A professional’s guide to managing employees with mental health issues

One in four people will experience mental health issues at some point in their lives and over 450 million individuals have mental health problems worldwide. Although this is a growing issue in Ireland, if managed correctly, most people with mental health issues can recover.

As an employer working to promote the wellbeing of your employees, it can be difficult to know what is best to do and best to avoid.

We recently spoke to Davina Ramkissoon, Wellness Director at Zevo Health, about how to effectively manage employees with mental health issues and ways to encourage employee wellness and resilience.

How can you spot someone who is struggling with mental health issues at work?

When considering your colleague’s wellbeing, it is important to first recognise any behavioural changes that are inconsistent with their normal ways of behaving.

Think about someone who you work closely with. Often, you’ll instinctively know when something is bothering them or if they’re stressed out based on their behaviours – communicating, relating to others, engaging with work tasks – all change.

This is not too dissimilar to mental health, as all the above is impacted negatively.

The signs and symptoms of mental health can vary greatly between individuals and across the different types of diagnosable disorders. Therefore, it’s important not to assume that we know what is occurring for an individual, or even try to diagnose them ourselves.

For example, my experience of anxiety may present differently to the way your anxiety affects you. Instead, it’s better to take note of the changes that are occurring in your colleague and for how long these changes are present.

Usually, acute sources of stress will resolve themselves in time, in a similar way that short-term triggers may acutely affect our mood (such as the anniversary of a bereavement). However, persistent changes in character are most concerning and important to address.

Changes to keep an eye out for can be grouped into 4 key areas:

  1. Physical signs – such as shaking, trembling, sweating, lethargy, aches and pains, changes in appetite and rapid weight loss/gain
  2. Psychological signs – these may be harder to spot but symptoms to be aware of include greater confusion and less clarity of thought, distraction, forgetfulness, difficulty making decisions and a decline in performance (i.e. increase in mistakes).
  3. Emotion – such as feeling hopeless, low mood, sadness, low self-esteem, fearful, feeling guilty, lack of motivation, irritability, sensitive to criticism and an uncharacteristic loss of confidence/ lost sense of humour
  4. Behaviour – such as isolation from peers, neglecting self-care, neglecting responsibilities.  Exhibiting an increase in risk-taking behaviours, anger and aggression or tearfulness. Loss of interest in activities they once enjoyed.

A good work-life balance is so important when it comes to good mental health, how can employers encourage staff to have a healthy work-life balance?

Work-life balance is important for creating a full, enjoyable life and many of us can be guilty of spending too much time in work, or still reflecting on work when we’ve gone home.

We need to be cognisant of the fact that WLB is not a universally defined equation either:  My definition, of it, for example, could be different to someone else’s.

As a manager, it’s important to understand your team members individually and what WLB means to them.  For some people it’s having flexible start and finishing times, for others, it’s about not accessing work emails outside of the office and for some, it might be working from home one day a week so they can get to their exercise class on time or pick their children up from school.

Defining WLB is a two-way process, employees should communicate their needs and then employers can ensure they cover all grounds by:

  • Ensuring managers understand what WLB means to their team members
  • Senior Leadership should try to role model positive WLB behaviours (I heard a great example of a VP who would email their team out of business hours and sign off with the following “I am emailing you outside of your normal business hours but I do not expect a response until you are back in the office tomorrow”).
  • Creating team or company-wide policies which facilitate WLB. This gives employees the indirect permission they may feel they need to make reasonable requests for their own WLB.

“Saying nothing” out of fear of offending someone or leaving someone to deal with their mental health in their “own way” can be a common method adopted in the workplace. Is this the right thing to do?

No. Respect and non-judgement are the two guiding principles to use here.

If you speak to someone in the right way, you will make them feel seen and respected without offence. Experiencing mental health difficulties can be isolating, especially with stigma still being prevalent in work and society.

We don’t want to feed into this isolation by avoiding the topic. But it’s also important to let the person tell you their needs. Getting this balance right is a delicate dance that requires compassion, trust, vulnerability and openness. It takes courage to start these conversations.

I would also say for people who do feel fearful about starting this conversation that anticipation is completely normal. Especially if you haven’t done it before. People often ask if they will make it worse by asking someone how they are, but the opposite is true.

Not asking someone can make them feel even more alone. Consider a time when a colleague has approached you in the past over concern of your wellbeing. Reflect on what they did that helped you to share with them, then reflect on how your felt after sharing.

