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Elizabeth City
Tuesday, April 20, 2021

When Your Employee Discloses a Mental Health Condition

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When an employee discloses that they have a mental health condition, it can be hard to know how to handle the conversation— especially if this is the first time you’ve faced this situation. Navigate the conversation carefully. Don’t make a big deal about the disclosure — it’s important to normalize the discussion. Ideally you’ll treat it like you would any other medical issue. Follow the person’s lead in terms of what they want to share and don’t ask a ton of questions or push them to give you more information. You don’t have to have all the answers right away so tell the employee that you’ll reflect on what they told you and get back them. Make clear that you may need to discuss the situation with HR, especially if they are asking for accommodations. But it’s possible that you’ll be able to offer them whatever flexibility they need within your company’s policies. If you’ve had experiences with mental health issues, consider sharing them without making the conversation about you. This type of disclosure, especially if you hold a senior position, can go a long way toward normalizing these topics in your organization and demonstrating that it’s possible to succeed at the highest levels when you have a mental health condition.

When one of your direct reports has the courage to talk with you about their mental health condition, how you respond is critical. You want the person to know you appreciate them sharing while also reassuring them that their job and your perception of them are not at risk. At the same time, you need to figure out what impact, if any, this will have on your team and their workload. What do you say right away? What questions do you ask? How do you decide what accommodations, if any, to make?

What the Experts Say

It’s important to keep in mind that the employee likely had to overcome a lot of fear to talk with you about this topic. “The person has done something difficult and risky by raising this issue. In most cases, a tremendous amount of thought has gone into the decision,” says Kelly Greenwood, founder and CEO of Mind Share Partners, a nonprofit that focuses on changing the culture of workplace mental health. “The disclosure decision is complex,” says Susan Goldberg, core doctoral faculty member at Fielding Graduate University, and it depends on the “individual’s personal situation, the particular employer, and societal issues.” Therefore, how you handle these interactions is critical. The good news is that these can be productive conversations, as long as you follow a few pieces of advice.

Thank them for telling you

Start off by acknowledging the effort it took for the employee to tell you. “If nothing else happens in the first conversation, be sure to thank the person for sharing,” says Greenwood. But don’t make it a big deal. Your goal should be to normalize the topic as much as possible. She says that even if this is the first time you’re having a conversation like this, they happen all the time. “Your reaction shouldn’t convey, ‘this is a big serious issue,’ because that could increase their shame or fear about their future,” she says. Goldberg also cautions against being overly emotional. “You don’t want the employee to have to deal with your reaction.” Your response should be consistent with your relationship. “This is not the time to act like a friend if you don’t have a close, trusting relationship. Nor should you be distant if you’ve been close up to this point,” she says. In other words, treat the person and this conversation the same way you have in the past.

Listen

Give the person space to say what they want to say and tell you what they need in terms of flexibility or accommodations. “Listen actively with an open mind and without judgment,” says Greenwood. Pay attention to your nonverbal cues. “If you’re acting skittish or uncomfortable, it’s discouraging for your employee because it sends a message that you don’t want to talk about it,” says Greenwood. You can adopt a curious mindset, but hold back from asking a ton of questions, especially ones that require that the person disclose more information than you need. For example, “you don’t need to know what the disability they have is called,” says Goldberg, or how long they’ve had it. Let them lead the way in how much they want to tell you.

Tell them you want to support them — but don’t overpromise

It can be tempting to tell the person (especially if they’re a high performer) that you’ll do whatever it takes to support them, but you want to tread carefully. It may be that they’re just telling you as an FYI, says Goldberg, and they don’t need you to make any adjustments to their workload or schedule. Don’t make assumptions. If they’re asking for time off or changes to their work schedule, be careful not to overpromise. Instead, make clear that your intention is to partner with them to sort it out. For example, you might say, “I hope I’ve made it clear that you are a valuable member of this team and organization. We’ll figure this out together.” In this initial conversation, you don’t have to have all the answers readily available. Give yourself permission to not have the perfect response and to figure out what’s possible. Greenwood suggests you might say, “Thank you so much for sharing. Let me take some time to digest and get back to you on X day.” Be specific about when you’ll have the next conversation so they don’t have to worry.

Don’t make it about you

It’s possible that you or someone you’re close with has been through something similar, but don’t focus the conversation on you. Keep in mind that “everyone is different in terms of how their condition shows up. My anxiety is different from another person’s anxiety,” says Greenwood, and “you can’t assume you understand what they’re going through or the extent to which it’s affecting their work.” That said, sometimes sharing a personal story can help to normalize the topic. If you have the kind of relationship with the employee where you share personal stories, just be sure that what you share is hopeful. Don’t talk about someone who never got better or had to quit their job, and don’t downplay their experience by insisting everything will be OK because it was for you or someone else. 

