Under Pressure: Mental Health at Work in Times of Uncertainty

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[author: Stefano de Luca Tamajo]*

Today is World Mental Health Day. To mark the occasion, we have republished our article exploring the important area of workplace mental health, one of the most pressing concerns for employers globally in today’s difficult climate. First, we explore the position in Italy and then seek insights from 18 other countries from across the world, including three new contributions from Belgium, Estonia and Germany for this republished version.
 

Mental health at work can be a difficult area for employers to navigate – even more so in the challenging and complex environment of today. Potential workplace restructurings, downsizings, and technological advancements, against a backdrop of broader global uncertainty, are creating a volatile environment that significantly affects workers’ mental well-being. Nevertheless, it is something that employers must take seriously as failing to manage it correctly can have significant legal implications.

In this article, we first look at the position in Italy, with a particular focus on workplace stress, the impacts of current trends such as advances in AI and increased restructuring exercises and the legal obligations on employers regarding their employees’ mental health at work. We have then also sought the views from 18 other countries. They provide their expert insights on mental health at work from the perspective of their own jurisdictions, including the legal obligations that apply and how current trends are affecting the local landscape.

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Workplace stress and mental health

Mental health is commonly defined as being more than the absence of a mental health condition; it is a state of well-being where individuals can cope with the normal stresses of life. In the workplace, this broad definition is crucial. Why? Because a critical aspect of mental health at work is the issue of ‘work related stress’.

Work related stress is explicitly defined in Italian Law as a condition accompanied by physical, psychological, or social dysfunctions. It may result from several situations such as where individuals feel they are unable to meet the demands or expectations placed upon them, feel that they operate within an inappropriate working environment and culture, or suffer from a lack of fair communication and dialogue with their employer. This can be caused by factors such as the content of the work itself, the inadequate management of work organisation and poor workplace conditions.

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Stress from uncertainty: The effects of downsizing and technology

As workplaces evolve due to advances in technology, workers often find themselves fearing redundancies and drastic changes such as delocalisation (i.e. the closure or relocation of business operations). These concerns, sometimes exacerbated by organisational changes happening elsewhere in the business, are contributing to a sharp increase in workplace stress and anxiety.

According to a recent study conducted by ADP Research, one third of Italian workers have expressed concerns about potential job cuts in their companies. This fear is even more pronounced in industries most impacted by automation and digitalisation. As technological advancements continue to reshape the workforce, employees are increasingly worried about their skills becoming outdated, which significantly contributes to elevated stress levels.

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Duties for employers under Italian law

Italian Law mandates that employers must take all necessary measures to ensure the physical and psychological health and safety of employees. Employers are obliged to safeguard workers from undue stress, harassment, or any conditions that might lead to mental harm.

Furthermore, employers have a specific obligation to assess all risks associated with workplace stress. These must be assessed by employers using the risk assessment document known as the DVR. Employers are legally required to assess and mitigate these risks to protect their employees’ well-being, that being the state of their physical, mental, and social well-being; not merely the absence of illness or infirmity, as noted above.

Failure to protect employees’ mental health may lead to severe legal consequences. Employees suffering from stress-related issues or other psychological injuries may file claims against their employer, seeking compensation for damages. If an employee is successful, the compensation awarded may include both economic damages, such as medical costs, and non-economic damages, including for emotional suffering. Courts have shown an increasing willingness to protect the mental well-being of employees, with several landmark decisions in Italy emphasising the employer’s duty to ensure a psychologically safe working environment.

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Takeaway for employers

Looking ahead, the intersection of workplace stress, organisational restructuring, and technological advancements will continue to be a critical issue. Employers must take proactive steps to safeguard the mental health of their employees, not only to comply with explicit legal obligations but also to foster a healthier, more productive work environment.


Australia:

There has been a growing spotlight in Australia on the obligations of employers to manage psychosocial hazards in the workplace. Under Australian workplace health and safety (WHS) laws, psychosocial hazards (and the associated risks of psychological harm), like hazards to the physical health and safety of a worker, must be eliminated. If they cannot be eliminated, then they must be reduced to the extent that it is reasonably practicable to do so.

