A review of more than 135,000 occupational health referrals has revealed fresh insight into why employees struggle to stay well at work. The analysis highlights rising cases linked to neurodivergent conditions, widening gender gaps in mental health and early warning signs of physical health problems among young workers.
The findings show that neurodivergent conditions, such as autism, dyslexia and ADHD, are now the third most common reason for referral. One in ten employees were referred because they needed help to manage a neurodivergent condition at work.
Mental health remains the leading cause overall, with one in three referrals linked to anxiety, depression or stress. Gender differences are clear: men were more likely to struggle with depression, while women were more often affected by anxiety.
The review also uncovered unexpected health issues in younger age groups, including a rise in bowel conditions among young men and early heart issues in women aged just 16–19.
Occupational health clinicians say these findings point to five key trends, with practical steps employers can take to support their workforce.
The rise in referrals linked to neurodiversity reflects both greater awareness and growing workplace pressures. More people are disclosing conditions and seeking help, but symptoms can be made worse by stress, menopause or lack of adjustments.
Clinicians warn that support is often delayed until performance problems arise. Involving occupational health sooner can make a big difference, with needs assessments helping to identify barriers and recommend adjustments. These may be simple, such as daily planning strategies, AI tools to proofread documents, or assistive technology funded by Access to Work.
While some employers may worry about costs, failure to act could be far more expensive. Neurodivergent conditions are protected under the Equality Act, meaning inadequate support can result in tribunal claims and fines.
Two thirds of referrals are for women, suggesting men are not accessing support as often. For many, stress and anxiety in their twenties evolve into more serious depression by middle age. By 40 – 49, more than one in ten men are referred for depression, compared with 7 per cent of women.
This pattern raises concern, given that suicide is the leading cause of death in men under 50. Experts say managers need to start “courageous conversations” by asking colleagues how they are really doing and actively guiding men to support such as talking therapies funded through Employee Assistance Programmes.
Anxiety is the most common reason for referral among women under 50 and the top issue for young women aged 16–19, where one in five referrals is due to anxiety.
Anxiety can be useful in preparing people to face challenges, but it becomes harmful when constant “what if” thinking causes ongoing distress. Symptoms include rapid breathing, pounding heart, poor sleep, headaches and panic attacks.
Employers can help by offering education on recognising triggers, resilience training and practical coping strategies. Physical activity and mindfulness programmes have also been shown to reduce anxiety. Occupational health can recommend adjustments to further support individuals.
Bowel conditions, including IBS and colitis, are a top ten reason for referral among men across all ages. The gut and brain communicate closely, meaning poor mental health can trigger bowel issues, and inflammation from bowel conditions can worsen depression.
The reverse is also true: improving gut health can boost mood. Employers are encouraged to think holistically, recognising that physical and mental health are intertwined. Promoting a “whole person” approach – covering diet, stress management and mental health – can benefit both wellbeing and performance. Perhaps the most surprising finding was a rise in referrals for heart problems among young women. Two per cent of referrals for 16–19-year-old women were linked to heart issues – compared with 5 per cent of men over 50.
A call to action for employers The data paints a picture of a workforce facing complex challenges, from the need for greater neurodiversity support to tackling gender differences in mental and physical health. For employers, the message is clear: early intervention, education and a joined-up approach to wellbeing are essential.
Investing in occupational health is not only about reducing absence – it is about protecting employees, supporting inclusion and helping people thrive at work.
