Unless you have been living under a rock, you would know that one of the latest pushes in all management circles — public, private, C-suites, academia — is to figure out how to improve workplaces so that they are supportive of good mental health. But part of that push is recognizing that we are not there yet, and even if we were, life happens outside of the workplace too, and eventually, even the most awesome place to work is going to deal with mental health issues with its employees.

Analysis without resolution

Earlier today, our branch held a half-day management discussion on mental health issues and included a desire for us all as managers to make a personal commitment to what we would “undertake” to improve our support on mental health issues. Some of them range from the obvious (don’t look at your phone while you’re talking to someone) while others are more complex (how to manage performance when there is an undiagnosed but suspected mental health issue on display). As I look at them, I start to feel like I’m doing a simple analysis without resolution. But these are the thoughts that tickle my brain.

One of our conversations was around the type of mental health issue. For example, something that is a one-off is often easier to respond to, as it is clear what the cause is, and even what some of the options are to help. At least insofar as you are helping as a manager with the “incident”/”episode”. By contrast, it is often more difficult when it is either not obvious what the issue is or where it is ongoing. So, a death in the family might prompt obvious responses for sympathy, leave, etc., while prolonged grief presents more challenges for the manager to know how to help, or even in some cases, whether to help at all.

But even the episodic can prove challenging. At one point in my career, one of our young staff was travelling for work here in Canada, and had an allergic reaction to something she ate, ending up in the hospital. To me, everything seemed stable, and she was an adult…the situation sucked, but I didn’t think we had any role to play other than staying in touch with her. For me, it was only marginally different than if she had gotten sick in Ottawa. Yet my director was going out of her way (in my view) to help her mother figure out how to get there to be with her, etc. Even looking into whether or not we could pay for the trip. By instinct, I would have done none of that. For me, it seemed like we were actively intervening in her life, in her business, and I wouldn’t be comfortable doing that. Yet tragedy struck. The young woman had a seizure and died. Suddenly it didn’t seem like our involvement was enough. 

To the extent I can separate out the tragedy from the work side of things, some of it still bothers me in the abstract. Does the age of the person factor into my role as a manager? Should I be more aggressive intervening for a younger employee than an older employee? Would I decide on my role on the basis of whether or not they were married? Surely if it is right to intervene for one employee, it can’t be their age or marital status that determines my role? And while this was a physical health issue, would it make a difference if it was a mental health one?

Way back when I was starting in government, I had a co-worker who was about the same age. She was bright, articulate, good interpersonal skills, a work friend and a good colleague. Her dwelling was struck by lightning while she was having a shower, and she was jolted. In short, it messed her up. What seemed at first like it was a simple physical recovery problem became evident that it was more than that, a combination of concussion-like symptoms mixed with paranoia. I noticed she seemed more pessimistic than normal, but that’s all I noticed. But her supervisor noticed the paranoia and called her parents who took her back home to help her heal. Would I have intervened enough to call her parents? Was it because she was single that our role as coworkers and friends changed? If she had been married, would our role have been simply to ask the spouse, perhaps, if they had noticed something?

I find myself often thinking about this role as manager in helping staff who are off on extended sick leave. In the Government of Canada, our benefits and rules basically give you up to 2 years of medical leave if needed, without pay. At the end of two years, you have to “resolve your leave situation”. This means one of four things:

1. Return to work, with a doctor signing off you’re not only okay to come back but with any accommodation issues that need to be addressed;
2. Retire, if you have enough years in to do so;
3. Medical retirement, which usually requires you to have a different amount of years of service plus a medical evaluation that says you are still unable to work currently with an indeterminate time remaining for recovery, if at all (i.e., in other words, you aren’t well enough to work and they have no timeline to suggest when you might be);
4. Quit/resign.

