How to deal with an employee’s mental health crisis at work

You already have robust health and safety plans in place to deal with a variety of possible crises in your workplace. They’re so ingrained it’s second nature now:

• If the fire alarm goes off, everyone knows how to get out and where to muster to wait for the fire service
• If someone collapses, your trained first aiders know what to do until the paramedics arrive

So, why aren’t we dealing with mental health crises in the same way? Well, the key differences are that mental health crisis preparation is comparatively new and the subject matter is, generally, uncomfortable.

Dealing with a mental health crisis requires well-trained soft skills and up-to-date information to create an action plan that’s fully understood by all staff and gives clear direction. Many workplaces simply haven’t had the right training or support to do this effectively.

But if you’re ready to learn how to respond to a mental health crisis in the workplace, we’re here to help. This blog post provides you with a brilliant starting point for you to discuss, create and share the right mental health crisis strategy for your organisation.

Read on for our 5-step framework for dealing with a mental health crisis, including immediate actions and follow-up support.

What is a ‘mental health crisis’?

Mental health charity Mind defines a mental health crisis for an individual as ‘when you feel at breaking point and you need urgent help.’ And sometimes that crisis point happens at work.

Prior preparation and training mean that mental health crises in your workplace can be handled in the best way possible for everyone.

There are different reasons why people have mental health crises, such as:

• Bereavement
• Experiencing or witnessing a traumatic event
• Burnout caused by workplace stress
• Mental illness symptoms, such as PTSD being triggered, or severe depression
• Domestic abuse
• End of a relationship
• Substance abuse or addiction
• Financial pressure
• Sometimes it's the cumulation of multiple factors over a period of time, with no clearly definable ‘thing’ in the moment.

Mental health crises don’t all look the same. People will present with different behaviours that need particular types of support at the point of crisis. The key for you as a manager – and for line managers – is to start from a place of knowing your employees.

You can’t identify behaviour that’s out of character, if you don’t know how they normally act at work. And this is the baseline for you to be able to recognise the subtler signs of a mental health crisis.

The likelihood that you’ll need to manage employees during a mental health crisis is quite high, according to research:

• Deloitte: “63% of respondents had experienced at least one characteristic of burnout — feeling of exhaustion, mental distance from their job, or decline in performance at work”
• WHO: “46% of UK employers noted an increase in the number of people experiencing mental health issues, and a quarter saw an increase in sick leave due to mental health”
• Mental Health UK: “91% of UK adults report that they experienced high or extreme levels of pressure or stress in the past year”
• Deloitte: “At least four out of 10 workers, managers, and executives say they “always” or “often” feel exhausted or stressed. The situation is so bad that 59% of workers, 66% of managers, and 71% of the C-suite say they’d seriously consider taking a job with another company that would support their well-being.”

‘I’m not qualified for this!’

You’re not alone in feeling the pressure of this responsibility. Many managers feel out of their depth when developing mental health strategies – especially around the heightened risks of mental health crisis situations. Which, of course, impacts your own wellbeing.

Remember: You’re not a firefighter, paramedic or police officer but you know what to do if there’s a fire, accident or crime at your workplace – and so do your staff.

It’s the same principle, based on the same H&S law, when it comes to mental health crises. You’re not expected to be a mental health professional. You’re not giving a diagnosis or expected to solve the whole problem. Your responsibility is to keep everyone safe in the moment and initiate the next steps.

This 5-step guide is useful if you’re in a mental health crisis situation in your workplace before you’ve had internal discussions. It’s also a good framework to use as you put your mental health crisis at work plan in place. And we’re here for any other training or support you need.

Step 1: Recognise the signs of a mental health crisis

Someone may have been on your radar for a while with worries about mental ill health, and a mental health crisis isn’t completely unexpected. Other employees may find themselves at a crisis point that seems totally out of the blue to everyone around them.

In the moment of crisis, the how and why don’t matter, just how you can best support that person to step out of crisis mode.

The signs of a mental health crisis aren’t the same for every person. But they include a variety of different behaviours, including:

• Obvious physical distress – crying, upset, shaking
• Extreme anxiousness – like panic attacks or flashbacks
• Extreme withdrawal – sometimes to the point of being completely shut down to any communication
• Self-harm, or threats of self-harm
• Suicidal thoughts and/or plans
• Mania – including heightened activity, psychosis, hallucinations, extreme paranoia, loss of connection to reality

When should you intervene?

You need to step in when there are any signs of visible stress or disruption to other employees, and if their behaviour puts themself or others at risk.

Step 2: Take immediate action to support employee mental health

But what should that intervention look like? No one wants to make a difficult, distressing situation any worse – and you won’t.

