Embedding Mental Health into Your Occupational Health Program

Many organizations run well-intentioned but fragmented mental health initiatives that address symptoms but fail to manage underlying psychosocial risks. This type of reactive approach drives hidden costs: lost productivity, burnout, turnover, regulatory exposure, and reputational risk. In addition, leaders face growing pressure from regulators while navigating inconsistent legal requirements across countries.

The most effective way to address these challenges is to embed mental health into the Occupational Health and Safety (OHS) management system. By aligning psychological health and safety with ISO 45001 and ISO 45003, organizations can move from isolated initiatives to a structured, cross-functional, auditable system that manages psychosocial risks with the same rigor as physical hazards, supporting resilience and consistency at global scale.

Why Mental Health Belongs Inside Your OHS Management System

An Occupational Health and Safety (OHS) management system is the structured framework organizations use to protect worker health and safety. It brings together policy, hazard identification, risk assessment, controls, training, monitoring, and continual improvement under a single governance system.

ISO 45001 sets out the requirements for an OHS management system. It follows the Plan-Do-Check-Act cycle to identify hazards, manage risks, and drive continual improvement. The standard was reviewed and confirmed current in 2024 and is used globally across sectors.

ISO 45003 builds on ISO 45001 by providing guidance on managing psychosocial risks within the OHS management system. These include how work is organized, such as workload, workplace, remote work etc., social factors, such as leadership, interpersonal relationships, support, bullying and harassment, and work environment, equipment or hazardous tasks.  Its core principle is clear: psychological health and safety should be managed through the same systematic processes as physical risks, not through standalone wellbeing programs.

 

When organizations align with ISO 45001 and ISO 45003, they move mental health support out of isolated initiatives and into a structured, cross-functional risk management system. That’s what builds resilience and ensures compliance across borders. – Dr Philippe Guibert.

 

The “Iceberg” Problem: Why Fragmented Mental Health Initiatives Fall Short

Most organizations already offer some form of mental health support, such as employee assistance programs (EAPs), awareness weeks, or resilience workshops. These initiatives are valuable, but on their own they rarely:

• Identify and control root causes of psychosocial risk (e.g., workload, role clarity, supervisory behavior).

• Provide global governance and reporting that satisfies regulators and stakeholders.

• Sustain improvements through primary interventions and feedback loops (monitoring, audits, and management review).

ISO 45003 makes clear that psychosocial risks should be addressed within the OHS management system, using the same disciplined approach applied to other occupational hazards: hazard identification, risk assessment, implementation of controls, performance evaluation, and leadership oversight.

 

Quite often we see organizations investing in fragmented mental health initiatives without addressing the underlying risks. In one recent project with a global energy company, we helped shift from these isolated efforts to a structured, ISO-aligned OHS management system approach. Through the implementation of effective control measures that change delivered a 25% reduction in overall psychosocial risk exposure – Morgan MacDonald.

 

The cost of fragmentation is real and material. Globally, depression and anxiety account for an estimated 12 billion lost workdays every year, about USD 1 trillion in productivity losses. At national level, the picture is similar. In Great Britain alone, work-related ill health and injury cost GBP 22.9bn and 40.1 million days lost in 2024/25, with stress, depression and anxiety driving a significant share. Absence and presenteeism linked to poor mental health are costed at around GBP 24 billion annually.

Beyond productivity, fragmented psychosocial risk management is linked to higher rates of burnout. Prospective studies associate burnout with severe injuries and adverse health outcomes, increasing the likelihood of regulatory investigation, litigation, and reputational damage. These risks underline why awareness campaigns alone are insufficient compared to a system-wide OHS management system approach.

How Cross-Functional Collaboration Builds Success

Effective psychological health and safety cannot sit with one function alone. Managing psychosocial risk through the OHS management system requires coordinated action across key functions and roles:

• Heath Safety Environment (HSE) & Occupational Health (OH). Lead the hazard identification and risk assessment process, integrate psychosocial risks in the overall OHS risk register, and ensure controls are operational. 
• Human Recourses (HR). Embed mental health in policies, job design, performance management, training and leadership behaviors, co-lead worker participation and consultation. 
• Risk / Compliance. Align governance with ISO standards and local legal requirements; oversee monitoring, reporting and audits. 
• Operations (Ops) & Line Managers. Implement day to day controls (workload, shift patterns, breaks, role clarity), model psychologically safe behaviors, and incorporate open care conversations and building psychological safety into work routines.
• General Management / C-Suite. Provide strategic mandate, resources and leadership commitment; review performance and drive continual improvement.

 

Too often, mental health efforts sit in silos. HR runs workshops, HSE focuses on physical safety, and Ops manages workload separately. Incorporating ISO 45003 principles into your policies and training changes that. It creates clarity across functions, aligns everyone to global best practice, and makes psychological health and safety much more than just a box to tick. – Su Chantry.

