Trauma informed leadership

New research from McKinsey makes the case for trauma-informed leadership as core to organisational performance. At PTSD UK, we see what happens when workplaces get this right, and crucially, what happens when they don’t. With one in three employees having experienced trauma, and managers shaping mental health more than doctors or therapists, this isn’t optional any more.

The Statistics Behind Trauma-Informed Workplaces

The recent McKinsey Health Institute survey of 30,000 employees across 30 countries found that 33% of employees report experiencing a traumatic event that has affected their lives (McKinsey, 2026).

McKinsey is clear that this figure is almost certainly an underestimate. As they put it: “The true percentage of individuals experiencing trauma in the general population may be higher, since not everyone chooses to disclose it or is accurately aware of the effects of a traumatic event” (McKinsey, 2026).

And the part that matters most for any business – those employees report lower levels of adaptability, learning, engagement and other performance outcomes than colleagues who haven’t experienced trauma (McKinsey, 2026).

Beyond trauma specifically, the broader picture of workplace pressure in the UK is also stark. Health and Safety Executive figures (2025) show 22.1 million working days were lost to work-related stress, depression and anxiety in 2024/25 – with each affected person taking an average of 22.9 days off. Trauma doesn’t exist separately from workplace stress. For many people, trauma changes how the nervous system responds to pressure, uncertainty, conflict and overwhelm – meaning everyday workplace stressors can quickly become psychologically and physically unmanageable.

The question isn’t whether trauma and chronic stress are showing up in your workplace. They are. The question is whether your leadership is equipped to recognise it.

Compassion and accountability aren’t opposites

Trauma-informed leadership is not about lowering standards. It’s not about removing accountability or lowering expectations.

It’s about bringing your humanity to your leadership without losing your authority. About recognising that accountability and compassion aren’t opposites – they work together, not against each other. About building a culture where people don’t have to reach crisis point before they get support.

And it’s about something far more practical: we now understand more about how the human brain actually works under pressure than we did even ten years ago. Neuroscience and psychology have given us a much clearer picture of how stress, fear and past experiences affect attention, memory, judgement and behaviour. Trauma-informed leadership is the application of that knowledge to how we manage people.

This isn’t new thinking, either. High-reliability sectors – aviation, surgery, emergency response – have institutionalised debrief practices for decades, precisely because they’ve understood for longer than most corporate environments that sustained performance depends on processing strain, not powering through it.

Looking after your people and getting the best out of them aren’t two separate goals. They’re the same goal.

Why Managers Need Trauma-Informed Training

A 2023 study by the Workforce Institute at UKG, surveying 3,400 people across 10 countries, found that managers have as much impact on their employees’ mental health as their spouse or partner (both 69%), and more than their doctor (51%) or therapist (41%) (Workforce Institute at UKG, 2023).

This is the structural reality of how influence works in workplaces. Managers control who speaks first in meetings. Whose ideas get credit. Who gets protected when they take a risk. What happens when something goes wrong. That’s an enormous amount of leverage over the conditions that make people feel safe or unsafe, and over the conditions that allow people to perform at their best.

McKinsey’s own research backs this up. Team leaders, they found, have the strongest influence on a team’s psychological safety – more than team composition, organisational culture, workload or physical environment (McKinsey, 2021). The reason isn’t that those other things don’t matter. It’s that humans are fundamentally relational. We read the room by reading the people with power in it.

A manager’s tone in a meeting, how they respond to a mistake, whether they ask questions or give answers, whether they’re predictable or volatile: these send constant signals that the team is always interpreting, often unconsciously.

Other UK-relevant findings from the UKG study:

• 60% of employees worldwide say their job is the biggest factor influencing their mental health.
• 46% of UK employees report being “often” or “always” stressed about work.
• 31% of employees with a workload problem say they’ve “rarely” or “never” talked to their manager about it – because they think their manager wouldn’t care, is too busy, or that they should be able to figure it out alone.

Manager behaviour shapes workplace mental health more than almost any other factor a business can directly control. Train managers well, and you can transform the system. Don’t, and no amount of perks, EAPs or wellbeing initiatives can fully compensate.

What Is Trauma – And How Does Trauma Affect People at Work?

The word “trauma” is used loosely in everyday conversation, which has made it harder to take it seriously in workplaces. So it’s worth being clear what it actually means.

Trauma refers to the psychological and physiological impact of experiences that leave the nervous system in a prolonged state of threat or distress.

Most people, if asked, would describe trauma in terms of the obvious – serious accidents, assault, sudden bereavement, military combat, sexual violence, medical emergencies, or witnessing harm to others. 

