When An Employee Is Mentally Ill

How to support them while keeping your company going

Emilia Clarke doing stock photography, via Vanity Fair

If you manage more than zero people, chances are someone has a mental health issue. Thankfully, this being the 21st century, people talk about it. Being a modern manager, you mainly have to listen, but you also need to plan.

This is the rough protocol I’ve evolved over 7 years, but if you remember nothing else, just remember to listen.

  1. Have a face to face conversation. Ask how they are and listen.
  2. Accommodate mental illness like any illness (sick days, different hours)
  3. Recommend therapy, and make sure that you’re paying them enough or offering enough health insurance to make this possible.
  4. Personally work with them on improving productivity.
  5. Check back in regularly.

This doesn’t always work, but it’s still your job. People are your company, and their health is your company’s health.

Mental Illness Is Real

The first step to dealing with mental illness is talking about it. If you talk you can get help, and with help, most people get better. This simple step, however, is the hardest one to take.

Personally, I was depressed for months before my mother pushed me to get help. When it happened again I also waited for almost a year. I studied psychology and I still struggled to ask for help. It’s hard for anybody because you feel like this is something you should fix yourself, and you feel even worse when you can’t do it.

It’s this attitude that you need to overcome as a manager. You can’t just tell someone to work harder or try exercise or something, you have to respect mental illness as a real illness which requires medical help.

In my experience, I’ve found that talking about my own issues helps, but note that no employee has to talk to you about their health issues at all. You can only listen if they want to talk, and your only role is to support them, you cannot and should not ‘fix’ them.

When An Employee Comes To You

If an employee comes to you, you’re already way ahead. That means that they’re already over the hard part — talking about it. They still may need encouragement to get help (I, for months, was content to just say ‘I’m depressed’ and do nothing about it), but you’re not starting from zero.

The first thing is whether you believe them, because it may sound like an excuse to come in late or take days off.

As a practice, I always believe them. If you can’t trust an employee up to this point, you shouldn’t have hired them, and you need to follow the same protocol either way.

From there, I just follow the plan. Listen, accommodate, recommend and personally work with them. We offer mental health days and flexible hours, if they need it, with one condition.

A manager can only manage what they know, so we insisted on clear communication. They couldn’t just not show up and say it was a mental health day later. That’s hard for someone struggling, but it’s doable. Note that this isn’t to check on them, it’s simply because we work in teams.

From there you can help them to get treatment (later on whether your company makes this possible) and also be there to listen and support them as someone that cares. Again, it is like any other illness, a manager can’t cure depression any more than diabetes, but you can help, and you must help. We always made a commitment to supporting the employee as much as possible, even if it sometimes didn’t work out.

Then onto productivity. I would also directly work with the employee, in our case editing their writing or working with them on projects, and have regular check-ins to see how they were doing it. Sometimes you can delegate this to their direct manager, but for most of my company’s life that was me. Even now I still take over directly.

When You Have To Talk To An Employee

This is the harder case. By the time mental illness gets to a boss, it’s usually because there’s a problem, so it’s a tense situation for everyone. As a manager, you may be having a conversation about what seems like a disciplinary issue, but then discover that something else is going on.

That employee is sitting in front of you because they’ve caused an issue, and it’s hard to see that the underlying cause may be out of their control. I found that it helps to start the conversation by asking ‘how are you?’ Sometimes no one has really asked that for a while.

The other thing is that mental health isn’t just in our heads. Often something is really wrong in an employee’s life. When I was depressed it was because I was losing pigmentation on my face (like vitiligo, but not) and had to wear makeup, in high school. This wasn’t in my head, it was on my face and it would have made anyone anxious and sad.

In my experience at work, a lot of times people have serious family or relationship problems. They can get therapy for coping skills, but the underlying situation is just bad.

Whether they’re having mental issues for a tangible reason or not, the response as a manager is still the same. Listen, accommodate, recommend therapy and work closely with them.

Managing Other Staff

One problem I didn’t anticipate was how this affects other employees. What they see is one employee getting preferential treatment, showing up late, getting direct attention from the boss. Meanwhile, someone showing up and maybe dealing with their issues on their own gets less.

This was something I could have managed better. One thing I wish I’d done was to communicate a mental health policy sooner, to everyone. We came up with a culture in an ad hoc way and it looked ad hoc. It just looked like I was being easier on some people and the others didn’t know what was going on. And they can’t really know, because you can never disclose. Which leads to the next point.

Running A Better Company

At some point, listening isn’t enough. There’s no point encouraging someone to get help if they can’t afford it. There’s no point recommending therapy for a bad family situation if you’re not paying them enough to move out.

Hence you fundamentally have to pay decently and offer health insurance (if you’re in a country that requires it).

This is hard because it costs you money, but it’s an investment in your people who are, as mentioned, your company.

Besides money, the other thing you can provide is time. To all of your employees. This is something I didn’t do and didn’t really think about until now, but an employees life shouldn’t have to rise to the level of illness before they get flexible hours or mental health days. We actually cracked down on office hours as we got bigger, but if I was doing it again I’d try to implement a more flexible system that scaled.

Getting Better

The wonderful thing about mental health in the 21st century is that most people do get better with treatment. From a manager’s perspective, this means that your employees' productivity will improve, and your company culture will improve as a result of how you handle this.

Some people (or situations) of course do not. I had one case where an employee quit in a huff and began threatening staff on social media. We had to hire security for an event and even when I spoke to his parents they said there was nothing they could do. I hope he’s doing well, but I had to block him and just cut him off for the safety of our staff.

The vast, vast majority of mentally ill people, however, are dangers only to themselves. They are the same talented people that you hired, just going through a rough patch. If you provide a supportive environment (with benefits), gainful work is sometimes the best thing for mental health, and these people can become your best and most loyal employees.

It’s the right thing to do, and it’s also the right thing for business. So good luck and remember, if nothing else, just listen.

Most images here are from Emilia Clarke’s stock photography shoot with Vanity Fair. The rest are stock photos curated via the amazing Twitter account Dark Stock Photos.