Advice for managers on mental ill health conditions

Talking at an early stage

As a manager, you may have employees who experience mental health difficulties. As soon as you notice that an employee is having difficulties, talk to them – early action can prevent them becoming more unwell.

If the person does not want to speak to you, suggest they speak to someone else, for example someone from your employee assistance programme, occupational health team or their own GP.

Managers should concentrate on making reasonable adjustments at work, rather than understanding the diagnosis. Their GP, medical support or occupational health should be able to provide guidance on what you can do to help them.
If an employee goes off sick, lack of contact or involvement from their manager may mean they feel isolated, forgotten or unable to return. You can reduce the risk of them not returning to work by:

keeping them informed about what is going on, including social events
reassuring them early on and throughout their absence

Use routine management tools to identify and tackle problems or needs

Use scheduled work meetings, appraisals or informal chats about progress to find out more about any problems an employee may be having. You could have health and safety as an agenda item at meetings. As well as things like display screen equipment assessments for example, this could be used for stress or mental health issues. Remember, you must protect workers and others from mental health and stress at work risks in the same way you must protect them from other health and safety risks.

If you have specific concerns about someone's health, talk about these at an early stage. Ask questions in an open, exploratory and non-judgemental way. These conditions affect people differently, so adjustments to how they work could relieve symptoms. You should be positive and supportive while exploring the issues and how you can help.

If a person has been off sick, you should discuss their return to work and reintegration into the workplace beforehand. A written plan can help. You both might want to agree when they have reached the stage of 'business as usual'. At this point, you can use existing management processes to review their performance, needs and work plan.

Supporting an employee who is tearful and upset

If an employee gets upset, talk to them, reassure them, and tell them that you will give them all the help and support available. Explain that things will go at a pace that suits them. If you are in a meeting with them, ask if they would like someone else with them.

Try to be sensitive to the level of information the person can cope with. In the middle of a crisis, they may not be able to think clearly and take in complex information. Try to stay calm yourself.

Problems can build up over time and while you may feel pressure to do something, it might be better to take some time to think about options properly. Agree with the person which issues are most urgent.

If the session is not helpful for the person or you, rearrange it for when they are less upset. If the problem carries on, you should encourage them to seek help, for example from occupational health or their GP.

Ensure, if your first aid needs assessment identifies a requirement, that your first aid provision will support workers with stress or concerns about their mental health.

A much smaller number of people will experience more severe anxiety or depression. These can be associated with episodes of 'mania', which can include:

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 and you should keep your responsibilities for all employees in mind.

Take the person to a quiet place and speak to them calmly. Suggest that you could contact a friend or relative or that they go home and contact their GP or a member of their mental health team, if appropriate. You may be able to make an appointment and go with them to the surgery, if they want you to.

If someone is experiencing hallucinations or mania, they may not take in what you are saying. In this case, they 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
the NHS – call 111

or call an ambulance.

Managing a person with an ongoing illness

Most people who have ongoing mental health problems continue to work successfully. But when someone needs support, managers can work with them to ensure 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 they need it. It is discriminatory to make assumptions about people’s capabilities, their promotability or the amount of sick leave they may need because of their illness.

HSE has developed principles to support disabled workers and workers with long-term health conditions in work.

Coping strategies

Most people are encouraged to develop a coping strategy as part of their care. This 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, inexpensive adjustments may well prevent a more costly period of illness.

Advance statements

Some people find it useful to draw up an 'advance statement' which explains how they want to be treated if they become unwell. The statement can cover practical arrangements such as details of the people who need 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 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, you should put the statement into practice to maintain trust.

Guidance and support

Advice and support are available for those in work who have experienced mental health issues, and for their employers.

There are several specialist organisations that can provide guidance and support – our Useful links page has more information.