In Australia, the impact of downsizing and technological advances has a direct relationship with this obligation – which can easily extend to the way in which an organisational restructure or change is managed. Further, Australia like many other countries, has also more recently experienced a significant shift in AI adoption. Issues relating to the use of AI at work, such as potential job loss and re-skilling/training, are currently flagged by the Australian Government as requiring serious regulatory consideration.

Ultimately, this is a difficult area for employers to navigate, with a key challenge being the identification and control of such hazards. Nevertheless, workplace health and safety regulators are increasingly taking action against employers who do not proactively manage their risks. Many organisations should see the solution as a multi-disciplinary one, made up of various measures – from policies and procedures, to environmental and cultural shifts that offer skills and tools to empower workers, foster resilience and build ‘psychosocial capital’ across the organisation. - John Makris, Kingston Reid


Belgium:

In Belgium, the leading cause of long-term disability is mental health disorders (depression, burnout, stress, etc.), followed by musculoskeletal disorders and chronic diseases.

Belgian legislation imposes clear and structured obligations on employers to prevent psychosocial risks at work. These risks include stress, burnout, workplace violence, and moral or sexual harassment, which can lead to both psychological and physical harm.

These measures are mainly aimed at prevention. Employers must therefore carry out a risk analysis in order to identify potential psychosocial risks associated with each work function/activity. Employers must identify situations that may lead to psychosocial risks and evaluate them based on work organisation, job content, working conditions, living conditions at work, interpersonal relationships and plan the appropriate measures to eliminate or reduce these risks. These measures must be evaluated on a regular basis as part of a dynamic risk prevention system.

In the face of increasing hyperconnectivity, the Belgian legislator has also recently introduced a right to disconnect, pursuant to which employers are required to provide measures (including training) to guarantee the right to disconnect of employees. - Claeys & Engels


Brazil:

In Brazil, a new regulation is due to come into effect on work safety which introduces an obligation on employers to map ‘psychosocial risks’ as part of the mandatory assessment, mitigation and remediation of risks to the health of employees at work. ‘Psychosocial risks’ include factors such as moral and sexual harassment, stress, and work overload. Under the regulation, companies will be required to implement measures to manage these risks, ensuring that employees do not suffer from mental health conditions due to toxic work environments. The new regulation was due to come into effect in May 2025, but uncertainties surrounding potential loopholes, subjective elements of the regulation and the possible need of further regulation may lead to delays. In fact, just two weeks before the new regulation was due to come into effect, and in response to growing concerns about a lack of clarity over the implementation of the new framework, the government postponed the introduction of the regulation’s key enforcement mechanisms (i.e. audits and sanctions) for one year (until 26 May 2026). The government has also promised to provide more guidance on the new regulation through communications and inspections. - José Carlos Wahle, Veirano Advogados


Chile:

In Chile, employees have experienced similar problems to those mentioned, particularly stress and anxiety generated by work overload, lack of control over tasks, tight deadlines, fear of dismissal, economic uncertainty, and high-performance expectations. In addition, a recent study conducted by the Chilean Association of Security and the Pontifical Catholic University of Chile concluded that:

‘The most severe manifestations of symptoms of depression in the work environment were observed among those who showed high levels of burnout (80.5%) and among those who have experienced a higher proportion of situations involving violence and harassment at work (55.4%). These symptoms are less prevalent among those with higher levels of job satisfaction.’

Furthermore, and similar to the position in Italy, the Chilean Labour Code establishes an obligation on employers to take the necessary measures to effectively protect the life and health of employees. Although this regulation primarily relates to the prevention of occupational hazards or work accidents, a broad interpretation may imply that the employer must also take care of its employees’ mental health.