But trauma also includes a much wider range of experiences that people often don’t recognise as trauma at all, and yet they can have a profound impact on the nervous system, particularly when they accumulate over time. These include things like:

• Persistent bullying at school or work
• Emotionally absent or critical parenting
• Repeated humiliation, exclusion or rejection
• Sudden job loss or redundancy
• Difficult divorces or relationship breakdowns
• Long-term financial stress
• A non-life-threatening but frightening medical diagnosis
• Microaggressions, racism, homophobia or other forms of repeated discrimination and oppression of marginalised groups
• Workplace cultures of fear, blame or unpredictability

These experiences are easy to dismiss because, individually, they look manageable. But repeated over time, they can leave the nervous system every bit as dysregulated as a single major traumatic event. 

For some people, the impact of trauma develops into a diagnosable clinical condition.

Post Traumatic Stress Disorder (PTSD) is a condition where the brain’s threat-detection system stays on high alert long after the danger has passed. Symptoms include flashbacks, nightmares, hypervigilance, intrusive memories, avoidance, dissociation and a constant sense of being on edge.

Complex PTSD (C-PTSD) develops from repeated or prolonged trauma, often in childhood or in relationships where escape wasn’t possible. It includes the symptoms of PTSD alongside difficulties with emotional regulation, sense of self, and relationships.

Both are diagnosable, evidence-based medical conditions. And both are far more common in the UK workforce than most employers realise – around 2.6 million people in the UK are currently living with PTSD (University of Birmingham, 2024). That doesn’t include the many more affected by C-PTSD, which still isn’t captured in most economic or workforce analyses. In a UK workforce of 250 people, statistically around 10 of them have PTSD right now. Many won’t have a diagnosis, won’t have told their employer or be getting the right support.

For this group, trauma isn’t a past event they’re carrying lightly – it’s an ongoing, often debilitating set of symptoms that sits on top of everything else employees navigate in a working week. While their colleagues might be dealing with the normal pressures of deadlines, change, conflict and uncertainty, someone with PTSD or C-PTSD is dealing with all of that plus a nervous system that can be triggered by something as small as a tone of voice, an unexpected email, or a meeting room that feels too crowded.

But here’s the part that matters most for any employer – trauma-informed leadership isn’t only relevant for employees with a diagnosis, or the 33% of employees who have experienced trauma. It’s relevant for everyone, because the principles that help someone with PTSD or C-PTSD thrive at work – psychological safety, predictability, clear communication, trust, agency – are the same principles that help every employee perform at their best.

PTSD and C-PTSD make the case especially clear. But the case is the same for everyone.

What Is Trauma-Informed Leadership in the Workplace?

Trauma-informed leadership is an approach to managing people that recognises how stress, fear and past experiences shape the way we think, decide, communicate and behave at work.

But it’s about more than the past. It’s also about how we respond to what’s happening now. Because the truth is, past and present are never fully separate. Someone’s reaction to a difficult email, a tense meeting or an unexpected change isn’t just about what’s in front of them. It’s filtered through everything that came before. A manager who shouts in a one-to-one might be an inconvenience for one employee and a profound destabiliser for another whose nervous system has learned, somewhere along the way, that raised voices mean danger.

A trauma-informed leader understands this. They know that the same workplace event can land very differently for different people, and that this isn’t weakness or oversensitivity – it’s rooted in the nervous system. They learn to recognise the signs of activation in themselves and others, and they design teams and systems that help people stay grounded rather than reactive.

It’s grounded in a principle from neuroscience and psychology: when people feel safe, they think more clearly. When they feel threatened – by uncertainty, by loss of status, by unpredictable change, or by something in the present that echoes something difficult from the past – their nervous systems shift into protective mode. They become defensive, withdraw, or overanalyse. They become less able to take in new information, less able to contribute, and less able to do their best work.

A trauma-informed leader doesn’t try to remove pressure entirely, and they don’t try to insulate their teams from the real demands of a job. What they do is work with how brains actually function under pressure, rather than against it. A workforce thinking clearly is a workforce performing well.

Trauma-informed leadership is not the same as treating trauma. It’s about creating conditions where every employee, including the many in your workforce who are living with PTSD, C-PTSD or the after-effects of other difficult experiences, can work safely and well.

Why this matters more for some people than others: the “window of tolerance”

One of the most useful concepts in modern trauma research is the window of tolerance – a term coined by Dr Dan Siegel, clinical professor of psychiatry at UCLA School of Medicine.

