Managing Employee Mental Health Difficulties in Small and Microbusinesses: A Difficult Balancing Act: Symposium on Exploring the Role of Managers and Leaders in Promoting and Protecting Mental Health at Work: Lessons from Research and Practice.

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Background: Supporting employees with mental health difficulties is a key challenge for employers (OECD, 2015). Research identifies a difficult ‘balancing act’ in managing employees with mental health difficulties, in which the needs of the employee, co-workers, business, and manager’s values, feelings and interests are weighed against one another (Bramwell et al., 2016; Kirsh et al., 2018; Martin et al., 2018). How this balancing act is negotiated within the
specific context of small and microbusiness (1-49 employees), has received little attention. Occupational Health issues in small businesses tend to take lower priority (Martin and LaMontagne, 2018) with resolutions found through dialogue and negotiation, rather than rigid policies and procedures (Andersen et al., 2007). Features such as informality, close spatial and social proximity, and resource poverty (Mallett and Wapshott, 2017) create opportunities and
constraints for effective management of employees with mental health difficulties. Drawing on empirical evidence from small and microbusiness managers with lived experience of managing employees with a mental health problem, we use a tension-based lens to examine how managers navigate support and performance practices and analyse tensions experienced by
managers and their response strategies.
Methods: Twenty-one UK-based small and microbusiness managers with first-hand experience of managing employees through mental health difficulties were interviewed. Using a combination of narrative and semi-structured approaches (Scheibelhofer, 2008) interviews explored management responses to employee mental health difficulties from discovery and disclosure through to steps taken to support the employee. We focussed on eliciting detail on specific employee cases, rather than broader perspectives on promoting mental wellbeing at
work to derive a sample comprising 45 employee cases. Analysis used a data-driven thematic approach (Braun and Clarke, 2012) combined with a matrix approach (Nadin and Cassell, 2004) for each employee case described.
Results: We identify contextual features of small workplaces shaping management responses and highlight a conflux of impacts on co-workers, business operations and managers. We identify three key tensions for small and microbusiness managers that surfaced when traversing a continuum of support-performance interventions: (1) Individual vs Collective; (2) Confidence vs Caution; (3) Informal vs Formal. Our findings demonstrate how managers
require agility and constant renegotiation of support and performance in light of tensions that become salient over time and according to context.
Conclusion: Our analysis exposes how small and microbusiness managers handle tensions when managing at the nexus of mental health support and performance and thus makes an important and timely contribution to the scant empirical evidence base on managing mental health problems in small and microbusiness. We contribute to theory by taking a tension-based
lens to bring into focus how managers work dynamically through tensions as employee mental health difficulties emerge and impacts become evident, striving to balance individual and collective needs, and modifying the formality and assertiveness of their intervention. We argue that the small and microbusiness context may exacerbate managerial tensions and managers feel these acutely, particularly as responsibility often loads on one individual with multiple roles
and competing priorities.
Original languageEnglish
Title of host publicationBOOK OF PROCEEDINGS 15 th Conference of the European Academy of Occupational Health Psychology ‘Supporting Knowledge Comparison to Promote Good Practice in Occupational Health Psychology’
Publication statusPublished - 2022


  • Mental health
  • Small business
  • Managerial skills

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