Stress

01 What Is Stress?
The NHS defines stress as: the feeling of being under too much mental or emotional pressure.

Pressure turns into stress when you feel unable to cope. People have different ways of reacting to
stress, so a situation that feels stressful to one person may be motivating to someone else.

“ Pressure turns
into stress when
you feel unable to
Mental health charity Mind says that stress isn’t a
psychiatric diagnosis, but it’s closely linked to your mental
health in two important ways:
(the things that cause stress) is key to keeping stress at an
acceptable level.

Many situations can cause or exacerbate stress such

cope yy Stress can cause mental health problems, and make
existing problems worse. For example, if you often
struggle to manage feelings of stress, you might
develop a mental health problem like anxiety or
depression.
as big life changes, whether they be positive – such as
moving home or getting married – or negative such as
bereavement. Stress can be related to work, family life,
relationships, housing, personal issues, or socio-economic
issues.

yy Mental health problems can cause stress. You might See Also:
find coping with the day-to-day symptoms of your
mental health problem, as well as potentially needing https://www.nhs.uk/conditions/stress-anxiety-depression/
to manage medication, heath care appointments or understanding-stress
treatments, can become extra sources of stress.
https://www.mind.org.uk/information-support/types-of-
Stress, which can sometimes be referred to as pressure or mental-health-problems/stress/#.W4lNePZFzIU
drive can be good for us. It can help us to make decisions,
meet deadlines or react in an emergency situation. It can
drive us to achieve goals and to thrive. However, when
stress is too prolonged or often it can turn into distress
and lead us to feeling overwhelmed and exhausted.
Managing our levels of pressure and identifying stressors

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 Symptoms of Stress Work Related Stress
The NHS defines stress as: the feeling of being under too
much mental or emotional pressure.

Cognitive symptoms Emotional symptoms

ƒƒ Memory problems ƒƒ Moodiness

ƒƒ inability to concentrate ƒƒ irritability or short temper

ƒƒ poor judgement ƒƒ agitation, inability to relax

ƒƒ focusing on the negative ƒƒ feeling overwhelmed

ƒƒ high levels of anxiety ƒƒ sense of loneliness or

isolation
ƒƒ constant worry
ƒƒ depressed or general
ƒƒ nervousness. unhappiness.

Behavioural symptoms Physical symptoms

ƒƒ Eating more or less ƒƒ Muscle tension and aches

ƒƒ sleep disturbance ƒƒ gastrointestinal Source: HSE

disturbance (diarrhoea
ƒƒ isolating oneself and constipation) Work related stress develops because a person is unable
to cope with the demands being placed on them. Stress,
ƒƒ procrastinating or ƒƒ nausea or dizziness
including work related stress, can be a significant cause of
neglecting responsibilities
ƒƒ chest pain, rapid heart illness and is known to be linked with high levels of sickness
ƒƒ using alcohol or drugs beat absence, staff turnover and other issues such as more errors.
to relax
ƒƒ loss of sex drive As well as absenteeism, presenteeism can be detrimental to
ƒƒ nervous habits (nail biting, a person’s wellbeing at work. Presenteeism, in the current
pacing...) ƒƒ frequent colds
context, refers to employees who are suffering from the
ƒƒ allergic reactions such as effects of work related stress but remain at work.
eczema.
Stressors are things that cause stress and triggers are
Pressure turns into stress when you feel unable to things that can start feelings of anxiety. Stressors in the
cope. People have different ways of reacting to stress, workplace could be targets, workload, long hours or feeling
so a situation that feels stressful to one person may be undervalued. Triggers in the workplace could include
motivating to someone else. having to speak in front of a large group of people, having
poor self-esteem or having too much pressure.
Stress can manifest itself in many ways both physical and
mental, some of the more common signs and symptoms of Employers have a legal duty to protect employees from
stress are shown in the table. stress at work by undertaking a risk assessment. If you
have fewer than five employees you don’t have to write
anything down. But it is useful to do this, so you can review
it later, for example if something changes. If you have five or
more employees, you are required by law to write the risk
assessment down. As with all risk assessments, a stress risk
assessment should look at how you will manage risk with
appropriate and reasonable controls.

