It's time to talk

For many of us, work is a major part of our lives. It is where we spend much of our time, where we may have most contact with other people, where we make our money and where we sometimes make our friends. Having a fulfilling job is good for your mental health and general well-being.

We all go through tough times and work can help us cope or make us feel worse.

Someone you work with may be feeling the distress that comes with life events, such as the loss of someone close. They may say they are at the end of their tether, but feel unable to take time off. Or they may be experiencing panic attacks or a mental health problem like depression.

However powerless you may feel at first, knowing the basics about how to support your colleague can really help you - and them. Working in a supportive team that cares about the well-being of its members can make a huge difference to their ability to cope. You can't solve your colleague's problems for them, but there are a few simple steps you can take.

How do I know if a colleague has a mental health problem?

Sometimes it will seem obvious when someone you work with is going through a hard time, but there is no simple way of knowing if they have a mental health problem and sometimes you don't need to know.

It's more important to respond sensitively to someone who seems troubled than to find out whether or not they have a diagnosis.

Signs of depression

People who are depressed may:

• be tearful, nervous or irritable
• have low confidence
• lose interest in their work and find it difficult to concentrate
• feel overwhelmed and unable to deliver what is expected of them
• lose their appetite
• get tired easily.

At worst, they may feel suicidal.

Signs of anxiety

Anxiety takes many forms, from general anxiety to anxiety triggered by a particular situation (a phobia). People experiencing anxiety may seem unusually worried or fearful in most situations. They may:

• appear pale and tense
• be easily startled by everyday sounds
• have difficulty concentrating
• be irritable
• try to avoid certain situations.

Panic attacks

These are usually a sign of anxiety and are common in the workplace. Someone experiencing a panic attack may breathe rapidly, sweat, feel very hot or cold, feel sick or feel faint. A task that other people consider simple may seem impossible to them. The symptoms of a severe panic attack can be quite similar to a heart attack, and someone experiencing one may be convinced they are going to die. You can find out more about panic attacks with Mind.

Obsessive compulsive disorder (OCD)

This is a common form of anxiety involving distressing repetitive thoughts. Compulsions are actions that people feel they must repeat to feel less anxious or stop their obsessive thoughts.

For example, some people cannot stop thinking about germs and the diseases they could catch. To cope with this anxiety, they may wash their hands over and over again. Compulsions commonly involve ritualised checking, cleaning, counting or dressing. You can find out more about OCD with Mind.

Self-harm

Some people deliberately harm themselves when they are distressed, usually secretly, as a way of dealing with intense emotional pain.

They may cut, burn, scald or scratch themselves, injure themselves, pull out their hair or swallow poisonous substances. Self-harm can be a sign of other mental health problems. You can read more about self-harm with Mind.

For more information on other types of mental health please visit the Mind website.

Why don't we talk about mental health?

"When people in the office are talking about mental health problems, it makes me feel odd. If I'm down at the time it feels like I have a guilty secret."

"I haven't got bi-polar written on my forehead, but for me it's not an issue. Some people at work know about it just because it has come up in conversation."

There are good reasons why someone with a mental health problem might not want other people to know. Mental ill health is one of the last taboos. It's an area many people don't understand much or talk about often and, as a result, we often act on prejudices. This can lead to unfair treatment - discrimination.

A survey has shown that most people with mental health problems expect to experience discrimination if they talk about their difficulties, but the number who actually experienced discrimination when they did tell someone was much lower.

"If I told people I've been diagnosed with schizophrenia they would probably want me out. People all think schizophrenia makes you dangerous. It has some effect on me at some times, but I'm not dangerous. I'm just not sure I trust anyone enough to tell them."

The media often portray people with mental health problems as dangerous, but people with mental health problems are more likely to be the victims of violence or to harm themselves than to be violent towards other people.

How can I help a colleague in mental distress?

When a colleague tells you they have a mental health problem, becomes distressed or starts behaving out of character, it can be very confusing.

