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17 September 2019

Mental health issues at work

When a staff member is experiencing mental health distress at work, the first step you can take is to recognise that there is a mental health issue. These questions and answers may help you recognise when this is happening.

Most managers work closely with the employees they are responsible for. Most are in a good position to identify issues early and take steps to help. Early intervention by a manager can restore an employee’s confidence – strengthening their mental health and making them happier and more productive at work.

The following questions and answers may help you recognise when an employee is experiencing a mental health issue at work.

This article is the first part of the three-step process Recognise, Relate and Respond, to help navigate the management of mental health issues at work.

What is mental illness?

A mental illness is a health condition that can affect how a person feels, thinks, behaves, or interacts with other people. It is diagnosed according to standardised criteria. It can involve a single episode, be long lasting, or somewhere in between.

It’s not known exactly why people develop mental health conditions – people the world over are still trying to find this out. Mental illness is thought to be caused by a number of interacting elements too, just as physical health and illness in general are. An episode of illness seems to happen in someone who is biologically and psychologically at risk, or undergoing social or environmental upset.

If you have a mental health condition, you have an illness – you do not have a character fault, weakness or something inherently ‘wrong’ with you.

Stress, anxiety, depression, bipolar disorder (also known as manic depression) and schizophrenia are mental illnesses.

Does having a mental illness affect a person’s ability to work?

Having a mental health condition does not always affect a person’s ability to work. Sometimes it may affect a person’s ability to work only for a certain period of time. It is difficult to say how any particular illness will affect a person’s ability to work, if indeed it does at all.

How many people does mental illness affect?

The general consensus is that one in six people are likely to seek help for a mental health problem in their lifetime. The number of people whose ability to work is impaired by mental illness is difficult to determine. However, the number of people with mental illness who are chronically disabled and cannot work comprises just 3-5 per cent of the general population. What is important to remember is that most people with experience of mental illness can work and want to work. Work is also important in helping people get well, and stay well.

Why aren’t people always upfront about their mental health issues?

There are several reasons. They may have had negative experiences telling family, friends or a previous employer. They may have been made to feel ashamed.

Some people with experience of mental illness have worked very hard toward their recovery and do not want to be seen as disabled. In other cases, where the illness is undetectable, the individual may feel they have nothing to gain by disclosing, and much to lose.

How do I identify early signs of mental health problems?

Usually there is a change in an employee’s typical behaviour. Look for things like decreased performance, tiredness, increased sick leave or problems with colleagues. A normally punctual employee might start turning up late. Conversely, an employee may begin coming in much earlier and working later. Other signs might be tearfulness, headaches, loss of humour and changes in emotional mood. You might notice an increased use of alcohol, drugs or smoking.

Sometimes employees may not realise they are becoming unwell or are already unwell. You are not expected to diagnose their condition but, as their manager, the earlier you notice an employee is experiencing mental health difficulties, the quicker you can take steps to help them. The longer you leave a situation like this, the harder it is to solve the problem and the employees’ condition may get worse.

What should I do if my employee has frequent or unexplained periods of absence?

If someone is having frequent short bursts of sick leave with a variety of reasons such as stress, migraines and back pain – or there is no reason given – there may be an underlying, mental health condition that should be discussed.

If you are to look systematically at patterns of absence, staff need to be able to trust you. They need to be reassured that your motive is to improve healthy working, not to discipline them. After reviewing absences you may need to discuss with your employee what steps you can take together to improve their health and wellbeing at work.

Do mental health problems mean the person has lower intellectual abilities?

Absolutely not. People with mental illness usually have average or above average intelligence. Their abilities vary just as they do within the general population. Mental illness should not be confused with intellectual or cognitive disabilities.

Why can’t they overcome their illness?

Having a mental illness has nothing to do with being weak or lacking willpower. People with mental distress cannot ‘snap out of it’ or ‘pull themselves together’ – much as they might like to!  Like people with any illness, people can play an important part in their own recovery, but they do not choose to be ill.

Is recovery likely?

People with mental illnesses are rarely continuously ill. People with mental health problems don’t always move in a continuous line from sick to well. Their recovery is sometimes up and down. Many people who experience mental illnesses can go back to work, and develop strategies for periods of unwellness if they are given support.

What things should I consider when an employee appears stressed or says they are stressed?

Using the term ‘stress’ is not always helpful, as people use it to mean different things. A distinction needs to be made between ‘pressure’ and ‘mental health conditions’. We all feel under pressure some of the time but not everybody suffers the adverse reaction of stress or a mental health condition.

Can people with mental illness tolerate pressure?

It is not true that people with mental illness cannot handle any pressure or stress. Some stress has positive effects and we all know that what is stressful for you may not necessarily be stressful for your neighbour. There is no ‘one-size-fits-all’ when it comes to mental illness.

What will make people who are already working feel comfortable disclosing a mental illness?

Establish an atmosphere where differences are not punished. Provide a workplace where every employee is treated as an individual. Accommodating the needs of every individual builds healthy work relationships between all employees.

How do I recognise if professional or clinical help is needed?

Although someone does not have to be 100 per cent well to work, and in general work is good for mental health, in some instances an employee may really not be mentally well enough to work. If someone continues to show signs of distress despite adjustments and support you have provided, you should seek advice from your human resources department or advisor. You can recommend your employee sees their general practitioner (GP) and seeks appropriate help.

What do I do if someone is exhibiting extreme behaviour in the workplace?

One in four people will experience ‘mild to moderate’ mental health conditions, such as anxiety and depression. However, a much smaller percentage of people may experience episodes of psychosis.

This may present as extreme heightened activity, and loss of touch with reality, including distortion of the senses such as seeing or hearing things that aren’t there.

In these rare instances, an employee may behave in ways that impact on colleagues or clients. In this situation you need to be aware of your responsibilities for all employees.

Try to take the person to a quiet place and speak to them calmly. Suggest that you contact a friend or relative, or that they go home and contact their GP or a member of a community mental health team if appropriate. You might also be able to help them to make an appointment and even go with them to the doctor – if they so wish.

Be aware that if someone is experiencing hallucinations or mania, they may not be able to take in what you are saying. In this case the person will need immediate medical help. Contact their GP or community mental health services, or the ambulance service if the problem is urgent.

This situation is rare and when it does happen it is usually not completely ‘out of the blue’. This is why early identification of changes in behaviour and prompt action are so important.

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