A 2016 Chartered Institute of Personnel and Development’s

(CIPD) survey concerning absence, presenteeism and stress
in the UK shows:

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“ Stressors are
things that cause
stress
yy Overall, absence levels have dropped marginally
compared with the previous year, from 6.9 days per
employee per year to 6.3 days. However, it’s the CIPD’s
data about the causes of absence and the methods of
yy Around two-fifths of survey respondents say reported
mental health problems (such as anxiety and
depression) have increased among employees in the
past year.
managing it that provides the most food for discussion
and shows where employer attention needs to be yy The survey findings suggest that addressing long hours’
focused. cultures and increasing focus on wellbeing are among
the steps required by employers.
yy Stress has once again topped the list of the most
common causes of long-term absence, and is the The HSE has identified six areas that, if not managed
second most common cause of short-term absence properly, can lead to or exacerbate work related stress. They
after minor illness. also provide guidance for employees about dealing with
these circumstances. This guidance is summarised in the
table below:

Causes of How many employees What management should do to support employees

stress may demonstrate this
Demands An employee may ƒƒ the organisation should provide employees with adequate and achievable demands in
struggle to cope with relation to the agreed hours of work
the demands of their ƒƒ people’s skills and abilities should be matched to the individual job demands
job ƒƒ jobs should be designed to be within the capabilities of employees
ƒƒ any concerns raised by employees should be addressed
Control An employee may feel ƒƒ where possible, employees should have control over their pace of work employees
unable to have a say should be encouraged to use their skills and initiative to do their work
about the way they do ƒƒ where possible, employees should be encouraged to develop new skills, helping them
their work undertake new and challenging pieces of work
ƒƒ the organisation should encourage employees to develop their skills
ƒƒ employees should have a say over when breaks can be taken
ƒƒ employees should be consulted over their work patterns
Support Employees may feel ƒƒ an organisation should have policies and procedures to adequately support employees
that they do not receive ƒƒ systems should be in place to enable and encourage managers to support their staff
adequate information ƒƒ systems should be in place to enable and encourage employees to support their
and support from colleagues
their colleagues and ƒƒ employees should be aware of what support is available and how and when to access it
superiors ƒƒ employees should know how to access the required resources to do their job
ƒƒ employees should receive regular and constructive feedback
Relationships Employees may ƒƒ the organisation should promote positive behaviours at work to avoid conflict and
be subjected to ensure fairness
unacceptable ƒƒ employees should be encouraged to share information relevant to their work
behaviours, eg bullying ƒƒ the organisation should have policies and procedures in place to prevent or resolve
at work unacceptable behaviour
ƒƒ systems should be in place to enable and encourage managers to deal with
unacceptable behaviour
ƒƒ systems should be in place to enable and encourage employees to report unacceptable
behaviour
Role Employees may not ƒƒ the organisation should ensure that, as far as possible, the different requirements it
fully understand their places upon employees are compatible
role and responsibilities ƒƒ the organisation should provide information to enable employees to understand their
role and responsibilities
ƒƒ the organisation should ensure that, as far as possible, the requirements it places upon
employees are clear
ƒƒ systems should be in place to enable employees to raise concerns about any
uncertainties or conflicts they have in their role and responsibilities
Change Employees may feel ƒƒ the organisation should provide employees with timely information to enable them to
that the organisation understand the reasons for proposed changes
does not engage ƒƒ the organisation should ensure adequate employee consultation on changes and
with them frequently provides opportunities for employees to influence proposals
when undergoing an ƒƒ the organisation should ensure adequate employee consultation on changes and
organisational change provides opportunities for employees to influence proposals
ƒƒ employees should be aware of the probable impact of any changes to their jobs. If
necessary, employees should be given training to support any changes in their job
ƒƒ employees should be aware of timetables for changes
ƒƒ employees should have access to relevant support during changes

There are times in life and work when stress can be beneficial to us and actually works for, rather than against us. This is
referred to as eustress, and includes situations of high pressure, emergency situations, and when we require the drive we
need to get things done (meeting deadlines etc). When stress is to prolonged and happening too often it can become
detrimental and we call this distress. This prolonged stress can lead to exhaustion and eventually to burnout. This is detailed
in the graph below.