It may distress you, too. It can seem easier to ignore the situation than to try to provide support. But providing support at work can make a huge difference to someone's life.

The most important thing you can do is treat them with respect and dignity. Talking with your colleague is the first step towards finding out how they would like you to support them.

Why is it important to talk?

It can be a very big deal for a person to discuss how they feel and they may feel ashamed to 'admit' their problem. Be open and tell them that you care.

Let your colleague know that you are there if they want to talk. Make sure you can talk somewhere quiet and private. You may want to have lunch or a coffee or go for a walk together to keep the conversation between the two of you.

Once you have found a time and place for a private chat, make sure that you won't have to run off to a meeting or take a phone call. Make sure the time is convenient for both of you.

• Let your colleague share as much or as little as they want to. Ask questions to help you understand what they are going through, but tell them that they don't have to answer any questions that make them feel uncomfortable. Make it clear that you don't blame them for their problems.
• Don't try to diagnose someone or second guess their feelings. You probably aren't a medical expert and, while you may be happy to talk and offer support, you aren't a trained counsellor. Try not to make assumptions about what is wrong or jump in too quickly with your own diagnosis or solutions.
• Keep your questions open-ended. Say "Why don't you tell me how you are feeling?" rather than "I can see you are feeling very low", and try to keep your language neutral. Give the person time to answer and try not to grill them with too many questions.
• Reassure them that what they tell you is private. Ask them if they have discussed their situation with others and if they do or don't want you to mention it to anyone else. Ask them how they would like you to help them.
• Talk about well-being. Exercise, good diet and relaxation can all help improve everyone's mental well-being. Talk about ways of de-stressing and ask your colleague if there is anything that they find helps. Ask if your colleague is in touch with any self-help groups or has supportive friends.

The power of words

The words you use can have a powerful effect on how people feel. Jokes and banter may seem harmless, but saying "Keep taking the pills" or calling someone a 'nutter' can be hurtful, and makes it less likely they will open up.

It's worth remembering that this can be classed as harassment and bullying and can result in disciplinary action. If you aren't sure if a comment is offensive, think about how you would feel if it was directed at you.

What are tips for listening?

Sometimes the most important part of talking is letting the other person know that you are listening.

• Listen carefully to what your colleague is saying to you and repeat what they have said back to them to ensure you have understood it
• Try to interpret the words in terms of feelings so you could respond "I can see that it makes you very unhappy when..."
• You don't have to agree with what your colleague is saying, but by showing you understand how they feel, you are letting them know that you respect their feelings
• If you disagree, be open and honest about it, and continue to listen to what they have to say.

How do I respond in a crisis?

People with mental health problems sometimes experience a crisis, such as breaking down in tears, having a panic attack, feeling suicidal, or losing touch with reality. This can be a response to a build-up of stress at work or at home. You may feel a sense of crisis too, but it's important to stay calm yourself.

There are some general strategies that you can use to help.

• Listen to your colleague without making judgements.
• Reassure them and offer practical information or support.
• Ask your colleague what would help them.
• Avoid confrontation, even if they become agitated or aggressive.
• Don't send them home if they would prefer some quiet time to themselves.
• Encourage them to get appropriate professional help.
• If you are aware that a colleague has self-harmed, make sure they get the first aid they need.

Seeing, hearing or believing things that no one else does can be the symptom of a mental illness. It can be frightening and upsetting. Gently remind your colleague who you are and why you are there. Don't reinforce or dismiss their experiences, but acknowledge how they are making your colleague feel.

Helping someone with a mental health problem through a crisis can be stressful and upsetting. It is important to talk it through with your HR manager or boss or a friend without identifying your colleague.

How do I respond if a colleague is suicidal?

If your colleague says they are feeling suicidal or can't go on, or if you suspect they are thinking of taking their own life, it is very important to encourage them to get help.

They could contact the Samaritans straight away. They can call 08457 90 90 90 at any time (local rates).

