Introduction
Many organisations provide informal support for employee mental health. Line managers check in, reasonable adjustments are made, and wellbeing resources are offered.
However, there are situations where these measures are no longer sufficient. Employers often sense that something more is required, but feel uncertain about when to escalate, what escalation involves, and how to do so responsibly.
This page focuses on helping employers recognise when mental health support at work needs to move beyond informal or managerial approaches, and when involving qualified mental health professionals becomes appropriate.
What escalation means in an employer mental health context
In a workplace context, escalation does not automatically mean crisis or emergency intervention. Escalation refers to a shift from informal, non-clinical support to structured, professional mental health input.
This may include referral to qualified counselling, engaging external clinicians, or introducing more formal support arrangements. The purpose is to ensure that the level of support matches the level of need, while maintaining clear professional boundaries.
For employers, escalation is a decision about risk, responsibility, and appropriateness, not about labelling or diagnosis.
Situations where informal employer support may no longer be enough
Informal support plays an important role in maintaining wellbeing at work, but there are indicators that suggest it may no longer be sufficient.
These include difficulties that persist despite adjustments, escalating distress, reduced ability to function at work, or situations where mental health concerns begin to affect safety, judgement, or working relationships. Complexity increases where there is a history of mental health difficulties, exposure to trauma, or multiple stressors inside and outside work.
Employees may minimise their difficulties or struggle to articulate what they are experiencing. Managers may feel unsure whether their concerns justify escalation.
For employers, recognising these patterns early reduces the likelihood of more serious difficulties developing later.
The organisational risks of delaying escalation
Delaying escalation is often driven by good intentions. Organisations may hope that difficulties will resolve with time, or worry about overreacting or causing unnecessary concern.
However, prolonged reliance on informal support can increase risk. Employees may continue to struggle without appropriate care, managers may become over-burdened, and situations can escalate unexpectedly.
Delayed escalation can result in longer absences, increased distress, more complex recovery, and greater organisational impact.
For employers, timely escalation is often what prevents situations from becoming harder to manage and more costly over time.
Escalation does not remove employer responsibility
A common concern is that involving professional mental health support means responsibility is handed over entirely.
In practice, escalation complements rather than replaces employer responsibility. Employers remain responsible for reasonable adjustments, communication, workload management, and supporting a safe and appropriate return to work where relevant.
Professional support provides clinical expertise and containment, allowing employers and managers to operate within appropriate boundaries rather than attempting to manage complex mental health needs alone.
Avoiding over-escalation of mental health support at work
While under-escalation carries risk, over-escalation can also be unhelpful.
Referring every difficulty to clinical services can undermine confidence, increase anxiety, and blur the distinction between normal distress and mental health conditions. Escalation should be proportionate and based on impact, persistence, and complexity rather than assumptions or labels.
Clear criteria, supported by professional guidance, help organisations make escalation decisions with confidence and consistency.
For employers, the aim is not to escalate early in every case, but to escalate appropriately when informal support is no longer sufficient to manage risk safely.
The role of managers and HR in escalation decisions
Managers are often the first to notice concerns, but they should not be expected to make escalation decisions alone.
HR plays a key role in providing structure, consistency, and access to appropriate support. Clear escalation pathways reduce uncertainty and ensure decisions are not dependent on individual confidence or experience.
For employers, shared responsibility and defined processes protect managers while supporting employees more effectively.
How professional mental health support fits into workplace care
Professional mental health support provides expertise that informal or managerial approaches cannot offer.
This may include counselling, assessment, or specialist input tailored to the individual’s needs. Professional support also provides confidentiality and clinical governance, which are essential for managing psychological risk appropriately.
For employers, partnering with qualified providers ensures that escalation is handled ethically, safely, and in a way that aligns with workplace responsibilities.
How Mynurva supports appropriate escalation
Mynurva works with organisations to provide professional mental health support when escalation is appropriate.
We support employers in recognising when informal approaches are no longer sufficient and provide access to qualified clinicians in a way that integrates with workplace structures. Our approach emphasises clear boundaries, proportionate responses, and continuity of care.
By working alongside employers, we help ensure escalation decisions are timely, appropriate, and grounded in clinical expertise.
What this means for employers
Escalation is appropriate when mental health difficulties are persistent, escalating, or complex, and when informal workplace support is no longer sufficient to manage risk responsibly.
Organisations that have clear escalation criteria and access to professional support are better positioned to respond early, reduce risk, and support employees effectively.
A considered next step
If your organisation is unsure when informal mental health support is no longer enough, a considered conversation can help clarify when escalation is appropriate.
Having clarity before difficulties intensify is often what makes support most effective.