How to Manage an Employee with Mental Health Issues

There is a new culture of openness surrounding our mental health. Gone are the taboos and blind-eyes of yesteryear, replaced by dialogue, empathy and understanding. As positive as this is, it doesn’t diminish the challenges of suffering from or dealing with mental ill health, and one of the first areas of life affected by mental health issues is work. As a manager, it is vital to be equipped with the necessary knowledge and the correct approach to be able to negotiate this tricky area.

Role of a manager

A good manager is someone who can foster great performance from the team of people under them. Central to this are communication skills, awareness, the realistic setting of goals and workloads and an ability to doctor their management style to individual team members. One challenge that managers face daily is the challenge of ill health amongst their staff. Whilst physical ill health is usually dealt with in a confident manner, mental ill health can provide a much more complex and delicate challenge. While the protocol in dealing with it should be much the same as with physical ill health, and the end goal should be the same (returning to a high level of performance as soon as possible) it’s important to be aware of those complexities and the best way to approach them.

Education and awareness

Educating your staff and yourself is essential when tackling mental ill health in the workplace and laying foundations for a more open, supportive and transparent environment. Many places of work now have Wellness plans which staff can use to help identify mental health issues, highlight how these can affect mood and performance, and what they should expect from their management in terms of communication and support.

Awareness can be raised through training, and there are many online and classroom courses for employees. Not only do the courses educate, they also encourage open dialogue and help break through taboos associated with talking about mental health issues. For managers and supervisors there are also courses which can help them expand their knowledge base and offer additional training in dealing with mental health problems or substance abuse that can occur amongst staff. While there are a number of courses on offer all around the globe, some crucially also allow for the flexibility of online learning combined with the opportunity to provide the prospective pupil to develop practical skills through work placement schemes.

Spotting signs

Of course, a manager isn’t expected to have any medical training beyond (perhaps) a first aid qualification – and certainly not the kind of specialized training needed to diagnose mental illness. But it is wise to familiarise oneself to detect signs of possible mental health problems, especially as those problems tend to get worse if left unchecked and unsupported, particularly in a stressful environment.

So if an employee’s behavior suddenly changes – if they interact with other staff differently, their standard (or enjoyment) of work drops, their appetite noticeably decreases or if they are smoking or drinking more, this may indicate that all is not 100% well. Another common signal is lateness, missing deadlines or increased absence from work. These signs may not indicate mental health issues, and conversely, someone who is experiencing issues may not display any of these signs, so it is vital to maintain good communications with staff and to create an environment of openness where an employee will feel comfortable confiding in a manager.


As mentioned above, a working environment which inspires confidence in employees to speak to their colleagues and managers if they are suffering mental ill health is crucial. Any interaction with someone you think may be having mental health problems must be supportive and open, especially if you have to address their poor performance – adding more stress and insecurity to their situation will exacerbate the issues.

If you need to have a formal meeting then don’t brush it under the carpet, it is better to address any problems before they escalate. Approach the meeting in a positive, solution-oriented fashion. Don’t make any assumptions about the cause or nature of the mental health problem and don’t directly align it with the performance problem. Make sure you conduct the meeting in private, with plenty of time so that proceedings aren’t rushed if the employee begins to open up. Remember, one meeting may not be sufficient to fully explore or resolve the issues, so be prepared to adjourn, and also be prepared to research or seek advice between meetings. There are training courses to help managers have these difficult conversations.

Absence and return

Common mental health disorders such as depression or anxiety are one of the leading causes of workplace absence. An employee suffering from mental ill health may need to be absent for some time, either to recover fully or due to medication reasons. It is crucial for a manager to maintain contact with them throughout their absence, and not to pressure them to return before they feel ready. Again, remaining professional, positive and supportive is also key to keep them feeling valued and not isolated. Agree what the other staff will know about their absence, and try to focus – without pressure – on their return (discussing a phased return is a good approach).  

When they feel well enough to return to work, arrange an interview to welcome them, assure them of your support and understanding and to let them know what is expected of them in terms of performance. Consider whether to assign them a slightly less challenging role or to modify their duties for a time, to allow them to get comfortable and return to a high level of productivity.

Dealing with the mental health of employees is one of the most challenging tasks for any manager. A combination of support, education, clear communication and patience is key to maximizing the productivity and wellbeing of your team.  

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