The Silent Cost at the Office: Why Small Changes Can Decide Whether People Stay or Leave

## An invisible burden we've learned to ignore We've become good at talking about productivity. Less good at talking about the price. The truth is that in many Norwegian organisations the biggest cost isn't in the budget, but in people's bodies and minds: a persistent unease that won't let go, sleep getting thinner week by week, and an instinct not to open email before breakfast because you already feel pressure in your chest. What frustrates me is not that working life is demanding. It always has been. What frustrates me is that we act as if mental health is a private matter, while everything in modern work life is designed to leak into private life: Teams notifications on your phone, flexible hours, goals that shift quarterly, and a culture where "gritting your teeth" is often read as moral superiority. At the same time, recent coverage shows how small, concrete measures can have a big impact — at least on physical health. An NTNU study mentioned in VG points out that a simple change can reduce the risk of lower back pain. It's tempting to shrug: lower back pain isn't anxiety. But the logic is worth taking seriously: when causes are tied to everyday habits and cumulative strain, it's precisely the small changes that add up. My point is this: We need an equally down-to-earth, low-threshold and systematic approach to mental health at work as we have for ergonomics. Stress, depression and anxiety don't arise in a vacuum. They are shaped by the work environment, expectations and leadership — and therefore they can also be prevented there. ## Stress is not just "a lot to do" — it's lack of control Stress at work is often reduced to a question of workload. But many people can tolerate periods of high effort when three conditions are present: control, predictability and meaning. When one or more of these disappear, "busy" becomes "dangerous." Let's be honest: much of the stress that makes people ill today isn't that the tasks are difficult, but that the frameworks are unclear. Priorities change without explanation. Projects are given new "must-have" requirements. Responsibility is spread wide ("everyone owns quality") while authority is placed narrowly. The result is a constant mental squeeze: you're expected to deliver but aren't given the tools, time or mandate. This is also where the work environment becomes more than perks. Work environment is the operational system that decides whether work pressure is manageable or harmful. A good work environment accounts for human variation: some need silence to deliver, others need frequent sparring; some tolerate a high pace of change, others trigger the body's alarm system. **Opinion:** Companies have turned "stress management" into an individual project — mindfulness courses, apps, breathing exercises — while continuing to produce stress structurally. We would never tell an employee with a bad office chair to just "strengthen their core" and buy an app. We'd replace the chair. With mental health we must also start "replacing the chair": adjusting frameworks, expectations and leadership practices. ## When anxiety moves into the calendar Anxiety at work can look like many things. Often it doesn't arrive as panic, but as a subtle over-activation: double-checking everything, spending unreasonable time on small details, avoiding meetings, or putting off tasks for fear of being judged. On the surface this can be read as perfectionism or "low efficiency." Underneath is often a perfectly rational response to an environment where mistakes are punished socially or career-wise. In many organisations there's an invisible practice: "We say it's okay to fail, but we remember every mistake." That creates a performance climate where employees focus more on avoiding negative signals than on creating value. Anxiety is also triggered by fragmentation: too many parallel processes, too many channels, too many expectations of immediate response. When the day is driven by notifications instead of priorities, people lose their sense of control. And when control disappears, anxiety rises. **Recommendation for the work environment:** Make the workday less reactive. - Agree on *communication rules*: when to use chat, when to use email, when it's appropriate to call. - Establish *meeting discipline*: fewer meetings, clearer agendas, explicit decision points. - Introduce *focus blocks*: time without meetings/notifications where deep work is expected. These are not "soft measures." These are productivity design that also function as anxiety prevention. ## Depression: When the workplace amplifies rather than supports Depression at work is difficult because it's often invisible until suddenly it isn't. Many show up, deliver "OK," and use all their energy to appear normal. After work they collapse. Some can't eat. Others isolate. And almost all feel ashamed, because depression is still interpreted as weakness — despite knowing it's a real medical condition. The workplace can be stabilising: routines, social belonging, mastery. But it can also amplify depression if the environment is characterised by heavy comparison, unclear feedback or a culture where those who ask for help receive less interesting tasks and therefore lose a sense of meaning. This is where accommodation is often misunderstood. Many leaders think accommodation means "removing everything" and leaving the person alone. In practice that can make things worse because it removes structure and sense of value. Good accommodation often involves *small, concrete adjustments* that make functioning possible. ### Accommodation that actually works (and doesn't cost much) 1. **Reduce cognitive noise, not necessarily responsibility**: fewer parallel tasks, clearer prioritisation, more focus on one deliverable at a time. 2. **Agree on expectations explicitly**: what is "good enough" this week? what is most important? 3. **Shorter, more frequent follow-ups**: 15 minutes weekly can be better than 60 minutes monthly. 