In November 2009, the National Institute for Health and Clinical Excellence (NICE) published guidance for employers on promoting mental wellbeing through productive and healthy working conditions.1 Excess work related stress harms employees’ physical and mental health. From an economic perspective, impaired efficiency at work associated with mental health problems costs the United Kingdom £15.1bn (€16.9bn; $22.5bn) a year.2 From a health perspective, stress at work is consistently associated with increased total mortality and acute myocardial infarction.3 4

Ideally, the guidelines should outline discrete steps that could easily be implemented, improve the efficiency and satisfaction of workers, and ultimately be shown in a randomised controlled trial to improve morbidity and mortality. Although the guidance falls short of this ideal, business managers and human resources departments may still benefit from the advice.

Unfortunately, some of the advice is so general that it is almost useless. For example, the first recommendation in the guidance is to: “Adopt an organisation-wide approach to promoting the mental wellbeing of all employees, working …