How to address concerns about a colleague’s mental health

As a manager, you’ll need to talk to an employee about concerns around their mental health at some point. Perhaps you’ve already been there. It’s not a comfortable position for anyone.

You know the person’s potentially vulnerable, you know you’re not a mental health professional, and you don’t want to say the wrong thing or make anything worse. But you have a duty of care that’s a heavy responsibility.

Here, we’ve listed some of the warning signs of poor mental health and a general guide to having that initial conversation in a considerate but useful way.

Recognising warning signs of poor mental health

If you notice that someone isn’t how they usually are at work, it’s a good idea to trust your instincts and tune in a bit further. Physical, emotional or behavioural changes can be the early warning signs of a decline in mental health.

By spotting a possible issue and acting promptly, you can help that individual get the right support before their mental health deteriorates any further. It’s crucial to remember that different people can show different symptoms for the same mental health issue.

Common early warning signs include:

Behavioural changes

Changes to behaviour at work include things like:

Someone who’s never late has a problem with punctuality
An individual’s engagement with their work, and subsequent performance, is dropping off
Someone who’s usually enthusiastic develops an air of resignation or apathy
A usually social person withdraws from team activities, social events, or everyday social interactions (for example, choosing to eat lunch alone)
Irritability, anger, or even aggression towards colleagues
Different work patterns, like leaving early, arriving late and taking extended breaks
And the opposite – working extra hours than normal
Taking more risks than usual
Over-reacting to problems they would previously have managed fine

Physical symptoms

Physical symptoms of mental ill health can be quicker to spot and may include:

Change to appearance by neglecting personal grooming
Appetite and weight fluctuations, or digestive troubles that may necessitate more frequent toilet breaks
Fatigue – beyond usual tiredness
Joint and back pain, or more frequent illnesses
Visible signs of tension, like trembling
Nervous, strained speaking voice

Psychological indicators

These psychological factors are often those that people are best at masking. No one wants to feel out of control of their emotional state, especially at work. So these signs may be more obvious indicators:

Mood changes
Tearfulness and other signs of sadness
Loss of humour during usual daily interactions, which often goes hand-in-hand with increased sensitivity
Expressions of hopelessness and a distinct lack of motivation
Being indecisive, confused and/or distracted by usual work expectations

These signs can be picked up from verbal or non-verbal cues that will be unique to the individual.

Decline in work quality

As a manager, it’s most likely that a dip in work performance will initially cause concern. This might look like:

Someone struggling to take in or remember information
Lack of ability to focus on the task at hand
Standard of work slips
Missed deadlines, or taking it right to the wire

Mental health issues can be caused by an ongoing medical condition, grow incrementally over time, or occur suddenly due to a life event.

It can be difficult to see the signs, regardless of the cause. This is partly because social stigma makes people reluctant to discuss their mental health and partly because individuals all present different combinations of indicators.

Approaching the individual to address your mental health concerns

So, you have concerns about an employee. What do you do now?

You know you have a legal duty of care to fulfil and the HSE guidance states: “As soon as you notice that an employee is having difficulties, talk to them – early action can prevent them becoming more unwell…Managers should concentrate on making reasonable adjustments at work, rather than understanding the diagnosis.”

Even when you fully agree with all of this, it doesn't help you broach this delicate subject or keep a very personal conversation professional.

Dr Nicole Lipkin describes the difficulty of the situation for both sides: “It can be extremely isolating to be at work while privately dealing with a mental health issue, afraid of being found out, but desperately wanting support. By the same token, it can be uncomfortable, awkward and confusing trying to navigate how to help or support someone who is struggling, even if every molecule in our body wants to help.”

Does this ring true for you? You’re not alone. Here is some practical advice to use as a starting point for raising your concerns.

1. Privacy

Make sure you have conversations about any kind of health issues in a private space. This might be in your office, if it’s not an open-plan design. Or the person you want to talk to may prefer to be somewhere other than their workplace to express their difficulties. This might mean visiting a local cafe or going for a walk.

It’s more likely that people feel they can share their honesty if they’re comfortable. Explain you won’t share their private information with anyone unless they give their permission. They may actually want you to tell particular people for them because they’re finding it hard to communicate.

At this point, it’s crucial to point out any parts of your Health and Safety policy that state when you won’t keep information confidential.

For example, ‘I’m not going to tell everyone what we discuss. But if I feel that you’re not safe, I may have to tell specific people.’ This means that you can maintain trust, even if you have to inform medical professionals or other staff members, because you’ve been upfront about that possibility.

2. Express concern, not judgement

Social stigma around mental ill health prevents people from seeking help. Particularly when you’re initiating a first conversation, it’s really important to make it clear that you’re coming from a place of concern.

