The medical side of mental health support at work

What counselling and employee assistance programmes do

Counselling and employee assistance programmes give people a confidential person to talk to, usually for a short course of sessions, with practical help on money and legal questions alongside. For everyday stress or a hard few months at work, they are often the right first step.

They are the most common support employers offer. In the CIPD’s 2025 survey of 1,101 organisations, 71% offered access to counselling and 67% offered an employee assistance programme [1].

Holding a service is a different thing from people using it well. A study of 46,336 workers in 233 organisations found that people who took part in individual offers such as mindfulness and wellbeing apps appeared no better off across several measures of wellbeing [2].

Where a doctor or psychiatrist adds

A doctor adds what a counsellor is not trained to give, a diagnosis and a treatment plan that can include medicine, with a check for physical causes and for risk. A psychiatrist adds specialist assessment when illness is severe or has not improved with first treatment.

NICE guidance on depression in adults sets out treatment for less severe and more severe depression, from guided self-help and talking therapies to antidepressants, and asks that people can express a preference for recommended treatments and receive them in a timely manner [3].

Its guidance on generalised anxiety disorder follows stepped care. When anxiety causes marked impairment or has not improved with lighter help, it recommends a high-intensity psychological therapy or medicine, chosen with the person, and specialist services when the illness is complex or the risk of self-harm is high [4].

When to move from counselling to a doctor

Counselling remains valuable for many people. Any of the signs below means a doctor should be involved as well.

• Low mood or anxiety that has lasted several weeks, or keeps returning.
• Sleep or work that is getting steadily worse.
• Any thought of self-harm or suicide.
• Drinking or other substances used to cope.
• A question about medicine, whether starting it or changing it.

How to get people to the right care quickly

Give everyone one number that reaches a person who can arrange a doctor the same day, and train managers to point to it. Mental disorders are common, and the World Health Organization estimates that 16% of working-age adults had one in 2023 [5]. It also estimates that 12 billion working days are lost every year to depression and anxiety, at a cost of US$1 trillion in lost productivity [5].

Speed matters most in the first conversation. When a person who asks for help is seen by a doctor within days, the right treatment can begin while the problem is still small, and the counsellor and the doctor can work from the same plan.

WHO guidelines on mental health at work recommend organisational interventions, manager training, worker training, individual interventions and support for return to work [6]. Its fact sheet describes return-to-work programmes that combine work-directed care with ongoing clinical care [5].

Manager training is the gap most firms can close quickly. Only 29% of organisations train line managers in mental health, though 73% of those that do say their managers are confident having sensitive discussions and signposting support [7].

• Can a person reach a doctor, as well as a counsellor, without a referral from work?
• How soon can a psychiatrist see someone when a doctor asks?
• Who follows up after the last counselling session?
• What does the company see, and does it stay anonymised?

Crisis routes everyone should know

If someone is in immediate danger, call the local emergency number or go to the nearest emergency department. In the UK, Samaritans can be reached free on 116 123, day or night, every day of the year [8].

NICE advises that a person with depression who presents considerable immediate risk to themselves or others is referred urgently to specialist mental health services [3]. Put the local routes in writing for every office and every country, and make sure people who travel know the number where they are.

Who workplace support is not for, and the risks

Workplace support sits beside a person’s own doctor and never replaces emergency care. Someone in crisis needs the routes above first, and someone already under a psychiatrist should keep that care in place.

The main risk is delay, because a course of counselling can run on while an illness deepens if nobody checks progress, and medicine brings side effects that need review. NICE advises reviewing how well treatment is working between 2 and 4 weeks after it starts [3]. The other risk is privacy, so the employer should never learn who used which service.

What The Wellness for teams does

The Wellness for teams is one membership for the whole firm, its leaders and their families, with inpatient, outpatient and dental care, diagnostics and health programmes in 13 cities. A concierge arranges every appointment with GMC registered doctors, including a psychiatric consultation when a doctor recommends one.

The company receives one invoice a year and sees anonymised reporting only, with small groups left out, under a data processing agreement. Nobody is refused care, and care beyond the plan is billed at the published fee.