers had expressed their uncertainty about what support to offer, and were themselves struggling with their own workplace stress. In the meantime, morale and productivity were dropping and sickness absence and mistakes were increasing. So here I was, listening to the shopping list of desired outcomes from their respective HR managers. One of the items requested was for specific members of staff to access counselling services as soon as possible. I reflected that they were essentially saying that some of their human resources were impaired and needed to be fixed and they saw counselling as the answer to this problem; but is this what we, as counsellors, are here for?

We’re certainly part of the solution, but as I listened to the HR managers, I was struck by their focus of action on the individual. They were the ones who, through counselling, were supposed to fix their mental health in order to deliver the output that they as a human resource were being paid to produce. Is this too harsh? Maybe. This is certainly not what the HR managers said. Their language was littered with phrases like ‘managing stress’, ‘building resilience’ and ‘coping with pressure’. These are all useful skills and I acknowledge that counselling will help with all of these. I also understand that there is differing vulnerability to workplace stress, depending on the individual’s life history and current life situation. But where is the organisation’s responsibility in this? Does this make us as counsellors akin to an army doctor, patching up the battlefield wounded in readiness to return them to the fray? If so, how do we feel about this? Is this what we have trained for?

Both Techie and Old School’s HR managers described a number of factors that their workforce was currently subjected to, which I recognised from the HSE six main causes of workplace stress list. Both companies were going through a period of growth, leading to changes in their working practices and an increased individual workload. This growth had led both companies to recruit additional staff to join teams being managed by team leaders who had either recently been promoted from within or were new to the organisation. To use the Health and Safety Executive’s words, this means that there had been a period of change, leading to increased demands on employees, and it was likely that new staff and newly promoted staff were unclear on their role and had limited control over the situation. Given the increased workload, staff might not be receiving the support that they needed, potentially leading to difficult workplace relationships.

Identifying risk

We have just ticked off all six of the factors identified as resulting in workplace stress. If I were completing a risk assessment for either company, it would be clear that staff stress would be an identifiable risk. Why then had it not been identified? Why, when Techie had adjustable anti-glare screens, ergonomic chairs and adjustable-height desks, had no one considered that constantly working long hours and performing complex tasks to meet tight deadlines were a risk to health? In the same vein, in Old School , the factory machinery had safety guards, the employees wore appropriate PPE (personal protective equipment) such as ear guards and were surrounded by posters on safe manual handling. But it hadn’t occurred to anyone that significantly increasing the number of products produced, with the new and inexperienced staff working in a cramped area, subjected to increasing monitoring of quality and being asked to continually improve, was going to be stressful. Particularly when, in both companies, many of the team leaders were now leading teams that were previously their peer group. So, while occupationally competent, they had no experience of managing people and certainly not of managing their friends.

Could these two organisations be described as toxic? I think so. If, for example the workload is so high and the pace of work so relentlessly fast that anyone who is subjected to it is likely to be negatively impacted, is it the employees’ responsibility to adapt their response to this pressure? Isn’t this akin to sending an employee to weight training so that in the workplace they can be expected to carry heavier and heavier loads? This puts the responsibility solely on the individual, with the implication that those employees who cannot carry the metaphorical load are weak, a trope that in itself is toxic to an individual’s mental health and a narrative that is implicated in the stigma surrounding mental health.

While the employees in both companies would be subject to a range of factors impacting on their mental health, both workplaces would be likely to be at best adding additional stress and at worst be the primary cause of an employee’s mental health issues.

I reflected how, as a counsellor being referred clients from either organisation, I should/would address the organisation’s role from the perspective of my client. The first question was, if it became clear that the client’s mental health issue was directly related to the workplace, should I be addressing the cause? I have reflected on this at length and acknowledge that we are caught between the individual and organisation’s responsibility and our usual focus of working with what’s in the room. But can we really restrict our voices on this issue to within the counselling room’s four walls? If we are taking referrals from an organisation, whether directly or through an EAP, and we become aware that an organisation’s toxic environment is harming our client, if we don’t speak up, aren’t we complicit in the damage to our client?

Finding solutions

I believe there are actions we can take that fit within our ethical guidelines and the counselling remit but also reduce the risk of us becoming complicit in the continued workplace actions that are causing harm.

In the counselling room, I will ask clients about options for practical support and specifically discuss the pros and cons of raising the issue with their manager/s, including the potential legal implications. I will also signpost to relevant legislation, and organisations such as HSE, whose workplace stress guidance may enable the client to recognise that the issue is not theirs but the organisation’s. By supporting clients to let their organisation know which working practices are negatively impacting them, the organisation, through being made aware of the issue, has the opportunity to rectify it. At the very least, their awareness of the problem removes the ‘not foreseeable’ legal defence, should the client pursue the organisation for its part in damaging their mental health.

