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Supporting employees in mental health crises: A guide for leaders

by Bill Howatt
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Every leader must understand the “Duty to Inquire” when preparing the workplace for crises. When they observe changes in an employee’s behaviour and reasonably suspect something is wrong, the duty is to ask if the employee needs assistance. Duty to Inquire is the first crisis intervention action an employer can take to protect a worker.

When done professionally and confidentially, the duty to inquire protects the employee from embarrassment. The science is simple and clear. Human rights legislation has set the standard, and employers must ensure their leaders are trained and prepared to fulfill this duty.

To fully understand the duty to inquire, know that an employee has a “duty to inform” if asked whether assistance is needed, which then triggers the “duty to accommodate.” Employers have no legal right to medical details. They need only be provided with accommodation criteria to remove barriers and assist employees.

Recognizing signs and symptoms

Before addressing mental health crises, leaders and HR professionals should have a foundation for recognizing the signs and symptoms that indicate something is wrong. They should not try to diagnose—just notice behavioural changes that appear to impact employees’ functioning.

The test for this is defined by the Supreme Court’s “Reasonably Ought to Know.” If you own a car, you can relate to this example: If it has started every day for the past three years but fails on a cold day, you do not need to be a mechanic to know something is wrong. You reasonably ought to know that something is preventing it from functioning as it has in the past.

Every human is unique, and there are many root causes of mental illness, including substance use, organic factors, trauma, and psychosocial issues. There is no expectation for leaders to be mental health experts. Their role is to lead a team to achieve goals.

All they need to do to trigger a duty to inquire is notice a gradual or sudden decline in performance and behaviour, along with facts—like those in the car example—that would indicate to a reasonable person in their position that something is wrong.

Blinking light that something may be off

The following are examples that a reasonable person would notice something is off:

Changes in behaviour: A sudden shift in an employee’s usual behaviour, such as increased irritability, withdrawal from teams, avoidance, or a decline in openness to cooperation and collaboration.

Emotional indicators: Employees may exhibit heightened emotions such as sadness, anxiety, or frustration. These may reflect deeper issues when coupled with changes in behaviour.

Physical appearance: Neglecting personal hygiene, appearing tired, or showing signs of distress (such as anxiety or constant fidgeting) can be symptoms of mental health struggles.

Work performance changes: Declining work quality, missed deadlines, lack of concentration, or errors in tasks that were previously managed well are symptomatic of underlying distress.

Attendance issues: Frequent absences, lateness, missed meetings, or requests for leave without clear explanations may signal that an employee is facing significant mental health concerns.

Employees coming to work in a different mood or seeming off for the day is relatively common. Leaders need to check in to ensure employees are OK when they notice this. They should monitor if a trend is emerging by observing changes in behavioural patterns over time, which may indicate a more significant concern requiring attention.

The five-step approach to supporting employees

The following five-step model is a way for a leader to fulfill their obligation when they observe or hear changes in an employee’s behaviour that meet the reasonable-ought-to-know-something-is-off test. Confidentiality, privacy, and approach are critical points to consider before proceeding with the five steps.

Identify the concern: You observe or hear a sign or symptom that raises your concern. Depending on the severity, check in to ensure the employee is OK. Do not assume there is an issue. However, note the concern and flag it as something to monitor.

Monitor trends and prepare to meet the employee if concerned: If you observe a trend of signs and symptoms and there appears to be a pattern, prepare for the duty to inform conversation. Organize your facts directly related to work (e.g., late three times in two weeks, missed two assignments, had two arguments, and walked out of a meeting—all atypical). An example framework to prepare a script for a duty to inquire check-in:

  • Clarify your intention—“I have noticed some changes in performance; you’re not in trouble today, I’m here to check in to see how I can help.”
  • Confirm understanding—“Do you understand?”
  • Discovery—“Over the past two weeks, I have noticed [facts]. Can you help me understand what contributed to these changes in performance?”
    Notice there’s nothing about mental health—keep your focus on work and be supportive.
  • Response—What the employee says gives you the path to help. For example, if they report being bullied and scared to come to work, as the leader, you can take action. If they report a personal issue, you can refer them to EFAP. The point of duty to inquire is to check in to see if an employee is OK and allow them to ask for help.

Duty to inquire check-in: Ensure this check-in is done in a private place and at a convenient time. It’s always best to do it in person, but if that’s difficult, an online meeting can work. When supporting a worker you are concerned about, keep in mind the possibility that they are stressed and that stigma may be a barrier to sharing that they would benefit from help. Body language, tone, and approach are key (i.e., empathetic and caring). Another critical consideration is not to be in a rush when engaging a worker who may have a mental health concern, as the conversation may result in a need for support and follow-through to get them to safety or in touch with employee assistance or their MD. Approach the employee with empathy and a non-judgmental attitude. The goal of this check-in is to review your prepared script, determine if the employee needs support, and ensure they know support is in place.

Provide resources and make an action plan: How the duty to inquire conversation goes will determine the action plan and resources required. It is beneficial for leaders to be clear on all available resources and how to access them. Every leader should have their EFAP contact on their personal device. If a leader needs support, they may call the manager assist line for ideas. Leaders should be trained to support employees and educated on available resources. They must understand the duty to accommodate process and their role in the duty to inquire.

Follow up: Follow up and ensure the action plan has been implemented. An employee a leader is concerned about must be monitored and supported until the situation has been resolved. This demonstrates that the leader cares and provides the employee with a support system. Never assume employees have stable support systems. A leader can help an employee get the help they need.

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