Maintain confidentiality

Reassure the employee that you will make every effort to honor confidentiality but that you may need to speak with HR. If the person is uncomfortable with that, or worried about having something go into their employment file, you might say, “I may have to tell them eventually, but I can talk in generalities, without naming you, at first.” It can be helpful, says Greenwood, to explain to the employee why you may have to tell HR. This includes ensuring that the employee gets the legal protections they’re entitled to in order to avoid discrimination as well as access to all the company’s resources and possible accommodations. She also notes that, depending on where you live, it may be required by law to go to HR once someone has disclosed a mental health condition, even if the employee hasn’t requested an accommodation. If you’re unsure about local regulations, feel free to first talk to HR without using the employee’s name.

But, as much as possible, keep the information to yourself. “It’s tempting to talk to others about it for your own emotional support — or to explain why you’re moving work around — but it’s not OK unless the employee expressly gives you permission to disclose,” says Greenwood. In some cases, the employee may give you permission or even ask you to let others know. If they do, make sure that you are clear in any communication that the person has asked you to tell others so no one else thinks you’re talking behind the employee’s back.

Consider what changes you can make

There is a variety of things that your employee may want or need so that they can take care of their mental health. These might include keeping different hours, working alone or in a group, taking time off to see a doctor, or having occasional “mental health” days. Whether or not you can grant these requests will often depend on your company’s existing policies. Greenwood says it’s important for managers to know the difference between “accommodations,” which are formal, reactive exceptions to existing policies for a specific employee after a disclosure, and “adaptations,” which are proactive adjustments you can make for everyone that are within the company’s policies, such as flexible hours. If you need to make accommodations for an employee, it’s critical to involve HR (more on that below), who will be familiar with the national and local laws that determine what you’re legally allowed to do.

Some of the changes made to working hours or workload might impact other people on your team, and you’ll have to figure out “what to tell employees who ask why this person is coming in late, or experiencing different treatment,” says Goldberg. She suggests that you keep your answers to any questions straightforward and simple. For example, you might say, “It’s an accommodation,” or “We worked out different hours.” Talk with the employee about how they would prefer you address any concerns that come up from their colleagues.

Ask for help from others

This person came to you because you’re their manager. “It’s not your role to be their therapist, doctor, or lawyer,” says Greenwood. Don’t offer health or legal advice. And don’t try to figure this out on your own. Whenever possible, work with HR to come up with possible solutions — and let the employee know that’s what you will do. “The ideal situation, if an accommodation is required, is that you co-create a solution for the person with HR and the employee,” she says. “Hopefully HR can provide you with a ‘menu of options’ of what they’ve provided in the past.” You don’t want to put it on the employee to come up with those options, unless they’d like to. Greenwood says that when she disclosed her anxiety to a previous boss, she “was not in a place to be thinking out of the box.”

In small companies, or those without a supportive HR department, it may be up to you to figure out what you can do. Goldberg’s research shows that smaller companies often have the ability to offer more flexibility, but “it can also be more challenging because you may not be able to afford what they’re asking for.”

Refer them to other resources, if available

There may be other resources inside your company that you can refer them to. “We’re seeing more and more employee resource groups form around issues of mental health, often started by more junior employees,” says Greenwood. You can point them to those groups, if available. You can also direct them to any mental health benefits that your company offers, such as therapy or meditation apps. If you don’t have those resources, you can suggest they contact an EAP (employee assistance program) but keep in mind that not all EAPs are high quality, and while it can play an important role in supporting the employee, it’s not sufficient on its own. Keep in mind that the clinical care is best left to a professional but you are still responsible, as their manager, for the employee’s work experience.

Make yourself “tell-able”

Ideally, we’d all work for a manager whom we felt comfortable talking to when we needed help balancing work with our mental health. Unfortunately, that’s not always the case. But you can make it more likely that people will come to you by being a role model. Greenwood emphasizes the importance of leaders and managers talking openly about these issues. “You don’t necessarily have to talk about your own mental health condition if you have one, but it could be about your kid having a hard time sleeping, or concerns you have about burning out. You want to show that managers are fallible and human,” she says. Being vulnerable in this way gives people a small opening so they in turn feel more comfortable sharing. And, if you hold a powerful position in your organization, sharing your personal experience with mental health, whether it’s addressing it directly or, say, openly blocking out your calendar to go to therapy, can go a long way toward normalizing the discussion in your organization and demonstrating that it’s possible to succeed at the highest levels when you have a mental health condition.

Principles to Remember

Do:

  • Follow the person’s lead in terms of what they want to share.
  • Think carefully about what type of flexibility you can offer them.
  • Make clear that you may need to discuss the situation with HR, and therefore may not be able to keep the conversation confidential.