Research shows that both parties benefit in this interaction, the person starting the conversation feels good for their altruistic action and the person sharing feels “lighter” and supported afterwards.

Making someone feel safe enough to explore their feelings with you is one of the best things you can offer someone. If you’re still hesitant, check whether there is someone else who would be better able to start the conversation, perhaps someone they are closer to. And lastly, pick your timing – before a big meeting is not the right time.

What are some other common mistakes you’ve noticed companies make when it comes to mental health at work?

The most significant mistake that I’ve seen is when organisations view wellness and mental health as separate to the operational procedures of the business, when in fact they directly impact business outcomes.

Organisational health is underpinned by many factors such as culture, leadership, clear policies, communication and trust. By getting these right, they all lead to increased performance and contentment at work.

Every action that an organisation makes can impact employee wellbeing either positively, neutrally or negatively. When making decisions consider how it will impact the people and consider where tweaks can be made to minimise the negative impact on wellbeing.

Whenever there is going to be disruption to people’s work lives due to necessary business changes,  clear, consistent communication is needed to support people through the changes.

What supports for employees struggling with mental health issues would you recommend employers implementing?

There is proactive (prevention) and reactive (intervention) support.

Proactive support describes all the things we do before a crisis, some examples of this are:

  • Introduce Mental Health Policies or Charters (refer to the GAA or  the wellbeing statement for the Law Society of Ireland)
  • Promote National Awareness dates throughout the whole year e.g. 10th October is World Mental Health Day
  • Training for Management and HR around support for employees experiencing mental health
  • General employee training for how to look after their mental health and that of their team members.
  • Understand how CSR committees, sports and social teams can indirectly facilitate improved mental health.
  • EAP and healthcare support
  • Managers conducting regular check-ins

Then you have reactive support, and this might occur when an employee has depleted all their resources and can no longer cope on their own. This is where we tend to see a lot of first-time presentations of mental health within the workplace because an employee’s gut reaction is to continue without support.

Many employers have processes in place to support people through absences from work due to ill mental health. These processes when communicated with the individual really helps to set their expectations as to what support is available to them.

People are often reluctant to discuss mental health issues at work; how can an employer encourage open conversations on mental health?

I would encourage organisations to develop a Mental Health Policy or charter if you haven’t done so already. Having a concrete policy reassures employees that their company is proactively addressing wellbeing and can create the openness required to bring these discussions to work.

Leadership should be encouraged to role model vulnerability which will facilitate trust, openness and difficult conversations.

One of the most important relationships you have at work is with your manager, as they are the ones who can help guide your development and provide support during times of personal distress. If positive working relationships are developed, then these conversations can be started sooner.

Embrace mental health campaigns and revisit them as often as you can. With new hires joining the organisation and people moving on, it’s important to keep running events such as these as it keeps the door open for new people to join the discussion and for tenured staff to continue learning.

If an employee is on sick leave for mental health problems should you keep in contact? Should you tell their colleagues why they are on leave?

Keeping in contact during an absence is really important, as it can help to reduce any anticipatory stress or anxiety on returning to work.

The opposite can prolong an absence and reduce the employee’s confidence. By keeping in contact, we hope to get the person back to work as soon as possible with the necessary support around them.

Should you tell their colleagues that they are on leave?

Only if they want you to, you need to agree with the individual what they want to be communicated to their team and how this will help them feel better able to return to work. Every employee has a right to privacy so a person with a mental health difficulty has the same rights to privacy as anyone else.

Finally, if you could give just one piece of advice to an employer’s regarding mental health in the workplace what would it be?

The conversation on mental health will never stop and nor should it. We know there is a gap between health knowledge and behaviour – i.e. we know what reduces stress, but do we always do those things like exercising regularly?

It is important to remember: new people will join the organisation and staff will leave. This means that whilst the company’s culture will be largely supported by the values, people who are new may not have been exposed to the same level of mental health training which your previous employees would have.

Therefore, regular refresher training is critical as well as regularly updating your wellness interventions and policies based on how the work demographic changes. Ensure that policies are brought to life so that they are a living document.

Leadership should also be showing their buy-in into wellness initiatives and employees should act regarding their own health and encourage the support of team members for enhanced team resilience.

You can’t have significant lasting change if people aren’t pulling in the same direction, we need to find a common ground which we can all build from.

Interested in improving your employee’s wellbeing?

If you’re interested in learning more about wellness at work or other retention issues please get in touch, our dedicated team would be delighted to advise.