How to Talk About Mental Health at Work

Mental ill-health costs businesses up to £42 billion a year, in presenteeism, absenteeism and staff turnover. While initiatives like Mental Health Awareness week encourage open dialogue around mental health, there’s still a long way to go. Many people suffering from mental ill-health still don’t feel they can speak to their employers about it for fear of being ignored or having their feelings dismissed.

If you're a small business owner, it's vital for you to know how to approach the subject of mental health with your employees. Here are some considerations on how to create a culture of openness in your SME:

First steps

Initiating conversations about mental health can seem daunting, as it’s such a sensitive and personal subject. Before approaching such discussions, make sure you’re aware of every form of support your company can offer, so you know where to direct employees, whatever the outcome of your chat.

Be aware of indicators that someone may be in distress. For example, language can signpost mental health concerns. Persistent low mood has often been referred to as the ‘tyranny of shoulds’, so the use of words like ‘should’ and ‘must’ may be common. Low mood and anxiety are also associated with a sense of hopelessness and helplessness, so look out for language with this tone.

There may be changes in behaviour, like a once smartly-dressed employee appearing more dishevelled, or the once punctual employee starting to be late, or the once easy-going becoming more irritable. If you can pick up on some of these behaviours and changes in language – and feel confident in offering support to employees – you can ask for an informal chat.

Active listening

Research shows that in 15% of cases where an employee disclosed a mental health issue to a manager, the employee became subject to disciplinary procedures, dismissal or demotion. This sequence is dangerous, not only leading to feelings of loneliness and otherness in the employee, but also having a much wider impact on the workplace, with other employees not speaking out for fear of the same treatment. As such, it's vital that you show empathy and understanding for any employee who opens up to you about their problems.

One way to do this successfully is to practice active listening techniques to show that you're fully engaged in conversations with employees about mental health. Active listening is about fully connecting with what’s being said and absorbing the meaning. The listener refrains from interrupting and making the conversation about themselves. Instead, they keep their speech minimal, occasionally repeating what the speaker has said, or rephrasing the content to demonstrate they’ve understood its meaning.

For example, keep questions open-ended and simple, like “I’ve noticed you’ve seemed a bit distracted in the last 2 meetings, is everything okay?”. We all have the tendency to respond to questions like this by saying “I’m fine”, so ask again, “Are you really fine?”. It's also crucial to give your employee time to answer and try not to ask too many questions in one go.

If they do begin to talk, show you’re really listening by rephrasing and summarising what they’ve said, offering empathetic phrases and asking how you can help. Often, the feeling someone has understood and identified with your situation can be a starting point for someone who is in distress. Understanding how they’re feeling also puts you in a stronger position to be able to direct them towards relevant help.

Looking ahead

After your conversation, consider the best next steps for your employee. Begin by letting them know your door is always open, and schedule a follow-up chat to offer them stability and reassurance. Point them towards the relevant business policies you have in place which will provide support and any staff who can offer help, like mental health champions or mental health first aiders.

There may be some immediate support you can offer while you consult with a specialist on a long-term plan. These solutions may include offering more flexible working hours to allow employees to accommodate their shifts around other activities. You may also be able to offer short breaks to those suffering from poor sleep as a result of deeper problems.

Managers may turn to their HR department for advice on how to implement these changes for employees, and to ascertain any other support their company provides. However, for smaller businesses, there may not always be an internal HR department available. In this case, there a number of cost-effective tools for smaller businesses, which can offer the advice and support needed for struggling employees. Employee Assistance Programmes (EAPs) offer access to a 24/7 phone line, plus the opportunity to speak to a professional in person about any problems.

At Nuffield Health we introduced a new online digital platform PATH, which uses a number of evidence-based mathematical algorithms to determine a person’s risk factors and generate a completely tailored assessment for them. The data collected can then be used to drive an organisation’s wellbeing strategy for the future, increasing the success rate and return on investment.

Know your rights

All UK employees have a right to reasonable adjustments in the workplace under the Equality Act 2010. This means all employers must show that they are willing to accommodate work practices, and provide other aids and adaptations, for those in need. Reasonable adjustments depend on both the employee and their health, plus your business and its resources. However, they don’t have to negatively impact the workplace or the performance of the employee.

Consult with a doctor or psychotherapist and work with your business and the employee in question to agree on adjustments you can offer to balance the needs of the employee and the business. Common adjustments can be as simple as offering opportunities to work from home during more difficult times or scheduling regular meetings together to go over workloads and reduce feelings of stress and anxiety.

About the Author

Brendan is the Professional Head of Emotional Wellbeing at Nuffield Health. He has over 25 years of experience treating mental health problems in the NHS and private sector. Brendan is a BABCP Accredited Cognitive Behavioural Psychotherapist and Supervisor, fully qualified EMDR (Eye Movement Desensitisation and Reprocessing) practitioner, and NMC registered Mental Health Nurse.

Looking ahead

After your conversation, consider the best next steps for your employee. Begin by letting them know your door is always open, and schedule a follow-up chat to offer them stability and reassurance. Point them towards the relevant business policies you have in place which will provide support and any staff who can offer help, like mental health champions or mental health first aiders.

There may be some immediate support you can offer while you consult with a specialist on a long-term plan. These solutions may include offering more flexible working hours to allow employees to accommodate their shifts around other activities. You may also be able to offer short breaks to those suffering from poor sleep as a result of deeper problems.

Managers may turn to their HR department for advice on how to implement these changes for employees, and to ascertain any other support their company provides. However, for smaller businesses, there may not always be an internal HR department available. In this case, there a number of cost-effective tools for smaller businesses, which can offer the advice and support needed for struggling employees. Employee Assistance Programmes (EAPs) offer access to a 24/7 phone line, plus the opportunity to speak to a professional in person about any problems.

At Nuffield Health we introduced a new online digital platform PATH, which uses a number of evidence-based mathematical algorithms to determine a person’s risk factors and generate a completely tailored assessment for them. The data collected can then be used to drive an organisation’s wellbeing strategy for the future, increasing the success rate and return on investment.

Know your rights

All UK employees have a right to reasonable adjustments in the workplace under the Equality Act 2010. This means all employers must show that they are willing to accommodate work practices, and provide other aids and adaptations, for those in need. Reasonable adjustments depend on both the employee and their health, plus your business and its resources. However, they don’t have to negatively impact the workplace or the performance of the employee.

Consult with a doctor or psychotherapist and work with your business and the employee in question to agree on adjustments you can offer to balance the needs of the employee and the business. Common adjustments can be as simple as offering opportunities to work from home during more difficult times or scheduling regular meetings together to go over workloads and reduce feelings of stress and anxiety.