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12 Recognising and responding

Often the most challenging thing for managers is knowing what to do when they recognise that someone is struggling or is increasingly becoming distressed. Managers who acknowledge the prevalence of mental health conditions in the workforce can significantly reduce sickness absence and incapacity for work through early intervention and support.1

Talking to someone at work can be more effective than costly interventions.

‘Workplaces need to encourage more conversations, make more time to ‘check in’ with colleagues to see if they are OK, and if not, dig a little deeper to see what is affecting them.’
2012 R U OK? Australian Workplace Relationships Survey

Why it matters

If you have a diverse and trusting work culture, an employee who is experiencing signs of mental ill health may be able to take the initiative and talk about this with you. However, some employees may feel unable to do this because they may not realise that they are unwell or they are worried about stigma and discrimination they may face.2

You are not expected to diagnose a mental health condition but, as a manager, the earlier you notice that an employee is experiencing potential signs of mental ill health, the sooner you can take steps to help them.3

Early recognition of signs of mental ill health and having a conversation to offer genuine concern and support can often prevent an employee from becoming ill, taking long term sick leave or needing to submit a workers’ compensation claim.4

‘For me, if behavioural changes are drawn to my attention, I do then listen and get fast care and treatment as I know the faster I treat it the faster I’ll recover. Some members of my workplace seemed hesitant about doing this for me though and initially indicated it wasn’t anyone’s job to keep an eye on me. This seems wrong. A first aid officer wouldn’t ignore someone fainting. I’m happy to report my agency’s management agreed something should be done and did arrange for an SES officer to be trained as a mental health first aid officer.’
An APS Senior Executive Service employee

How it’s done

Early warning signs that an employee may be experiencing mental ill health

  • Emotional responses and erratic behaviour – uncharacteristic behaviour which may be overly sensitive, irritable, angry, teary or tense
  • Obsession with parts of the job, and neglect of others
  • Working longer or fewer hours than usual
  • Disengagement and low morale
  • Withdrawal behaviour such as reduced participation in work activities
  • Increased unplanned absence
  • Increase in use of negative language and workplace conflict
  • Physical symptoms such as appearing tired, headaches
  • Changes in physical appearance such as less attention to personal grooming
  • Reduced levels of performance.

Recognise early signs. Get to know your team and you will be more likely to notice when things are not going well. Changes in an employee’s usual behaviour are the most observable early signs, for example, a decline in performance, tiredness, increased sick leave, increased time at work, or a usually punctual employee coming in late. Use normal work processes and people management practices to identify early signs of ill health.

Managers find themselves in the role of ‘first-responders’. As a manager you can take the initiative to have frank conversations that the person’s peers may not have. Employees make careful judgements about how the information they give you will be received, so if you are an open and authentic person at work, you are more likely to be approached.

Regular conversations with individuals or work planning sessions provide a good opportunity to talk about any issues the employee might be experiencing. Don’t leave these conversations to a formal performance management discussion—exploratory conversations about mental health conditions or disability should not be happening in the context of performance management.

Some simple ‘Dos and Don’ts’ when supporting a person with a mental health condition:

  • DO: reassure the person that you are genuinely concerned about them and that they can talk to you when they need to.
  • DO: be understanding and patient, but also encouraging and confident.
  • DO: help the person to talk about the specific issues and problems they are experiencing, rather than more generalised ‘complaining’.
  • DO: assist the person in developing an action plan; later, follow up and check how they are going.
  • DO: encourage them to access appropriate support and, if appropriate, professional treatment.
  • DO: provide specific, honest, timely, and development oriented feedback.
  • DON’T: tell the person we all get stressed and to ‘snap out of it’.
  • DON’T: tell the person not to think about it and it will all get better, or that there is nothing to worry about and ‘it’s not that bad’, or that they shouldn’t show weakness in the workplace.
  • DON’T: ignore the problem when you talk to the person or avoid talking with them about important issues.
  • DON’T: make assumptions.

‘When I advised my manager that I was feeling depressed and anxious, he responded by moving me to a corner of the room away from my team so that I could have some ‘peace and quiet’. Instead, it made me feel isolated and stigmatised. I was completely out of the loop with what was going on in my team, and I feel that my performance suffered. It would have been better if he had spoken to me about how he could best provide the support I needed.’
Barbara, an APS employee

Put a support plan in place

Developing a plan to support the employee is a key factor in early intervention, maintaining an employee at work and achieving a successful return to work. The support plan below is a template that can be adapted by agencies as required to enhance early intervention and keep the employee with mental ill health at work. It is crucial that this is seen as a collaborative process, working with the employee to ensure the best outcomes for them. It is unlikely to be effective if it is used as a heavy handed performance management tool.

The support plan is best completed in consultation between the employee and their manager, treating practitioner and agency case manager. Other key people involved in the employee’s health may be invited to contribute.

For return to work plans when there is a workers’ compensation claim, please see the Comcare website Return to Work plan.

Mental health workplace support plan

[name of employee]

Treating Doctor name

Contact number

Other treating practitioner

Contact number

Fit for duty:

Currently undertaking treatment

If yes, any impact of the treatment in the workplace?

Reasonable adjustment / functional restrictions / duty modification – list practical specific restrictions and timeframes for review

Risk factors for relapse

Potential signs for deterioration / relapse in the workplace


When any of the above signs become apparent, the manager and employee agree on the following actions:

Employee responsibilities

Manager responsibilities

Signed

Employee
Date

Manager
Date

Unplanned absence

Unplanned absence is one of the most common early warning signs of mental ill health. Employees with mental health conditions may have increased rates of unplanned absence. Seek to understand the reasons for the unplanned absence, such as ability to attend, motivation to attend and barriers to attend work. This will help you to work with the employee to support and improve attendance.

Contact the employee if there is an unplanned absence from work. Explore with them their reasons for non-attendance. Offer support. Stay in contact with the employee in cases of prolonged absence to maintain the connection with the workplace (you can use these opportunities to let them know what is going on in the workplace, especially if there are restructures or team changes, etc.).

Useful tools

  • Comcare, Recognition, response, recovery
  • Shift, United Kingdom Department of Health, Line Managers’ Resource: A practical guide to managing and supporting people with mental health problems in the workplace.
  • beyondblue, helping others with Depression
  • beyondblue, helping others with Anxiety Disorders

Other relevant information sheets:

Footnotes

1 Comcare 2011, Submission to House Standing Committee on Education and Employment inquiry into mental health and workforce participation, Comcare, Canberra, p. 4.

2 Shift, UK Department of Health, Line Managers’ resource, A Practical Guide to managing and supporting people with mental health problems in the workplace, Shift, London, p. 14.

3 ibid.

4 Comcare 2010, Early Intervention to support psychological health and wellbeing, Comcare, Canberra, p. 1.