This guideline is for all people aged 16 or over in full-time or part-time employment, including those on permanent, training, temporary or zero-hours contracts, and those who are self-employed and volunteers.

This guideline has been updated because NICE identified new evidence that could affect the recommendations.

Despite evidence that better mental wellbeing and job satisfaction are associated with increased workplace performance and productivity, the government review Thriving at work estimates that 15% of UK workers have an existing mental health condition. Poor mental wellbeing costs employers in the UK an estimated £42 billion to £45 billion annually through presenteeism, sickness absence and staff turnover (Deloitte [2020] Mental health and employers: refreshing the case for investment).

The total annual cost of poor mental wellbeing to the government, including NHS costs, benefit provision and tax revenue losses, is between £24 billion and £27 billion. Lost output costs the economy between £74 billion and £99 billion (Thriving at work). Changes to workplaces and working patterns as a result of the COVID‑19 pandemic have had a large impact on working practices and organisational cultures; however, it is unclear what the longer-term effects of this will be.

Workplace policies and activities to promote and protect employee mental wellbeing vary widely. Mental wellbeing has been described as 'feeling good and functioning well', reinforcing that mental wellbeing is on a spectrum and positive mental wellbeing is not just the absence of symptoms of poor mental health. Consequently, the aim of interventions should not just be to prevent poor mental health, but instead should promote positive mental wellbeing.

The Department for Work and Pensions reports that most employers have basic health and wellbeing policies, including at least 1 covering flexible working, sick pay or injury training (Department for Work and Pensions [2014] Health and wellbeing at work: a survey of employees). Larger and public sector organisations are more likely to offer at least 1 of the following: health screening, occupational health services, independent counselling or stress management.