Don’t:

  • Make a big deal about the disclosure — it’s important to normalize the conversation.
  • Overpromise what accommodations you’ll be able to give the person until you’ve had time to think it through and talk to HR.
  • Hide your own experience with mental health challenges, especially if you’re a senior leader.

Advice in Practice

Case study #1: Be a role model so people feel comfortable reaching out.

Meredith Arthur, a content lead at Pinterest, was working at an early-stage startup in San Francisco and was responsible for managing a customer service team whose members all worked in different locations. She had been in the role for a little over a month when one of her direct reports told her that she’d been struggling with some mental health issues, and that a close family member had died by suicide a couple of years prior.

Meredith’s first reaction was that she was glad the employee felt safe talking to her, and she suspects it was because she had been open about her work in the area of mental health. In fact, she’d started a website, Beautiful Voyager, for “overthinkers, people pleasers, and perfectionists.” She talked openly at work about the site and its mission to connect people who were struggling with stress, anxiety, and overthinking. “Everyone at this startup knew how committed I was to this work,” she said. “I had been outspoken about how important these issues were to me.”

In the conversation with her employee, Meredith started by saying, “Tell me more. Let’s talk.” And they did. “She told me more about herself, her situation, her hopes and dreams, and the things she was facing, health-wise. She knew that I was upfront and outspoken about my own path to discovery about mental health and the role it played in my daily life. She mentioned that she felt comfortable talking to me because of what I’d experienced,” Meredith says.

The conversation lasted about 45 minutes and was the first of many. “We checked in regularly about her schedule and her health. She told me when she was going to therapy appointments and I knew that her schedule would be affected by what she was going through, and that it would be important to stay in close contact about it,” she says.

Meredith was able to make some changes that would make it easier for her direct report to take care of herself. For example, she had to miss some team meetings and needed to shift her work hours. There was also one time where she needed to take a few days off unexpectedly. Fortunately, none of this impacted the business, so it was easy for Meredith to be flexible.

Because of her own experience, she was able to help the employee navigate some of her anxieties. Meredith explains: “She never wanted to speak in front of the wider team. I knew she was shy, but with this new information [about her mental health], I found myself coming from a place of empathy and understanding around her fear.” Meredith made clear she wasn’t looking for perfection in these situations but wanted her employee to grow. “I encouraged her to share more of herself with others on the team. The more she shared about herself, the more her confidence seemed to grow when speaking in front of the group.”

Meredith left that company a year later and the employee was doing well. “She became an outspoken advocate for suicide prevention,” she says. Meredith continues to run her website and published a book, Get Out of My Head, to help others navigate stress and anxiety.

Case study #2: Be flexible when you can.

Jimmy McMillan, the owner of Heart Life Insurance, suspected that one of his employees, a case manager, was struggling. She was responsible for document processing, customer service, and chasing doctors’ offices for records. “She was fantastic most days,” Jimmy says, and she’d even work late to finish important documents. But there were other days when “she was nowhere to be found and no one could get in touch with her via phone, text, or email. It was strange; she would just vanish.”

When she wasn’t available in this way, it meant that the other staff had to work longer hours. Jimmy knew something was going on, but he wasn’t sure what. During a regular performance review, he decided to bring it up. “It was a delicate conversation,” he says. He was straightforward about what he was observing and asked her questions about her absences, without making assumptions or forcing her to share personal information. “I said something like, ‘We care about you and you do a fantastic job; however, sometimes things just seem off. Your attendance is inconsistent, and at times it’s impossible to get in touch with you. Is everything going OK?” She confided in him that she had bipolar 1 disorder and was seeing a psychiatrist. She explained that sometimes changes in her medications would lead to mood swings and there were days where she couldn’t function. Hence, the absences.

Jimmy knew very little about the disorder. “I knew enough about mental illness to underwrite a life insurance policy…but my experience was all secondhand. I didn’t know the first thing about trying to lead or manage [someone with bipolar disorder].” So he did some research. “I read up online as much as I could, and I asked other psychiatrists and counselors about it as we crossed paths professionally.”

Because this employee was excellent at her job, he wanted to make it work. “I gave her leeway to take time off with short notice, by just sending me a simple one-line email,” he explains. He was able to manage the workflow during her absences. “We used project management software that allowed me to assign her tasks to another case manager. When she was ready to work again, we could just assign the tasks back to her and move on.”

He said that her disclosure made it much easier to handle her absences. And looking back over the time she was at the company, she didn’t take any more time off than anyone else on the team. And “she would always make the time up even though I never asked her to,” Jimmy says.

She eventually left the company to work in a local law firm where she could earn a higher salary. Jimmy was sad to see her go but as he says, “I’d hire her again in a heartbeat.” And, he says, he learned a valuable lesson from the experience: “Mental illness should be treated with the same compassion and grace that we give any other serious disease.”

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