Managers’ support to employees with common mental disorders during the COVID-19 pandemic: the importance of staying in touch Open Access

One in three workers is affected by common mental disorders (CMD) during their lifetime (Steel et al., 2014). Longitudinal studies show that these individuals are at risk of both long and recurring episodes of sick leave as well as early retirement (Ahola et al., 2011; Knudsen et al., 2013; Koopmans et al., 2011). Such absence from work has social and financial implications for the individual, workplaces, and society at large, making it a major public and occupational health concern. Managers are pivotal in supporting worker well-being and work participation (Wallo and Lundqvist, 2020; OECD, 2021a; Jansen et al., 2021) and understanding the barriers and facilitators to such support in different work settings is vital for effectively guiding their efforts. Employers are legally responsible for the work environment (European Agency for Safety and Health at Work, 2008) and are obliged to prevent work-related ill health among employees as well as support employees who are already ill to remain at or return to work. Managers are delegated operative tasks related to work environment responsibility but struggle to identify and handle mental health problems among employees (see for example (Martin et al., 2018; Porter et al., 2019; Thisted et al., 2020). Personal factors such as knowledge and attitude can influence managers’ support for these employees (Bertilsson et al., 2023; van de Voort et al., 2019) but little is known about the importance of contextual factors such as the structure and resources within the organization (Wallo and Lundqvist, 2020; Jansen et al., 2021; van Hees et al., 2022). The objective of this study was therefore to explore how contextual factors affect managers’ perceived ability to support employees with CMD. The study was conducted during the COVID-19 pandemic, which provided the opportunity to examine both standard organizational factors, such as industry and company size, and pandemic-driven changes in work organization, such as remote work. In addition, we aimed to determine whether previously identified managerial characteristics remained significant when contextual factors were considered.

Mental ill health is common in the working population. For common mental disorders (CMD) such as depression, anxiety, and stress-related conditions, the estimated prevalence rate is 15% and the lifetime prevalence is up to 35% in OECD countries (OECD, 2012). These conditions, and their sub-threshold symptoms, have negative effects on the individual’s functioning, work capacity and general health (Vingård, 2020; Ford et al., 2011). As a consequence, employees with CMD are absent from work more often than those without such conditions, and CMD are a leading cause of sick leave in many western countries, including Sweden (OECD, 2021b; Swedish Social Insurance Agency, 2023; OECD, 2012). On the other hand, presenteeism (working while ill) is also common (OECD, 2021b). Managers report loss of productivity both before and after sick leave due to CMD (Bernfort et al., 2021), and the effects of CMD on sick leave can be longstanding (Knudsen et al., 2013). The costs associated with sick leave due to CMD are substantial, and the costs of presenteeism might be even higher (Evans-Lacko and Knapp, 2016).

The connection between workplace factors and mental health is becoming increasingly clear. For example, poor working conditions such as high job strain or low social support are associated with a higher risk of developing common mental health problems (Harvey et al., 2017; de Vries et al., 2018). Some occupations are more exposed than others. A longitudinal cohort study of over 600,000 young adults showed that the risk of sick leave due to CMD was higher in the public sector and in manual occupations (Björkenstam et al., 2022). Within the private sector, the risk was highest in education, health and social services (Björkenstam et al., 2022).

