Mental Health Struggles in the Workplace: Know the Warning Signs

Why Is Knowing the Warning Signs Important?

Mental health conditions are estimated to affect 1 in 5 Americans.¹ However, less than half (47.2%) receive treatment for their mental illness.² Unfortunately, stigma, prejudice, and discrimination are common experiences for people living with mental illness and can have harmful effects on a person’s health, work performance, social relationships, and self-esteem.³

Knowing the warning signs of common mental health conditions and connecting employees with needed treatment and services early helps them get the best outcomes possible. Untreated mental health conditions take a heavy toll on the people living with them, often causing them to feel lost, alone, and disconnected in the workplace. Knowing the warning signs is an important first step in showing your employees you care, helping them get treatment and support (if needed), and creating a healthier and more productive workplace.

What Are the Warning Signs?

Warning signs for specific mental disorders will vary based on each disorder’s unique set of symptoms. However, employers should be aware of the general types of changes that could signal someone is struggling with their mental health.

Changes in Appearance

Consider if there are any differences from the person's usual appearance. For example:

• Is the person’s energy level different? Are they unusually excited or energetic? Are they more fatigued or have lower energy than they normally do?
• Do they appear to have gained or lost an excessive amount of weight in a short period of time?
• Has their personal hygiene changed? Do they appear as though they are no longer taking the same level of interest in bathing, doing their hair, and putting together outfits?
• Are they fidgety, restless, or exhibiting nervous movements?

Changes in Behavior

Consider whether the person is behaving differently than typical. For instance:

• Is the person withdrawn or avoiding social situations? Conversely, do they seem unusually talkative, social, and in need of attention?
• Does the person seem to no longer enjoy activities they usually enjoy, such as not engaging in hobbies or spending time with loved ones they usually enjoy being with?
• Do they appear to be misusing substances (e.g., behaving as though intoxicated)?
• Are they missing deadlines or turning in lower quality of work then what’s characteristic of them?
• Are they showing up late to work, taking frequent breaks, or disappearing for extended amounts of time (e.g., being gone for hours during lunch break)?
• Is the person complaining of physical symptoms uncommon for them, like headaches or digestive issues?

Changes in Mood

Whereas affect is the outward expression of emotion, mood refers to one’s general emotional state, which tends to be more stable. Changes in mood to consider are:

• Is the person more irritable or aggressive than usual?
• Do they seem unusually anxious, nervous, or worried?
• Is the person experiencing very high moods (like being unusually “up”, excited, and energetic) or very low moods (like being unusually sad or “down”)?
• Is the person easily overwhelmed and seemingly unable to cope with difficulties they normal can (including everyday tasks)?
• Has the person expressed feeling hopeless?

Changes in Thinking

Consider whether the person seems to have difficulties with their thinking. For instance:

• Are they easily confused?
• Do they seem to have problems concentrating, focusing, or paying attention?
• Has the person mentioned having obsessive thoughts that they can’t stop thinking about (such as thinking about a traumatic event over and over)?
• Does the person seem to have persistently negative thoughts, such as “everything is terrible” or “this will never get better”?
• Are they overly personalizing situations, such as blaming themselves for things going wrong?

Taking the Next Step

Using the Notice. Talk. Act.™ at Work Approach to Creating a Healthier Workplace

If you see a coworker exhibiting any of these types of changes over time, be proactive and gently ask whether they are okay. Your role is not to try to diagnose the person but rather to provide a listening ear and support, which can make it easier to ask for and accept help. Further, “checking in” with one another creates an organizational culture of caring and helps normalize asking for help.

American Psychiatric Association’s (APA) Notice. Talk. Act.™ at Work approach is an online training module to help managers and peers respond to the warning signs for potential mental health struggles. Specifically, training materials will teach employers the following critical steps:

• Notice. Employers need to recognize the warning signs and changes in a person’s appearance, mood, behavior, thinking, or work performance. These noticeable changes should be persistent (i.e., at least 2 weeks) and not just someone having a bad day or a bad few days. If the changes are extreme enough to warrant an immediate response, make sure you understand your role within your organization’s safety protocols.
• Talk. Find a quiet and private place to ask the person, “Are you okay?” Expressions of concern let people know you care and contribute to a supportive work environment. When talking with the person, provide examples of the behavior that is worrying you, but be sure not to use a judgment or negative tone. Take an approach of genuine caring and concern, expressing that you want to learn more from their perspective. Be a good listener and remind the person that we all have challenging times in life when we would benefit from extra support and guidance.
• Act. Listening is a big help but so is connecting the person you are concerned about with care. This can start by reminding the person about the Employee Assistance Program (EAP) and sharing information about how to connect with the EAP. If you are worried about the person's immediate safety, do not leave the person alone. Seek emergency assistance, including calling 9-1-1 if necessary. If safety is not an issue, check back in with the person in a day or 2 to see how things are going. If they are experiencing any barriers to accessing help, do your best to help them troubleshoot and overcome them.

