Publication

Workplace Mental Health in Small and Medium-Sized Enterprises

Published: 26 November 2025

ERC SOTA Review No 67

Associated Themes

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  Mental Health

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The purpose of this review is to synthesise contemporary research examining the state of workplace mental health in small and medium-sized enterprises (SMEs).

Evidence suggests that employees in SMEs experience mental health challenges, such as stress, depression and anxiety, at rates comparable to and in some cases higher than employees in large organisations. Yet, SMEs are less likely to engage in workplace mental health promotion and are more likely to report barriers to investing in wellbeing initiatives.

Studies highlight resource limitations, the absence of dedicated HR or occupational health capacity, and lower awareness of the business case for investing in mental health as the most common barriers to engagement. At the same time, the close-knit, informal nature of many SMEs presents a unique opportunity to foster trust, psychological safety, and rapid change if mental health is prioritised.

Few interventions explicitly consider the unique barriers and facilitators faced by SMEs, and even fewer have been evaluated for long-term sustainability and cost-effectiveness. Addressing the lack of SME-specific research in this area is crucial to improve both employee wellbeing and business sustainability in UK businesses.

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