Mental health has long been associated with stigma. In recent years, the recognition and public discussion of mental health stigma – including within workplaces – have grown across Europe. Despite this increased awareness, stigma at work continues to affect workers in all sectors, influencing disclosure, help-seeking, and equal participation in employment.
Definition of mental health stigma
Mental health stigma refers to the ‘negative attitudes, beliefs, and stereotypes about mental health issues, which lead to discrimination of people who experience mental health conditions’[1]. In practice, this means that individuals may be judged, excluded, or treated unfairly because they are experiencing mental health difficulties. Such stigma is often rooted in misunderstanding of mental health, fear, or persistent stereotypes and can result in feelings of shame, social withdrawal, and discrimination[2]). Mental health stigma is widely understood as a multidimensional phenomenon involving[3]:
- Knowledge (ignorance or misinformation): Stigma often begins with a lack of accurate information about mental health, leading to misconceptions and stereotypes.
- Attitudes (prejudice): These misconceptions can result in negative value judgments or unfavourable opinions about people with mental health conditions.
- Behaviours (discrimination): Prejudiced attitudes may translate into unequal or unfair treatment, such as exclusion, harassment, or reduced opportunities.
The EU has recognised the wide-ranging impact of stigma in its Comprehensive Approach to Mental Health[4], which stresses the importance of stigma reduction by encouraging early prevention and reintegration into employment of the affected workers. At international level, the OECD’s recommendations on integrated mental health, skills and work policy[5] move in the same direction, underlining that addressing stigma is a systemic responsibility that must be embedded in organisational practices.
Mental health stigma in work contexts
Mental health stigma also manifests within work environments, where common stereotypes continue to influence attitudes, behaviours, and decisions[6] [7]. Workers experiencing mental health difficulties may be perceived as unreliable or unpredictable, less productive or capable, difficult to work with, or unable to cope with job or organisational demands[8]. Such assumptions can affect recruitment, task allocation, promotion decisions, and return-to-work processes, creating structural barriers to participation, career development, and recovery. In all, workplace mental health stigma is linked to a range of negative outcomes for the workers concerned. Disclosure of a mental health condition can also trigger discriminatory behaviours from managers and colleagues, such as excessive monitoring or micromanagement, providing less opportunities for advancement, over-attributing mistakes to illness, and gossip[8] [9]. In some cases, these reactions escalate into harassment or bullying behaviours[1]. Such responses can create secondary victimisation, whereby workers experience additional harm – in addition to the mental health condition - through blame, exclusion, or withdrawal of support[10].
Persistent exposure to stigma may also lead workers to internalise these negative beliefs as part of their identity, resulting in self-stigma[2]. Self-stigma and anticipated discrimination undermine their confidence and self-efficacy[6] [11], generate doubt about their own ability to perform at work[12] and may limit their participation in workplace activities as workers withdraw socially. Stigma also discourages workers from disclosing a mental health condition or seeking necessary support. The fear of discrimination remains a barrier for requesting work accommodations, even when such adjustments would enable individuals to continue working or return to work safely[1].
Evolution of mental health stigma
Mental health stigma has deep historical and social roots that continue to mould workplace experiences. Historically, mental illness was often seen as a moral failing or threat to social order[13], and individuals were institutionalised in asylums during the 18th and 19th centuries, reinforcing social distance. Later, the medicalisation of mental illness reframed it as a health condition, but persistent stereotypes - such as being chronically impaired or less productive - remained[14],[15] , influencing how workers are perceived in work settings today[16].
Sociologically, stigma functions to maintain boundaries between “normal” and “deviant” behaviour[17]. In workplaces, these norms relate to productivity, reliability, and emotional self-control, making workers with mental health challenges appear to violate the “ideal worker” standard[18] . Labelling theory emphasises that stigma arises from social reactions rather than the condition itself [19], meaning that individuals are defined by the label rather than their actual behaviour or abilities[20].
Major societal changes since the late 20th century have begun to challenge traditional stigma. The deinstitutionalisation movement marked a shift away from segregated psychiatric care towards supporting people with mental health problems to live and participate in society[21]. Human rights frameworks such as the UN Convention on the Rights of Persons with Disabilities[22] reframed mental illness as an inclusion issue, and workplace well-being initiatives linked stigma reduction to organisational responsibility[23]. Despite this progress, structural stigma - embedded in policies, norms, and workplace culture - unfortunately persists[24].