They could also get help from their friends, family, GP or mental health services.

You can ask your colleague how they are feeling and let them know that you are available to listen. Talking can be a great help to someone who is feeling suicidal, but it may be distressing for you too.

It is important for you to talk to someone about your own feelings and Samaritans can help you as well. Or you may just want to talk to a friend or family member, without mentioning your colleague's name.

Mental Health Foundation - suicide thoughts

What can I do as a manager?

Managers often find it difficult to deal with someone they think has a mental health problem, particularly if the person or they themselves are reluctant to talk about it. But it's important to talk.

• Take time to talk to the person privately and ask if something is wrong. Take your steer from them. Don't try to diagnose what you think is the matter.
• Ask what would help them at work. They may need a quiet place to work or more time to perform certain tasks.
• If they haven't been performing as well as usual, they may feel guilty or fearful about it. Be honest in assessing their performance - they may feel their performance is worse than it is.
• It can be useful to agree in advance how to handle any continuing problems. Encourage your colleague to identify factors that might play a role in them becoming unwell and consider how to deal with them. You may also want to agree how best to respond to a crisis.
• Don't make assumptions about what someone can and can't do.
• Be aware that new computer systems or other changes, restructuring or the risk of redundancy can be especially difficult for someone who is also coping with a mental health problem.
• In the language you use and the attention you give them, treat them with respect and act as a model to encourage other colleagues to do the same.
• Suggest they ask for advice from your occupational health advisor or contact any support service your organisation uses such as the Employee Assistance Programme.
• After your first conversation, fix another meeting to check how your colleague is coping and whether further changes to their working arrangements are needed. Then keep the dialogue going.

What does the law say?

Employers and staff should be aware of the law relevant to mental health at work:

• The Equality Act 2010 makes it illegal for an employer to treat employees or job applicants disabled by mental health conditions 'less favourably' than other employees. An employer also has to make 'reasonable adjustments' for all employees with a disability.
• The Health and Safety at Work Act says that every employer must, as far as reasonably practicable, ensure the health, safety and welfare at work of all their employees. This applies to mental and physical health.
• Management of Health and Safety at Work Regulations say employers must assess risks to the health and safety of employees, including mental health.
• The regulations are particularly relevant to stress and the effects of stress on mental health. Employers' risk assessments should help them determine how to minimise risks to their staff.
• Data protection regulations say that all information on workers' health is 'sensitive and personal data'. They say that employers should be allowed to hold only limited health information, with strict limits on who can access the health files of an employee with mental health problems.

What about keeping in touch and returning to work?

Keeping in touch

Many people who have mental health problems dread returning to work after they have been off sick. And it can be awkward to know what to say when people have been ill, especially if it has never been talked about. There are ways of keeping in touch that will help overcome that awkwardness later on.

• Ask the person who is off work what they would like their colleagues to be told. Try to get a balance between maintaining their confidentiality and letting people understand what's happening.
• Invite them out when staff are spending leisure time together. They may decline, but still appreciate being asked.
• Send cards and call your colleague if you would normally socialise with them - just as you would if they had a physical health problem.
• Have a 'cup of tea' policy where someone can come into the office informally before returning to work.

Returning to work

Coming back to work after a period off sick due to mental ill health can be exhausting. In some jobs, the person could begin by doing a task at home.

Sometimes a phased return to work can be helpful, with someone working a few hours a day and building back up to working their contracted hours. If you're unsure what is reasonable, ask for advice from your HR manager or occupational health advisor.

How can I create a healthy workplace?

You don't have to have a mental health problem to have mental health or well-being needs. A workplace that is positive about mental health supports the well-being of all employees, as well as encouraging openness about mental health problems.

Looking after staff has benefits. It encourages loyalty and brings out the best in all employees.

Job design and matching people to the right role is also key. Advice from your HR manager or an external HR advisor can be a great help in making sure your workplace is healthy.