Mental Health Part 2: Managing Mental Health

In part 1 of this series on mental health we examined how we can all go about helping colleagues and acquaintances if we see they are struggling with poor mental health.  In this talk we address the following question: How does one handle the situation if we supervise or manage someone with a mental health issue?

As a manager you always wear two hats: one represents your duty to manage performance, and the other your duty to care for your people.  When you encounter mental health issues in the workplace you still need to perform both duties.

For example, you observe a worker’s performance decline, and you decide to address it.  It is often only at this point that you may become aware that they have a mental health concern.  At this moment you should take off your ‘managing performance’ hat and explicitly put on your ‘duty of care’ hat and conduct a ‘helping conversation’ as we’ve just explored.  You should signpost this shift explicitly.  For example, by saying something like:

 ‘I’m sorry to hear you’ve been struggling, and I want to talk with you about what I can do to support you’

Of course, If the mental health concern is severe, you should cease performance management.

But generally, if the mental health issue is moderate and well-managed, and you’ve conducted the above conversation, at this point you should take off your ‘duty of care hat’ and explicitly put on your ‘managing performance’ hat.  Why?  Because it is well documented that staying at work and improving performance are far better for that person’s mental health than (generally) staying at home and /or not improving performance.

Again, you should signpost this shift explicitly.  For example, by saying something like:

‘I now want to have a conversation in which I can support you to better perform in your role and have more success at work’

Here’s another more tricky issue I want to touch upon in managing mental health in the workplace.  Sometimes someone with a mental health concern may be detrimental to others in the workplace.  They may be angry, or behaving erratically, or letting others down in terms of their work. Now you have real complexity with respect to your duty of care.  You have a duty to this person but also to those around them (including yourself!). 

How do you balance these duties?  How much empathy should you show the person?  What kinds of negative consequences should you put in place?  Well, it depends on two variables: how intentional their poor behaviour is and how much remorse and accountability they feel.

Generally, you should provide more structure and more consequences for intentional harm and low accountability.  So, if they meant it and don’t have remorse, you need to provide negative consequences.

Conversely you ought to provide fewer negative consequences for people who couldn’t control their behaviour at the time and who feel remorseful about it. Likewise, you should demonstrate more empathy for them.  It is perfectly appropriate to lower your empathy for people who intend harm and feel no remorse.  Your empathy is now better directed at those around the damaging person … and this includes you!

One caveat: generally, some structure in the form of consequences is good for people with mental health issues even if they do not intend harm and they do feel remorse.  This is because structure is actually supportive and less ambiguous for them as they work to re-adapt.  It gives them something to measure their progress against.

And finally, some advice for dealing with quite nasty people in the workplace.  A sub-category of psychiatric diagnoses is the personality disorders.  Although generally you will encounter few of these in the workplace, you will encounter them at some time in your career.  And you’ll certainly encounter quite a few who have what we call maladjusted personality traits: these are less severe personalities but who nonetheless cause a high proportion of workplace conflict and distress. 

These are people who demonstrate very marked deviations from social norms. Typical characteristics are vanity, Machiavellian conduct, impulsivity, coldness, arrogance, dominance, immorality, dishonesty and an unusual absence of guilt.

How do you recognise you are dealing with enduring personality traits? You discover there is a pattern of conflict and interpersonal distress around them that extends across time and across a variety of relationships.  In other words, they are the common factor.

 What do you do? Lower your empathy and don’t go it alone.  Work with others to contain their bad behaviour. Never use explicit aggression.  Normally we de-escalate problems using a combination of appeals to reason and emotion.  This won’t work here.  This is probably not about reasonableness for them, and they don’t care about the distress they are causing others.

In contrast, make their behaviour non-rewarding by not demonstrating any emotional upset or weakness.  Work with colleagues and, if at all possible, put in place negative consequence for their poor behaviour.  The best you can do is to contain and control their behaviours as they will not change their personality.  Hopefully, eventually, they will leave for greener pastures!