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You walk into your office one morning to discover a coworker at his desk, sobbing hysterically. He hurls paper clips at anyone who comes near him. This is not only an atypical morning: you’re witnessing a mental health crisis in the workplace.
Your first reaction may be shock, followed by fear. This coworker is normally pleasant, if a little subdued. Today’s behavior marks the first time you’ve ever seen him express such a strong emotion, which makes him seem like an entirely different person. In a sense, he is a different person: he’s having a crisis, which is altering his brain chemistry and what you’ve come to think of as his personality.
Unfortunately, you don’t have much time to ponder what this all means. Other coworkers are visibly disturbed by his behavior, and it’s impossible to get any work done. As an HR leader, you need to take steps to handle the situation compassionately and professionally.
What is a mental health crisis?
Much like a chronic physical ailment, such as an injured knee, a mental health crisis is usually preceded by subtle signs. According to the National Alliance on Mental Illness (NAMI) a person suffering from a mental health condition will begin to experience one or more symptoms in the following five categories: mood disturbances, social withdrawal, irregular expression of feelings, thought disturbances, and changes in behavior.
These symptoms can be subtle at first, but will likely increase in frequency and intensity. Although everyone occasionally feels a little worn out, consistent withdrawal from pleasurable activities, significant changes in personality, and the inability to concentrate or speak in a sensical manner are all warning signs HR professionals can look out for. If an employee starts to display these symptoms over a period of several weeks, they may be headed for a crisis.
Unfortunately, once it has manifested, a mental health crisis can be disruptive to the workplace. However, it’s important to remain calm and compassionate in these situations. If a coworker suddenly threw out his back or sprained his ankle, your first impulse would be to immediately seek medical attention. This is the same impulse you should have when you encounter a coworker suffering from a mental health crisis.
Why do mental health crises happen in the workplace?
Much like their personality, every person’s mental wellbeing is unique. An easy way to conceive of this is to think of your taste in movies. You may love romantic comedies and a few scary films, while another person loves art house cinema and absolutely loathes romantic comedies. Both of you love these movies for your own personal reasons, but neither of you is “wrong”: you just have slightly different tastes.
Likewise, the circumstances that can trigger a mental health crisis in one person are going to be slightly different than the triggers for another person. One coworker may thrive under deadline pressure; another may find that pressure overwhelming and counterproductive. However, there are a few work-related situations which tend to cause mental health problems regardless of the coworker’s personality.
Most of these situations stem from a feeling of isolation or neglect. According to NAMI, worries about a task or project, a feeling of being misunderstood by coworkers or supervisors, the effects of perceived or real discrimination, or feeling bullied or lonely at work are strong predictors of a mental health crisis.
While everyone tends to be concerned about projects or tasks at work from time to time, excessive worry or obsession about a particular project can cause someone with a mental health condition to experience a crisis. Similarly, if an employee is being tasked with too much work on a regular basis they often will start displaying signs of stress, which can easily lead to a mental health crisis.
However, a mental health crisis may also occur because of factors originating outside of the workplace. Dramatic changes in a personal relationship, a significant loss or bereavement, or exposure to violence or trauma can prompt a mental health crisis, even if the work environment itself doesn’t have any significant stressors. This is why preventing a mental health crisis in the workplace requires nuance and forethought from HR professionals.
Preventing a mental health crisis in the workplace
With all of this in mind, what is the best way to prevent a crisis? Quite simply, it comes down to understanding how to manage mental illness at work, which in turn relies on the substance of your relationships with your coworkers.
While employees are legally protected from having to reveal their mental illness to you, it never hurts to learn how to talk about mental health without overstepping your bounds. Openly acknowledging that employees may need mental health care, especially during universally difficult times, may seem like a simple step. However, normalizing discussions about mental health will encourage employees to seek you out and discuss any problems they may be having that could affect their performance.
Essentially, by erasing shame around the issue and instead introducing open communication into the company culture, employees will feel better about requesting accommodations in order to reduce work-related stressors.
They may choose to disclose a pre-existing mental illness with you and ask for alternate schedules or a modified physical working environment (both of which are allowed under the law). They may choose to discuss an incident in their life, such as exposure to a traumatic incident, that is currently affecting their performance. They may indicate that they are feeling isolated or discriminated against by a coworker or supervisor.
Whatever they choose to discuss, your role as a people leader is to facilitate connecting employees with the specific help they need. You are neither their physician nor their friend. However, by letting them know what legal and mental health care options are available to them, you are their invaluable professional advocate.
Handling a mental health crisis at work effectively
Of course, even the best prevention outreach won’t always forestall all crises. What do you do in the moment when an employee is having a mental health crisis at work?
The first step is to assure the suffering employee that help is on the way. If the person is violent or you don’t feel safe in their presence, you shouldn’t stay in the same physical space: remove yourself and others from their immediate location. Call for emergency help, such as 911, as soon as you can. Indicate the nature of the emergency, and describe the employee’s behavior in detail.
However, if they are not an immediate danger to you or others, start speaking to them with compassion. Don’t chastise or alienate the employee by arguing with them or telling them to “snap out of it.” Instead, express sympathy and understanding. Ask them non-judgemental questions: how long have they been feeling this way? Have they had any thoughts about suicide? Take the time to genuinely listen to their responses.
If the employee indicates that they have been contemplating suicide, this qualifies as a medical emergency: you need to call for professional help immediately. However, if they are not suicidal, calling a therapist who they have been working with (or a psychiatrist recommended from your health provider) is the next step.
The mental health professional will be able to recommend specific actions based on the person’s behavior. In some cases, they may recommend that the employee immediately go to the hospital for treatment. In other situations, they may schedule a future appointment. In all cases, stay close to the employee until a clear course of action emerges.
Being able to support your organization with personalized mental healthcare, like Spring Health, is one of the best ways to navigate a crisis, reduce burnout and stress, and improve employee wellbeing.
Read this blog to discover ways to provide meaningful support to employees during the Ukraine war, written by a Spring Health therapist.