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 Seeking Help and yy harassment

Support
yy reduced productivity

yy accidents
The NHS suggests that If you’ve tried self-help techniques
and they aren’t working, you can get free psychological yy errors
therapies like cognitive behavioural therapy (CBT) on the
NHS. yy increased costs from compensation or health care.

You don’t need a referral from your GP and you can refer
yourself directly to a psychological therapies service, or you
can get a referral from your GP if you prefer.
You can also find mental health apps and tools in the NHS
apps library.
It is important to offer confidential support to employees
suffering stress. It is helpful to help employees recognise
stressors in their work and home life and learn how to
manage them effectively. The Barbour service offers
employee factsheets on stress and mental health at work.

See More: Some Tools to Tackle

Find a psychological therapies service in your area: https://
beta.nhs.uk/find-a-psychological-therapies-service/
Stress
You could:

Stress in the yy try these 10 simple stress busters: https://www.nhs.uk/

Workplace - Signs and

conditions/stress-anxiety-depression/reduce-stress/

yy use these easy time-management techniques: https://

Symptoms www.nhs.uk/conditions/stress-anxiety-depression/time-
management-tips/
Stress can lead to many problems in the workplace
including: yy try mindfulness – https://www.nhs.uk/conditions/stress-
anxiety-depression/mindfulness/ – studies have found
yy absenteeism mindfulness can help reduce stress and improve your
mood
yy high staff turnover
yy use calming breathing exercises: https://www.nhs.uk/
yy poor time-keeping conditions/stress-anxiety-depression/ways-relieve-
stress/
yy disciplinary problems

