Why it’s time to inspect work-related stress

Through its web pages and publications, the Health and Safety Executive (HSE) reminds employers that they have a legal duty to protect workers from stress at work. Unlike many other hazards or hazardous activities (such as Noise or Working at Height), stress is not addressed in any specific Regulations. Rather, it is implicitly encompassed by the overarching duties of employers to ensure the health, safety and welfare of employees.

Despite these duties, workers are still being harmed. Each year, the HSE presents data regarding occupational fatalities, injuries and ill-health. The latest statistics, covering April 2023-March 2024, were released in November 2024. This included a specific analysis of work-related stress, depression and anxiety.

Drawing from the Labour Force Survey (LFS) data, the HSE estimates that 776,000 workers are suffering from both new and long-standing cases of stress, depression or anxiety. This is a prevalence rate of 2,290 cases per 100,000 workers. This accounted for 16.4 million working days being lost (an average of 21.1 days per case).

The LFS is a national survey of 23,000 households run by the Office of National Statistics (ONS). The HSE commissions the ONS to include questions relating to work-related illnesses and injuries. The HSE has been collecting data through the LFS since 1990 and the figures do paint a broadly consistent picture.

The HSE has a 10-year strategy to fulfil its mission of 'protecting people and places' (the current strategy runs from 2022-2023). In this document, the HSE recognises that there is an upward trend in work-related ill-health, with stress, depression or anxiety being the most common causes. The HSE states that it will work to reduce this trend.

To turn such commitments into action, the HSE sets out a range of deliverables in annual business plans. In the 2024-2025 plan, the HSE states (p.9) that it will develop 'practical steps for all workplaces that help them prevent exposure to issues causing work-related stress.

Our ongoing focus on musculoskeletal disorders and other health risks means we are already targeting key causes and factors that underly work-related stress. In this statement, the HSE is singling out the effective management of physical health risks, rather than a range of other organisational factors, as a crucial step for reducing psychological harm. We might also question the assertion that employers can prevent, rather than assess and manage, exposure to issues causing work-related stress.

In this business plan, the HSE commits to undertaking 14,000 pro-active inspections. Of these, just 16 will specifically relate to 'violence, aggression and work-related stress' (p.41).

In contrast, a total of 4000 inspections will target exposure to silica and wood dust (which cause a range of respiratory conditions).

A search of the HSE's enforcement data (which is freely accessible to the public) reveals that stress has not been the subject of any 'successful' prosecutions in the past 10 years. Of the 29,777 enforcement notices that have been issued in the past five years, none refer to stress (compared to 1086 that mention silica or 4580 mentioning wood dust). Only one intervention refers to mental health. This related to the failure by a Hospital Trust to remove identified ligature points from wards for mental health patients, rather than risks to employees.

These figures do not capture other HSE interventions, such as giving advice to organisations. This can still be an expensive and onerous process as the HSE can charge £174 per hour under the fee for intervention scheme if they believe there is a material breach of health and safety law, regardless of whether they take enforcement action.

In short, the HSE's concern about physical ill health is reflected in their inspection regime and enforcement history. The same cannot be said for work-related stress. It may be beneficial to explore this mismatch (for example whether or why different significance is attached to physical and psychological health).

Even with more inspections, the HSE cannot visit every organisation. There are other and potentially better ways of driving positive changes. As one example, the HSE held an ill-health 'prevention summit' in November 2024, featuring speakers such as Sir Cary Cooper.

Those organisations are, however, routinely advised by human resources, health and safety, and (sometimes) occupational health professionals. Psychologists could have a significant and positive impact by providing allied professions with a practical, evidence-based understanding of how to support psychological health at work.

Dr Nick Bell CPsychol CFIOSH
Honorary Principal Lecturer, Cardiff Metropolitan University