How to Talk to an Employee Who Shares a Mental Health Issue With You

Scenario: An employee you supervise comes to you and tells you they are working through a mental health issue.

This situation may be alarming if it’s not a situation you’ve dealt with very often. You may think to yourself, “I have no idea how to handle this! What do I say? What if I say something wrong?”

This guide will walk you through the do’s — and a few don’ts — associated with this type of conversation.

Step One: Realize there is no perfect response. Relax and be empathetic.

Start by saying, “Thank you for trusting me enough to come talk to me about this. It’s not easy to share something like this with other people.”

Tell them you most likely won’t have all the answers they need right now but that you will help them get the answers.

Showing empathy costs nothing but it builds trust. Reassure them they are not alone. A lot of people experience mental health symptoms and the symptoms are most often treatable through therapy or medications or a combination of both.

Step Two: Find out what the employee needs from the city and take good notes.

Ask, “Are there any accommodations you need to help you perform your job duties?” Emphasize the most important job functions. For example, if this employee is the person who happens to go to the post office to pick up the city’s mail every day but their primary function is to patrol your city’s streets, don’t talk about the mail pick-up. Talk about the job duties that are most central to their job, the reason their job exists, and whether or not they need an accommodation to perform those job duties.

Ask them if they need mental health leave. Sometimes people need time off to work on mental health issues, and sometimes they don’t. Just ask them, “Is this something where you think you might need a medical leave?”

When you’re having a conversation, take good notes. When people are nervous or the conversation produces emotions, wee don’t process and retain information as well, so take good notes and ask questions. That way, you don’t have to ask the person the same things over and over, and you’ll have the information ready when you go to talk with someone who may have some of the answers – an HR person, the police chief, or a city administrator.

Step Three: Give the employee a timeframe for getting back to them with answers to their questions, and make sure you follow up when you said you would.

Give the employee a timeframe for getting back to them, especially if you know there is going to be a delay. People who are experiencing any kind of mental health issue are going to be nervous about it. They are going to be nervous about what is going on behind the scenes, and you need to tell them if there is going to be a delay. Let’s say an employee comes to you and you know you need to talk to HR about FMLA or other leave policies, but you know the HR person is out until next Monday. Tell them, “I need to talk to Maria in HR about some of your questions, but I know she’s out until Monday, so it’s probably going to be Tuesday until I can get back to you.” That will go a long way toward alleviating their anxiety if they don’t hear from you right away.

There are a few things you may want to find out from your HR or administrative staff at City Hall:

• Does our city have a group health insurance plan or employee assistance program (EAP) with choices of therapists and mental health providers?
• How can the employee find out if their therapist/provider is covered by our health insurance or EAP?
  • Note: If the employee is already seeing a therapist and that person is included in the city’s health plan or EAP, the city’s role in helping them get treatment may be done. If however, the city’s group health insurance plan does not have good choices of therapists, or the coverage of therapy is subject to deep deductibles and copays that the employee can’t afford, that might be an issue your city would like to explore further to make sure the employee gets the help they need.
  • Occasionally, a health plan or employee assistance program will be open to allowing an employee to see a therapist or mental health provider that is not included in their coverage. It doesn’t hurt to have someone at the city ask for this coverage if the employee is experiencing issues getting coverage for the person they want to see.

Step Four: Let them know you will be checking in on them periodically as their supervisor and then make sure you do it.

If you’re the supervisor of an employees who is having a mental health issue, it’s part of your job to make sure they are doing okay. You need to keep an eye on their performance and how they are doing. It’s completely appropriate to tell them, ‘Hey, I’m going to check in on you from time to time just to see how you’re doing.”

Step Five: Avoid the following five ‘don’ts.’

• Don’t ask very personal questions about symptoms, treatment, and personal relationships.

Everyone has a different level of comfort in sharing personal information. If they want to share some personal things, that’s up to them and you can listen and be empathetic, but don’t probe and don’t ask a lot of sensitive and personal questions. It’s possible they are having relationship issues or going through a divorce and they may not be ready to share a lot of information at that point.

• Don’t diagnose their symptoms.

This is really tough in the age of Google and WebMD, but don’t play doctor; don’t offer opinions about symptoms. Even if you had a cousin who had the exact same symptoms and they got a diagnosis, don’t share it. The employee should get diagnosis and treatment from someone who is qualified to give it.

• Don’t make promises.

Don’t make promises about what the city can do. Tell them you are there to help them get answers to questions but don’t make promises. You don’t know what kind of reasonable accommodations they may ask for and what the city is willing and able to do. You don’t even know at this point what a reasonable accommodation might look like. Tell them you will talk to the people you need to talk to and get back to them.

• Don’t overreact if they tell you they are taking mental health medications.

It’s not uncommon to have a reaction when you hear somebody is on a mental health medication and to wonder if they can still be at work. It’s important, however, not to overreact just because it’s a mental health medication.

Most modern mental health medications will allow an employee to keep working safely. In fact, lots of Americans take mental health medications for some type of situation. According to the Centers for Disease Control (CDC), during 2015 to 2018, 13.2% of adults in our country used antidepressant medications. The CDC has also reported that mental health issues have been on the rise during the pandemic. so it’s very possible that number is even higher in recent years.

There are likely employees at your city who are taking psychiatric drugs and are perfectly able to do their jobs.

However, if the city’s policy is that all medications need to be reviewed by a doctor, then you need to follow your policy, but don’t give extra scrutiny to psychiatric medications than you would to other types of medications.

If the city has no policy, then you will have to evaluate the situation on a case-by-case basis. Get legal help and check in with your HR and/or administration department.

Sometimes the person with mental health symptoms will disclose they are having side effects from the medication either to you as their supervisor or possibly to a coworker who then talks to you. If those side effects are such that they could interfere with the employee’s ability to safely do the job, then it probably makes sense to get a doctor’s note. One example of this might be if a medication caused a tremor that interferes with the employee’s ability to use equipment they need to use.

Bottom line: don’t be afraid of mental health medications just because they are mental health medications.

• Don’t release private medical information about the employee.

Never share medical info with other employees. You can share that an employee is on a leave of absence but that’s about it. The employee may share that information themselves, but if you’re a supervisor or coworker, you should not be the one sharing medical information.

Step Six: Welcome the employee back to work when they return the same way you would if they had had a broken leg.

Coming back from any type of leave can be a little daunting; an employee may not feel comfortable talking to coworkers or answering questions, but they also need to get caught up on what’s going on in the department.

Welcome the employee back in a matter-of-fact manner and let them know they were missed. Spend some time getting the employee up to date on changes in policies, staffing, workloads, procedures, etc.

When coworkers are nervous that they will say something wrong, or look stupid, or hurt someone’s feelings, they often want to just pretend like nothing happened or ignore the person who is returning to work. That is not a very healthy way to support that person. Instead, the employee’s supervisor and coworkers can talk about how to make transition back; treat them the same way they would as if they had a broken leg. Help them feel good about coming back, know they were missed, that you are there for them.

If your department is lucky enough to have a well-trained peer support group, you can ask if the person would like to have a peer assigned to support them.

If there were performance issues prior to the employee taking leave for their mental health treatment, then you do need to take a few minutes as their supervisor and review your expectations around conduct sometime soon after they come back. For example, if prior to taking medical leave, the employee was coming in late frequently, you need to tell them expectations are that they need to be on time for their shift. Do leave the door open for them to come talk about it if they are struggling with some aspect of their performance. Tell them, “if something comes up and getting here on time is getting to be an issue, come talk to me and we’ll talk it through, but otherwise I do expect you to be on time.”

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