How do we meet our responsibility for people in a mental health crisis without taking away their choice or control?
Many businesses are understandably concerned about managing mental health crises. Lines of responsibility become blurred, and your decisions as an HR professional can feel shaky at best.
No carefully planned crisis procedure can adequately cover all eventualities – every situation is different. And the ramifications if you get it wrong can be far-reaching. I regularly hear from colleagues who’ve been faced with something unfamiliar even to specialist HR teams who manage complex mental health cases on a daily basis. Increasing openness within organisations around emotional wellbeing can raise employee awareness of panic attacks or self-harming behaviour – challenging their assumptions that these happen rarely, so the overall situation is likely to appear to worse before it gets better.
So how exactly do you ready your business for supporting staff in mental health crisis? There are four main considerations, which should be integrated with HR policies and procedures as part of your organisation’s wider wellbeing approach. This will give your line managers more confidence in supporting mental health in the workplace, and knowing when to seek help from HR. It’s important for employers to have such a framework – both to support managers and employees when an issue emerges, and because a focus on good mental health can prevent many problems from escalating.
The first consideration is having a plan. The second is making sure that everyone knows when something is too big for them to handle without expert help. The third is protecting those dealing with a situation in the moment. And the fourth is keeping the person in crisis at the centre of any action taken, so their wishes are taken into account even when they might not be in control of themselves. Balancing these four concerns can be tricky, but there are some useful tools to help you do this.
Four ways to help your organisation deal with a mental health crisis
1. The importance of having a plan
Most mental health treatment services ask people to complete what’s called a ‘wellness recovery action plan’ (WRAP) in partnership with their care provider. This details roles and responsibilities – including those of the person themselves. The mental health charity Mind has downloadable wellness action plans for both employees and line managers. It may be useful to point people to these as a resource and example of what good practice looks like – to boost managers’ awareness of signs that things are going awry, and to encourage employees to flag up how they might act when they’re feeling distressed.
Someone well-versed in their own condition may be able to articulate exactly what should happen if they’re in a mental health crisis. They may know everything from where they’d like to be assisted (perhaps a quiet, dimly lit room or outside in the fresh air), what they might want to hand (maybe some water or something sweet to keep up their blood sugar) and who to call. Others may not know what they want until it happens, so have some general ideas, like the ones above, in your back pocket.
A wellness plan can also be used by all as an inclusive tool to support people, learn about particular stress triggers, and create an environment where activities such as taking a team’s wellbeing ‘temperature check’ becomes the norm.
Approaching the subject is best left for when someone is feeling stable and in good health. Along with a wellness plan, using a document like a workplace adjustment passport can also help employees and managers create an informal agreement about how their condition can best be supported at work. Passports are living documents that help structure a conversation around someone’s ongoing workplace adjustments. And they help give the reins to the employee while reassuring their manager they’ve addressed their duty of care.
2. Drawing the line in a mental health crisis
Knowing when to act relies on a certain amount of judgement and experience that isn’t easy to impart through training. High emotions can be fairly common at work, especially during times of stress or change, but if you know your staff, you’ll know when something isn’t quite right. Likewise, if emotions are spilling out too frequently, it can indicate a crisis might be likely.
It can be a natural reaction to hold back and allow someone to calm down if they’re distressed, but there are occasions when you need to step in. Sadly over 6,000 people take their own lives in the UK every year, but a simple conversation with a non-judgemental listener can sometimes be enough to prevent someone doing so.
However, if you assess there’s a risk of harm to them or someone else, if someone appears to be getting more distressed, or if you see signs of them losing touch with reality, call the emergency services. Above all, make managers aware that they’re not expected to ‘fix’ a mental health breakdown, any more than they’d be expected to fix a broken limb.
3. Protecting those doing the helping
Joining the ranks of traditional first aiders, qualified ‘mental health first aiders’ can confidently take the lead when it counts, providing a reassuring presence until help arrives. First aid courses for mental health generally cover common mental illnesses, verbal techniques to assess risks and steps to get the right support afterwards. If your organisation has first aiders – or has plans to train some – it’s good practice to make sure all employees know who they are and where to find details of any follow-up support you have available, whether it be employee assistance helplines or employee relations.
It’s also vital to emphasise the self-care aspect of the mental health first aid role at every opportunity. If your first aiders are not in a good place with their own health, helping others might come at a cost. And first aiders should never risk their own safety by approaching someone behaving aggressively, for instance.
4. Keeping the person in crisis at the centre of the action
Encouraging people to take responsibility for their own mental health is empowering and part of any good wellbeing strategy. Fostering a sense of accomplishment throughout recovery – with work as a key factor – aids the ongoing management of a condition. Gaining and maintaining control of one’s own care is essential for wellbeing: before, during, and after a crisis. Should someone not be well enough to decide for themselves, at least knowing in advance what course of action will be taken and having confidence that those around them know what to do significantly reduces anxiety, which can itself be preventative.
Helping your workforce be confident in a crisis
As for most things in business, a well-formulated plan is the key to a good outcome and could even mean the difference between life or death. The right training and empowerment will equip your workforce with the skills they need to be confident in a mental health crisis.