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“ Stress can
lead to many
problems in the
yy download some relaxation and mindfulness apps on
to your phone: https://apps.beta.nhs.uk/category/
mental_health/
workplace yy listen to an anxiety control audio guide: https://www.
nhs.uk/Video/Pages/anxiety-control-training-podcast.
aspx?searchtype=Tag&searchterm=Mental+health__
Moodzone&.
Other things that may help:
yy share your problems with family or friends
yy make more time for your interests and hobbies
yy take a break or holiday
yy take some regular exercise and make sure you’re eating
healthily
yy make sure you’re getting enough sleep (see tips on
better sleep).
Mental Health at Work
and the Law
All employers have a legal responsibility under the
Health and Safety at Work Etc Act 1974 (HASAWA) and
Management of Health and Safety at Work Regulations
1999 to ensure the health safety and welfare at work of
their employees. This includes minimising the risk of stress
related illness or injury to employees. Control measures
to reduce health risks such as work-related stress, once
identified, are required
The Equality Act 2010 – covers disability and discrimination
and brings together and replaces previous anti-
discrimination legislation and regulations including The
Disability Discrimination Act 1995.
One aim of the Equality Act 2010 is to protect people with
disabilities and prevent disability discrimination. The Act
permits greater scope for positive action and attempts to
enhance the legal protection for people with disabilities,
particularly mental illness.
The Mental Health Act 2007
The Mental Capacity Act 2005
The Human Rights Act 1998
The Management Health and Safety at Work Regulations
1999.
yy Employers must not treat a disabled person less
favourably than another employee because of disability.
PAGE 5 > BARBOUR – SAFE IN OUR KNOWLEDGE
yy Employers must not treat an employee badly because
you think they have a disability.
yy Employers must not treat an employee unfavourably
where this is a link to a disability.
yy Employers must make reasonable adjustments to work
practices, and provide other aids and adaptations, for
disabled employees.
yy The law covers employees during recruitment,
employment and if they are being dismissed for any
reason, including redundancy.
yy Employers are not allowed to use ‘pre-employment
questionnaires’ to ask about health before you offer a
job except in very specific circumstances.
Reasonable adjustments and flexibility are essential.
Fit Notes
A fit note is a doctor’s statement of an employee’s fitness
for work, which is designed to encourage employers,
employees and doctors to work towards a more flexible
approach at work, helping employees to return to work as
soon as they are able.
The Fit For Work Advice line in England and Wales can be
accessed on 0800 0 32 6235 and www.fitforwork.org. The Fit
for Work Scotland advice line in Scotland can be accessed
on 0800 019 2211 and www.healthyworkinglives.scot/
Pages/default.aspx.
The Government are encouraging employers to sign up
for the Time to Change campaign to end mental health
discrimination, details can be found here: http://www.time-
to-change.org.uk/.
Reasonable Adjustments
Reasonable adjustments are changes to enable a person to
work more easily and give them the equal opportunities.
Examples of reasonable adjustments for an employee with
a mental ill health conditions could include changes in
shift patterns, allowing time off for cognitive behavioural
therapy, or a gradual return to work.
Reasonable takes into account the time, cost and effort to
make the changes, how practical the changes are the size of
the organisation.
What Do Reasonable Adjustments Look
Like?
yy A phased return to work after absence starting with
part-time work and building up hours over a period of
weeks or months.
Stress
> 01
 yy Reviewing aspects of the job that are particularly
stressful and rearranging responsibilities.
yy Adjusting the content of the job with task variation.
yy Considering a review of training, development or
support needs after absence or illness.
yy Working at home for some of the time.
yy Time off for attending counselling/therapy, etc.
yy Changing shift patterns or exploring different work
options (e.g.part-time work, job sharing).
yy Flexible working around agreed outputs.
yy A later or earlier start to avoid rush hour travel.
yy Assessing the physical work environment.
yy Providing a quiet place for an employee to go in case of
feelings of stress or anxiety.
yy More frequent one to one opportunities for review with
a manager.
yy Providing a mentor in the workplace.
Source: Fit For Work
Return to Work Interviews
yy Welcome them back.
yy Establish if they are fit for work.
yy Explain any changes.
yy Discuss any handover arrangements.
yy Talk through reasonable adjustments.
yy Agree a time for next catch up.
yy Most of all – LISTEN.
Next Steps
Ensure the best possible working environment: promote
a happy workforce with management consultation and
support offered to employees:
yy Create a culture which encourages staff to make
their mental and physical wellbeing a priority: show
staff that the company invests in this.
yy Risk assess for the key stress factors at work: and
implement reasonable control measures.
PAGE 6 > BARBOUR – SAFE IN OUR KNOWLEDGE
yy Promote mental and physical wellbeing: through
training, seminars, work groups and handouts. Consider
workplace intervention in the form of an employee
screening and care management.
yy Understand mental health: educate yourself on the
most common conditions and the relevant legislation
and industry guidance.
yy Create a business case: employers need to understand
the positive business reasons of supporting staff with
mental ill health. It is key to understand issues such as
conflict, presenteeism, employee engagement and staff
turnover.
yy Act quickly when someone becomes mentally
unwell: talk to the person and involve specialists and
HR where necessary. Don’t let the process drift.
yy Tackle the causes of mental ill health and guarantee
early intervention: make sure you can spot the signs
of workplace stressors, or notice the early signs of a
mental health illness to stop a problem from escalating.
yy Consider mental health first aid: trained mental
health first aiders can spot signs and symptoms and
offer advice and support.
yy Encourage disclosure: talk to employees in a
supportive and confidential way in order to allow them
to be honest about their feelings. If possible, draw up
a document that identifies triggers and reasonable
adjustments.
yy Promote rehabilitation: understand the return to
work process from fit notes to reasonable adjustments
and communicate this to the relevant people. Ensure
a process is in place for those returning to work, which
allows them the best possible integration and support.
yy Make sure your policies and procedures are up to
date: and if appropriate there is a stress management
strategy in place.
Key Terms
Mental ill health: if a person is suffering mental ill health
then their state of emotional well-being may be affected.
Anxiety: a feeling of unease, such as worry or fear that can
be mild or severe.
Depression: depression affects people in many different
ways and can cause a wide variety of symptoms. They range
from lasting feelings of sadness and hopelessness to losing
interest in the things you used to enjoy and feeling very
tearful or anxious.
Stress
> 01
“ It is
important to
offer confidential
Stress: the feeling of being under too much mental or
emotional pressure.

