The earlier you notice that an employee is experiencing mental health difficulties the better; early action can help prevent the employee becoming more unwell. Line managers can play a key role in identifying and addressing barriers to normal working life rather than trying to understand the diagnosis. If an employee is already off sick, lack of contact or involvement from the manager may mean they feel unable to return; involvement and reassurance at an early stage minimises the risk of not returning to work and the difficulty of resolution.
For more information on picking up the early signs of mental health distress go to:
It might be that certain tasks, work environments, times of the day or particular teams are associated with people experiencing difficulties, Discuss whether there is potential problem at scheduled or usual work planning sessions, appraisals or informal chats about progress; these may provide neutral opportunities to find out about and discuss any problems an employee may be having.
If you have specific grounds for concern it is important to talk about these at an early stage. Ask questions in an open, exploratory and non-judgmental way. When talking to an employee remember stress affects people differently, making adjustments to the job could relieve the stress and you should be positive and supportive – exploring the issues and how you can help.
If a person has experienced a period of sickness absence, you should discuss the format of their return to work and integration in advance of any return date. A documented plan can be valuable. You both might want to agree when they have reached the stage of ‘business as usual’. At this point, you can use normal management processes to review their performance, needs and work planning.
The important points are to talk to them, reassure them, state positively that all help, assistance and support will be offered, and affirm that discussion will continue at a pace that suits them; ask if they would like someone of their choice with them Try to be sensitive to the level of information the individual can cope with; in the midst of a crisis they may not be able to think clearly and accept complex information. Remember try to remain calm yourself!
Many problems build up over time and whilst you may feel the pressure to do something it may be better to take some time to properly consider the options. Try to agree with the person, what is urgent and what is important.
You may need support in managing the situation. If the session is not proving helpful for the person or you rearrange it for when the person is less upset. If the problem continues you should encourage them to seek appropriate help, your occupational health department or encourage them to see their own GP.
One in four people will experience ‘mild to moderate’ mental health problems, but a much small number will experience more severe anxiety or depression, associated with episodes of ‘mania’: extreme heightened activity, psychosis, loss of touch with reality, hallucinations, distortion of the senses. In these rare instances, an employee may behave in ways that impact on colleagues or clients. In this situation you need to be aware of your responsibilities for all employees.
Take the person to a quiet place and speak to them calmly, suggest that you contact a friend or relative or that they go home and contact their GP or a member of the mental health team if appropriate. You may be able to make an appointment and go with them to the surgery – if they wish this.
If someone is experiencing hallucinations or mania, they may not take in what you are saying, in this case the person will need immediate medical help. If an employee is disturbing others and refuses to accept help seek advice from your occupational health provider, the person’s GP or contact NHS Direct, or the ambulance service.
For further advice see the links section
Most people who have ongoing mental health problems continue to work successfully, but where someone needs support, managers and employees can work together to ensure a flexibility to suit their health needs.
People with mental health problems should be treated in exactly the same way as any other member of staff unless they ask for help or demonstrate clear signs that help is needed. It is discriminatory to make assumptions about people’s capabilities, their promotability or amount of sick leave they may need because of their illness.
Most individuals are encouraged to develop a coping strategy as part of their care which often involves noting signs of a possible relapse and taking pre-emptive action, such as, cutting down on work, being careful about drinking alcohol, taking exercise and finding time to relax. It is important you support the employee at this first warning stage. Small and inexpensive adjustments may well prevent a more costly period of illness.
Some people find it useful to draw up an ‘advance statement’ which explains how they wish to be treated if they become unwell. The statement can cover practical arrangements such as treatment preferences, details of the people to be contacted or provided with information.
It might be helpful to draw up an advance statement which relates to the workplace. It could include signs that indicate that the person is becoming unwell, who to contact (perhaps a close relative, care coordinator or GP), what sort of support is helpful and what is not. If an employee draws up an agreement with you, it is important for you to put the statement into practice to maintain trust.
There are many projects offering support to employees who have experienced mental health problems and to employers. These projects have excellent success records in placing people in employment and in supporting them to be effective employees in the long term. In fact many people require only minimal support once they have been given the opportunity to work.
Managers can find out more about helping people with mental health problems on the SHIFT line manager resource website.
The following organisations may be able to help you as an employer dealing with a member of staff experiencing some mental health issues.
A list of those organisations that can help the person experiencing problems directly appears on the dealing with my mental health page
ANXIETY UK works to relieve and support those living with anxiety disorders by providing information, support and understanding via an extensive range of services, including 1:1 therapy services. It works regularly with external agencies and healthcare professionals to improve the service provision offered in the main to those living with anxiety disorders.
NHS Direct offer people in England and Wales medical information and advice by phone or over the internet. They can also refer callers to various self help and support organisations. In Scotland, contact NHS 24 on 08454 24 24 24.
The MindinfoLine service is run by a dedicated team of specialists, responding to more than 20,000 enquiries a year. Topics range from types of mental distress, where to get help and drug treatments, to alternative therapies, who's who in mental health services and advocacy.
Rethink's National Advice Service provides expert advice and information on issues that affect the lives of people coping with mental illness. For general enquiries about Rethink's work, please call 0845 456 0455 or for More information check out the website.
Shift is an initiative to tackle stigma and discrimination surrounding mental health issues in England. Our aim is to create a society where people who experience mental health problems enjoy the same rights and opportunities as other people.
Employers' Forum on Disability is the world's leading employers' organisation focused on disability as it affects business. Our mission is to enable companies to become disability confident by making it easier to recruit and retain disabled employees and to serve disabled customers.
The Mental Health Foundation is a leading UK charity that provides information, carries out research, campaigns and works to improve services for anyone affected by mental health problems, whatever their age and wherever they live.
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