Now take, for example, an employee who is off for leave because of a head injury or mental health concerns. They can’t work because they can’t concentrate, maybe their judgement is impaired, they are dealing with health issues plus the extra emotional and psychological burden of doing so, and one of their key “grounding” networks and routines i.e. work and the workplace is no longer part of their life. Yet as a manager, at the first instance of being on sick leave, and again at 12m, 18m, and 23m, I have to write to the employee and say, “Hey, by the way, while you’re dealing with all of that, here are 20 pages of dense documents to read and then decide what you’re doing with your life”. 

On multiple occasions, I have had employees that I was managing come to me and say, “What should I do?”. Except my role is both to manage them and represent the organization. If I lead them through the decision points, and they aren’t able to return to work, aren’t old enough/haven’t served enough to take regular retirement, and don’t qualify for medical retirement, then their last choice is to quit, yet I could be accused of trying to get rid of them by helping them figure that out.

This is why labour relations will quickly tell you not to do that, and instead point them to their union, the Employee Assistance Program, their family, etc., instead of helping directly. I can explain the options, tell them what they CAN do, but avoid any semblance where I am telling them what TO do. And yet, I am their manager. Part of that job is helping them understand their options, making informed decisions, whether that be training, applying for or accepting new jobs, etc. Yet in this situation, there’s an inherent conflict of interest in roles. Equally, referring them to the union or EAP isn’t exactly a slam dunk that they will get the help they need.

If that sounds too abstract, let me give you an example, which I will combine aspects from different experiences into a single case. Suppose you have an employee who is on extended sick leave. They come to you at one point, they have all their medical forms with them, and they’re trying to figure out which work forms plus which medical forms need to be submitted. Equally, you also know, because they told you, that a friend is going to take them on a vacation to get away from the stress at home, and they’re going to go down south for a week. And they want to know if that’s a problem for their leave benefits. So they’re asking you (a) which medical forms need to go with which work forms and so they’re sharing medical forms that you don’t need to see and probably shouldn’t and (b) asking if they should tell the insurance company they’re going down south or will that create an impression they’re not really sick. As a manager, you now have more information than you need to or should have; an employee is asking you to help them file for their sick benefits, which if you get wrong, will no doubt come back and bite you because the “manager told them to file it that way”; and, they’re asking you for ethical guidance on how to manage information with their insurance company, which would also bite you whether you tell them to tell or not tell the insurance company. 

At times, it can feel like the movie War Games. The only way to win the game is not to play.

On top of that, I as a manager, have never had any training to help deal with someone in that situation. Sure, I reached out to Labour Relations for assistance and they walked me through what I needed to do, but there is a large gap between the formal guidance in the abstract and the specific management on the ground when the employee that you manage is sitting in front of you. 

One thing that I do believe in quite strongly as a manager is my “duty” to you if you’re my employee. It starts when I’m interviewing or recruiting you, long before you’re hired, and it even continues past when you stop working for me. Our journey together starts before you report to me and it continues after you stop reporting to me. It starts with seeing if working for me is even the right fit for both of us, and it continues with helping you with career decisions after you leave, if desired.

Yet I struggle with knowing where the line is between my role as manager to you as an employee, and my role as manager to you as simply a human who needs help. Where the line between work relationship and almost personal relationship is blurred by issues of your personal health. At the very least, the premise of “First do no harm” has to guide all actions, but that is not enough. But I’m not sure it’s simply an empowerment model either.

My commitment

After I go through all those little prickly threads, while still not knowing where my full duty or boundaries lie, it doesn’t change the fact that I still have to “act”. Oddly enough, I don’t find that decision particularly hard, as we frequently have to implement decision models with imperfect information. Canada Life has supported a simple guide for acting as manager, and I really liked a few aspects of it, partly as they articulated some of my thoughts far better than I had imagined. Their page is here: https://www.workplacestrategiesformentalhealth.com/managing-workplace-issues/supportive-performance-management

The first element to me as a manager is to LISTEN. To be open to hearing what they have to say. The link above has this captured as COMMUNICATE WITHOUT JUDGEMENT, which is a nice way of viewing it. But I feel there is a small piece missing. In order for that communication or discussion to happen, the employee has to be willing to open up and share their situation. Often, the focus in these management discussions is on the importance of de-stigmatizing the issue of mental health. “Let’s Talk”, “Break the Silence”, “Don’t Judge”, “Welcome Diversity”. All of which are great. But I find myself looking at the hesitancy and I am not convinced the stigma is the main reason that some remain silent. 

