Practical advice on how to help
Being aware of mental illness and the effects it may have on people in the workplace is important for a number of reasons – to the person affected, to colleagues, to managers and employers, and to productivity as well.
Untreated mental illness costs the Australian economy hundreds of millions of dollars every year. Familiarity with the effects of mental illness, how it is treated, and simple modiﬁcations which can be made in the workplace to provide support, are actually good for productivity.
When the workplace maintains someone in a job through a period of being unwell it is far less costly than losing them and having to recruit and train someone new.
Improved workplace environment
When employees feel respected and cared for, they generally feel better about themselves and the work they do. This leads to better morale, and a happier, more productive workplace.
We are all potentially affected
One in ﬁve of us will be affected by a form of mental illness at some time in our lives. An understanding of mental illness and its impact on the workplace is helpful, therefore, whether it is a work colleague, friend, family member or even yourself who is affected.
Duty of care
Discrimination against someone in the workplace, or having a workplace which is unhealthy or unsafe, can have legal implications. It is important, then, to understand everyone’s legal rights and responsibilities regarding mental illness in the workplace.
How to help a colleague affected by mental illness
Mental illness is greatly misunderstood, and those affected are often stigmatised and treated disrespectfully because of this.
No one expects you to be a psychiatric expert, but understanding the basic facts, such as symptoms and effects on everyday functioning, can dispel myths and help you be more aware of how it feels for your colleague when they are unwell.
Mental illness can have a serious affect on a person’s life. This affect varies from person to person. Some have very occasional episodes of being unwell and recover in a relatively short period of time, as they would from a bout of flu or a minor injury. Others experience longer-term psychiatric disability requiring workplace modiﬁcations.
It makes a big difference to those affected when someone makes the effort to understand and offer support. People with mental illness can sometimes feel left out or not listened to. It is important to remember to include them in discussions, meetings and social events.
When someone with a mental illness is receiving appropriate treatment and support, they may not need additional help at work. When they become unwell, though, it can be confusing to know where to turn for help.
Avoid giving advice on dealing with mental illness (unless qualiﬁed to do so). Instead, focus on getting professional help, see ‘Services’ in this guide.
Ask the person if they have discussed with their manager or anyone else at work what appropriate action should be taken, and if they have a contact number for their doctor or mental health service.
How to react to a colleague with mental illness
Here are some examples of helpful and unhelpful ways of reacting to a colleague affected by mental illness.
Tanya is 42-years-old and is employed as a bank teller at the branch where you work. While chatting to you in the lunchroom, she mentions that she has a diagnosis of Bipolar disorder.
Change the subject and avoid talking to her again.
Let her continue to talk about her illness if she is comfortable doing so, and be supportive and encouraging. Ask if she would prefer you not to mention her diagnosis to others. Talk to her again at lunchtime, especially if she is sitting alone and would like company.
Jim is 38-years-old and works in the same team as you at an insurance company. He has just returned to work after a month away recovering from an episode of Depression, which he has openly discussed.
Avoid engaging with him, and make jokes about him being lazy.
Ask how he is going in a relaxed way, and offer to ﬁll him in on what has been happening in your area while he has been away.
Kate is 34-years-old and has just started at the building supplies company where you work. You will be travelling interstate together for training in a week, and your manager tells you (with Kate’s consent) that Kate has Schizophrenia.
Tell Kate you are aware of her diagnosis and badger her with insensitive questions. Talk behind her back about her illness on the trip.
Behave naturally with Kate and get to know her. If she mentions her illness, ask her to let you know if there is anything you can do to help on the trip.
Managers and employers have an important role in supporting workers with a mental illness.
Discussing mental illness
If an employee has disclosed that they have a mental illness, it is important to be willing to talk about their condition with them and to express support. This support from management can make a great difference to someone’s conﬁdence and ability to work well.
At the same time, it is important to be frank about any productivity issues involved and how you can work together to address these – emphasise strengths and then look at areas where support is needed.
Discuss, too, their right to conﬁdentiality and an agreement on when it would be appropriate to contact a doctor or family member if they become unwell at work.
If they are willing for their condition to be generally known, discuss whether it would be helpful to give fellow-workers access to this information – see also ‘Getting back to work’.
If an employee has not disclosed they have a mental illness but you are concerned they may be affected, do not hesitate to express these concerns as you would with any other health issue.
Ask a senior manager or human resources manager who might be the best person to speak with the employee, and how it can be done in a conﬁdential, respectful and appropriate way.
Making a plan
Once an employee has been diagnosed with a mental illness, it can be useful to discuss any workplace modiﬁcations that are helpful to the person and to maintaining their productivity.
For some people, working 9-5, Monday to Friday, is not the most practical option. A provision for working part-time, using time-in-lieu and working from home at times, can be more productive for people affected by mental illness.
Provision for medical appointments, extended leave and leave-without-pay may also be necessary, as with any other illness.
