Harvard Business review

How to Respond When an Employee Shares a Mental Health Challenge

The Covid-19 pandemic made us all vulnerable, and many of us are struggling to keep our mental health. In the U.S., the percentage of adults with recent symptoms of an anxiety or depressive disorder increased from 36.4% to 41.5% from 2020 to 2021 — so much so that the U.S. Preventive Services Task Force, an expert panel managed by the Department of Health and Human Services, recommended that doctors screen all adult patients under age 65 for anxiety. The Lancet also estimated that the pandemic caused an additional 53.2 million cases of major depressive disorder globally and an additional 76.2 million cases of anxiety disorders globally.

So, if one of your employees is struggling with their mental health, how do you talk about it? While you will have to have conversations that feel intimate and discomfiting, it’s also not your job to be the office therapist, and you don’t need to have all the solutions when a team member is struggling. As Daisy Auger-Dominguez, chief people officer at Vice Media Group stressed to me: “We are not therapists, [but] we have to show evidence of care in our engagement with our teams. We also must ensure employees have access to the things that they need to be able to do their work well.”

The good news is that it’s possible to handle mental health conversations without overstepping your expertise. And while it’s natural to worry you’ll start asking the wrong questions or that your employee might ask questions you can’t answer, you can take steps now to create a culture where vulnerable conversations are OK, where boundaries stay in place, and where people can get the help they need.

If having conversations about employee mental health makes you nervous, here are three things to remember:

  1. You’ll feel more confident if you have some prepared questions about workplace mental health in your back pocket.
  2. You can protect your boundaries and your team’s boundaries while still having meaningful discussions about mental health.
  3. Showing up is the most important thing.

Be Prepared for Vulnerable Conversations

Jen Porter, COO of the non-profit workplace mental health consultancy Mind Share Partners, says all managers need to be familiar with the basics of privacy practices in the workplace, and to have a set of questions in your back pocket for when mental health conversations happen.

Porter’s advice is to be curious about the impact of an employee’s mental health challenges, not the cause. She says, “You can ask anything you want about the impact of what’s happening on their work and at work. That’s fair game.” What you shouldn’t ask about, she says, is why the employee is having difficulties. Stay away from “what’s going on at home, the deep causes, the health history…anything that falls into that camp. That’s all therapist camp.”

In the U.S., the Americans with Disabilities Act (ADA) offers a basic rule: You can’t discriminate against someone based on health. This means “you can’t force them to talk about their health,” notes Porter. But you can address impacts on work — and the ADA also states employers should provide “reasonable accommodations” to employees with disabilities, including mental illness.

Porter suggests asking open-ended questions and pairing them with non-judgmental observations. “You can ask something like, ‘Hey, I’ve noticed you’ve been absent in our usual meetings, just wanted to check in and see how you were,’ or ‘You’re such an awesome project manager, but a lot of things seem to have been falling by the wayside. I just wanted to check in on you and see if there’s extra support you need or, or if you need to have a conversation with someone.’” These are very human, Porter notes, but still about work.

If your employee opens up, however, what do you do? Porter says, “Clearly they’ve found you to be a person that they trust — well done.” Your job as a manager is to listen, and then enable your employee to get help — but Porter emphasizes that you “don’t want your employee to feel like you’re dropping them or handing them off. … We always recommend a more collaborative approach.”

Auger-Dominguez agrees. “You can say, ‘I’m feeling a little bit over my head right now. If it’s ok with you, I’ll reach out confidentially to HR to make sure that I’m giving you all the support that you need. And let’s meet again in a week.’” You might even suggest that you and the employee walk down to the HR office or connect to a mental health employee resource group. “Just because they’re getting support from someone somewhere else doesn’t mean that they’re [still] not getting support from you,” Auger-Dominguez notes. “It just means that they’re getting support from multiple places and you can focus on where you can give the right support, which is in a work-related context.”

If there’s low trust in HR within an organization, Porter suggests connecting an employee to ERGs and peer-based groups, which tend to have higher trust among employees. “Often people in those groups will have worked with HR or will have tried out the mental health benefits. And sometimes that storytelling and normalizing can be super helpful.”