Several reviews and reports emphasize the central role of managers in supporting worker well-being and work participation (Wallo and Lundqvist, 2020; OECD, 2021a; Jansen et al., 2021). However, qualitative research has found that managers find it difficult to identify and handle mental health problems among employees. Managers refer to the indistinct nature of mental conditions (Jansson and Gunnarsson, 2018; Porter et al., 2019; Thisted et al., 2020), lack of knowledge (Porter et al., 2019; Lemieux et al., 2011; Brijnath et al., 2014), stigma and/or previous negative experiences of employees with mental health problems (Thisted et al., 2020; Porter et al., 2019; Kirsh et al., 2018), and difficulties balancing the employees’ need for both privacy and managerial support (Martin et al., 2015; Kirsh et al., 2018; Holmlund et al., 2022). In addition, cross-sectional studies have shown that managers’ individual characteristics play a role. For example, having had managerial training about CMD is related to initiating more preventive actions (van de Voort et al., 2019) and more work accommodations (Bertilsson et al., 2013), whereas having negative attitudes towards CMD can hamper support (Bertilsson et al., 2023; Bryan et al., 2018). Moreover, managers who feel confident in handling employees with CMD are more likely to be in contact with them, both before and during sick leave (Bryan et al., 2018), and their willingness to address mental health is related to both the length of sick leave and levels of presenteeism among workers with depression (Evans-Lacko and Knapp, 2018).

The effect of context on leadership has long been an understudied topic (Oc, 2018). However, interest has developed over time (Johns, 2024) and in the wake of the pandemic (Bauwens et al., 2021). Context in leadership research refers to the environmental and situational factors that shape leadership behaviours, constraints, and opportunities (Johns, 2006, 2017). It operates at multiple levels, which include broad societal trends such as economic conditions, national culture, and global crises; industry characteristics and organizational structures; as well as more proximal working conditions such as job design, time pressure and physical distance (Oc, 2018).

Studies show that managers’ actions are highly dependent on organizational conditions such as how work is organized and what resources are available (Oc, 2018; Biron et al., 2018; Genrich et al., 2022), which, in turn, affect employee well-being (Lundqvist et al., 2024). In relation to employees with CMD, several contextual factors have been emphasized. For instance, managers’ scope of responsibility seems to be important. In a survey study of Swedish managers, both manager position and the number of subordinates were associated with how managers found out that an employee had a CMD (Bertilsson et al., 2021). Another study based on the same dataset found that managers who were responsible for the work environment were more likely to initiate preventive actions than those who were not (van de Voort et al., 2019). Managers themselves mention the presence or lack of organizational support and resources, such as established procedures and engagement of upper management, as facilitators of or barriers to good management of employees’ mental health (Porter et al., 2019; Martin et al., 2015; Genrich et al., 2022; Kirsh et al., 2018). But overall, several reviews have concluded that there is little research on the importance of organizational factors for managers’ work with mental health in the workplace (van Hees et al., 2022; Jansen et al., 2021; Wallo and Lundqvist, 2020).

The COVID-19 pandemic brought profound changes to the way people worked, and the shift to remote work was one of the most significant. In OECD countries, 39% of workers shifted to remote work at the start of the pandemic (OECD, 2021c). Sweden did not introduce a lockdown but the recommendations issued by the Public Health Agency of Sweden were to apply physical distancing, avoid large gatherings, and enable staff to work from home if possible (Ludvigsson, 2020). In the private sector, about 30% of employees worked from home for at least half of the working week during the time of this study (October 2021) (Statistics Sweden, 2022). The government also provided financial support for companies to temporarily lay off personnel with continued pay if production was severely diminished due to the pandemic.

Several studies on leadership during remote work suggest that while managers reported positive experiences in general, they also found the role more demanding, with limited organizational support (Andersone et al., 2023; Teng-Calleja et al., 2024; Mikołajczyk et al., 2024). A main challenge was maintaining good communication and relationships within the company (Kirchner et al., 2021; Criscuolo et al., 2021; Ipsen et al., 2022). Other challenges were finding sustainable ways of working (i.e. digital hygiene and work-life balance) to preserve their own and their employees’ health, as well as supervising individuals and teams (Mikołajczyk et al., 2024; Couto et al., 2024).

It is evident that leadership behaviour affects employee wellbeing during remote work, but more research is needed to establish effects over time and in different settings (for example hybrid vs fully remote work) (Lundqvist and Wallo, 2022; Ebojoh and Högberg, 2024). It seems that core leadership skills–for instance communication, trust and goal setting–still apply but may need to be adapted and/or complemented (Lundqvist and Wallo, 2022; Ebojoh and Högberg, 2024; Tigre et al., 2022). For example, Boccoli et al. (2024) found that leaders’ digital communication skills mediate the positive effects of transformational leadership in remote work by making employees feel more supported (Boccoli et al., 2024).

