Health at work is often framed in physical terms. We measure sickness absence, track injuries, and promote exercise, nutrition, and sleep. These are essential, they focus rightly on the individual, but they miss out the many other forces that exist in all workplaces. The reality is they miss something quieter and more powerful: the social environment. Health is not just something carried inside individual bodies. It is also something carried between people.
Active bystandership, the willingness and ability of people to notice harm, risk, or need and take constructive action, is one of the most under-recognised health resources available to organisations. It shapes whether stress accumulates or dissipates. It determines whether small problems are corrected early or allowed to grow into bigger issues which often leads to chronic damage to many people within the setting and to the organisation. It influences whether people feel isolated or supported. In short, active bystandership helps decide whether a workplace makes people healthier or slowly erodes them.
To understand why, it helps to borrow a concept from the medical sociologist Aaron Antonovsky, who asked a deceptively simple question: why do some people stay healthy despite stress and adversity? His theory of ‘Salutogenesis’ shifted attention away from what causes disease and toward what creates health.
The concept of ‘Salutogenesis’ was a word that I had never heard until one day in 2010 I was listening to the former Chief Medical Officer of Scotland, Sir Harry Burns who used the term in a presentation. For much of my policing career, my lens as a police officer was very rigid. I focused on the violent offender and simply wanted to gather the evidence that would eventually convict an offender. My time with the Scottish Violence Reduction Unit forced me to think differently and after listening to Harry Burns my lens began to change.
A major change was looking at both the causes and wider contributory factors which would lead to violent behaviour. The power of the situation became my focus. What happened to people that led to them committing violent acts. I recalled how in 1988, during my day in Sherwood Crescent in the Scottish town of Lockerbie privately asking myself, “why do people do such evil things?”. The bombing of Pan Am 103 over the Scottish town left its mark on me and listening to the Chief Medical Officer reminded me of that private thought I’d had that day. His sharing of the work of Antonovsky really landed with me.
Burns used Antonovsky’s concept to argue that a violence reduction approach must involve creating the right conditions for good health and in turn less violence. He argued that health is built through resources, psychological, social, and environmental, that help people cope, adapt, and find meaning.
I recently began to think about my current work supporting workplace culture and started to think back to Antonovsky’s idea’s. A lot of what I read on workplace culture and the many harms we know happen in these settings, tends to focus on why bad things happen or the traits of bad leaders that contributes to harmful issues. I’ve learned that whilst the focus on the bad grab’s attention, it rarely fixes a problem.
As a passionate advocate of the bystander approach, I recognised that Active Bystandership is one of those resources described by Antonovsky.
When people intervene early, offer support, challenge harmful behaviour, or simply check in with someone who seems withdrawn, they strengthen the social fabric that protects wellbeing. Health becomes something co-created, not merely individually maintained. The workplace is not just daily tasks, the work. It is a system of signals. People constantly read cues about whether it is safe to speak, safe to struggle, or safe to care. When bystanders act, they send a powerful signal, you are not alone here.
This matters because many workplace harms begin long before they are formally recognised. Stress rarely appears suddenly. It accumulates quietly through overload, isolation, unresolved tension or poor relationships. Burnout often begins as small moments of silence, when someone notices a colleague drowning in work but says nothing, when inappropriate behaviour is ignored, or when early warning signs are dismissed as temporary. Active bystanders interrupt that accumulation.
A colleague who notices someone working late every night and offers help, reduces strain before it becomes exhaustion. A team member who respectfully challenges a dismissive remark prevents the slow corrosion of psychological safety. A supervisor or colleague who checks in when performance dips, may uncover stress, grief, or illness that would otherwise remain hidden. These interventions act like pressure-release valves. They prevent stress from becoming chronic.
This aligns closely with the broader definition of health promoted by the World Health Organisation, which describes health as a state of complete physical, mental, and social wellbeing, not merely the absence of disease. Social wellbeing depends on connection, trust, and mutual responsibility. Active bystandership strengthens all three.
One of the most powerful mechanisms through which active bystandership improves health is psychological safety. This term, developed and researched extensively by Amy Edmondson, describes an environment where people feel able to speak up without fear of humiliation or punishment. Psychological safety is not about comfort. It is about freedom from interpersonal threat. Edmundson’s work suggests the best teams have the most mistakes, not the least. This is because people safe to talk through mistakes. They learn.
Active bystanders are the builders of psychological safety. Every time someone speaks up constructively, supports a colleague, or challenges harmful behaviour, they reinforce the norm that people matter. They demonstrate that silence is not the default setting.
This has measurable health benefits. When psychological safety is high, people report lower stress, higher engagement, and greater resilience. Stress becomes more manageable because it is shared, discussed, and addressed. People are more likely to ask for help before reaching breaking point. They are less likely to internalise blame or carry invisible burdens.
