Managing mental health at work

When and how managers should intervene in an employee’s personal problems

Employers that ignore the mental health of employees do so at their peril. According to a 2001 study by the National Institute of Mental Health in Bethesda, Md., The Impact of Mental Illness on Society, mental illness accounts for more than 15 per cent of the cost burden of disease in developed countries. That’s a bigger economic impact than all types of cancer combined.

In addition, according to the Toronto-based Global Business and Economic Roundtable on Addiction and Mental Health, only 25 per cent of those suffering from mental health issues seek help and just six per cent actually get proper treatment.

Managers have a right and a responsibility to intervene promptly when personal issues affect the workplace. Failing to intervene can have damaging effects, such as putting a troubled employee at risk for personal harm, physical ailments and job loss. Inaction can also damage the working environment, resulting in lowered team productivity, poor morale and resentment towards the manager who did nothing.

However, managers are rarely trained to respond to the emotional needs of their workforce. That’s where an employee assistance program (EAP) provider can help out.

Approaching the employee

Managers can offer support when prolonged changes are noted in an employee’s mood. It is appropriate for a manager to express concern at this point, while remembering that people have a right to privacy and cannot be reprimanded for mood alterations or behavioural changes that do not affect the workplace.

Intervening at this stage could potentially uncover and address professional or personal issues before they affect the employee’s work. During this confidential discussion, managers should be prepared to:

•listen with empathy or accept the response that the employee is not willing to discuss the matter further;

•offer concern for their well-being;

•recommend resources; and

•promote and provide contact information for an EAP if appropriate.

This is known as a suggested referral. A suggested referral is when the manager informs the employee about the EAP and how the service can help, but doesn’t mandate counselling.

Workplace indicators

Managers are often the first to notice problematic behavioural changes that affect an employee’s performance. These workplace indicators can point to the existence of a mental health issue or substance abuse issue, and typically fall into four categories: lowered productivity and job efficiency, increased absenteeism, impaired personal skills and changes in physical appearance (see sidebar).

A manager shouldn’t make a diagnosis based on these indicators. Instead, the manager should cite them as the foundation for an assessment of problematic workplace behaviours and performance issues.

Prior to confronting the troubled employee, a manager should consult with the organization’s HR team and review related policies. The manager should then initiate a face-to-face discussion with the employee in a caring but direct manner:

•report observed behavioural changes;

•focus on safety and performance in an effort to correct poor work performance, not personal issues or dependence;

•pose open-ended questions to elicit in-depth responses and explanations;

•lay out a clear performance management process with desired expectations and consequences;

•recommend support and assessment from a qualified professional such as a family physician, counsellor or the EAP;

•negotiate a fair, flexible working arrangement if necessary to accommodate treatment; and

•provide time frames and next steps.

The end of the line

Mandated referrals, when the manager has referred the employee to counselling through a formal process, should only be used when the employee’s workplace performance has declined to the point where strong disciplinary action or termination would be appropriate.

The mandated referral is seen as a final opportunity for the individual to address personal concerns that may have affected his performance and should include the following:

•communicate to the employee (usually in written format) that he must contact the EAP to avoid disciplinary action that would normally arise from his performance; and

•a release of information form to obtain confirmation that the individual has contacted the EAP. Only a confirmation the employee attended the sessions and complied with counselling recommendations is released to the manager. Details of the sessions are kept confidential.

Managers shouldn’t use a mandated referral to push an employee with noticeable needs into counselling if there are no performance issues. This could result in alienation of the employee from the manager, confuse the manager’s role and mar the reputation of the EAP as a voluntary and confidential service.

Confronting an employee can be an uncomfortable and challenging task, even for the most experienced manager. However, when discussions are well-planned and appropriately conducted, the management referral can serve as a strong source of motivation for a troubled employee. EAP referrals, whether suggested or mandated, are most successful when balanced between genuine care and holding the employee accountable for workplace performance.

Bringing in help from the outside

An EAP provider can help managers help employees. Their consultants have specialized experience in work issues, mental health, corporate and small business environments and general knowledge of HR-related topics.

While not meant to replace or replicate HR or legal departments, a management consultant can assess the manager’s unique circumstances and offer direction on how to handle the problematic employee or workplace situation.

The consultant can support the manager in a variety of tasks including:

•addressing performance deterioration;

•addressing erratic or inappropriate expressions of feelings or behaviours;

•dealing with excessive personal disclosures at work;

•understanding what is and what is not a performance issue;

•recognizing the symptoms of depression, addiction, stress or burnout;

•approaching the troubled employee; and

•referring an employee to the EAP.

The consultant will ask the manager questions about the employee’s presenting problem, his work and behavioural history, performance management efforts to date, effect or potential effect of the problem as well as internal supports and strengths the employee has.

There are two main situations in which the manager’s intervention can be helpful. The first is when there’s a noticeable change in the employee’s mood but his work hasn’t yet been affected. The second is when the emotional problems have led to performance issues at work. The consultant can help the manager properly approach the employee in both of these instances.



Danger signs
Problems that appear at work

Workplace indicators of depression, stress, burnout or addiction include:

•patterns of lateness or frequent absences;

•productivity changes;

•accidents or compromised safety;

•inappropriate or extreme expressions of emotion;

•frequent complaints of fatigue or unexplained pains;

•difficulty concentrating, making decisions or remembering things;

•decreased interest or involvement in one’s work;

•working excessive overtime over a prolonged period of time;

•expressions of strange or grandiose ideas;

•lack of co-operation or difficulties working with colleagues;

•missed deadlines or poor work quality; and

•displays of anger or blaming of others.

Estelle Morrison is the director of LifeWorks Strategic Solutions at Ceridian Canada, a Markham, Ont.-based EAP provider.

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