Please note: the following article was developed for educational purposes only and covers a wide variety of general workplace safety concerns and considerations, some not relevant to workers' compensation coverage or commercial auto coverage.
Here's something you might not expect: when we asked over 1,000 small business employees about their biggest safety concern at work, they didn't say slip and fall hazards. They didn't mention faulty equipment. They said mental health.
It's a shift that's reshaping how we think about workplace safety. And according to Pie Insurance's 2025 Employee Voice on Workplace Safety Report, it's a conversation we can't afford to ignore.
Think about traditional workplace safety for a moment. You probably picture hard hats, safety goggles, and training on proper lifting techniques. These things still matter, of course. But something else has quietly moved to the top of employees' worry lists.
In Pie Insurance’s recent survey, nearly one in three employees identified mental health as their primary safety concern at work. That outpaced worries about physical injuries, environmental hazards, and equipment safety. Even more telling, employees named mental health as both the greatest risk they face and the most overlooked one in their workplaces.
The World Health Organization notes that work can be protective for mental health, but it can also contribute to potential harm. And when that harm happens, it doesn't just affect someone's mood or stress levels. It can impact their ability to work safely.
One employee in our survey shared a story that stuck with us:
"A 40-something year old co-worker developed shingles on her face near her eye due to the stress of workload."
It's a stark reminder that workplace stress isn't just about feeling overwhelmed during business hours. According to Pie Insurance’s 2025 Employee Voice on Workplace Safety Report, more than a third of employees say workplace stress affects their personal lives, influencing everything from their relationships to their sleep patterns.
Among those dealing with workplace stress, the ripple effects are significant. Most report reduced motivation or burnout. Many experience increased anxiety or depression. Others have physical symptoms like headaches and fatigue, difficulty sleeping, or trouble focusing when they're at home. Some say it's straining their personal relationships.
These aren't separate issues. They're interconnected challenges that can follow someone from the office to the dinner table to the bedroom, affecting their wellbeing around the clock.
Here's where things get interesting. When we look at how employers and employees view mental health support in the workplace, we see what we're calling "The Great Safety Divide."
Most employers report feeling confident in their ability to address mental health issues at work. But only about six in ten employees share that same confidence in their employers. That's a notable gap in perception.
The implementation gap may be even more revealing. While about half of employers report having mental health protocols in place, only three in ten employees observe having access to these protocols. It's not that employers don't care. It's that what they think they're providing and what employees actually experience aren't always matching up.
And here's what makes this particularly important: nearly three out of four employees say some form of mental health support from their employer would make a meaningful difference in their lives. The need is there. The desire for help is there. But the connection between available resources and employees who could benefit from them isn't always happening.
When it comes to mental health support, employees aren't asking for complicated programs or expensive interventions. They're asking for practical flexibility and basic resources.
Top of the list? Flexible work hours or remote work options. Nearly one in five employees identified this as their most wanted form of mental health support. Following that was a simple allowance for mental health days, which about one in six employees requested.
Other requests included confidential counseling or therapy services, employee training on mental health awareness, and stress management workshops or trainings. Notably, about a quarter of employees said no support was needed or wanted, which suggests that while mental health support matters to many it could be offered as an optional resource that employees can choose to access when needed..
Research from the CDC's National Institute for Occupational Safety and Health has found that work-related psychosocial hazards were assessed at $187 billion in direct U.S. medical costs. Mental health workers' compensation claims are increasing in the United States, possibly due to an increase in state laws covering these claims and growing awareness among workers about the connection between working conditions and mental health.
One finding from the 2025 Pie Insurance Employee Voice on Workplace Safety Report stands out: more than four in ten employees report feeling pressure to work through fatigue, illness, or unsafe conditions to meet deadlines or quotas.
This pressure to perform regardless of how you're feeling can create a cycle that compounds stress and burnout. And it's not just about mental wellbeing. When employees feel they have to rush or push through exhaustion, it can increase the likelihood of mistakes and accidents.