• Stay calm and assess the situation: Take a deep breath and think ‘safety first’. Consider the physical and psychological safety of all involved.
• Determine immediate risk: If there’s any risk of self-harm or harm to others, escalate to HR or emergency services.
• Use active listening and empathy: Avoid judgmental language and demonstrate to the person in crisis that you understand their distress. Use the words they’re saying and frame comments in a supportive way. Phrases like ‘Stop being silly’ and ‘Calm down’ are not useful in these moments of crisis. They diminish the emotional pain and are instructions that the individual is unable to follow at this moment.
• Find a private space: If possible, persuade the individual to come with you to a private space where you can talk one-on-one. Remove onlookers from the situation, their intentions may be to help, but no one needs an audience at this moment.
• Ask open-ended questions: Questions like, “I’ve noticed you seem upset; do you want to talk about it?”, put the power of the conversation with the individual. This isn’t an information-gathering exercise. You’re creating a respectful, caring space for someone to regulate themselves.

Step 3: Provide initial support

You need to tailor your initial support to each individual, depending on the signs of crisis they’re exhibiting. It’s good to have a rehearsed plan for all these avenues:

Know when to escalate

If this is a severe crisis with the individual showing less common, more extreme signs of distress, you need to call for the right professional help straightaway.

For example, if someone is using an implement to hurt themselves and even threaten others, 999 is the first port of call.

Other situations may need immediate HR involvement. This is why having a plan in place is crucial, preferably before you ever have to deal with a mental health crisis in your workplace.

Encourage the person to express their needs

It’s tempting to jump straight into problem-solving mode, but you can’t assume you know the right solution. Instead, activate your listening mode and really give time and space for the individual to say what they really need at that moment.

Offer practical support

If you’re in a position to offer practical help once the person has said what they need, great! Perhaps they’ve had a bereavement and you can immediately offer some time off for them to deal with the arrangements and initial shock.

Signpost to relevant resources

Sometimes the best thing you can do is direct people to experts who can give them the help they need. This might be local support groups, crisis helplines, mental health first aiders, or EAPs.

Step 4: Manage the wider team

If you’ve invested in a full mental health strategy, then it’s likely that your workplace culture is already infused with respectful compassion for individuals in crisis.

As a manager, it’s absolutely crucial to maintain the confidentiality of any employee who confides in you during a mental health crisis. Any critical details must only be shared on a need-to-know basis.

But you also have to provide appropriate communication, if the incident has impacted team dynamics. Those close to the individual will inevitably want to know how they are, out of genuine concern. It’s important to reassure and inform within the professional boundaries of your role.

Step 5: Follow up after the mental health crisis

As part of your mental health crisis management plan, it’s important to have a strategy for following up. It’s useful to include both formal and informal requirements in this, as your organisation will want a consistent approach that doesn't change with the individuals in charge.

Include:

• Review of workplace policies: Did the response to this incident reveal any gaps in mental health support? Learn the lessons and implement changes quickly, so you're better prepared next time.
  
  
• Reintegration of the individual: How are you managing their return to the workplace? If they had a period of leave, can they have a phased return instead of going straight back into full-time? Was there contact with them during their absence – a ‘get well soon card’ reinforces the ‘health’ aspect and may help reduce feelings of embarrassment.
  
  
• Regular check-ins by management: A simple ‘How are you doing?’, outside of planned reviews, can go a long way.
  
  
• Highlight ongoing well-being practices: Things like workshops, flexible work arrangements, and specific mental health training. What are you doing now? What else might be helpful? Does everyone know about it?

Be well prepared for future mental health crises with Resilient People

Everyone needs to know what to do if there is a mental health crisis – for the individual and the rest of your employees. Resilient People will help you mitigate the risks, and lay the necessary foundation of shared knowledge, to lessen the impact of mental health crises for everyone.

Knowing what to do before an issue occurs will be best for your team and company overall. Here’s how we help:

• Train managers and staff: Ensure the team knows how to respond to a mental health crisis.
• Implement mental health first aid training: Equip leaders and mental health first aiders with the right knowledge and practical skills.
• Strengthen support structures: EAPs, peer support networks, and HR policies that have compassion towards mental ill health at their heart.

Developing a mental health first aid strategy, which includes responding to mental health crises, isn’t solved with a ‘pick and mix’ of courses. We work as your mental health expert, starting by understanding your organisation and leading mental health risk assessments. Then we’re in a position to design the exact mental health support that your people will benefit from the most.

For example, one of our long-term clients is a railway company. To create their mental health strategy, we’ve been able to provide:

• Emphasis on management training – including it as part of new manager training programs
• Training a group of wellbeing champions to promote staff wellbeing across the organisation
• Extensive one-to-one well-being and psychology coaching across the network, minimising the impact of traumatic events and the pressure of high-stakes roles
• Staff access to our online resource hub.

Because that’s what works for them.

Let’s talk about what you need, to help you handle mental health crises in your workplace.