Sharing the Warning Signs

Share the warning signs for mental health struggles with all employees. This will help normalize mental health and show that the organization cares about and prioritizes the mental health and well-being of its employees.

These warning signs can be shared with employees through the organization's intranet, electronic newsletters, and other communications addressing the importance of overall employee health and well-being. We all have a role to play in chipping away at stigma and encouraging people to seek help when it’s needed. Doing so has a high return on investment, but even more importantly, it's the right thing to do.

Tips for Employers: How Can You Help an Employee with Mental Health Concerns?

Everyone has struggled in life at some point, and most of us have also experienced firsthand the power of someone reaching out to us when we needed help. Caring about the mental health of your workers is important because it may represent the first “open door” they have encountered to asking for and receiving help. Additionally, from a work standpoint, good employee mental health is critical to building a resilient workforce, increasing productivity, improving performance, and retaining valuable employees.

Strategies to help employers who notice an employee struggling with their mental health include the following:

• Know the warning signs. In addition to knowing the general types of warning signs described above, employers should be familiar with the mental health conditions likely to be encountered in the workplace so they can potentially recognize a person in need of help. Because nearly all mental disorders are associated with an increased risk of suicide, knowing the warning signs of mental health struggles could not only help someone get the treatment they need—it could also help save their life.
• Break the silence. Share your commitment to employee well-being by creating a culture in which mental health conditions, as well as suicide, are talked about as openly as hypertension, diabetes, and other chronic illnesses. Employees in a safe and supportive environment are more likely to seek help when needed, and early action leads to the best results.
• Let your employees know you care about their mental health and well-being. For instance, during times of high stress, such as the holidays or during crisis events (e.g., public health pandemics, natural disasters, following a mass shooting event) managers and other leadership should consider sending out an email that: 1) acknowledges this is a stressful time; 2) reminds workers to prioritize their mental health and take care of themselves; 3) prompts individuals to reach out and ask for help if needed; and 4) supplies information about company benefits, including how to access the Employee Assistance Program if available.
• Promote and practice resiliency. Building resilience helps employees enhance their own well-being, tackle stress, thrive in competitive job markets, address workplace conflicts, and meet other challenges on the job. Improving resilience in the workplace is associated with greater job satisfaction, engagement, happiness at work, and overall organizational commitment.
• Help employees keep their stress in check on the job. Stress affects everyone, and job demands can be a major source of it. Employers can reduce excessive workplace stress and help employees manage stress by focusing on 5 areas:
  1. Providing training for leaders and supervisors on effective ways to manage stress;
  2. Working with employees to create challenging but realistic goals for optimal performance;
  3. Modeling good work-life balance;
  4. Identifying and using employees' strengths and skills for career advancement; and
  5. Communicating clearly and managing conflicts respectfully.
• Utilize the Center for Workplace Mental Health’s Mental Health Works Guide. This guide provides organizations with the tools, assessments and lens to create a culture of well-being where employee mental health can be addressed without stigma.
• Know the impact of mental health on your employees and business. Employers should understand, first and foremost, how having a mental health condition impacts a person in terms of their health, emotions, thinking, and ability to function in their everyday lives. Secondly, appreciate that mental health issues can keep workers from being their best selves and performing their best.

Resources

Employers can learn more about how to support mental health needs in the workplace through the resources below, provide by the APAF Center for Workplace Mental Health:

• Resilience: A Strong Workforce Needs It includes tips for employers on how to embody resilience in the workplace and create a culture of strength and support.
• May is Mental Health Month Toolkit offers strategies and resources that workplaces can use all year long to help promote resiliency, enhance employee self-care, reduce isolation and loneliness, and show support for people struggling with mental health concerns.
• Center for Workplace Mental Health Resource on Workplace Stress discusses why workplace stress reduction is a critical responsibility of employers and how they can go about achieving that goal.