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13. Recognising when help is needed
People do not have to be 100% well to be at work. However, in some circumstances you may notice that an employee is not well enough to be at work and that they require professional help.65,300 was the number of reported suicide attempts in Australia in 2007 1.
Why it matters
One in five people will experience ‘mild to moderate’ mental health conditions, such as anxiety and depression.2 A much smaller percentage will experience episodes of more severe mental health conditions; for example, psychosis or thoughts of suicide.
In the workplace, an employee with a more serious mental health condition might behave in ways that impact on colleagues, for example talking about plans for suicide or being disruptive or aggressive. Part of their ill health may be a lack of insight that their behaviour is impacting on others. As a manager you need to be aware of your responsibilities to all employees.
If an employee is not mentally well enough to be at work, staying at work may be detrimental to their own health and recovery, as well as possibly impacting negatively on fellow employees. If this is the case, your role as a manager is to be proactive in recognising that professional/clinical help is the best option, and to facilitate this before the employee and others are affected further.
How it’s done
If someone has disclosed having a mental health condition, work with them to establish a management plan on how to support them when they are unwell. The plan should include information on signs that indicate the person is becoming unwell, who can be contacted when the employee is unwell (for example a relative, GP or close friend) and other practical arrangements.
Pre-agreed statements are especially relevant for employees who are prone to episodes where they lose touch with reality as they may not be able to rationally take in what you are saying.
LOOKFor warning signs (situations, feelings, behaviours).
ASKReach out and talk to the employee. Find out what they are experiencing.
ACTIONAssess the risk and refer to appropriate support services.
Lifeline—ph. 13 11 14 3
As a manager it is important to look out for warning signs in employees who experience mental health conditions. Know your employees so you are able to recognise early warning signs unique to each individual. Sometimes there will be a need for immediate action so it is important to know who you can contact.
Consult your human resources team for advice and practical strategies. Advise the employee to visit their GP. You might be able to help them make an appointment. Direct the employee to services such as SANE, beyondblue, MensLine and Lifeline or to the local mental health crisis team.If you believe that the worker poses a health and safety concern in the workplace, you have a duty of care to take action to prevent any risk.4
Concerns about suicide or self harm
Most individuals considering suicide or self harm give warning signs or signals of their intentions. The best way you can help prevent suicide is to recognise these warning signs and respond to them.
If you think an employee is considering suicide, it is important to tell him/her that you care and that you want to help. Encourage them to talk—the opportunity to talk about how they feel and why they want to die often provides great relief. Asking or talking about suicide does not cause someone to become suicidal.
If you are really worried, don’t leave them alone. Ask a friend or a relative to come and pick them up. It is important to ensure the employee is safe while still respecting their privacy. However, you should never agree to keep a plan for suicide a secret. It is one of the few areas that even mental health professionals will not agree to keep confidential.
In some situations the employee may refuse help and, while you can’t force them to get help, you need to ensure the appropriate people are aware of the situation, such as your human resources team or the employee’s medical practitioner. Don’t shoulder this responsibility yourself.If help is needed urgently, dial 000 or, if known, contact the treating GP or mental health practitioner(s).
You may wish to try the Psychiatric Team at your nearest hospital or emergency department.
If you urgently need to speak to someone out of hours call Lifeline 13 11 14. These services are available 24 hours a day, 7 days a week.
SANE Australia provides a Helpline service on 1800 18 SANE (7263), Monday to Friday 9:00am-5:00pm EST.
Free information packs can be requested 24 hours. The Helpline provides information and a referral only. Crisis contact details are available from the Helpline. It's free and confidential.
Concerns about agitation or disordered thinking
Some forms of mental illness may present as extreme heightened activity and/or loss of touch with reality, hallucinations and delusions. In these rare instances, try and take the person to a quiet place and speak to them calmly. Implement their individual pre-agreed statement of action. Call a friend or relative who can take them home and notify their GP or mental health professional if appropriate.
What if someone is aggressive?
A very small number of people with mental health conditions may become aggressive. If an employee becomes aggressive, it is important to stay calm, talk in a slow but firm manner and ask the employee to stop their aggressive behaviour. It may help to suggest the employee sit down to help them feel more at ease. If they do not stop, leave the employee in a safe environment where they are not at risk to themselves or others, until they have calmed down. Take any threats or warnings seriously and contact the GP or mental health professional if known.5
Directing employees to attend medical examination
In accordance with regulation 3.2 of the Public Service Regulations 19996, an agency head may direct an employee to undergo a medical examination if they believe that the state of health of the employee:
- may be affecting the employee’s work performance; or
- has caused, or may cause, the employee to have an extended absence from work; or
- may be a danger to the employee; or
- has caused, or may cause, the employee to be a danger to other employees or members of the public; or
- may be affecting the employee’s standard of conduct.
Keep all personal health information private and confidential.The Australian Taxation Office (ATO) has established a Strategic Intervention Unit for managing compensable psychological injuries. This involves early contact with employee, early referral to a psychiatrist to contact the treating doctor for advice about what the ATO needs to do to have the treating doctor certify capacity to commence rehabilitation, and low caseloads so that the Case Manager can work closely on rehabilitation.
Other relevant information sheets:
- 2. Understanding my role as a manager
- 3. Talking about mental health
- 12. Recognising and responding
- 14. Looking after yourself and carers
1 Australian Bureau of Statistics 2012, National Survey of Mental Health and Wellbeing 2007, ABS, Canberra, (unpublished data), cited in National Mental Health Commission 2012, A contributing life: the 2012 National Report Card on Mental Health and Suicide Prevention, Sydney, NMHC, p. 67.
4 Australian Human Rights Commission2010, Workers with Mental Illness: a Practical Guide for Managers, AHRC, Sydney, p. 21