Last month I wrote about the importance of having wellbeing programmes in place, and how it can help employees feel engaged, increase productivity and reduce absence. Linked to that is the importance of managing mental health issues that may arise, including implementing ways to help reduce the chances of mental health (MH) problems occurring.

Managers have a crucial role in managing MH. A negative, unorganised and inconsistent manager may have a detrimental effect on people’s mental health, whereas a supportive manager with strong leadership can help your teams feel valued and recognised.

It is important to remember that just because someone has a MH illness does not mean they cannot perform as well as their colleagues. Often, people with MH conditions are high performers and achievers.

Because the manager’s role in supporting good mental health in the workplace is so crucial, it’s important to provide excellent training and develop a Mental Health Policy for managers to refer to. Guidance should state that:

• Managers are not expected to diagnose but should seek advice from Human Resources (HR) or Occupational Health (OH) if they have any concerns about an employee.
• Approach all aspects of a person’s MH as you would for any other kind of health-related problem, including sickness absence, assessing fitness for work using specialist advice, considering workplace adjustments, and managing performance.

Prevention, Intervention and Support

Provide your managers with the necessary resources to help prevent employees develop work-related stress and to support employees with MH conditions. Each level of intervention includes:

• Primary Prevention
  • Creating a workplace environment that is conducive to good MH, including training line managers in the soft skills needed to encourage disclosure of any MH problems
  • Job design – creating work that is satisfying and not excessively pressurised
  • Removal of risk factors, including bullying and harassment
  • Promoting good working relationships.

• Secondary Intervention
  • Providing support to employees at an early stage of any MH problems, such as stress management and resilience training
  • Help line managers to spot when a team member may be struggling with stress or any kind of distress.

• Tertiary Level Support
  • Support your managers in identifying and supporting employees with severe mental ill health by providing mental health first-aid training, guidance on using the management support part of your Employee Assistance Programme (EAP), and training in making effective referrals to OH or other medical specialists
  • Employees with more serious long-term illnesses will often need a different management approach, particularly where the condition includes relapses and remission periods. Most employees with enduring mental ill health will generally function well when given support, which also helps them to quickly divulge when they identify the early warning signs that they are not well. That vital workplace support helps to empower them to manage their situation at work.

• Therapeutic Support
  • Regularly promote the support available through your EAP or any external programme, especially therapies for common MH problems, such as Cognitive Behavioural Therapy (CBT)
  • When referring employees for counselling or CBT, always ensure that they are equipped to handle employees with MH issues
  • CBT is recognised as being effective in helping people back to work following MH problems as work-focused goals and strategies can be set, which employees often find empowering. CBT is typically delivered in six to eight sessions of counselling, either face to face or via online e-therapy programmes.

Building Resilience

Building employee resilience makes good business sense – resilient employees are better able to maintain their performance at work, even under pressure. However, keep in mind that many instances of stress and distress are symptomatic of wider problems, which would need investigating. Resilience training would not correct those problems.

Training individuals and teams to become more resilient is particularly important where change has the potential to undermine confidence and morale. Resilience training can also help employees to:

• Be more flexible about organisational change
• Adopt a “can-do” attitude and be more optimistic about their future at work
• Remain calm under pressure and feel less anxious about work and home life.

Encouraging Disclosure About a Mental Health condition

Often, people are reluctant to disclose that they have a MH condition. Mental ill health is a sensitive issue, but most employees welcome an open and honest approach. Ensure your managers have regular catch-up sessions with their teams. Use simple, non-judgmental questions – this helps employees to talk openly and helps managers to spot signs of trouble early. Building a good rapport makes it easier for employees to disclose a MH problem.

Making Timely Referrals to Occupational Health

Referrals to OH may be triggered under various circumstances, including changes in behaviour or sickness absence that may be related to an underlying MH problem, or if the employee’s MH problem is work related. Sometimes, a situation at work may affect an employee’s MH, for example difficult relationships with colleagues.

Where an employee discloses a MH problem, encourage them to consult their GP first, and inform them of support available through your EAP or any other service.