 

Senior leaders consistently highlight three pressure points: regulatory compliance, psychosocial investigations, and inconsistent global standards. Because ISO 45003 is a guidance standard rather than certifiable, multinational organizations must also demonstrate how psychosocial controls align with local legal requirements. A robust OHS management system provides the structure, documentation, and cross-functional accountability needed to manage this complexity.

Applying ISO 45001 and ISO 45003 in Six Practical Steps

By integrating occupational health and mental health within your OHS management system, organizations gain a single, unified risk management system that ensures global consistency and auditability. This approach embeds practical controls into daily operations, strengthens resilience and workforce capacity, and supports comprehensive occupational health and workplace wellbeing strategies. It also enables early detection and intervention, helping organizations move beyond fragmented initiatives toward a sustainable, system-level model of mental health and safety. 

Here is a practical six-steps pathway:

1. Set the mandate: Begin by updating your OH policy to explicitly include psychological health and safety and reference ISO 45001/45003. Form a cross-functional steering group that brings HR, HSE, OH, Risk, Ops and business leaders together to share ownership.
2.  Map your psychosocial hazards: Use surveys, interviews, incident data and workload analysis to uncover stress triggers, like unclear roles or excessive demands, and integrate findings into the corporate risk register.
3. Assess risks and prioritize controls: Evaluate likelihood and impact, then apply practical solutions, redesign tasks, adjust staffing, improve rostering, strengthen leadership training, and enhance reporting channels.
4. Build competence and participation: Deliver training for leaders and frontline managers to recognize early signs, escalate appropriately, and foster psychological safety. Encourage worker participation through consultation mechanisms.
5. Monitor, measure and report: Define indicators like absence, turnover, incident reports, and workload/work clarity audits. Review them regularly in management meetings and conduct internal audits per ISO 45001.
6. Continual improvement and global consistency: Roll out governance, policies and training across all regions; adjust for local regulatory nuances while maintaining global standards, a key advantage of an OHS management system approach.

Regional and Global Scale Matters

Local providers may excel in individual jurisdictions, but multinational organizations face a more complex challenge: achieving consistent standards, comparable data, and scalable controls across countries. Regional and global programs must align centrally while adapting to local legal frameworks, a governance requirement that an OH&S management system is specifically designed to meet.

When psychosocial risks are embedded within an OHS management system aligned to ISO 45001 and guided by ISO 45003, organizations gain the structure needed to manage psychological health and safety consistently across borders. This approach replaces disconnected initiatives with a single system that supports auditability, regulatory confidence, and long-term workforce resilience.

Decades of our own experience across multiple sectors and regions show a consistent pattern: fragmented mental health initiatives tend to address symptoms, not causes. System-level integration through the OHS management system enables organizations to move beyond short-term interventions toward sustained risk reduction and resilience at scale.

FAQs

Q1. What is ISO 45003 and how is it different from ISO 45001?
ISO 45001 is the requirements standard for an OH&S management system. ISO 45003 provides guidelines for managing psychosocial risks within that system, ensuring psychological health is managed with the same rigor as physical hazards

Q2. Do we need both ISO 45001 and ISO 45003?
Yes, both standards serve different purposes but work together. ISO 45001 provides the structure for an OHS management system, covering all workplace health and safety requirements. ISO 45003 adds guidance on managing psychosocial risks within that system, ensuring.

Q3. What counts as a “psychosocial hazard”?
Psychosocial hazards are the workplace factors that can cause psychological and physical harm. These risks include excessive workload, role ambiguity, bullying/harassment, low job control, insecure contracts and unstable work environments. ISO 45003 details how to identify and manage these hazards.

Q4. How do we measure impact?
To measure impact of an OH&S management system, organizations should consider tracking key performance metrics such as absence, turnover, near miss reports; role pulse survey results, workload audits and incident investigations; audit and review per ISO 45001. Beyond compliance metrics, organizations increasingly track financial outcomes: recent UK data shows an average GBP 4.70 return for every GPB 1 invested in workplace mental health, driven by reductions in absenteeism, presenteeism, and improved productivity. This dual approach, operational KPIs plus ROI analysis, provides a clear picture of both risk reduction and business value.

Q5. What cross-functional teams are involved in a successful OHS system?
HSE/OH lead risk processes; HR embeds policies and behaviors; Risk/Compliance oversees governance; Operations implement controls; GMs provide mandate and continuous review.

References:
ISO 45001:2018. Occupational health and safety management systems (confirmed current 2024). ISO.org 
ISO 45003:2021. Psychological health and safety at work: guidelines for managing psychosocial risks. ISO.org
American Society of Safety Professionals (ASSP) – ISO 45003. ASSP Guide
WHO. Mental health at work
HSE UK. HSE publishes annual workplace health and safety statistics – HSE Media Centre
Deloitte 2024. Poor mental health costs UK employers £51 billion a year for employees | Deloitte UK
Journal of OH. Occupational Burnout and Severe Injuries: An Eight-year Prospective Cohort Study among Finnish Forest Industry Workers | Journal of Occupational Health | Oxford Academic
EU OSHA / SLIC Guidance. Introduction use of Risk Assessment Methods in OSH management and in supervision