Even though Chilean law does not expressly address the issue of mental health at work, and notwithstanding the ILO conventions ratified by Chile, the Superintendence of Social Security is responsible for the Work Environment Assessment Questionnaire on Mental Health (or ‘CEAL-SM’), an instrument to help employers identify and measure psychosocial risk factors at work. This serves as a tool to protect employees’ mental health. If it is not implemented, the employer may be fined by the Labour Inspectorate. - Marcela Salazar, Munita & Olavarría


Czech Republic:

Although mental health is not referenced to any significant extent under current occupational health and safety legislation in Czechia, the general provisions concerning the protection of employees’ health can – and should – be interpreted broadly to include their mental well-being. Furthermore, the right to mental health protection in the workplace is indirectly derived from broader constitutional principles, in particular from the Charter of Fundamental Rights and Freedoms, which guarantees employees the right to satisfactory working conditions. Again, employers should interpret this on the basis that it applies to their employees’ mental, as well as physical, health. This is essential in modern workplaces, where psychological stress, burnout, and other mental health issues are increasingly recognised as significant risks.

Still, a few provisions do focus on mental health. For instance, psychological burden is recognised as a health risk in connection with, (i) monotonous work, (ii) work at an imposed work pace, (iii) in a three-shift or continuous work regime, or (iv) work performed only at night. Where these risks are present, the work may need to be classified and therefore assessed under category two (there are four categories – the higher the category, the higher the risk to the health of the employee). Also, the Labour Code obliges employers to take the neuro-psychological capacity of its employees into account when determining their workload and when considering their remuneration.

Anti-discrimination and related laws apply, protecting employees against discrimination, unequal treatment, bullying etc, while harm to an employee’s mental health could also give rise to personal injury claims. - Milan Flachs, Randl Partners, advokátní kancelář, s.r.o.


Denmark:

In 2020, Denmark enacted its first Executive Order specifically aimed at employers’ obligations regarding the ‘psychosocial working environment’ (i.e. the psychosocial effects of work on employees). The legislation states that work must be planned, organised and carried out in a responsible way to ensure that its impact on the psychosocial working environment is safe and healthy, individually and collectively, in both the short and long term.

The main focus areas of the Executive Order are:

  • heavy workload and time pressure;
  • high emotional demands when working with people;
  • offensive behaviour, including bullying and sexual harassment; and
  • work-related violence.

The enactment of the Executive Order marks an increased awareness of the implications of a poor psychosocial working environment in Denmark – not only for individual employees but also society in general. Recently, we have seen an increased number of employees claiming compensation from their employers in response to what they feel are poor psychosocial working environments. - Yvonne Frederiksen, Norrbom Vinding


Estonia:

Employers must design and furnish the workplace such that it is possible to avoid occupational accidents and damage to health and maintain an employee’s work ability and well-being. In connection with this duty, they must organise a risk assessment of the working environment, which includes assessing psychosocial hazards that may affect employee mental or physical health (such as causing work stress). The law provides a non-exhaustive list of psychosocial hazards: work involving a risk of an accident or violence, unequal treatment, bullying and harassment at work, work not corresponding to the abilities of an employee, working alone for an extended period of time and monotonous work and other factors related to management, organisation of work and working environment.

Based on the risk assessment, employers must take measures to prevent damage to health arising from the identified psychosocial hazards. This includes adapting both the organisation of work and the workplace to suit the employee, optimising the employee’s workload, allowing breaks to be included in the working time during the working day or shift and improving the psychosocial working environment.

Failure to comply with these employer obligations may result in fines and/or employee claims. In fact, we have seen an increased number of employees claiming compensation for stress linked to poor psychosocial working environments. Such claims are difficult to navigate. There are often many reasons for employee stress and those reasons may not be (solely) related to an employee’s work or working environment. Data protection regulations also restrict the employer’s ability to review information regarding its employees’ health and personal life, making it challenging to identify the reasons for the stress and assess any potential liability. - Johanna-Britt Haabu, COBALT


Germany:

Employers must take all reasonable protective measures to organise work in a way that avoids risks to life and health as far as possible and any remaining risks are kept to a minimum. This includes the prevention of risks to health arising from mental stress at work. Employers must regularly assess the workplace for such risks and implement preventive measures to avoid them.