If we are working with an EAP, while maintaining client confidentiality, we could feed back that the organisation might benefit from training, for example.

At Breathe (www.breathespaces.com), where I am Director, we provide a range of mental health and wellbeing services for individuals and companies, including counselling, training and consultancy. With a background in occupational psychology, and being a Fellow of the Institute of Leadership and Management, who is currently completing a Doctorate in Counselling Psychology, without wishing to sound like an X Factor contestant, I’m passionate about improving mental health and wellbeing in the workplace.

At Breathe, we are working with organisations to develop a range of programmes in addition to EAP provision that enables them to not only reduce their toxicity, but actively support and improve the mental health and wellbeing of their employees. My doctorate research is to measure the efficacy of equipping employees with the skills to not just survive within a toxic workplace but to proactively challenge and change negative working practices.

What of Techie and Old School? For both organisations, we plan to support the EAP counselling provision with bespoke training that is informed by the experience of their employees and therefore designed to address the specific negative workplace practices that are damaging their employees’ mental health and wellbeing. This strategy means that the EAP counselling service becomes a safety net, supporting individuals experiencing mental health issues, rather than a trampoline, bouncing individuals straight back into a toxic workplace.

For our counsellors, we have a robust induction and continuing professional development programme that equips them with the information and resources to provide clients with the support and signposting that they need. In addition, we include the impact of workplace systemic issues within supervision with this information as an aspect of our workplace reporting process.

Closing thoughts

I realise that this is a complex matter but, just as we are adept at balancing complicated and sometimes conflicting factors within the counselling room, we need to utilise this skill outside the room as well. I haven’t provided a complete answer; I’m not sure there is one; but I know that we have to acknowledge and mitigate the risk of becoming the cost- effective sticking plaster on the psychological wounds that an organisation is inflicting. In these days of seemingly never-ending austerity, exacerbated by the looming implications of Brexit and the continual drive by organisations to seek to do more with less, while maintaining quality and a competitive edge, it is likely that levels of workplace stress and its negative impact on employee mental health, will continue to rise. We cannot be silently benefitting from organisations that focus on employees managing the symptoms of a toxic workplace, rather than actively encouraging organisations to acknowledge and address the underlying causes.

Helen Jones is the Director of Breathe, a counsellor, training specialist and Fellow of the Institute of Leadership and Management. She is currently completing a Professional Doctorate in Counselling Psychology, with a research focus on mental health and wellbeing in the workplace. www.breathespaces.com www.platfform.org All profits will be reinvested into Platfform’s work, for mental health and social change.


1 Merriam-Webster.com [Online.] https:// www.merriam-webster.com (accessed27 August 2019).
2 Health & Safety Executive. Management of health and safety in the workplace: UK results from European survey of enterprises on new and emerging risks, 2014 (ESENER-2). http://www.hse.gov. uk/statistics/pdf/oshman. pdf?pdf=oshman.
3 Employee Assistance Professionals Association. History of EAPs. [Online.] https://www.eapa.org.uk/organisationalbackground/ [accessed 27 August 2019].
4 www.foxlawyers.com. 2019. Sharp rise in disability discrimination claims at tribunals. [Online.] https://www.foxlawyers.com/ sharp-rise-in-disability-discriminationclaims-at-tribunals/ (accessed 27 August 2019).
5 Ministry of Justice. [Online.] https://www. gov.uk/government/organisations/ ministry-of-justice, Tribunal Statistics. (accessed 27 August 2019).
6 Health & Safety Executive. Work-related stress, depression or anxiety statistics in Great Britain, 2018 – annual statistics. [Online.] http://www.hse.gov.uk/statistics/ causdis/stress.pdf (accessed 27 August 2019).
7 Health & Safety Executive. 2019. Work-related stress and how to tackle it. [Online.] http://www.hse.gov.uk/stress/ what-to-do.htm (accessed 10 May 2019).
8 The HR Exchange. 2011. HATTON V. SUTHERLAND (2002) EWCA Civ 76 (2002) PIQR P241. [Online.] http://www.thehrexchange.co.uk/ wp-content/uploads/2012/06/HATTONV.-SUTHERLAND.pdf (accessed 27 August 2019). 9 Menzies Law. 2015. Case update (2): health and safety – seeing stress coming. [Online.] https://www.menzieslaw.co.uk/ case-update-2-health-and-safety-seeingstress-coming/ (accessed 27 August 2019).