I think most employees know enough about their diagnosis and their problems to find a way to explain it in a way they will be comfortable doing so. They know they have a problem. They may not know the words for it, or how to describe it exactly, but they know they are having a problem and they know their own symptoms. And if they are in the mindset that they should “be a man!” or just “suck it up, buttercup”, that’s them feeling like their problems should be manageable and they’re feeling weak if they ask for help. Stigma, sure. But to have a conversation, they have to overcome two other barriers.

If they can overcome their sense of stigma, the second element is that they have to be willing to have a difficult conversation. Yet nobody likes them, there’s a reason why people put them off in their personal or professional lives. It’s uncomfortable. There are courses on “how to have a difficult conversation.” There are marriage counsellors whose practice consists extensively in helping people do that. So they need to be able to not just break the silence but also break the ice. Doing that with someone “above” you at work, who has power over you, or at least with a power imbalance between you, is even more difficult. Some of that is just uncertainty…they don’t know what to expect. Even calling a support network like the EAP program is beyond some people. Because they don’t know what to expect, they won’t call. 

A friend of mine was in that situation. She didn’t really know what they did, how it worked, etc., even though she had heard of it lots of times. She felt she wasn’t in crisis so it likely wasn’t appropriate, etc. Once I explained my experience calling them, and how it had worked, she was like, “Oh, that’s easy enough.” And she called. Would she have called otherwise? I don’t know. But there are not only tons of employees who don’t know, but there are also a large number of MANAGERS who don’t know either, and yet as a manager, they’re encouraged to refer people there for help. How can you effectively refer people if you don’t know what they’ll do to help?

Third, even if you accept that you can get past the stigma and are willing to have a difficult conversation, you still have to overcome the issue that you are about to have a conversation with someone at work about something that is extremely personal. There is nothing I can think of more personal than what is happening inside your body. Yet here you are about to discuss it all with your boss. 

Let’s ignore mental health for a moment. Instead, let’s make it a bit simpler. Let’s say it is simply a genetic health issue, maybe a heart murmur. You have had it all your life, but it’s been “murmuring” more than usual of late, and your doctor recommends surgery. Yet you work a high-paced job and you have to go tell your boss that you have a heart condition that requires surgery. No stigma, it’s genetic not a lifestyle, not serious, not terminal, but suddenly you have to tell your boss that you have this genetic thing. 

Now, I know what you’re thinking. Just tell your boss the minimum they need to know, don’t overshare, all good. Except here’s the thing. If you don’t share details with the boss, they don’t know how to help you, or if they even need to do so. And their response is likely to be different if you tell them you’re having wisdom teeth out, treating hemorrhoids, or having heart surgery.

Yet let’s now make it that you’re dealing with grief over the loss of your parent. Most people would respond with sympathy and support, because of your obvious loss. But you’re really emotional, and you overshare that it’s more complicated than that because he sexually abused you as a kid. Holy Hannah, yes, that’s going to mess you up. And your boss probably doesn’t need to know that, but they do now, and they realize it’s not just bereavement grief. It may not even be grief at all. And their “role” in supporting you shifts from normal platitudes about a loss to realizing they have no clue how to help you. But they DO know you’re going through some stuff, and it’s not light crap either. So they are going to be more supportive when you come to them on a day’s notice and say you can’t cover some event you were supposed to cover. If your boss doesn’t know what’s going on, it’s harder for them to know how to react. They have no barometer to know how serious the storm is for you, and if you aren’t comfortable telling them, it’s hard for them to manage. 

