How can I support a colleague with a diagnosed mental health condition?

If a member of your team discloses to you that they have a diagnosed mental health condition, try not to make assumptions. As this diagram suggests, just as it is possible to have poor mental wellbeing but no mental health diagnosis, it is entirely possible to have good mental wellbeing despite a diagnosis. Each and every one of us will move along these two continuums.

“Stress” is not a medical diagnosis but can result in low wellbeing.

There are many different mental health conditions, which fit into two broad categories – those where the individual is insightful and aware of what is going on around them (neurosis) and those where the individual loses touch with reality and may develop symptoms such as delusions and hallucinations (psychosis). Neurosis is significantly more common than psychosis. Each condition, whether neurosis or psychosis, can be experienced at varying degrees.

If you are aware that one of your team has a mental health diagnosis, it can help to learn more about the condition – for example, the type of symptoms they may experience and how it could impact on their work. Information on specific mental health conditions can be accessed from the NHS. Occupational Health can provide further information from a work perspective if required.

Stress is not in itself a diagnosable mental health condition, but symptoms associated with stress can be debilitating and have an adverse impact on both attendance and performance at work. If not managed it can lead to health problems, including depression and anxiety.

Mental illness can affect how people think, feel and act. As a result, people suffering from mental ill health may behave, communicate or respond in unexpected ways that may be at odds with a given situation. Although mental illness can adversely impact on functioning and sometimes necessitate sickness absence or the need for adjustments at work, the majority of people with a mental health diagnosis can remain in employment and thrive at work.
Possible signs of mental ill health that may be seen in the workplace:

• Changes in mood – can be low or high
• Emotional fragility
• Anxiety and/or irritability
• Deterioration in performance
• Loss of confidence – needing more reassurance
  Loss of interest and/or motivation
• Becoming withdrawn from colleagues and friends/family
• Feeling or looking tired (possibly reporting poor sleep)
• Tummy troubles – may need the toilet more
• An increase in short-term sickness absence

If a member of your team has a long term or recurring mental health condition, the disability provision of the Equality Act 2010 may apply. In these circumstances, there would be a requirement to implement reasonable adjustments, if needed, to help the colleague remain at work. Examples of reasonable adjustments can be found in the resources section.

Within the Act, a disability is defined as “a physical or mental impairment which has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities”. “Long-term” in this context is lasting one year plus or likely to last one year plus.

You should bear in mind that not everyone who is covered by the Act would view themselves as disabled. This might include someone whose long-term health condition is well controlled with treatment. The Occupational Health service is able to provide further advice where required.

As a line-manager, you should also be aware that those in other protected characteristic groups – for example, LGBT+ and BAME groups – may be more at risk of developing mental health problems. This is not through any inherent susceptibility, but thought to be primarily associated with discrimination, social inequality and other disadvantage.

Make sure that all new recruits to the team have completed a New Starter Health Questionnaire, which will highlight to Occupational Health (OH) any workplace health requirements, including reasonable adjustments. With the new recruit’s consent, OH will make you aware of any recommended support or reasonable adjustments at work.

Include a wellbeing check-in during all one-to-one meetings with team members. This does not need to be an in-depth discussion on their condition or treatment, but more “How are things going at the moment?” or “How are you finding work?” “How is your health – is there anything you would like to make me aware of and is there any additional support I can provide?”. Allow the colleague to decide if they would like to give you more detailed information about their health. You could raise the option of a management referral to Occupational Health for further guidance if required.

Consider the possibility of the disability provision of the Equality Act applying (this would ultimately be a legal decision). Is the condition long-term (one year plus)? Is there an adverse impact on functioning that is more than trivial? Is there a requirement for treatment to control the disabling effect of the condition? Where the Act applies, the employer is required to implement reasonable adjustments, if needed, to support the employee to remain at work. This  contains some examples of reasonable adjustments. This should be explored on a case-by-case basis. It would be for the manager to decide what is reasonable and workable for the department, but your HR Advisor or Business Partner can provide guidance on reasonableness where required.

Mind Wellness Action Plans provide a structure for exploring workplace health needs in more depth. The WAP tool can be used by the team member and their manager to formalise support and adjustments at work. It can also be an opportunity to discuss possible stress triggers at work and early warning signs for illness. An advance directive can be agreed while the colleague is well to allow the manager to take certain actions if there is evidence of deteriorating health at work – for example, contact someone at home, the GP or Occupational Health. 

In some cases the condition can be caused by stress at work (especially depression and anxiety). Also, these conditions, and some others, can be made worse by stress. For that reason it is important that employers try to remove or manage the causes of stress (the HSE's Management Standards for work-related stress offer useful advice on achieving this).

From the University

Chaplaincy providing support for all regardless of worldview or religion

Colleague Wellbeing

Counselling options and support services

Domestic Abuse Support

Working with a Disability (Occupational Health)

Exeter Speaks Out Support/ reporting of incidences of harassment, bullying, intimidation and discrimination.

Management referral to Occupational Health

HR Advisors/Business Partners

Managing Mental Health & Stress Standard University of Exeter, Health and Safety

Spectrum Life University's Employee Assistance Programme (including counselling service)

External Resources and tools

Access to Work

Approaching a sensitive conversation about mental ill health (ACAS/ Mental Health at Work)

Adult Psychiatric Morbidity Survey (NHS)

Protected Characteristics (Equality and Human Rights Commission)

Challenging conversations and how to manage them (ACAS)

Good Work – The Taylor Review of Modern Working Practices

Guide for Line Managers: Wellness Action Plans (WAPS) (MIND)

Mental health and employers | Refreshing the case for investment (Deloitte)

Mental health facts and statistics (MIND)

Mindful Employer Charter and resources – “ Line-Managers’ Resource” and “Making Work Work”

Pre-placement Questionnaire - check on Trent that this has been completed by all new members of staff in your team as this questionnaire is the employee's opportunity to approach Occupational Health with any conditions they may need support with. This is confidential though so you may not be aware of what has been disclosed to Occupational Health on the form.

Self-help Guides - Devon Partnership Trust (NHS)

Suicide awareness training

Types of mental health problems (MIND)

Work-related stress, anxiety or depression statistics in Great Britain, 2020 (HSE)

Working From Home Wellness Action Plan (MIND)

Advice for employers on workplace adjustments for mental health conditions