This creates what Antonovsky called a “sense of coherence”, the feeling that the world is understandable, manageable, and meaningful. That feeling is strongly associated with better mental and physical health outcomes. The absence of active bystandership produces the opposite effect.
Silence creates ambiguity. Ambiguity creates threat. And threat activates the body’s stress response. When people feel they must face problems alone, their nervous system remains on alert. Cortisol and adrenaline increase. Over time, chronic activation of this stress response contributes to anxiety, depression, cardiovascular disease, and burnout.
In contrast, supportive social environments calm the nervous system. Human beings regulate stress collectively. A reassuring conversation, a shared laugh, or an act of support signals safety. The brain reduces its threat response. Recovery becomes possible. Active bystandership makes these moments more frequent. US Neuroscientist Dr Bruce Perry in his book, co-written with the wonderful Oprah Winfrey, suggests that simply checking in with a colleague, asking simply, “How are you doing?” provides a single dose of therapy. Active Bystandership acts as calming effect on the brain. Both the giver and receiver benefit from this shot of warmth.
Research into team performance reinforces this. When Google conducted its extensive internal study of effective teams, it found that psychological safety, not intelligence, seniority, or experience, was the strongest predictor of success. Teams performed best when members felt able to speak openly and support one another. Performance and health were not competing priorities. They were mutually reinforcing. Teams that support each other, or look out for each other, flow together. The Māori concept of ‘Whanau’, extended family was adopted by the New Zealand All Blacks. This concept became the ‘Follow the Spearhead’ mantra of the team. My ‘ASOne’ programme which helps to support workplace culture came from my readings on this topic.
Many fail to properly understand the concept of active bystandership. The approach does not merely prevent harm. It actively creates conditions in which people can thrive. It helps to provide coherence in staff. It transforms workplaces from collections of individuals into communities of care.
This has profound implications for prevention. Traditional culture strategies often focus on downstream intervention, supporting people after harm has occurred or challenging behaviour at point of attack. Active bystandership works upstream. It prevents harm from escalating in the first place.
Consider the difference between these two environments. In one, people notice problems but stay silent. Stress accumulates without support, behaviours slowly deteriorate, finally individuals withdraw. Health declines quietly until absence, illness, or crisis forces attention. I see this in many policing organisations who develop crisis intervention programmes to address suicide.
In the other environment, people feel a responsibility to intervene early and constructively and are supported when they do. Problems are identified quickly. Support is offered naturally and is normalised. Stress is shared and reduced. Health is maintained, performance increases, staff retained, less misconduct, less sickness and mistakes. In likes of policing this will also lead to an increase in trust in the profession.
The difference in the two environments isn’t policy, it is behaviour. It is the everyday decision to act rather than observe.
Active bystandership also strengthens identity and belonging, which are essential components of wellbeing. When people help others, they reinforce their own sense of purpose and value. Helping behaviour activates reward pathways in the brain, releasing neurotransmitters such as dopamine and oxytocin that are associated with positive emotion and connection.
In other words, helping others is not only good for the recipient. It is biologically beneficial for the helper. This creates a virtuous cycle. Support generates wellbeing. Wellbeing increases capacity to support others and health becomes self-reinforcing. In environments where people feel unable to act, moral injury and learned helplessness emerge. Moral injury is often the start of a journey of poor well-being for the longer term.
Importantly, active bystandership does not require heroic intervention. It often consists of small, consistent actions: checking in, asking questions, helping, challenging respectfully, and refusing to normalise harm. Culture is not shaped by dramatic moments alone. It is shaped by repeated signals about what is acceptable, what is valued, what is protected and when silence is seen as the only unaccepted behaviour.
When active bystandership becomes normal, health becomes embedded in the system itself. This reframes responsibility. Health is no longer solely the domain of Leadership, HR departments, occupational health departments, or individual self-care. It becomes a shared social function. The work of US psychologist Dr Ervin Staub confirms that a sense of responsibility to act is the biggest motivator leading to bystander action. Active bystandership helps to instil that responsibility. Everyone becomes part of the health infrastructure. The motivator is supported by the idea that everyone benefits when people act.
This has a powerful effect on resilience. In environments with strong active bystandership, people do not need to be individually invulnerable. They are supported by collective awareness. Weakness can be temporary without becoming catastrophic. The system absorbs strain. Connection increases resilience. A sense of community becomes the buffer to high workplace stress
Active bystandership transforms colleagues into buffers against stress, witnesses against harm, and resources for recovery. Workplaces that cultivate active bystandership do more than reduce harm. They create environments where people can sustain energy, maintain dignity, and remain psychologically intact. They do not simply prevent illness. They actively generate health.
In our efforts to reduce bullying, harassment, mistakes and to support well-being active bystandership becomes an obvious response, but only if the setting chooses to use it.
What do you think?
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