The window of tolerance is the zone in which a person can think, feel, respond, communicate and make decisions effectively. Inside the window, we’re able to handle stress, process new information, listen to feedback, disagree without losing our balance, and engage with what’s actually in front of us.

Outside the window, things look very different.

When we’re pushed above the window (into “hyperarousal”), we become anxious, reactive, angry, defensive, overwhelmed. Heart rate rises, breathing shallows, thinking narrows. We’re scanning for threat rather than engaging with the work.

When we’re pushed below the window (into “hypoarousal”), we become numb, shut down, disconnected, exhausted, flat. We may go through the motions without really being there. Thinking feels foggy. Decisions feel impossible.

Both states make it almost impossible to do good work.

Here’s the part that matters most for employers:

Everyone has a window of tolerance. But not everyone’s window is the same size.

For someone with a robust nervous system, a stable background, and no significant trauma history, the window is wide. Most workplace stressors – a difficult meeting, a missed deadline, a tough conversation with a colleague – happen within the window. They might be unpleasant, but the person stays able to think and respond.

For someone affected by PTSD, C-PTSD, ongoing mental ill-health, chronic stress, or significant past trauma, the window can be much narrower. The same workplace events – the same difficult meeting, the same email, the same restructure announcement – can push them out of the window entirely. Not because they’re weak, oversensitive, or “not coping”, but because their nervous system, for reasons that aren’t a choice, has a smaller margin to work with.

This is why two employees can experience the same workplace event in completely different ways. One stays grounded and productive. The other shuts down, becomes reactive, or quietly disappears for the rest of the week. It’s the same event, but they’re working with different windows.

A trauma-informed workplace does two things at once. It widens the window over time by creating conditions of safety, predictability and trust – so people can develop more capacity to handle pressure. And it adjusts the demands at the edges – through reasonable adjustments, clear communication and supportive management – so people don’t get pushed out of their window unnecessarily.

Crucially, none of this means dropping standards or removing challenge. People do their best thinking inside their window of tolerance. Outside it, the brain is in survival mode – it isn’t capable of high performance, creativity, problem-solving or sound judgement. Keeping your team inside their windows isn’t softness. It’s the precondition for good work.

Why Trauma-Informed Leadership Improves Employee Performance

For employers asking where this fits on the bottom line, the evidence is strong.

The McKinsey Health Institute survey found that employees who feel supported, safe and adaptable at work report engagement and innovation at six times the rate of those who don’t (McKinsey, 2026). That could be the difference between an organisation that adapts and one that stagnates.

A 2024 Deloitte report found that mental health-related presenteeism – people at work but unable to perform – costs UK employers more than absenteeism and staff turnover combined. The real cost isn’t the people who are absent, but the people who are present while struggling outside their window of tolerance.

McKinsey’s State of Organizations survey found that organisations with more reflective leaders are nearly twice as likely to report that they can adapt quickly to change. In an economy defined by continuous disruption, that’s a competitive advantage.

The cost of mental ill-health in the UK:

• £51 billion per year – the cost to UK employers of poor mental health through presenteeism, sickness absence and staff turnover, with presenteeism alone accounting for £24 billion of that (Deloitte, 2024).
• £14,780 per person, per year – the average annual economic cost of each person living with PTSD in the UK, made up of lost productivity at work and additional healthcare costs (University of Birmingham, 2024)
• 22.1 million working days lost to work-related stress, depression and anxiety in 2024/25, with each affected person taking an average of 22.9 days off work (Health and Safety Executive, 2025).
• 42% of mental health sick notes issued in 2023 signed people off for a month or longer (Littler UK analysis of NHS data, 2024).
• £4.70 return for every £1 invested in workplace mental health support (Deloitte, 2024).

This isn’t a wellbeing issue sitting somewhere outside the business: it is the business.

How trauma and pressure affect decision-making at work

At the core of how pressure shapes behaviour is something McKinsey identifies as fear of loss. When organisations change – through restructures, strategy pivots, market shifts – people aren’t really resisting the change itself. They’re responding to what they believe the change threatens. Loss of status, credibility, certainty, belonging, or the identity tied to prior success. What looks like “resistance to change” is, more accurately, a self-protective response. Unmetabolised, that fear narrows thinking, distorts judgement and filters out the real risks an organisation needs to see.

One of McKinsey’s most useful contributions is its description of how pressure moves through organisations. It travels across three levels:

At the individual level, sustained pressure narrows thinking, distorts judgement and amplifies our default reactions. In practice, this looks like a manager who normally takes time to consider options now making snap decisions under deadline pressure. A leader who usually invites debate now interrupting to “move things along”. A team member who normally raises concerns now staying silent because the cost of speaking up feels too high.