Phased return to work: gradually rehabilitating a person

Mind
15-19 Broadway
Stratford
London
support to into their role. E15 4BQ
employees Tel: 020 8519 2122
suffering stress Fit notes: a form from a GP demonstrating how someone’s Fax: 020 8522 1725
health may affect their ability to work. Email: contact@mind.org.uk

Reasonable adjustments: changes to enable a person to Mind Cymru

work more easily and give them the equal opportunities. 3rd Floor, Quebec House, Castlebridge,
5-19 Cowbridge Road East,
Stressor: something that causes stress. Cardiff CF11 9AB
Tel: 029 2039 5123

Related Documents Email: contactwales@mind.org.uk

Samaritans
yy How to manage stress – Mind: https://www.mind.org.
Freepost RSRB-KKBY-CYJK
uk/media/1993364/how-to-manage-stress_2015.pdf
Chris
PO Box 90 90
yy Manage and Reduce Stress: https://www.mentalhealth.
Stirling
org.uk/sites/default/files/how-to-manage-and-reduce-
FK8 2SA
stress.pdf
Tel: 08457 90 90 90 (UK)
Tel: 116 123 (ROI)
yy Barbour Director’s Briefing: Fit Note
email: jo@samaritans.org
www.samaritans.org
yy Barbour Employee Factsheet: Fit Note

Construction Industry Helpline

yy Statement of Fitness for Work: Guide for Employers
Tel: 0345 605 1956
Email: info@LighthouseClub.org
yy Mental Health Promotion in the Workplace: Good
Website: www.lighthouseclub.org
Practice Report

B-eat
yy Working Together to Reduce Stress at Work: Guide for
Beat
Employees (INDG424)
Wensum House
103 Prince of Wales Road
yy Managing and Supporting Mental Health at Work -
Norwich
Disclosure Tools for Managers
Norfolk
NR1 1DW

Further Information Tel: 0300 123 3355

info@b-eat.co.uk

and References Anxiety UK

Zion Community Resource Centre
yy Combat Stress: https://www.combatstress.org.uk/
339 Stretford Road,
yy The Stress Management Society: http://www.stress.org. Hulme,
uk/ Manchester M15 4ZY
Tel: 08444 775 774 (open Monday to Friday 9.30- 5.30)
Rethink Mental Illness Admin/office line: 0161 226 7727
Head Office info@anxietyuk.org.uk
15th Floor
Mental Welfare Commission for Scotland
89 Albert Embankment
Thistle House,
London
91 Haymarket Terrace,
SE1 7TP
Edinburgh,
Tel: 0300 5000 927
EH12 5HE
Email: info@rethink.org
Tel: 0131 313 8777
Fax: 0131 313 8778

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 Scottish Association for Mental Health (SAMH)
Tel: 0141 530 1000
Email: enquire@samh.org.uk

Niamh Mental Wellbeing

80 University Street
Belfast
BT7 1HE
Tel: 028 9032 8474
Email: info@niamhwellbeing.org

Mental Health First Aid – England

MHFA England,
49-51 East Road,
Old Street,
London,
N1 6AH
Tel: 020 7250 8062

Mates in Mind
Registered office:
70 Chancellors Road,
London
W6 9RS
Web: https://www.matesinmind.org

Date of Issue: September 2018

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