Some employees in the survey mentioned that safety protocols feel too time-consuming, which might indicate that time pressure is causing workers to skip important safety measures. Among commercial vehicle drivers specifically, about one in eight expressed concern about pressure to rush, which can affect both physical and mental wellbeing.
Sometimes the most powerful data comes from direct quotes. Here's what some employees told us when asked about mental health and workplace safety:
"Be encouraged to take mental health days to prevent burnout. More mental health resources available."
"Allow for more time away from work to prevent burnout. Work life balance is important."
"Be aware of employees' mental health issues."
And perhaps most simply, one employee wrote: "Ask me if I'm ok."
That last one hits different, doesn't it?
Sometimes creating a mentally healthy workplace starts with that basic level of care and attention. Not a formal program. Not a policy. Just someone noticing and asking.
You might be wondering: why are we talking about mental health in a workplace safety report? Because they're not separate issues.
Survey research suggests that on-the-job injuries and accidents may be more likely when employees experience mental health difficulties like insomnia, anxiety, or depression. Job strain characterized by high demands and low control has been associated with increased risks of heart disease and stroke. And according to the National Alliance on Mental Illness, two in five workers worry their career would be negatively impacted if they talked about mental health concerns at work, even though most feel comfortable if a coworker shares their struggles.
When someone is stressed, burned out, or struggling with their mental health, it can affect their ability to focus, make decisions, and work safely. Mental health isn't separate from physical safety. It's a core component of it.
So what can we do with all this information? The findings from the 2025 Pie Insurance Employee Voice on Workplace Safety Report suggest a few practical directions.
The good news? Many of the things employees are asking for are relatively straightforward. Flexibility. Open communication. Recognition that mental health matters. These aren't impossible asks. They're practical starting points.
Want to explore more about what both employers and employees are saying about workplace safety? Check out Pie Insurance's complete 2025 workplace safety research, which includes insights from over 2,000 survey responses and reveals eye-opening perception gaps on everything from training to mental health protocols.
As one employee simply put it: "Ask me if I'm ok."
Sometimes, creating a mentally healthy and safe workplace really can start with something that basic.
How does mental health affect workplace safety?
Survey research suggests that employees experiencing mental health difficulties like insomnia, anxiety, or depression may be more likely to experience on-the-job injuries and accidents. Mental health challenges can affect focus, decision-making, and physical wellbeing, which all play a role in working safely.
What percentage of employees consider mental health their top workplace safety concern?
According to Pie Insurance's 2025 Employee Voice on Workplace Safety Report, nearly one in three employees identified mental health as their number one safety concern, making it the leading safety worry among employees surveyed.
What's the biggest gap between employers and employees regarding mental health support?
There appears to be a significant perception gap. While most employers report feeling confident in their ability to address mental health issues, only about six in ten employees share that confidence. Additionally, while about half of employers say they have mental health protocols, only three in ten employees report observing these protocols being available.
What kind of mental health support do employees want most?
The top request is flexible work hours or remote work options, followed by mental health day allowances and confidential counseling or therapy services. Notably, about a quarter of employees said no support was needed or wanted, suggesting that support should remain voluntary and accessible.
How does workplace stress impact employees outside of work?
More than a third of employees report that workplace stress affects their personal lives. Among those affected, impacts may include reduced motivation or burnout, increased anxiety or depression, physical symptoms like headaches and fatigue, sleep difficulties, trouble focusing at home, and strain on personal relationships.
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About the Research:
Pie Insurance commissioned YouGov PLC to conduct surveys of both employers and employees. All figures, unless otherwise stated, are from YouGov PLC. Details on sample sizes and fieldwork dates can be found in the full 2025 State of Workplace Safety and 2025 Employee Voice on Workplace Safety reports.
Thanks for reading! This content is intended for educational purposes only and does not imply coverage under workers' comp or other insurance offered through Pie Insurance Services, Inc. Please consult an agent or attorney for any questions regarding applicability of insurance.