However, we have found no studies on distance management specifically in relation to employees with CMD. This is an important field to explore since CMD are common among employees and working from home remains an alternative for many workers post-pandemic (OECD, 2020; Criscuolo et al., 2021).

This cross-sectional questionnaire study has an exploratory design and is part of the research project “Managers in action: The importance of organizational and workplace context for managers’ measures for employees with common mental disorders”. The project aimed to study managers in the private sector and their possibilities to support employees with CMD, focusing on organizational and contextual conditions. Data collection took place during the COVID-19 pandemic, therefore the survey was designed to take the temporary pandemic-related working conditions into consideration. The project was approved by the Swedish Ethical Review Board (Dnr: 2021-02808).

Participants were recruited from the Swedish Citizen Panel at the SOM Institute, University of Gothenburg. The Citizen Panel is a research-driven non-commercial web panel and includes over 75,000 individuals. Respondents are either self-recruited or recruited by probability-based sampling from the Swedish tax agency register. Data are collected through web surveys. A screening question was sent out to the panel in February 2021; 5,858 respondents answered that they were managers in the private sector. Of these, 212 individuals were already involved in other studies. Invitations to take part in the study were sent out in October 2021 to the remaining 5,646 individuals, with two reminders. Inclusion criteria were (1) holding a managerial or supervisory position and (2) having at least one subordinate. After the exclusion of 1,293 ineligible individuals and 928 dropouts, the final study population consisted of 3,425 participants. Our study sample consisted of the 1,136 managers who answered “Yes” to the survey question “During the last 12 months, have you had any employees with exhaustion, anxiety or depression at your current workplace?”. Among the managers included, the median duration of managerial experience was 10 years. About two-thirds (64.8%) had a college, university or doctoral degree, 78.9% reported having no negative attitudes towards CMD, and 41.4% had participated in managerial training about CMD. The recruitment process is presented in Figure 1.

The survey consisted of questions about work context (e.g. type of service), organizational structure (e.g. company size), organizational climate (e.g. attitudes to CMD in the company), managers’ job demands and resources (e.g. working overtime, support from human resources), managers’ measures to prevent sickness absence in employees with CMD, and managers’ individual characteristics (e.g. level of education, attitudes towards CMD). CMD were presented as exhaustion, anxiety, and depression. Due to the ongoing COVID-19 pandemic, questions relating specifically to the pandemic were also included. The survey was launched in October 2021, just about a year after the recommendations about working from home had been issued in Sweden. Therefore, questions were phrased as “During the last 12 months, …?”.

The 1,136 managers who reported having had employees with CMD in the last 12 months were asked the question “How do you think the possibilities to support these employees have been affected during the COVID-19 pandemic and the related restrictions?”. There were five response options ranging from “It has become much harder” to “It has become much easier”. Because the responses were very skewed, the categories were collapsed and dichotomized into “It is harder” (It has become much harder, It has become somewhat harder) and “It is the same as before or easier” (It is about the same as before, It has become somewhat easier, It has become much easier).