Stigma is not culturally uniform. In many European contexts, ideas of personal strength, self-discipline, and individual responsibility shape stigma[24]. In masculine-coded work cultures, emotional expression or vulnerability may be seen as weakness[16]. In care-oriented sectors, disclosure of mental diseases may elicit greater empathy, yet still risks being perceived as emotional instability[25].
Mental health disclosure
EU-OSHA surveys on occupational safety and health in post-pandemic workplaces highlight persistent challenges around mental health disclosure[26] [27]. Workers across the EU remain divided on whether revealing a mental health condition would negatively affect their career. In 2022, half of the respondents believed disclosure could be harmful to their career, with particularly high concern in France (68%), Cyprus (66%), Greece (66%) and Italy (63%). By 2025, these patterns persisted, with 63–69% of workers in these countries still strongly agreeing or agreeing that disclosure could negatively impact their career. Conversely, in countries such as Sweden, Hungary, and Estonia, the majority of workers strongly disagreed or disagreed with this statement (70%, 71% and 66%, respectively), suggesting more supportive workplace climates in these countries. The big difference in country data concerning these issues also shows very well the possible cultural nature of stigma and its understanding.
Despite these concerns, according to the 2022 and the 2025 data, close to six in ten workers report feeling comfortable speaking to their manager or supervisor about mental health. Again, country data shows the big cultural diversity across Europe. Comfort levels are highest in Denmark, Finland, and Sweden (respectively 81–80% in 2025 felt comfortable) and lowest in Hungary, Poland and Germany (respectively 32%, 50% and 51%). Comfort is also influenced by socio-demographic factors: Younger workers, workers with higher education and those in larger companies are more likely to feel more comfortable discussing mental health issues openly[26].
Overall, the surveys indicate that while some progress has been made, mental health stigma remains a barrier to disclosure and accessing workplace support. Patterns have remained largely stable between 2022 and 2025, with workers from some countries showing persistent concerns about career consequences, and others maintaining high levels of comfort in speaking with supervisors.
Factors of mental health stigma at work and its persistence
Work-related mental ill-health is often mistakenly attributed to individual vulnerability or personality traits. However, occupational stress models consistently demonstrate that mental health outcomes frequently arise from prolonged exposure to adverse working conditions [28] [29]. Research shows that psychosocial risks - including excessive workloads, conflicting demands, low autonomy, job insecurity, ineffective communication, lack of managerial or peer support, and third-party violence - are strongly associated with mental health problems among workers[1]. Despite this evidence, mental health difficulties are still often misattributed to a worker’s inability to cope with demanding environments. Such misconceptions, which lack scientific support, still persist in many workplaces[1].
Beyond these individual misconceptions, several organisational and interpersonal factors shape workplace stigma:
- Organisational culture and norms: Workplaces characterised by strong performance pressure, constant availability, and emotional restraint may implicitly signal that mental health difficulties are unacceptable. Such norms can foster silence, discourage help-seeking, and reinforce stigma[30] [31].
- Leadership behaviours and manager attitudes: Managers play a central role in shaping stigma. Supportive, health-oriented leadership can reduce perceived stigma, while low mental health literacy or negative attitudes heighten fears of being judged[32] [33].
- Unclear policies and structural practices: When organisational procedures for support, accommodations or confidentiality are unclear, workers often anticipate negative consequences. This reinforces stigma and discourages disclosure[34] [35].
- Fear-based and high-risk occupational environments: In hierarchical or safety-critical sectors (for example, military, aviation, security), mental health difficulties may be viewed as or may actually be incompatible with job demands. Workers may fear being labelled unfit for duty or losing career opportunities[36] [37].
- Work design: High workloads, time pressure, and low autonomy limit opportunities for supportive conversations. Workers may fear being seen as unable to cope, reinforcing stigma[38].
Measures and tools
Reducing mental health stigma in the workplace requires shifting the focus from individual deficits to the organisational environments that shape workers’ well-being. Reframing mental health as context-driven rather than worker-driven is therefore foundational for any effective stigma-reduction strategy.
Embedding stigma reduction with psychosocial risk management
A stigma-aware approach must be fully integrated into psychosocial risk management processes, as adverse working conditions significantly increase the risk of developing mental ill-health[1]. These same conditions also exacerbate stigma by creating environments in which acknowledging strain is discouraged, framed as incompetence, or associated with negative career implications[30] [31]. Workplaces with clear procedures on how to deal with psychosocial risks and conducting regular risk assessments, help to reduce stigma and its consequences.