The work environment itself can make a difference to how well someone feels and how well they are able to work. Discuss with the employee whether issues such as noise and degree of interaction with the public or other employees affect them, and what modiﬁcations are reasonable to manage these.
Ask about other simple steps too, such as whether writing all instructions down would be helpful (where these would usually be given verbally), if illness has affected short-term memory, for example. Allowing a longer period for training and induction is also an easy and cost-effective step that can make a big difference.
Talk to the employee about how you can both be prepared should they become unwell at work. For example, they may become depressed and unable to focus on tasks, start to feel anxious or even paranoid. If this happens, it would be a great help for you to have agreed on what should be done, such as calling their doctor to make an appointment.
Investigate what other workplace support may be available. Larger organisations may have an EAP (Employee Assistance Program) available. A local employment service may have a specialist consultant able to provide on-site or off-site support.
Understanding the law
You should also be aware of relevant legal rights and responsibilities – for example, the Disability Discrimination Act, which makes it unlawful to treat an employee less favourably because of a disability, and occupational health and safety legislation.
How can I apply these tips to everyday situations?
The following scenario describes how these tips can be used to work effectively with someone affected by mental illness. Read this, and then think about how you would deal with the next scenerio yourself.
You are the manager of a supermarket. Jake has worked on the checkout for three years, and has told you that he had a period of depression before that.
He is well-liked and efﬁcient, but has not turned up for work on several occasions recently. He has also started looking untidy and has stopped engaging with customers. What do you do?
Make a time with Jake to discuss work performance and mention your concerns about absenteeism, appearance and lack of concentration.
Ask if there is any reason for this. If not, remind him of what he has told you about his Depression. Ask if he thinks this may be an issue again, and if it is worth discussing how he currently feels with his doctor.
If Depression is the cause of the change in Jake’s behaviour, ask whether he would beneﬁt from some time off, and discuss his entitlements to sick and holiday leave, as well as any work modiﬁcations that would help.
Adjust other employees’ shifts so that there is no resentment of Jake ‘creating work’ for them.
Discuss with Jake whether more flexible rostering would help, working fewer hours until he feels well enough to work full-time again.
Check whether Jake wants other employees to know he has Depression and respect his wishes.
Talk frankly to Jake about the need to dress tidily and engage with customers.
If talking to customers is difﬁcult, discuss moving him temporarily to another, less stressful area of the workplace.
You own a small plumbing business and Colin has worked with you for about a year. You are happy with his work performance.
One morning he takes you aside and conﬁdes that his wife has Schizophrenia. She takes medication and is generally well, but has recently started having strange ideas and becoming paranoid. He is concerned she is becoming unwell, and will need to take time off work. What do you do
Understand, Support, Act
Afﬁrm that you recognise this is a serious health issue and you will treat it conﬁdentially.
Encourage Colin to take time off immediately to deal with the issue; remind him there may be a local family support group he can contact.
Offer the use of your ofﬁce if he needs to make any private phone calls regarding his wife’s health.
When appropriate, have a frank discussion with Colin about how much time he will need off work until his wife is well again, and what can be done to re-assign jobs to other employees.
Check how Colin would like his changed work hours explained to other employees.
In a crisis
If someone experiences a mental health crisis at work and becomes highly distressed, it can be difficult to know what to do. See How to help in a crisis for guidance on what you can do.
Mental health and other services
Mental illness is treated by health professionals, as with any other health issue. This treatment does not just mean the help someone gets from a psychiatrist or other doctor. It can involve a whole range of other mental health and welfare professionals, based in the community as well as at hospital.
General Practitioners (GPs)
A GP’s surgery is the best place to go when someone ﬁrst starts to feel unwell. This is the case for mental illness as well as physical ailments. GPs can refer someone to a psychiatrist or Community Mental Health Service if necessary, as well as provide ongoing treatment in some cases.
Psychiatrists are medically-qualified doctors who specialise in the study and treatment of mental illness.
Psychiatrists have specialist expertise in diagnosing mental illness, prescribing medication, providing psychological treatment and referral to other services.
Most people affected by mental illness have contact with a psychiatrist at some time, either through the public health service (at a Community Mental Health Service or hospital) or through referral to a private psychiatrist (where visits can be claimed under Medicare).
Clinical psychologists specialise in the psychological treatment of mental health problems.
They can provide ‘talking treatments’ such as psychotherapy and Cognitive Behaviour Therapy (CBT) that many ﬁnd effective for anxiety and depression-related disorders especially.
Psychologists cannot prescribe medication, and visits are not generally covered by Medicare.
To contact a suitable psychologist, ask a GP, or contact the Australian Psychological Society’s referral service (1800 333 497).
Community Mental Health Services (CMHS)
Mental health services are now mostly provided in the community. When someone has been diagnosed with a mental illness, they should be able to receive a range of clinical services in their local area, while continuing to live at home.