The explanatory variables were chosen to represent the work context and organizational structure, changes in work organization during the pandemic, and the managers’ individual characteristics. All variables are presented in full in Table 1, together with their response options and the recategorizations used for analyses. Variables representing work context and organizational structure included industry (measured with 16 industry options based on the Swedish Standard Industrial Classification (SNI) (Statistics Sweden, 2007) merged into four groups based on the people-data-things hierarchy described by Fine (1955)), company size (number of employees in the company), manager position, work environment responsibility and the number of subordinates. These were all significant predictors for managers’ support to employees with CMD in previous studies (Bertilsson et al., 2021, 2023; van de Voort et al., 2019; Schuller et al., 2024). Educational level of subordinates and frequency of contacts with subordinates were also included as part of the exploratory design. Variables representing changes in the organization of work during the pandemic included the extent of working from home among subordinates, subordinates temporarily laid off with continued pay, the effect of the pandemic on contacts with subordinates, and managers’ main workplace during the pandemic. None of these had been used in previous research on managers’ support to employees with CMD. Variables representing manager characteristics included the educational level of the manager, number of years as a manager, attitudes towards CMD, and participation in managerial training about CMD. These were all important for managers’ support to employees with CMD in previous studies (Schuller et al., 2024; van de Voort et al., 2019; Bertilsson et al., 2021, 2023).

Descriptive statistics were used to calculate numbers and proportions for all variables. Then, logistic regression analyses were conducted to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for associations between managers finding it more difficult to support employees with CMD and the explanatory variables. Logistic regression was chosen because the outcome variable was ordinal and had to be dichotomized (Harpe, 2015; Tabachnik and Fidell, 2013).

First, all explanatory variables were analysed separately to assess their individual relationship with the outcome. Then, the variables that showed a statistically significant association (p < 0.05) were analysed together in their respective group: work context and organizational factors (model 1), changes in organizational factors due to the pandemic (model 2), and manager characteristics (model 3), to explore which variable(s) within each group were most important for the outcome. Finally, variables with statistically significant associations (p < 0.05) in models 1–3 were analysed together in model 4 to assess which of the three types of explanatory variables had the strongest association with the outcome. Variables were excluded solely based on statistical significance. The choice to omit non-significant variables in each step was made to avoid having too many variables in the final model as this can lead to overfitting and make the models’ predictions less reliable (Tabachnik and Fidell, 2013). However, this approach comes with the risk of excluding important confounders and therefore, after the main analyses, we performed a sensitivity analysis for each model. In models 1-3, we expanded the models by adding all previously non-significant variables within each respective variable group. In model 4, we added all explanatory variables not previously included in the model (see  Supplementary material). We checked for multicollinearity between the explanatory variables and the highest correlation was between “Educational level of employees” and “How many employees worked from home” (Spearman's rho, 0.528; p < 0.001), meaning that no variables had to be excluded from the analyses. All analyses were performed using IBM SPSS Statistics 28 and 29 (IBM Corp., Armonk, NY).

Almost half (47.8%) of the 1,136 managers found that it had become somewhat or much harder to support employees with CMD during the pandemic. Equally many reported that their possibility to support these employees was about the same as before, whereas less than 5% thought that it had become somewhat or much easier.

The characteristics of the managers’ work context are presented in Table 2.

When the variables measuring work context and organization were analysed one by one (Crude; Table 3), we found that managers in blue- and pink-collar industries, small companies, workplaces with lower employee education levels, and those who had daily contact with their employees were less likely to find it harder to support employees with CMD during the COVID-19 pandemic (Crude; Table 3). The associations remained largely the same when the variables were analysed together (model 1; Table 3) and in the sensivity analysis ( Supplementary material). However, when analysed with the two other types of explanatory variables (changes in work organization due to the pandemic and the managers’ individual characteristics) none of these associations remained (model 4; Table 3), with no changes following sensitivity analysis ( Supplementary material). This indicates that although work context and organizational factors play an important role in shaping managers’ ability to support employees with CMD, their influence was diminished in the specific context of the pandemic. The pandemic brought on changes in how work was operationalized and carried out, particularly in specific industries and occupations, which in turn may have affected the outcome. Remote work was quite uncommon in blue- and pink-collar industries in Sweden during the pandemic; these workers (such as employees in retail and public transport) and their managers continued to work at their regular workplace. This factor, more than the sector itself, helps explain why these managers found it easier to support employees than those in the white sector, where remote work was more common.