4. **Flexibility with boundaries**: option for home office/adjusted hours, but with clear stopping points so work doesn't spill out. In sum: accommodation is a leadership skill, not an act of charity. ## What a lower-back study can teach us about mental health VG reports on an NTNU study where a simple change can reduce the risk of lower back pain. The preview's details are limited, but the point highlighted is clear: sometimes the solution is "much easier than you think," and an expert calls the finding very good news. Direct quote (short, necessary for the point): "The solution may be much easier than you think." This is interesting by analogy. In mental health work at the workplace we often lock into a narrative that everything is complex: culture takes years to change, people are different, and there is no quick fix. True. But it also becomes an excuse to do nothing. We don't need a "quick fix." We need *simple measures* that are repeatable, measurable and anchored in everyday work. Small steps that prevent strain from building up in silence. Just like with lower back pain, it's often the sum of small strains that tips the balance: slightly too few breaks, slightly too many interruptions, slightly unclear goals, slightly too much social pressure. And just like ergonomics, the workplace can dramatically influence risk through design and routines. ## Three myths that keep Norwegian working life stuck ### 1) "Mental health is private" Yes, people have private lives and private burdens. But the workplace also creates strain, and it can amplify or dampen symptoms. When an organisation says mental health is private, it absolves itself of responsibility for its own practices: staffing, prioritisation, leadership style and culture. ### 2) "The most important thing is to get people to talk more" Openness is good, but it's not a panacea. Many dare to speak up — and still face no structural change. Then openness becomes a risk: you've exposed yourself without the system responding. Companies must do two things simultaneously: create psychological safety to speak up, and have a clear process for what happens next. Otherwise "talk about it" becomes just a poster. ### 3) "We can't accommodate everyone" No, but you can address the most predictable strains. It's not about customising everything for every individual, but about removing unnecessary friction for everyone. Clear priorities, fewer interruptions, realistic staffing and fair distribution of work help both the robust and the vulnerable. ## A practical plan: How companies can build better mental health This is a proposal for a low-threshold "package" that can be rolled out in most organisations without major costs. It targets the keyword areas in practice: working life, mental health, stress management, depression, anxiety, work environment, mental health and accommodation. ### 1) Map strain — without psychologising - Do quarterly temperature checks on **workload**, **clarity of priorities**, **interruption level**, **role clarity** and **perceived support**. - Use the data for concrete changes: "We cut status meetings by 20%", "We introduce two focus blocks per week." ### 2) Train leaders in micro-behaviour Mental health is often decided by small signals: - How does the leader react to bad news? - Are people interrupted? - Are clear boundaries given, or only demands? Leadership training should be practical: feedback, prioritisation, conflict handling, and how to have an early concern conversation. ### 3) Create a clear accommodation ladder Don't wait for sick leave. Have steps that can be used early: - Step 1: adjusted deadlines and prioritisation - Step 2: temporary reduction in parallel tasks - Step 3: changed work hours/workplace - Step 4: collaboration with occupational health services and GP The important thing is that employees know there's a way forward without drama. ### 4) Make stress management part of operations Stress management is not just techniques. It's also rhythm. - Plan capacity: build buffers into projects. - Normalize breaks: breaks as culture, not as "slacking". - Remove unnecessary "always on": limit expectations of response after work hours. ### 5) Measure what matters Instead of only measuring job satisfaction, measure indicators of mental health risk: - overtime (amount and variation) - turnover - short-term sick leave - eNPS/psychological safety - meeting load (hours per week) Then: tie measures to actions. Otherwise mental health becomes a side project. ## Who benefits from making this difficult? There is a kind of cultural gain in portraying mental health at work as a big, personal mystery. Then the employer can say "we care" while avoiding changing how the organisation operates. Employees can get tools to handle symptoms, but not to reduce the causes. I believe the time for that is over. When we know that stress, anxiety and depression affect the work environment, delivery quality, safety, collaboration and sick leave, it's no longer "soft" to take action. It's professionalisation. And yes: it takes courage. Because it means someone must say out loud that certain goals are unrealistic, that some leadership styles create insecurity, and that "efficiency" is sometimes another word for understaffing. ## Conclusion: Small changes, big value — if we dare to take responsibility Mental health at work will not be solved by one campaign or one app. But it can improve significantly if we stop treating it as a private problem and start handling it as what it often is: a consequence of how we organise work. The NTNU finding mentioned in VG reminds us that simple, feasible measures can have noticeable effects on health. I believe the same mindset must be applied to mental health work: fewer interruptions, clearer priorities, more predictability, and an accommodation practice that is normalized — not stigmatising. It's not just about being a "good employer." It's about running a modern workplace that doesn't burn the people who keep it running. ## Sources - Author not stated, "New NTNU study: Simple change can reduce risk of lower back pain", VG, 2025-08-11