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<xTITLE>Stress, Depression, and Heart Attacks: What Poor Management Does to Employee Health</xTITLE>

Stress, Depression, and Heart Attacks: What Poor Management Does to Employee Health

by Katherine Graham
July 2021

CMP Resolution Blog by Lesley Allport and Katherine Graham.

Katherine Graham

We know a toxic culture in the workplace is bad for morale, engagement, and performance. New research evidence suggests the human costs can be far more serious.

Employees who work in an environment of poor management – where there are unreasonable demands, a lack of autonomy and recognition, and low levels of ‘psychological safety’ – are three times more likely to suffer from depression. The research, published in the British Medical Journal, also suggests there are higher risks of death from heart disease and stroke.

According to researchers, when employers don’t have an active commitment to providing support on mental health, it’s a predictor of bullying. In other words, if you want to know if bullying is happening it’s worth checking HR policies and support offerings.

But are toxic cultures really all down to bad management?

Managers have to make the tough decisions. Introducing change can be necessary and it is managers who are in the front line when it comes to pushing through sometimes difficult realities. There can be very reasonable explanations for why managers make extra demands. None of these things mean a working culture is toxic. Grievances and conflict aren’t unhealthy in themselves – they’re often the natural result of bringing diverse groups of people together into teams, and also a signal that people care about their contribution and their role at work.

Niggling concerns and clashes between managers and line reports only become a real problem when there’s no conversation. Or at least no open conversation, just resentment eventually spilling over into argument and relationship breakdown. Then comes the formal investigation and disciplinary processes and yet more stress for those involved – as well as those affected by the ripples of bad feeling around what’s been happening.

The angst has to go somewhere. It’s not surprising that psychological blockages in dealing with misunderstandings, miscommunications, and clashes in personality, lead to serious physical ill-health.

But, of course, there has to be management and not a dump of problems. To create a ‘clear air’ culture employees need to have confidence and trust in their organisation (and each other) to speak up and know that they will be listened to and understood in the right way. Staff at all levels need to have the skills to have ‘good’ conversations: for listening, empathy, self-awareness – all those things that make the difference between knee-jerk irritation and assumptions and constructive, grown-up ways forward. There needs to be the option of mediation for early interventions and not as a last resort.


Katherine Graham has worked in the field of dispute resolution for over 15 years’ as a mediator and trainer. She has mediated on the BBC Learning Zone and has given keynote speeches on conflict management and mediation for The MOD’s Equal Opportunities Conference, Women in Business Annual conference and “Getting Beyond Conflict”, a national conference on workplace dispute resolution. Katherine joined CMP Resolutions (formerly Conflict Management Plus) in 1992. She was made a director of the company in 1998 and became Managing Director in May 2009. Prior to this she managed teams in publishing and communications departments for major national charities including The Work Foundation, the RNID and the King’s Fund. She was the inaugural Chair of the Institute of Conflict Management.


Author of The Directory of Mediation Services for Social Landlords (National Housing Federation)

Editor, “Equilibrium” – a quarterly journal of dispute resolution

Co-author Mediation for Managers (NB Books 2002)

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Additional articles by Katherine Graham