When variables in this group were analysed one by one, work from home among employees and managers, as well as having fewer contacts with subordinates, showed a strong association with managers’ perceived possibilities to support employees with CMD, while having subordinates temporarily laid off was not important (Crude; Table 3). When the variables were analysed together (model 2; Table 3), the managers’ workplace was no longer significant, indicating that this factor was less important than where the employees performed their work and how often the manager and the employees had contact with each other. The extent of work from home among subordinates and the frequency of contact with them were the only variables that remained significant in the final model (model 4; Table 3), and with consistently high ORs in all analyses, suggesting that these factors were essential for managers’ possibilities to support subordinates with CMD during the pandemic. The highest odds were seen for managers who reported that contacts with subordinates occurred less often because of the pandemic; they were more than three times as likely to find it harder to support employees with CMD during the pandemic (adjusted OR, 3.06; 95% CI, 2.30–4.06) compared with those who reported that contacts occurred as often as before (model 4; Table 3). Similar odds were found for managers with subordinates who worked from home most or all of the time (adjusted OR, 2.87; 95% CI, 1.93–4.25) compared with managers whose subordinates did not work from home (model 4; Table 3). Managers whose subordinates worked from home part-time were also more likely to find it more difficult, but the odds were lower (adjusted OR, 1.58; 95% CI, 1.09–2.30) suggesting that the extent of work from home mattered. The sensitivity analysis confirmed the robustness of the associations, indicating that these factors were key drivers of managers’ ability to support their employees during the pandemic ( Supplementary material).

Among the person-related factors, only the managers’ level of education had an effect on managers’ perceived ability to support employees with CMD (OR, 1.72; 95% CI, 1.34–2.20). Other factors such as manager experience and attitudes towards CMD showed no association (Crude; Table 3). In the final model, when taking organizational factors and changes due to the pandemic into account, the managers’ level of education was no longer significant (model 4; Table 3). In the sensitivity analysis, it regained significance but only marginally (adjusted OR, 1.36; 95% CI, 1.01–1.83) and with a markedly reduced effect size compared to the crude analysis, which suggests that it was not a strong independent factor and only played a minor role during the pandemic.

All models had a better fit than the null model (likelihood ratio test; Table 3). Overall, model 4 had the best fit, and model 2 was almost as good. Both these models included the two predictors that were strongly associated with the outcome in all analyses and represented changes in the organization of work due to the pandemic. According to Nagelkerke R², model 4 explained a little less than one fifth of the variance in the outcome variable (Nagelkerke R², 0.177; Table 3).

To the best of our knowledge, this is the first study to explore private sector managers’ possibilities to support employees with CMD during the COVID-19 pandemic. We found that nearly half of the managers thought it had become harder to support these employees and that this was largely due to reduced opportunities to stay in touch with their subordinates.

First, we found that managers who reported having less frequent contact with their subordinates during the pandemic were much more likely to find it harder to support employees with CMD. We do not know what kind of support the managers in our study had in mind, but it is evident that it required staying connected with the employees. In general, it seems that being available and keeping up contacts and relations was prioritized by managers during the pandemic and was an important way to support their employees (Flood et al., 2022; Mackay et al., 2022; Björk et al., 2023; Lundqvist et al., 2023). In the case of CMD, we have found only one study that included the perspective of managers, and it examined barriers and facilitators for young employees with CMD to stay at work during the pandemic (Wallberg et al., 2023). The young employees described that due to their managers’ increased workload, the managers were less available, which led to fewer opportunities to ask for help and a risk of “falling through the cracks”. In the same study, managers too talked about the negative effects of seeing each other less, but with an emphasis on the lack of face-to-face contact due to the imposed working from home.

