Report: Mental Health is Top Workplace Safety Concern for Small Business Employees

A new survey of more than 1,000 small business employees found that stress, burnout, and mental fatigue are their top workplace safety concerns, ahead of physical injury or environmental hazards.

Pie Insurance’s 2025 Employee Voice on Workplace Safety Report is based on data gathered from an online survey conducted in July 2025 of 1,021 U.S. small business employees.

According to the report:

• 32% of employees cite mental health as their #1 safety concern, ahead of physical injury (20%) or environmental hazards (9%)
• 43% say they feel pressure to work through fatigue, illness, or unsafe conditions to meet deadlines or quotas
• 91% of employers are confident they can address mental health, but only 62% of employees agree
• Three in four employees say some form of mental health support would make a meaningful difference in their work and wellbeing

Pie Insurance compared the employee survey to results from a survey of small business employers, who were more focused on physical risks with equipment, environmental, and physical well-being. The 2025 State of Small Business Workplace Safety Report surveyed 1,018 small business owners and decision-makers in January 2025.

Fifty-two percent of employers surveyed said they have mental health protocols in place, but only 30% of surveyed employees observed having these protocols. The workers said they wanted flexible work hours (19%), mental health days (17%), and basic counseling or peer groups (12%).

Thirty-six percent of employees said that workplace stress and safety concerns impact their personal life, leading to reduced motivation or burnout (63%), increased anxiety or depression (62%), physical symptoms such as headaches or fatigue (59%), difficulty sleeping or insomnia (51%), trouble focusing at home (40%), and strain on personal relationships (35%).

Asked about whether they felt safe speaking up about safety concerns, 17% of workers said they hesitate to do so. Reasons given were fear of retaliation or negative consequences (35%), don’t want to seem difficult (33%), think nothing would be done (31%), resolved it on their own (29%), wasn’t sure it was a valid concern (25%), and didn’t want to get anyone in trouble (19%).

Another disconnect between employers and employees was found on the topic of safety training. Sixty-three percent of employers said they provided structured safety training sessions, but only 29% of employees surveyed reporting receiving regular, structured training. And 28% of workers said they never received formal safety training at all.

When it comes to adoption of artificial intelligence (AI), 44% of employers said their business uses AI applications, but only 20% of surveyed employees were aware their company uses AI. Employers were more confident about the role of AI in safety, with 64% saying they believed AI will improve worker safety over the next five years; only 23% of employees agreed.

The report offered up four suggestions:

• Close the mental health gap: Audit what you provide for mental health protocols vs. what employees experience. Implement flexible work arrangements and add mental health days to policies.
• Build safety into schedules: Schedule safety as part of project timelines, not an add-on.
• Make reporting safe: Establish anonymous reporting systems and train managers to respond supportively. Share actions taken from employee feedback.
• Verify that training actually reaches employees: Track completion, not just offerings. Identify who has missed training, and make training interactive and relevant to actual job situations.