Early referral to appropriate medical and/or specialist services help to nip things in the bud and prevent sickness absence. Therefore, an effective process should include:

• Making referrals as soon as there is a concern about an employee
• Provide OH with background information, including the employee’s job role, any workplace adjustments in place or attempted, whether a disciplinary or performance management process is under way, and whether there are any relationship problems with colleagues
• Asking the OH team relevant questions, e.g. about the individual’s fitness to carry out particular tasks, or the prognosis for a return to work (if the employee is absent)
• Discuss the advice received from OH with the employee as a precursor to building an action plan to help them remain in or return to work.

Encourage your managers to seek expert advice if they feel unsure, or if it is a particularly complex case. Advice could come from OH, HR, or external organisations such as mental health charities.

Feedback following a referral usually provides recommendations and advice about whether the health problem is likely to have an impact on the employee’s fitness to carry out his or her role. If the employee is absent from work, it should also give some idea about how long the absence is likely to last.

All parties must ensure that personal data, including information about individuals’ health, is handled in accordance with your GDPR policy. For instance, if OH needs to liaise with employees’ medical practitioners. You need a consistent approach for when a medical report is requested, who will request it, and how.

Case Management

Always use a case management approach when supporting employees with MH problems to return to, or stay in, work. This approach involves key functions – such as line managers, HR and OH – monitoring the employee’s situation and requirements, and liaising with one another about appropriate actions. Tailor your approach to the employee, as everyone’s mental ill health and their coping mechanisms are unique. Each case should be handled by a consistent group of people, including a single case manager to coordinate all actions.

Training Line Managers

Line managers need training to spot the common signs of mental ill health and to identify employees who are struggling. Training should cover how pressure can become negative stress and other work-related problems, such as poor performance. It should guide managers on how and when to seek specialist help if they cannot deal with, or do not feel comfortable, in managing the issue.

Training line managers should lead to:

• Greater confidence in approaching employees to offer early support at work
• More effective and timely referrals to OH or other specialist services
• More effective management support for absent individuals
• Less stigma about mental ill health at work
• A reduction in absence because of an increased ability to keep employees well at work.

The following areas should be covered in your training provision:

• Being Aware of Potential Triggers, including recognising MH problems. Managers should be alert to work-related factors that can adversely affect employees (see Environmental risk factors).
• Identifying Mental Ill Health. Line managers who know their staff and regularly hold catch-ups are well placed to spot any signs of stress or mental ill health at an early stage. Often, the key is a change in typical behaviour. Symptoms vary, as everyone’s mental ill health is different, but potential indicators are provided in the table below. However, these signs don’t automatically mean that the employee has a MH problem – it could be a sign of another health issue or something else entirely. Training should stress that managers should never make assumptions, and to talk to employees directly.
• Mental Health First-Aid Training. Designed to help managers successfully intervene when a crisis situation at work arises, such as when an individual may be a danger to themselves or others. These courses also cover dealing with panic attacks, acute stress reactions and conditions such as schizophrenia.
• Absence Management and Referrals. Training managers to hold difficult or sensitive conversations with employees will help them to manage absence and specialist referrals. This training should focus on making such discussions open and positive, so that both parties can explore issues freely. The training should emphasise that you do not expect managers to act as a doctor, but to understand when to involve HR or OH professionals.
• Return to Work. Managers need to understand the importance of keeping in contact with absent employees experiencing a MH problem, the value of a well-designed action plan for return to work, the legal and practical issues around adjustments at work, and the benefits of a case management approach to rehabilitation.
• Supporting Day-to-Day Wellbeing. Managers must be equipped with the skills to support the wellbeing of employees daily, and particularly during periods of significant organisational change. Managers need the tools to break unwelcome news sensitively and prepare for the possible psychological impact on employees. Develop regular training to boost management competencies to help reduce psychological harm at work, for example managing emotions, communicating on work issues and managing difficult situations.

June’s blog will focus on managing sickness absence and return to work for employees with mental health illnesses. Meanwhile, if you need help in managing mental health in your organisation, or indeed any other staff issues, do call me on 0118 940 3032 or click here to email me.

The source of this blog is XpertHR.