Mental stress can cover hazards arising from the organisation of work (e.g. working time arrangements, work processes, and workflows) but also from social relationships with superiors and colleagues (e.g. bullying or conflicts). Employers must develop appropriate measures to keep these stresses to a minimum. For example, and regarding work organisation, employers must ensure that work processes, responsibilities, and interfaces are sufficiently clear for employees. They must also avoid assigning more tasks to employees than they can reasonably handle.

If an employee is sick for at least six weeks (consecutively or in total) within 12 months, employers must conduct an ‘operational integration management programme’ with them (betriebliches Eingliederungsmanagement). This involves discussing possible preventive measures to avoid or minimise future illnesses. In the context of psychological stress, this might include reducing working hours, introducing mobile working, or finding other ways to reduce the psychological pressure on an individual basis. In cases of psychological stress caused by bullying, employers must protect affected employees and initiate preventive measures, e.g. through group coaching or, in extreme cases, consequences for the employees who are causing the stress. - Anja Dachner, Kliemt.HR Lawyers


Greece:

In recent years, employees in Greece have prioritised their mental well-being over securing, for example, job promotions or salary increases. This reshaping of priorities has resulted in part from the impact of significant stress factors such as climate change, the energy crisis and economic challenges. According to a recent study, women and young employees in Greece are the most affected by stress in the workplace, and most Greek employees prefer remote or hybrid work as a result of their aim to better balance their working and private life.

Greek law requires employers to safeguard the health and safety of employees in all aspects of their employment and this includes their mental health. To comply with this obligation, employers must conduct risk assessments, including of psychosocial risks like stress, burnout, bullying, and harassment. While work related stress isn’t expressly defined in legislation, it has been shaped by Greek case law as one of the psychosocial risk factors that an employer is obliged to consider as part of its obligations. More specifically, employers should take preventive measures to minimise potential risks to the mental wellbeing of their employees. These measures may differ depending on the workplace and may include, (i) training managers on mental health awareness, (ii) making adjustments to workload or work hours, and (iii) providing access to counselling or support services. The safety technician and occupational doctor (every organisation with more than 50 employees should employ such professionals) should also consider the possible or existing psychosocial risks in the workplace when executing their duties.

Failure to comply with these obligations may result in severe legal consequences, including potential employee claims for compensation. The compensation awarded may include both economic damage, such as medical costs, and non-economic damage, including moral damage. It is important to note as well that the Greek courts have shown an increasing willingness to protect the mental well-being of employees, with several landmark decisions emphasising the employer’s duty to ensure a psychologically safe working environment.

In particular, Greek caselaw has ruled that psychosocial risks such as work-related stress may fall within the scope of an occupational accident. It has been held that even a suicide attempt linked to severe psychological pressure in the workplace can be considered an occupational accident. Likewise, the death of an employee from a heart attack has been characterised as an occupational accident where it was proven that it resulted from excessive work-related stress and the employer’s failure to take the necessary preventive measures, thus breaching the duty of care. These judicial developments highlight that Greek courts acknowledge not only the importance of physical health, but also the need to safeguard employees’ mental health in the workplace. - Tasos Marmaras, KREMALIS LAW FIRM


Hungary:

The obligations of employers under Hungarian law are very similar to those that apply to Italian employers. Hungarian employers must provide a safe and healthy workplace and take all necessary measures to ensure the physical and psychological health and safety of their employees. Employers must organise work in such a way as to avoid psychosocial risks associated with it. Psychosocial risks are defined as the effects on the employee at work (e.g. work conflicts, work organisation, working hours and job insecurity etc.) that can lead to stress, accidents at work or psychosomatic illnesses. An impairment of health due to a psychosocial cause related to work is considered an occupational disease.

