Guest blog by Emily Pearson, Founder and CEO, Wellbeing Lead Academy
Occupational health often sees the consequences of work long before the board sees the pattern.
By the time an employee reaches occupational health, something has usually already happened. They may have been absent for weeks. Their manager may no longer know what to do. A return-to-work plan may have stalled. Occupational health can assess the individual, advise on the relationship between health and work, and recommend adjustments.
But there is another question organisations need to ask much earlier: what is happening upstream?
Is workload or lack of support contributing to the deterioration? Were psychosocial risks identified and acted on? Does the manager have the capability, capacity and authority to respond? Is this one individual case, or part of a pattern across a team or business? And who is responsible for joining those dots?
I come to this from outside occupational health. I have spent more than 25 years working across mental health, health and social care, and the last decade working with employers on workplace wellbeing. I have repeatedly seen organisations invest heavily in support around the individual while leaving the conditions of work largely untouched. Employee assistance programmes, awareness campaigns, mental health training and peer support can all have value. But support is not the same as prevention, particularly when workload, job design, poor management or culture are contributing to the harm.
As occupational health considers how its role should evolve in response to the UK's workforce health challenge, this distinction matters. I want occupational health to have more influence, not simply more responsibility. Broadening the profession's contribution cannot mean handing it every problem that sits elsewhere in the system.
Occupational health can identify repeated stress referrals from one team; it cannot redesign that team's workload. It can recommend an adjustment; it cannot guarantee that a manager has the capability or resources to implement it well. It can identify health barriers to a sustainable return to work; it cannot, alone, change a culture in which people are frightened to say they are struggling.
Human sustainability gives us a more useful question: is the organisation designed to sustain the health, energy and capability of the people it depends on, or does it wait until people become unwell and then try to repair the damage?
We are not short of guidance. Thriving at Work set out core mental health standards for employers. NICE now recommends that organisational-level approaches form the foundation of workplace mental wellbeing, with preventive action on culture, workload, job quality and autonomy.
HSE is equally clear that employers have a legal duty to assess and act on work-related stress risk. In 2024/25, 964,000 workers reported work-related stress, depression or anxiety, 52% of all work-related ill health. Read only as wellbeing statistics, those figures are worrying. Read as organisational risk data, they are telling us where prevention is failing.
This is why boundaries and governance matter. Health and safety brings risk identification and control. Occupational health brings clinical and work-health expertise. HR shapes employment systems and policy. Managers shape the everyday experience of work. Strategic wellbeing leadership should connect those functions, translate data into prevention and recovery priorities, and stop gaps forming between them.
Senior leaders must provide the mandate, resources and accountability that make the system work.
The opportunity is not for occupational health to own workplace mental health. It is for organisations to listen to occupational health differently. Referral patterns, adjustment recommendations and case trends can become organisational intelligence when they are appropriately aggregated, governed and connected to decision-making upstream.
Occupational health should not be expected to carry the failures of the wider system. Its insight should help the wider system improve.
We have published a free practical guide to help organisations identify which problem they are actually trying to solve, where responsibility sits, and what to do when the cause of harm falls outside one function's remit.
Download Creating a Mentally Healthy Workplace Practical Guide.
Emily Pearson is Founder and Chief Executive Officer, Wellbeing Lead Academy, and author of Solving a CEO's Blind Spot: Human Sustainability.