To avoid sounding like you’re judging negative behaviours or performance, start questions with ‘I’, rather than ‘you’ and use open wording. For example:

A simple, ‘How are you?’
‘I noticed you seem a bit stressed/angry/down recently, and I just wanted to check in with you.’
‘I spotted that your work was filed late and you’re usually great at meeting deadlines. Is everything alright?’
‘What can I do to help?’
‘What would you like to happen?
‘Have you spoken to anyone else who can support you with this?’ (Like your GP, or other mental health professional?)

3. Be an active listener

The CIPD has a useful ‘conversation checklist’, but in essence, active listening involves several key things:

No interruptions from outside the conversation like phone calls, people ‘popping in to ask something’ or pre-arranged meetings
Give them the time and patience to explain in their own way
Allow the individual to direct the conversation outside your prepared questions
Validate their feelings by accepting them as true
Lead with calm empathy

This isn’t always easy. But before anything can be solved, the individual needs to feel heard and understood. You need to hold back your need to give advice or develop an action plan – and just listen.

4. Avoid diagnosing or assuming

It’s best to avoid trying to define a possible mental health illness diagnosis. For example, ‘You’re feeling worried all the time. Maybe you’ve got anxiety, so maybe that means you can’t be client-facing any more.

Of course, you’re considering how you can make reasonable adjustments to their work if necessary. But assuming a particular condition and speculating about how it impacts their job will only make people feel insecure about sharing their mental health challenges again.

5. Hold boundaries

The very nature of the causes and symptoms of mental health issues is personal. Your role is to be supportive – but you also need to maintain professional boundaries.

If an individual is upset in the moment or at a crisis point, they may be asking you for the kind of help that’s way out of your remit. Of course, human instinct is to try and help, but in the workplace, this needs to be within your policies and structures.

For example, you can arrange for them to have weekly time off to see a mental health professional. You can’t be that counsellor, therapist or psychiatrist.

And it’s OK to say that you’re going to help them find the right person to help them with the situation because that’s not you. Not because you don’t want to help, but because you’re not qualified.

Providing mental health resources and support as a manager

One of the most useful ways to support someone with mental health issues is to help them find the right resources. Often, just locating the right support is a step too far for people already exhausted by their current state of mind.

Suggest resources

There are all types of resources available to help with mental health issues. The first point of call should be a GP’s appointment because that’s the gateway to a variety of NHS experts that they might not be able to access otherwise. Then you can suggest things like:

Local or online counselling services
Mental health hotlines
Wellness apps, that often focus on one area, like sleep disruption
Employee assistance programmes within your organisation
Occupational health
Educational online courses that offer self-paced learning about different mental health and wellness issues

Offer practical support for their role

This is all context-specific, but perhaps you can do things like:

Adjust their workload
Push deadlines
Remove some responsibilities associated with their role
Flexible timetable - maybe with some working from home
Arrange time off, so they can do some initial recovery
Have a phased return-to-work plan

These kinds of arrangements needn’t be a permanent change to their work life. But a temporary supportive structure while they recalibrate their mental health.

Create an open, supportive culture

Creating a supportive work environment is more complex than it seems. It’s shaped by the diverse personalities and perspectives of each employee. As a leader, it’s your responsibility to define and foster a truly supportive culture.

Ideally, all staff trust that being vulnerable enough to seek help is expected, encouraged, and not detrimental to their career. They also need to believe their private mental health information is treated with full confidentiality and won’t become the next gossip topic in the break room.

Part of creating a supportive work culture is having carefully worded policies in place that deal with mental health issues and the procedures managers should follow. It’s also crucial that if individuals feel victimised because of their mental health issues, that action is swift, fair and decisive.

Follow up

Make sure you check back in with any employee who’s shared any mental health issues with you. Nothing intrusive, just a conversation about how they’re feeling and how the support is working for them.

This keeps communication open and strengthens your connection with them. It also means that you can adapt their role with any practical changes needed.

Get specialist mental health training to further support your team

In 2022, an ERC insight paper called ‘Line managers: The emotional labour of managing workplace mental health issues’ came to some interesting conclusions.

“...for some managers, dealing with workplace mental health is a significant emotional burden”
“...managers feel the weight of expectation to manage those with mental health issues in an appropriate and professional way, but that they also experience anxiety and unhappiness because they feel unprepared and unsupported”
“Employers are often over-reliant on these individuals to manage workplace mental health issues, and the study suggests that they should recognise the potential emotional toll it can have. This is an important first step in the development of resources (e.g., training and counselling) to help and support these individuals.”

Who’s looking after the managers in your organisation? Listening to and supporting employees through mental health issues requires emotional energy. But your managers also need specific training to do this part of their job successfully.

Getting an expert partner on board helps take the strain off your managers and build their knowledge, skills and confidence. We offer a holistic approach, so you can get the right training for your managers, well-being champions, and the entire staff.

20.12.2024

How to address concerns about a colleague’s mental health