Employers in Hungary also have a specific obligation to carry out a risk assessment before starting their business and periodically thereafter. The risk assessment must include all psychosocial risks. Failure to carry out a risk assessment can result in a fine if the employer belongs to a high-risk category. If the employer belongs to a low-risk category, the failure to carry out a risk assessment cannot in itself lead to a fine, but a fine imposed for other reasons may be increased by up to 20% for such a failure.

As of March last year, the level of fines imposed by the Work Safety Authority has been significantly increased: fines can range from HUF 100,000 to 100 million (up to HUF 25 million HUF for micro and small enterprises or individuals, and up to HUF 50 million for medium-sized employers).

The takeaway for Hungarian employers is that the stakes are much higher with the increased fines, and that an increased amount of attention must be paid to ensuring the physical and psychological health and safety of employees. - Hedi Bozsonyik, Bozsonyik


Ireland:

In Ireland, there’s a duty to assess workplace risks and take reasonable care to prevent stress-related injury. We have not seen reported case law dealing with the interaction of this and the handling of redundancies/restructuring, which is already governed by rules around fairness, although employers are increasingly aware and focused on the impact of restructuring on wellbeing (of both those leaving and staying). - Catherine Hayes, Lewis Silkin


Luxembourg:

Luxembourg law does not require employers to take specific measures to ensure the mental well-being of their employees in the context of restructuring exercises or technological developments (such as digitalisation or advancements in AI).

However, as with Italian Law, Luxembourg law mandates that employers must take all necessary measures to ensure the physical and psychological health and safety of their employees. Employers are obliged to safeguard workers from undue stress, harassment, or any conditions that might lead to mental harm. - Ariane Claverie, CASTEGNARO


Netherlands:

The Council for Public Health and Society just recently published a report on the mental wellbeing of society, and it is sounding the alarm: “(…) we live in a “hyper-nervous society” in which pressure to perform, acceleration and individualism have gone too far and threaten the well-being of young and old alike.

This report reinforces the importance for employers to be aware of the long-standing rules under Dutch law with regard to their duty of care to provide for a healthy and safe workplace, which includes the mental well-being of their workforce. Employers are required to establish and execute policies to prevent or limit the psychosocial workload. This covers all factors in the work situation that cause stress, including but not limited to aggression or violence, direct or indirect discrimination, bullying, sexual harassment and work pressure. An employer who breaches this obligation could be held liable, if their employees suffer harm as a result. It might also give rise to the risk of an employee going on sick leave, thereby triggering the obligation to continue salary payments for a maximum of 104 weeks.

In order to comply with this obligation, employers often adopt a code of conduct that details the measures in-place to prevent or limit psychosocial risk factors. A legislative proposal is currently pending to make such a code of conduct mandatory for employers with ten or more employees. - Hylda Wiarda, Bronsgeest Deur Advocaten


Poland:

In Poland, there is no legal definition of work-related stress, however, there has been a noticeable increase in employee sick leave due to mental health conditions caused by workplace stressors, such as:

  • inadequate management of the work process;
  • inadequate support from superiors or co-workers;
  • negative relationships with superiors or co-workers.

The introduction of modern technology into the workplace is also emerging as an increasing cause of stress for some employees. There is a fear that machines will be tasked with work supervision, contribute towards management decisions in respect of employment, and ultimately replace staff entirely.

Despite the absence of an explicit legal obligation on the employer to counteract stress at work in Poland, employers are obliged to provide employees with safe and healthy working conditions, which really means counteracting the presence of workplace stressors. Considering that work-related stress can be diagnosed as a mental health condition, one of the most important countermeasures by employers is proper communication with the employee. - Monika Czekanowicz, Raczkowski


Spain:

In Spain, we are seeing new psychosocial risks emerge in relation to the balance between family and work life, which is becoming increasingly strained where employees feel they are working under significant pressure. Teleworking is sometimes seen as a flexible measure that can mitigate these risks, however it is not always the best option. Integrating new working time arrangements to achieve a better work-life balance is not an easy task and in some cases could actually have a negative impact on mental wellbeing, causing additional stress as the employee adjusts. This is particularly the case where the employee may still be managing long working days, against the burden of their family responsibilities.