This leads to our second finding, namely that managers whose subordinates were working from home were more likely to find it harder to support employees with CMD, with higher odds the higher the extent of working from home. From the workers’ perspective, support from the manager is equally important whether working from home or on site (Lundqvist et al., 2022; Lamprinou et al., 2021). This means that providing support to subordinates who work from home is equally important, but more difficult (Teng-Calleja et al., 2024). The effect of physical distance on leadership is still understudied, but existing research suggests that it makes leadership less effective (Oc, 2018). Here, we interpret this as being due to the reduced opportunities for social interaction brought on by remote working. The shift to working from home during the pandemic posed a big challenge for managers in keeping up communication with their employees (Kirchner et al., 2021; Reineholm et al., 2022; Lundqvist et al., 2023). Distance managers felt they lost contact with their subordinates and the ability to perceive if an employee had problems (Tautz et al., 2022; Wallberg et al., 2023; Lundqvist et al., 2023). Our study was conducted more than a year into the pandemic, but it is possible that the organizations had not yet implemented adequate and sustainable structures for staying connected.

We also found that some of the standard contextual factors had an impact on managers’ perceived ability to support subordinates with CMD: industry, company size, and educational level of employees. These represent the broader conditions of the organization and possibly reflect the level of and readiness for remote work during the pandemic. Surprisingly, the conditions more closely tied to the manager (such as manager position and number of subordinates) did not play a role. Similarly, only one of the manager characteristics mattered. The substantial organizational changes brought on by the pandemic probably overshadowed aspects that are normally important. This would explain why previously reported factors such as the manager’s attitude and experience were not significant in our study, and why only the pandemic-related factors influenced the managers’ support when all variables were considered. It is possible, however, that these associations then changed over time as a new normal was established.

This study addresses two major labour market trends: the increase in CMD and associated sick leave, and the increase in remote work. Given how common CMD are in the workforce, good management of mental health at the workplace is essential. More prompt awareness of and support to subordinates with CMD can reduce suffering and increase work participation, with great financial and social benefits for individuals, workplaces and society (van Hees et al., 2022). Managers have a central role in employee well-being, therefore there has been a call for policies and strategies for managers on how to support employees with CMD (Martin et al., 2018) as well as training to increase their competencies and skills in relation to mental health (World Health Organization, 2022). However, the scientific evidence base for workplace interventions is still weak (Deady et al., 2024), and existing guidelines do not take remote work into account (World Health Organization, 2022). Furthermore, research and practice have so far had a strong focus on interventions at the individual level and much less on the organization and workplace context (Deady et al., 2024).

Our study contributes with one important aspect by showing that how work is organized affects managers’ possibilities to provide support to employees with CMD. In particular, employers need to establish adequate and sustainable structures for managers to stay in touch with their employees, especially when work from home is an option (or necessitated by circumstances such as the pandemic). In a remote or hybrid work setting, employers need to make sure managers and employees have the necessary technical solutions to communicate, as well as the skills to use them effectively (Boccoli et al., 2024). But beyond that, and more importantly, employers should offer manager training in mental health (World Health Organization, 2022). Understanding the characteristics of CMD, its impact on work capacity, and how to communicate about it is crucial to provide effective support, but many managers lack such knowledge (Bertilsson et al., 2013; Tengelin et al., 2022; Hauck and Chard, 2009). The training should provide guidance on what to do and when (for example how to initiate a conversation about mental health and what questions to ask) and particularly include the challenges of supporting employees with CMD in an increasingly virtual work setting. A recent study identified that managers are helped by company guidelines and routines, but that these often describe ideal processes and can be hard to translate into practical advice for the particular situation at hand (Tengelin et al., 2025). Guidelines on how to support employees working remotely would benefit from taking such experiences into account. For organizations that cannot provide manager training, for example, smaller businesses with limited resources, a first step towards supporting managers in handling employees with CMD (regardless of worksite) would be encouraging and facilitating social interaction between managers and staff.

