NHS Health Scotland
Outcome Indicators


5.6 Activities in the workplace to promote mental wellbeing and prevent mental health problems will increase the knowledge and skills of managers and employees about mental health, increase the capacity of managers and employees to manage risk to mental health and increase job satisfaction. This, in turn, will contribute to a mentally health workplace in which there are improvements in the context, content and quality of work, reduced absenteeism and presenteeism, improved work-life balance amongst employers and more appropriate returns to work.

Informed by reviews of effectiveness evidence, NICE public health guidance Promoting mental wellbeing through productive and healthy working conditions: guidance for employers made action recommendations in five areas: strategic and coordinated approach to promoting employees’ mental wellbeing; assessing opportunities for promoting employees’ mental wellbeing and managing risk; flexible working; the role of line managers; and supporting micro, small and medium-sized businesses. The NHS Health Scotland Scottish Perspective on this guidance supported the action point’s subject, where appropriate, to adaptation to fit Scottish organisational arrangements.[1]

The Foresight Report [2, 3] shows that promoting mental wellbeing in employment and working life for all employees can improve productivity and reduce the prevalence of mental health problems. Poor-quality leadership has also been linked with mental health consequences (such as stress, burnout and depression), while high-quality leadership is related to reduced incidences of these negative outcomes as well as increased wellbeing. Flexible working arrangements enable individuals to integrate work and family responsibility within their personal time and space and are important in achieving a work–family balance. Research, however, suggests it is not enough to just implement family-friendly arrangements, but that family–work arrangements should be integrated into the organisational culture. The report suggests that workplace interventions to address stress and the consequences of stress are most promising if they involve a risk analysis, a participatory approach and a combination of person and organisation-focused programmes. Person focused interventions (stress management training), in particular those combining cognitive-behavioural techniques and relaxation can be effective in improving individual wellbeing. There is limited evidence, however, to suggest that individual approaches rather than organisational and organisational development approaches are more effective in managing common mental health problems. The effectiveness of organisation-focused interventions addressing (i) the nature of the task (ii) work environment and (iii) social relations is difficult to judge due to the lack of good studies; however, they have demonstrated potential. Changes are most likely in variables that are immediately targeted – e.g. increasing autonomy – and the effects can be expected on the organisational level (absenteeism).

On the basis of evidence, the Foresight project identified possible initiatives that would enhance mental health and wellbeing at work. A range of promising interventions were identified for further analysis. Interventions fell into five categories:

  1. Assess work environments for impact on mental capital and wellbeing.

  2. Better diagnosis and remediation of underlying work related stress.

  3. Develop more sophisticated ways of flexible working.

  4. Improve managerial competence in providing healthy workplaces.

  5. Raise the profile of mental health and wellbeing at work.



  1. NHS Health Scotland (2010). Scottish Perspective on NICE public health guidance 22: Promoting mental wellbeing through productive and healthy working conditions: guidance for employers. NHS Health Scotland: Edinburgh..

  2. Foresight Mental Capital and Wellbeing Project (2008). Final Report. The Government Office for Science, London. 

  3. Semmer, N.K. (2008). State-of-Science Review: SR-C6 Stress management and wellbeing interventions in the workplace. Government Office for Science: Foresight: London.