Once assessed as requiring treatment, they are usually allocated a case manager. This person is responsible for coordinating and implementing a treatment plan. You can find out where the local CMHS is by asking a local GP or hospital.
Crisis Teams – sometimes called Crisis Assessment and Treatment (CAT) Teams or Psychiatric Emergency Teams (PET) – are groups of mental health professionals who provide assessment and treatment for people seriously affected by mental illness.
They are based at the CMHS, and can assess people in their own home and arrange treatment, including hospitalisation where necessary.
It was once common for an episode of mental illness to lead to many months in a psychiatric hospital. It is now more usual to admit someone to hospital only if they are acutely ill and require intensive care for a while. This is generally provided in psychiatric wards within general hospitals.
What support services are available?
Mental illness can sometimes lead to psychiatric disability, affecting the way people are able to cope in their everyday lives.
Community-based support services aim to help people regain living, working and social skills so that they can get on with life again. Referral to one of these services is usually made by the person’s case manager at the CMHS clinic.
The SANE Help Centre at 1800 18 SANE (7263) can put people in touch with the following support services in their local area.
It can sometimes be difficult for people with a mental illness to have a safe and stable place to live. Any extra support in arranging and maintaining appropriate accommodation is especially important then.
A community support service can help to arrange supported accommodation or residential rehabilitation services for people who need help with everyday living skills like budgeting, cooking and cleaning.
They may also put people with a mental illness in touch with other housing services or the local council which may be able to arrange subsidised housing, or rooming houses for those who are able to live more independently.
Drop-in programs offer a welcoming, non-threatening place for people with a mental illness to spend time and meet people when they do not feel ready for more structured rehabilitation.
Attendance at a structured day program means people can access rehabilitation to regain living, working and social skills that have been affected by mental illness. This might include computer skills, arts & craft, gardening, budgeting, cooking, as well as appropriate social interaction.
The person usually has a key worker or support person allocated to them at the program. This key worker helps the person decide what their goals are, and different ways to achieve them. Goals can be anything from learning data entry or how to cook, to feeling more confident around other people.
Personal support programs
Available to eligible people, programs such as PHaMs (Personal Helpers and Mentors) and PSP (Perosnal Support Program) provides individual support to help people overcome social and economic barriers that affect readiness to return to work.
Family and carer support
Family and other carers of people affected by mental illness need support too. The symptoms of mental illness are confusing and distressing for everyone involved, especially at ﬁrst. It is important, therefore, that family and friends are put in touch with a carer support organisation.
What legal and advocacy services are available?
People affected by mental illness and their families often have difficulty getting access to the treatment and support services they need. They may experience discrimination, or otherwise be treated unfairly. In these circumstances it is important to know where to complain, and how to get the most useful and appropriate individual legal or advocacy support.
Health Complaints Commissioner
Each State and Territory has a commissioner who deals with concerns regarding the health system. These concerns may be about about unsatisfactory care, privacy, lack of respect or dignity, and negligent or unprofessional behaviour, for example.
Mental Health Legal Service
Some States and Territories have services that help people with mental illness regarding legal concerns.
Some concerns they may help with include health service complaints, issues regarding Mental Health Review Boards or Tribunals, criminal law, child welfare and family law, discrimination, guardianship administration, and Freedom of Information legislation.
Human Rights Commission
The Disability Discrimination Act makes it illegal to treat someone unfairly because of their disability in a range of areas such as employment, accommodation and provision of goods and services. If someone with a mental illness considers they have been treated in an unfair way, they can call the Complaints Line on 1300 656 419.
SANE’s StigmaWatch program monitors and acts on inaccurate or offensive references in the media to people with a mental illness, see Changing Attitudes, which explains the criteria and how to submit a report.
What employment support services are available?
People affected by mental illness and their families sometimes need support staying in a job, in addition to the assistance the workplace can provide. The following services may be helpful in these circumstances.
Centrelink can provide income support at a time when it is difﬁcult for someone affected by mental illness to work. For example, if someone becomes unwell and is unable to work, they may be eligible for Sickness Allowance, and a family member may be eligible for carer payments.
The Centrelink Disability, Sickness and Carers Line on 13 27 28 can provide information about entitlements.
A ‘Jobs in Jeopardy’ program can help employees at risk of losing a job due to illness or disability. Call 1800 624 824 for more information.
Disability employment services (DES) help people to prepare for, ﬁnd and maintain employment. Referral to these programs is via Centrelink.
Some jobactive agencies may also have expertise in ﬁnding work for people with a disability.
SANE Help Centre
Information, guidance, andreferral on mental illness and related issues.
1800 18 SANE (7263)
Provides 24-hour counselling service.
13 11 14
Human Rights Commission
Discrimination complaints line.
1300 656 419
Australian Psychological Society
For referral service to psychologists.
1800 333 497
For fire, police and ambulance.
Disability Services and Carers line.
13 27 28