At the relational level, pressure changes how we listen, how we disagree, and whether disagreement sharpens thinking or shuts it down. In practice, this looks like two senior colleagues digging into opposing positions on a strategic decision and stopping hearing each other – each one experiencing the disagreement as a threat to their credibility rather than a useful debate. Or a team meeting where someone raises a risk and is met with “let’s not be negative” – so they stop raising risks.

At the system level, pressure determines whether strain is processed or quietly accumulates. In practice, this looks like a restructure announced without explanation, followed by months of hesitation, rework and slowed execution as people try to make sense of it themselves. Or a series of strategic pivots, each one reasonable in isolation, that collectively leave a team unsure what they’re meant to be working on.

McKinsey describes the cumulative effect as showing up in “defensiveness, polarisation, rigidity or disengagement” and notes that what’s often labelled “resistance to change” is more accurately a self-protective response to perceived loss.

For people living with PTSD or C-PTSD, these dynamics can be amplified. The narrower window of tolerance means workplace pressures which a colleague might find manageable can feel genuinely overwhelming. Unpredictable change, unclear expectations, sudden criticism, conflict in meetings, or feeling unsafe to speak up – any of these can trigger responses that aren’t a choice and aren’t a sign of weakness.

What this looks like when it works: a hospital case study

Trauma-informed workplaces prioritise psychological safety at work – creating environments where employees can think clearly, contribute openly and perform at their best.

One of the most powerful examples in the McKinsey research comes from a senior executive at a hospital system, drawing on her training as a nurse.

During a restructure, she recognised familiar signs of strain – rising fatigue, quiet resistance. The workload was manageable. But the lack of closure – on projects ending, resources shifting, roles changing – was destabilising.

In response, she introduced a monthly reflection session designed to give people space to acknowledge what was ending, what they would miss, what felt unfinished, and the lessons they would carry forward.

The purpose, McKinsey notes, wasn’t catharsis – it was integration. As they put it: “A stronger sense of belonging reduced the need for self-protection and made candid dialogue possible”.

The outcomes were measurable. Less quiet resistance. Faster reengagement after pivots. Lower levels of conflict. Better decision-making. The workload didn’t decrease – but the sense of volatility did. People could focus on performance instead of bracing against change.

This is what trauma-informed leadership looks like in practice. It’s not soft or slow. It produces better business outcomes precisely because it acknowledges that humans aren’t machines, and that performance under sustained pressure depends on more than willpower.

McKinsey captures the principle behind this kind of leadership in the phrase: “When people feel met, they think better. When they feel managed, they shut down” (McKinsey, 2026, quoting a former US Navy rear admiral).

What does “feeling met” actually look like at work? It means a colleague raises a concern and, instead of being reassured (“don’t worry about it”) or redirected (“let’s focus on solutions”), they’re heard. It means a leader who, when someone says “I’m struggling with this”, responds with “tell me more” rather than “let me explain why it’ll be fine”.

The difference isn’t empathy as a personality trait. It’s whether the interaction reduces or amplifies the perceived threat. Leaders who can do this create conditions where tension can be worked through and learned from, not avoided or escalated.

For any employee, this distinction is the difference between being engaged or going through the motions. For those who’ve experienced trauma, it can be the difference between staying in work and leaving it altogether.

Why the world has changed, and why business has to change with it

Perhaps the most important section of the McKinsey research is its conclusion. It’s worth quoting directly:

“We are operating in a period of heightened societal and organizational stress. Digital overstimulation, geopolitical uncertainty, concerns about AI, and social polarization contribute to chronic activation and employee burnout”.

“As pressure becomes continuous, leadership models built on restoring stability between disruptions are less effective. In the current environment, leaders must sustain coherence while disruption continues, preserving the organization’s capacity to think and act amid nonstop change”.

This is the heart of it. The old model – work hard, recover later, deal with stress when there’s time – assumes there will be time. There isn’t. Disruption is no longer the interruption to normal business: disruption is normal business.

That doesn’t mean the leadership skills organisations have always valued – strategic clarity, decisiveness, accountability, execution discipline – become irrelevant. They remain essential. But, as McKinsey puts it: “when one crisis follows the next without time for recovery, these skills must be exercised in ways that do not erode cognitive, relational, and strategic capacity”.

Trauma-informed leadership isn’t a replacement for traditional leadership skills. It’s what makes them sustainable in a world that doesn’t pause.