Set and Protect Boundaries

Whenever you talk about mental health, personal boundaries come into play — the limits and rules we set for ourselves in our relationships. When we cross our own or others’ boundaries, things can feel uncomfortable, emotionally draining, and just not right. Many managers fear becoming their employees’ go-to resource for mental health challenges because instinctively we know that our boundaries will be crossed, which will zap our own energy and mood. This might lead us to avoid having vulnerable conversations with members of our team.

However, there is a way to have these conversations and protect boundaries, says clinical psychologist Dr. Emily Anhalt. When it comes to addressing how people should share in a work setting, Anhalt suggests using “boundaried vulnerability”: sharing enough with others to invite connection, without sharing so much that you or your team has an emotional hangover.

The idea, Anhalt says, is that “There’s a spectrum from too tight to too leaky. Too tight is when we don’t let ourselves show up as humans at work. When we’re going through a really tough time and someone asks how we’re doing and we say ‘I’m good, everything’s fine. I don’t know what you’re talking about.’” This doesn’t work well because people are perceptive and may feel like we’re shutting off possibilities for authentic connection. Too leaky is when people “evacuate so much of their emotional stuff at work that it puts other people in a position of being their therapist or fixing something they don’t have the responsibility to fix.”

Let’s say a person is going through a messy divorce. They’re really overwhelmed, and it’s affecting their work. If they pretend everything is fine, that’s too tight of a boundary and not reality. You and your colleagues actually want to know how the person is doing! But on the other end of the spectrum, saying something like “My spouse is just being absolutely horrible to me, and I don’t know what I’m going do about it. Every day I wake up and I don’t know how I’m going get through the day and I get here and it’s just more of the same. What do you think I should do? How should I handle it?” — that’s too leaky.

What’s the middle ground? Anhalt says the boundaried vulnerability version would be for the person to say something like, “To be honest, I’m actually going through some really tough stuff at home. It’s definitely affecting how I’m showing up at work. I’m getting support with it. But what I’d really love from you, if you’re open to it, is a little bit of extra time on that deadline? Is that doable?”

As managers, we can model boundaried vulnerability. If someone comes to us in a puddle, we can say, “I can tell that you’re going through a lot, and I want to make sure that you get the support you deserve for this.” In this situation, we’re modeling own boundaries while also helping the person move to the most appropriate next steps. Auger-Dominguez says you can also keep boundaries and support an employee by holding structured time open for them. If you learn about a mental health crisis during a one-on-one check-in, you can end that meeting by saying something like: “Our next scheduled meeting is five days from now. Is it okay to wait until then? Or would you like to check in earlier?” Then, honor their preference and show up for them at their desired time.

Further, as you set your own boundaries, it’s important to understand that our own anxieties and challenges may be triggered by leaning in to help our employees, says Arti Kashyap Aynsley, global head of health and wellbeing at Ocado Group. Managers want to “lean into being empathetic and compassionate, but we have tasks and deliverables and things that need to get done,” and there are only so many hours in the day. Managers can provide support and guidance, but other professionals in your organization likely have time and training dedicated to help employee mental health.

However, she notes, because rates of mental ill health are so high, and so many people need additional support, companies also need to give managers the time to accommodate increased needs of their teams. It’s not fair to expect managers to support their teams’ needs while not building in space for these conversations to happen.

Showing Up Is the Most Important Thing

Perhaps the most important thing a manager can do to support employees is to show up and listen, and then figure out what your employee needs.

Auger-Dominguez says if a team member seems “a little wobbly,” she asks a simple question: “Do you need me to witness, help, or distract you right now?”

This is important, “because if we get clear on that, I’m also normalizing asking what people need, rather than making an assumption. It also creates clarity on what the expectation is from me as their manager. Sometimes they just want me to witness, so it’s not about me solving for anything. It’s just about them. If they want help, I’m going to help them get the resources they need.” And if the employee needs a distraction, Auger-Dominguez might say, “Hey, let’s go for a virtual walk or coffee.” This strategy also helps develop your employees’ agency; that way, they feel empowered to ask for help, versus you trying to assume what they need.

The conversations you have with your employees are the culture you create. Dr. Thomas Insel, former director of the National Institutes of Mental Health, notes that only 10% of mental health outcomes are a result of clinical mental health care. The determinants of mental health are broader and societal, and our workplaces are a huge factor in our mental health. Mentally healthy workplaces want employees to feel valued, heard, impactful — and to have agency over their time, work, and decisions.

So, remember: You don’t need to be the office therapist. You just need to be ready to listen.

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