On the workplace level, social support from the manager is essential for both workers with CMD (van Hees et al., 2022) and those working remotely (Höddinghaus et al., 2024). Without adequate social interaction, there is a substantial risk that workers with CMD remain unnoticed and unsupported. A common way for managers to find out that an employee has a CMD is by observing a changed behaviour, for example, withdrawal (Kirsh et al., 2018; Martin et al., 2015; Bertilsson et al., 2021). Without regular contact, managers might miss these early signals. Seeing each other less also makes disclosure more difficult. Mental health is still surrounded by stigma; it is difficult to talk about and even harder to disclose (Brohan et al., 2012; Hastuti and Timming, 2021). When working from home, there are less opportunities for informal face-to-face interactions and small talk, which is when personal issues are generally disclosed (Tautz et al., 2022; Tepordei and Foot, 2022; Wallberg et al., 2023). Therefore, managers need to be proactive in picking up on mental health issues among subordinates working remotely. Scheduled face-to-face meetings (physical or digital) with subordinates and regularly asking a few questions about their mental well-being are two examples of how to do this. We also encourage managers to proactively request and participate in employer-provided training on mental health and remote work best practices (Tengelin et al., 2025).

The results from this study can be useful when developing workplace policies for handling mental health in the workplace, serving managers and human resources as well as occupational health. However, to provide clear guidelines on how to manage CMD in the setting of remote work, the effects of working from home on CMD need to be established (Lunde et al., 2022). There is also a need for more studies on managers and remote work. Workers state that part-time working from home can be beneficial for their well-being, but we need to explore further how such arrangements affect managers’ ability to fulfil their work environment responsibilities in relation to mental health at work.

Strengths of this study include the high response rate and the large sample representing many industries and company sizes. Convenience sampling of panel participants was used in this study instead of a population-based random sample of managers, therefore the results might be biased towards more interested managers, leading to less generalizability. On the other hand, the panel contributes to a high response rate with less bias due to non-participation and a large sample making it possible to include several factors in the model design. The cross-sectional design does not allow for conclusions about causality, but our results can reasonably only be interpreted in one way, that less contact and working from home made it more difficult to support employees; the opposite would not be logical.

There are factors that we were not able to consider in our study that might have affected the results. First, we have no knowledge of the managers’ situation before the pandemic; for example, how acquainted they were with remote working or how they perceived their ability to support employees with CMD during normal circumstances. Second, we do not know if the managers had more employees with CMD than usual during the pandemic, only that they had at least one employee with a CMD during the last year. Third, we have no information about other effects of the pandemic on the companies in which the managers were working or the managers themselves (financially, risk of catching the virus, etc.). Dealing with an increased workload and worries related to business survival as well as their own and employees’ health may have affected the feeling of being able to (or not) support the employees. This study concerns managers in the private sector, therefore the results cannot be generalized to managers in the public sector; further studies are needed to confirm that the results are valid in that setting. The same is true for other countries, where the culture and organization of work might differ from that in Sweden, as well as the circumstances during the pandemic. According to a recent report, Swedish managers’ work situation did not change dramatically during the pandemic (apart from certain industries where the situation was more strained) (Lundqvist et al., 2023). Therefore, we believe that our results are robust and offer insights that are also valuable in the post-pandemic era. The study adds to the previously scant knowledge of the importance of work organization for managers’ work with a large group of workers. However, further studies about managers’ handling of workers with CMD in the setting of remote work are needed to see if the results are the same when working from home is a conscious choice and proper routines for social interaction and support have been implemented.

As the first of its kind, the present study demonstrates that the organization of work was critical to how well managers perceived that they could support employees with CMD during the COVID-19 pandemic. Managers found it harder to support employees with CMD when they had fewer contacts with their staff and when their staff worked from home more. These novel results imply that being able to stay in touch and maintaining regular communication with one’s subordinates is of utmost importance for providing support to employees facing mental health problems, emphasizing the need to organize work in a way that promotes social interaction. In both traditional and remote/hybrid work settings, managers are advised to prioritize regular face-to-face meetings (physical or digital) with employees. Employers should support managers by providing adequate digital communication tools and training, as well as manager training on mental health and remote work best practices. Ensuring ways to stay connected should be high on the workplace health and safety agenda, especially in workplaces that allow working from home.