None of this is about turning managers into therapists or rewriting your entire HR function. It starts with a few principles – investing in managers as the highest-leverage influence on workplace mental health, building predictability into how decisions are made and communicated, and never requiring anyone to explain their trauma in order to access support. The deeper work – changing systems, training leaders, designing trauma-informed processes – is exactly what specialist programmes are built to do.

Why we agree this matters, and what PTSD UK is doing about it

At PTSD UK, the McKinsey research mirrors what we hear constantly from the people who reach out to us.

“I tend to find that taking time off due to C-PTSD and other mental health issues leads my employer to put in place a ‘Performance Improvement Plan’ . They say this is a supportive measure but it puts me at risk of being dismissed from work and prevents me from applying to internal vacancies. This then exacerbates my mental health issues.”

“During one absence review meeting, I relayed the history that led up to my diagnosis of C-PTSD which included accounts of child abuse and multiple recent violent attacks. The HR personnel and my manager listened to my account, but then immediately ‘got down to business’ and proceeded to discuss my return date.”

“I’d like the acceptance by employers that just because I was ok yesterday, and the day before, it’s perfectly feasible that I’m not OK today”

“My manager appeared very uncomfortable and couldn’t wait to leave the room.”

“Reassurance is key, now I know my current workplace is ‘safe’ non judgmental and works on trust, I’m fine…”

People tell us they want to keep working. And that work, done in the right environment, can be a real part of their recovery. But we also hear the opposite. We hear about managers who saw a panic attack as unprofessionalism. About being asked to “just push through”. About HR processes that demanded explanations people weren’t ready to give. About leaving jobs they loved, not because they couldn’t do the work, but because the workplace itself made recovery impossible.

The cost of not getting this right is enormous – in human terms, and in financial ones.

PTSD UK has been developing employer-focused resources for some time. Our website includes guidance for managers and information on supporting colleagues affected by PTSD and C-PTSD. Through the PTSD UK Academy, employers can access PTSD awareness training for employers, workplace trauma training, and online trauma training in the UK for managers, HR teams and organisations.

But we know information alone isn’t enough. Employers need a full programme – designed with lived experience at its heart – that supports an organisation to become genuinely trauma-informed from the inside out, with managers at the centre of the change.

We’re delighted to share that PTSD UK has been awarded funding to develop a new Trauma Informed Workplace programme – a co-produced training and organisational development project, designed in partnership with people affected by PTSD and C-PTSD, employers, and mental health professionals.

The programme is currently in active development, and we’re recruiting pilot organisations now to help us shape it. Pilot partners will play a real role in supporting the content and structure of the programme, ensuring it’s practical, evidence-informed, and genuinely useful for UK workplaces of all sizes.

Find out more:

• For existing trauma-informed training, PTSD awareness training for employers and CPD for managers: visit the PTSD UK Academy
• For pilot expressions of interest in our new Trauma Informed Workplace programme: email Josh at josh@ptsduk.org

A trauma-informed workplace isn’t a finished destination. It’s an approach. A way of leading, communicating and designing systems that recognises the full humanity of the people doing the work. For the millions of people across the UK living with PTSD and C-PTSD, it matters enormously. It is the difference between staying in work and falling out of it.

For UK employers, it’s the difference between an organisation that adapts and one that doesn’t.

Because the workplace someone walks into every day shapes whether they can perform at their best, contribute fully, and feel safe doing it. Whether through our existing training or as a pilot partner in our new programme, we’d love to help you build that kind of workplace. 

Frequently Asked Questions About Trauma-Informed Workplaces

What is a trauma-informed workplace?

A trauma-informed workplace recognises that trauma, chronic stress and past experiences can affect how people think, communicate, respond to pressure and perform at work. It focuses on psychological safety, predictability, clear communication and supportive leadership.

How can managers support employees with trauma?

Managers can support employees with trauma by creating predictable ways of working, communicating clearly, offering reasonable adjustments, avoiding pressure to disclose personal trauma, and responding to signs of strain with calm, respectful curiosity.

Is trauma-informed leadership the same as therapy?

No – it’s a different discipline entirely. Trauma-informed leadership isn’t about treating trauma. It’s about creating working conditions where people – including those affected by trauma – can think clearly and contribute well.

Why does PTSD awareness matter in the workplace?

PTSD and C-PTSD can affect concentration, emotional regulation, sleep, memory, confidence and responses to perceived threat. PTSD awareness training for employers helps managers understand these impacts and support employees appropriately.

What is trauma-informed training for managers?

Trauma-informed training for managers helps leaders understand how trauma and stress affect behaviour, communication, decision-making and performance, while giving them practical tools to build safer and more effective teams.