Core Revision
DOccMed Revision Guide · Chapter 8
Occupational mental health, stress and burnout
The HSE Management Standards, common mental health problems at work, and adjustments that actually help.
Why it matters in the exam
Stress, depression and anxiety are the largest category of work-related ill health in Great Britain, ahead of musculoskeletal disorders: HSE estimates 964,000 workers affected in 2024/25 (about half of all cases) and 22.1 million working days lost (nearly two-thirds of the days lost to work-related ill health). It is the single biggest cause of long-term sickness absence, and the referrals that reach OH are often the hardest: a stalled case, a grievance, a manager who wants a diagnosis and a date.
The examinable skill is to hold two ideas at once. Mental ill health is a genuine health problem deserving proper clinical management. And it is very often driven, sustained or complicated by a workplace problem that no amount of therapy will solve. Your job is to see both, and to say so.
What this chapter covers
- 8.1Stress: the definition that mattersHSE defines work-related stress as "the adverse reaction people have to excessive pressures or other types of…Preview below
- 8.2The HSE Management StandardsLearn these six. They are the framework the exam expects, and they are also the most useful diagnostic tool yo…Members
- 8.3BurnoutClassified in ICD-11 as an occupational phenomenon, not a medical condition. Three dimensions:Members
- 8.4The common conditions at workMembers
- 8.5Shift work and fatigueWorth a paragraph of its own, because it comes up constantly. Shift work disrupts circadian rhythm and is asso…Members
- 8.6What OH should actually doMembers
- 8.7Adjustments that workRemember that a mental health condition lasting or likely to last 12 months with a substantial adverse effect…Members
- —Common pitfalls · Exam triggersMembers
The core content
Stress: the definition that matters
HSE defines work-related stress as "the adverse reaction people have to excessive pressures or other types of demand placed on them". Note the distinction: pressure is not stress. Pressure can be motivating; stress is what happens when demands exceed the person's ability to cope.
Stress itself is not a diagnosis. It is a state that can lead to diagnosable conditions — depression, anxiety disorders, adjustment disorder — and to physical consequences.
The rest of this chapter is in the DOccMed guide
6 more sections, the pitfalls examiners set, and the exam triggers for this topic — written and reviewed by practising UK doctors.
Treat the illness and diagnose the workplace — run the six HSE Management Standards over every stress case, name the organisational obstacle in your report, and get people back early and gradually rather than late and completely.
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