Companies must ensure that their risk prevention system accommodates employees working remotely and guarantees them the same level of safety and health as the rest of the workforce. It should also anticipate eventual conflicts that might arise in case of an increase in stress, and identify ways to ensure a better work life balance if teleworking is unsuccessful.

On a different note, absenteeism has reached critical levels in Spain, with over 1.5 million people not attending work daily. The absenteeism rate exceeds 7%, and temporary disability alone accounts for over 5%, costing businesses and Social Security more than EUR 30 billion annually. Long-term absences (over one year) have doubled in under five years, placing a growing burden on companies, workers, and public services.

This issue cannot be solved by assigning blame, nor by ignoring reality. While public authorities must take urgent action — particularly by improving oversight in the medical leave system and involving mutual insurance companies more in recovery and return-to-work processes — companies also have a role to play. Key areas for employer action include:

  • Raising awareness: Absenteeism impacts remaining staff, who face increased workloads and stress. Open dialogue and internal communication can help address unjustified absences.
  • Improving workplace climate: A positive, flexible, and supportive work environment reduces absenteeism. Investing in employee wellbeing should be seen as a strategic move that boosts productivity and long-term sustainability.
  • Solving absenteeism requires coordinated efforts across institutions, companies, and society — with a shared understanding that health, responsibility, and engagement go hand in hand. - José Miguel Mestre Vázquez, Sagardoy

Sweden:

Mental ill-health is the leading cause of prolonged sickness absence in Sweden. Stress-related mental ill-health in particular has increased over time and never before have so many employees been on sick leave for stress as they were in 2024, according to the Swedish Social Insurance Agency. The reasons for this vary, but it is crucial for Swedish employers to proactively work to support the mental health of their employees in the workplace.

According to Swedish law, employers must regularly assess whether the work entails risks of illness or accidents that may need to be rectified. This must be addressed as part of a risk assessment that is documented in writing. The risk assessment must indicate which risks are present and whether they are serious or not. The risk assessment should include reference to both psychological and social factors. This is an ongoing task for employers in Sweden, who must follow up the assessment on a continuous basis, with input from the designated safety representatives and employees to ensure that any measures and potential action plans are made and implemented in the best way. - Knut Elmstedt, Elmzell Advokatbyrå


United Kingdom:

In the UK, there is a duty to assess workplace risks and take reasonable care to prevent stress-related injury. We have not seen reported case law dealing with the interaction of this and the handling of redundancies/restructuring, which is already governed by rules around fairness, although employers are increasingly aware and focused on the impact of restructuring on wellbeing (of both those leaving and staying). Lewis Silkin’s recent Future of Work Hub survey found that businesses in the UK are experiencing a rise in workforce expectations in relation to their role in supporting workforce health and providing “good work”. - Paul Gillen, Lewis Silkin


Ukraine:

Since the full-scale war started, the majority of working Ukrainians have faced various mental health issues. Communication with the team, paid psychological counselling, moral support, training and seminars, regular one-to-one meetings, additional days off, and financial assistance are among the ways employers in Ukraine have responded to such concerns.

There have also been notable legislative developments in this area. In January 2025, the Ukrainian government adopted the Law entitled “About the Mental Health Care System in Ukraine” which is focused on mental health care in the workplace. In particular, and under this new legislation, employers are considered to be entities that provide or facilitate mental health care. The law contains recommendations for employers to develop and approve a programme of psychosocial support for employees in the workplace. These obligations on employers are, however, optional rather than mandatory.

Effective 1 October 2025, the Ukrainian Parliament has also enacted a law authorising the State Labour Service to conduct unscheduled workplace inspections during martial law in response to mobbing (harassment) complaints from employees or trade unions. This law supports ongoing efforts to improve employee mental health by addressing mobbing as a serious psychosocial risk and promoting its prevention and thorough investigation. - Oksana Voynarovska, Vasil Kisil & Partners

*Toffoletto De Luca Tamajo.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations. Attorney Advertising.

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