Let me move away from that emotionally charged world. When my son was born, my wife’s water partially broke at 26w. All our plans for a so-called normal birth went out the window, and we were in the world of “hang on, delay delivery until as long as possible”, which turned out to be 36w, 5d because my wife is a rockstar and kept him safe with bed rest. One difficult birth later, NICU for two weeks, lots of issues around feeding, etc. Short version? I didn’t work more than 3d straight for almost six months. Emergencies, appointments, something pulled me out of the office. I felt like the most unreliable employee ever, and I derive a lot of self-identity from being good at my job. But I told my boss what was going on and why. And he got it. It was understandable, easy to see, and thus easy to be as supportive as possible. If I hadn’t told him what was going on, he would have just seen me being completely unreliable for six months. Missing a lot of work on short notice. Leaving in the middle of the day for appointments. Having mood swings and being less tolerant of normal levels of BS in the office. Hard for him to be supportive if he doesn’t know what is going on. Hard for him to manage around too.

And every time I have shared my reasons with my bosses, and what is going on, how I’m trying to cope and still get work done, they have been awesome. They understand and can figure out how to help, or at least show they understand. Work still has to get done, but they get it. 

So for me, the first commitment is to LISTEN, ENCOURAGE DIFFICULT CONVERSATIONS, and be WILLING TO SHARE MY OWN EXPERIENCES. So they know that I’m not some automaton.

Another key component that I sometimes struggle with articulating when dealing with employees, even if just about performance, is the difference between listening and validating. While I want to listen, I don’t want to necessarily reinforce their thinking about something if it doesn’t seem reasonable. I may not have a role in their interpretation in their personal life, but I do have a role when it comes to working.

I have listened to people vent, and I sometimes liken it to the difference between symptoms and diagnosis. For example, I have seen people witness a rather innocuous behaviour from their boss, misinterpret it, wrap it in some grand conspiracy theory with all the bells and whistles, and suddenly the boss must think they are the worst employee ever, not capable of anything. And what was the transgression? The director said good morning to someone else and not them as they passed by. I’m exaggerating, but only slightly.

Often the “evidence” is warped to confirm a bias they already think is true, and yet while I listen, I often will say I agree with certain “evidentiary facts”, but not the interpretation of them, nor the conclusion as to motivation.  I can validate that they are feeling a certain way, but I try not to validate their reasoning if I think it is “off”. The link above has this captured perfectly — “separate acknowledging from agreeing“. Exactly.

But for me, even after LISTENING and ACKNOWLEDGING, that just makes me good at interpersonal relations. I still have to do the next step which is MANAGE.

What do I have at my disposal to manage?

• Relationships;
• Workloads;
• Performance;
• Work environment;
• Work arrangements;
• Leave;
• People; and,
• Money.

The go-to solution for most managers is often to offer/approve leave. To my mind, that’s a valuable tool, but it is not the only one in the toolbox. I also manage my relationship with the employee and those around them. Maybe it is as simple as checking in with them regularly to see how they’re doing; maybe it is just asking them how they would like me to check in with them (i.e., for employees on leave, the guidance from Labour Relations is to set up a protocol with the absent employee about how often and in what form they want to communicate with their boss to manage the leave situation).

I can also manage workloads, although sometimes it is the type of work more so than the level of work (some might want slower pace research projects, others might more task-oriented process items). Performance still has to be done, of course, but like with workloads, that could be about focusing on certain manageable precise outcomes that they feel they can address (perhaps quantitative over qualitative goals). For the work environment, it is often easier to try things like lower lights or quiet spaces, while work arrangements often look like flexible hours or working remotely.

In addition, I manage people and that includes, as I said above, before they start working for me until after they stop working for me, and how I manage them affects their mental health as much as other factors. Integrity, personal respect, communication styles, visioning, all are obvious elements. And finally, I can spend money on training, indirectly on the EAP services, or even a coach if it would help.

Lots of other things I can do besides simply approving leave.

For me, it isn’t really a unique challenge that requires unique tools. The tools are the same, and the job is the same, even if the combination of tools is different.

To me, I’m hired to manage, not to ignore things or just do what is easy. If one of my employees has a physical issue or a mental health issue or a technical issue, my job is still the same…to manage, to figure out how I can help, and to decide what is the proper role for me to do that.