Embedding stigma reduction into psychosocial risk management means:
Enhancing leadership capacity
Evidence shows that managers strongly influence whether workers feel safe to speak about mental health. Health-oriented leadership - defined by supportive interactions, openness, and active engagement with worker well-being - reduces perceived stigma and increases intentions to disclose mental health concerns. Leaders with low mental health literacy or stigmatising attitudes, by contrast, contribute to climates in which workers anticipate judgment or disadvantage [33]. For example, structured training programmes - even when delivered virtually - improve mental health literacy and reduce organisational stigma by shifting norms around help-seeking[39].
The World Health Organization identifies manager training as one of the most effective organisational levers for reducing stigma and improving early identification and support. This highlights the need for systematic capacity-building to ensure that leaders can create supportive, stigma-free working environments[40]. Despite the recognised importance of leadership, evidence shows that many managers do not receive adequate training. In the UK, fewer than one in four managers receive training in mental health[41], while in the EU available data point to the same direction. For instance, stakeholders from Belgium, Denmark, Estonia, Spain, Croatia and Austria considered the lack of training and awareness among employers, managers, workers and labour inspectors as a major barrier to effectively identifying and addressing PSRs. Specifically in Belgium, several stakeholders emphasised the need for mandatory training for middle and senior management on PSRs[42].
Strengthening policy frameworks, procedures, and support systems
The absence of transparant policies on disclosure, reasonable accommodation and confidentiality can contribute to anticipated stigma, as workers may be unsure how their information will be handled or whether seeking support may lead to negative consequences. Effective anti-stigma strategies at the workplace could therefore include:
- clear procedures on how to respond to workers disclosing a mental health issues and which support measures are in place for them;
- transparent confidentiality safeguards;
- well-communicated rights and responsibilities;
- structured return-to-work processes that balance organisational needs with personalised support.
Evidence also points to the importance of proactive support systems, such as occupational health professionals who can facilitate disclosure, help assess needs, and ensure reasonable accommodations[43] .
Building inclusive work environments
General research on stigma, applied to the workplace, reveals that inclusive organisations – where diversity, equity, and respect for all workers are actively promoted – experience lower level of perceived stigma and higher rates of disclosure and help-seeking among workers with mental health conditions[44] [45]. Inclusive practices, such as, for example, fair access to career development and non-discriminatory workplace policies, signal that mental health challenges are legitimate and manageable.
Involving workers in decisions about work design and mental health measures, and offering adjustments such as flexible working hours or task adaptations help normalise mental health discussions[46]. When these practices are embedded at organisational level, they contribute to psychological safety, enabling workers to speak openly about difficulties without fear of judgment or exclusion, which benefits both individual well-being and organisational functioning[47] [48].
Initiatives at European and national level
Under its Comprehensive Approach to Mental Health, the EU has set up a dedicated drafting group under the mental health subgroup of the Expert Group on Public Health, which was engaged in developing an EU support package including the following elements:
- An EU spotlight section in the WHO toolkit on stigma and discrimination[49];
- A media awareness campaign on stigma (#InThisTogether)[50];
- A selection of best and promising practices to support actions by EU Member States and stakeholders on tackling stigma and discrimination[51];
- A discussion paper on addressing stigma and discrimination[52].
At national level, anti-stigma initiatives illustrate the effectiveness of contact-based approaches, where authentic lived-experience storytelling reduces social distance and increases empathy. For instance, ‘One of us’ (DK)[53], which is included in the EU’s Best Practice Portal, promotes targeted activities at national, regional, and local levels, facilitating dialogue between people with lived experience of mental illness, including within the labour market.
Another example, also part of the EU’s Best Practice Portal, is the H-Work project (IT) [54], a Horizon-Europe initiative aiming to improve mental well-being in workplaces across public organisations and SMEs. H-work combines psychosocial risk assessment with targeted, multi-level interventions and provides validated tools, including an Assessment Toolkit, an Interventions Toolkit evaluation resources, a digital Innovation Platform, policy briefs, and dissemination activities. Workplace pilots have demonstrated that the project strengthens leadership knowledge, increases worker engagement, and helped preventing the worsening of mental ill-health (including burnout, stress, and depression), contributing to reduced workplace stigma and increased inclusion and productivity for people with mental health conditions.
Conclusion
Workplace mental health stigma is influenced by organisational culture, leadership, and company policies. Evidence shows that inclusive, psychologically safe workplaces, clear procedures, and trained managers reduce stigma and encourage help-seeking. National and international initiatives highlight the effectiveness of contact-based and multi-level interventions. Continued efforts are needed to close gaps in training, policy implementation, and organisational practice to foster stigma-free, supportive work environments.
