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We, as humans, don’t like awkward conversations. We avoid them. As a leader, one of the most awkward conversations you might have with an employee is about mental health. It’s also one of the most important conversations you can have.
Leaders who show they care about their employees make the most difference in creating mentally healthy workplaces. In this article, we’ll cover specific strategies for having those conversations.
The ADA, FMLA, & HIPAA
You might be wondering if it’s okay to talk to employees about mental health.
First and foremost, please note that this content is provided for educational purposes only and should not be construed as legal advice. We encourage you to consult with legal experts. We also encourage you to educate yourself on laws that protect employees’ privacy and freedom from discrimination based on mental health conditions.
If you’re in the United States, the Americans with Disabilities Act, also known as the ADA, requires employers to make reasonable accommodations for people with a condition that substantially limits one or more major life activities. Accommodations help the employee be successful in the job. If an employee asks you for accommodations, keep the conversation focused on what’s being requested rather than asking prying questions about the employee’s medical history.
The Family Medical Leave Act, also known as FMLA, allows eligible employees to take unpaid, job-protected leave for a serious health condition. A mental health crisis such as an anxiety attack or major depressive episode may qualify.
Another law you may have heard about is HIPAA, which stands for Health Insurance Portability and Accountability Act. The HIPAA Privacy Rule applies to individually identifiable protected health information, or PHI, that’s obtained from someone’s health care plan or provider.
Understanding HIPAA Privacy Rule
An employee might disclose health-related information to you, and that doesn’t necessarily mean it’s protected under HIPAA. For example, if a team member announces she’s pregnant, it’s not a HIPAA violation to publish a congratulatory message in the company newsletter—although it’s a good idea to get her permission first.
If an employee requests time off to deal with a mental health challenge, the HIPAA Privacy Rule does not keep you from sharing that information with HR as part of the leave request. However, if you learn about someone’s diagnosis through the company benefits plan quarterly report, that information is protected under HIPAA—because it’s not something that you’d find in the employee’s personnel file.
If you need a doctor’s note or other health information for sick leave, workers’ comp, your company’s wellness program, or health insurance benefits, it’s okay to ask the employee for that. However, a health care provider cannot give you that information without the patient’s authorization, unless other laws require them to do so.
In general, the HIPAA Privacy Rule applies to disclosures made by health care providers, not what an employee tells you directly.
Again, I’m not a lawyer, so when in doubt, be sure to consult with legal experts who specialize in employment law.
Understanding Accommodations
Let’s talk a bit more about accommodations. Reasonable accommodations are adjustments to a work setting that make it possible for qualified employees with disabilities to perform the essential functions of their jobs.
If an employee comes to you asking for accommodations, they’re not asking for special treatment. They’re telling you they want to be successful, and because of a disability, they need some modifications to help them do that.
Now, not everyone will use those exact terms. Some people don’t identify as “disabled” but still need to be able to work a little differently than someone without their medical condition. Let’s look at some examples.
Example 1
Janice was in a horrible car accident a few months ago and has been on short-term disability while recovering from her physical injuries. Now that she’s ready to return to work, she’s facing a mental health challenge. She can’t bring herself to get behind the wheel again. Even riding in a car causes extreme anxiety and has triggered panic attacks. She lives in an area without mass transit options and lives too far away from her job to walk.
Allowing Janice to work from home is a reasonable accommodation that will help her be successful.
Example 2
As another example, Tom has a sleep disorder that makes it really hard for him to sleep at night. He struggled in an 8-to-5 job for years, with many notations in his employee file about being late, not being productive, and so on.
Then he found a job that let him work a flexible schedule. He usually starts work in the early afternoon and continues late into the evening. Now, his performance evaluations are stellar. It was all about allowing him to work in the way that works for his disability.
Preparing Before a Mental Health Conversation in the Workplace
When you’re talking about mental health with an employee, planning is vital. Here are five things you need to do when planning to have mental health conversations with employees:
- Write out a plan for the specific discussion.
- Familiarize yourself with applicable laws, like the ADA and FMLA. Your organization may also have relevant policies you should be aware of.
- Write out what you’ll say and rehearse it. I’ll give you a few pointers for what to say later in the chapter.
- Reach out to your Human Resources department. They can educate you on laws and policies and offer advice and feedback on your outline.
- Suggest meeting in a place that’s quiet and private. Privacy is critical.
What to Know During Mental Health Conversations at Work
When you're having the conversation, it's important you come into it aware of your energy and your own body language, as well as doing your best to be perceptive of the other person's energy and body language. Make eye contact and take a moment to see their humanity. You'd be surprised at how people pick that up when you're talking with them.
There is a lot to be learned from researching body language. One great tactic to use is mirroring the body language of the person you’re speaking with. And sitting side by side instead of directly in front of them or behind your desk will make them feel more comfortable and willing to talk.
Most importantly, please turn off your phone and don't look at it. It's really important that you're present, present, present.
During your meeting with the employee, begin by letting them know the conversation is confidential. If you are planning to share the information with anyone else, let them know with whom and how you plan on sharing the information.
Your employee may divulge information that you do need to share with others. If someone discusses harming themselves, someone else, or another type of crime, you are ethically and possibly legally bound to report.
You can tell them that your conversation will remain confidential unless you are ethically or legally bound to report information to the proper people. Your local laws, industry standards, and company policies can guide you in these instances. Your employee will appreciate your direct and honest communication.
Next, ask for permission to discuss the issue. For example, you could say something like, “I’d like to discuss something with you, and if you don’t want to talk about it, please let me know, and we won’t discuss it.” If the employee agrees to a discussion, focus on specific behaviors you have personally witnessed or experienced, rather than relying on second-hand descriptions. You could say, “You don’t seem like yourself today. Is everything okay?”
Be authentic and compassionate, not authoritative. Describe the changes you’ve seen and let them know you care about them. By keeping your statements behavior-based and expressing concern rather than placing blame, you can help reduce the employee’s defensiveness.
If the employee shares something related to mental health, inform them of the types of support that are available, including reasonable accommodations. Don’t assume a diagnosis or label; you aren’t their therapist.
The formula for mental wellness conversations
Mike Veny created a simple three-step formula to help you have conversations with an employee who may be struggling with their mental wellness.
Step 1: Start the conversation. One of his favorite ways of starting a conversation on mental health in the workplace is with the question, “How can I support you?” He wrote about it in his book, Transforming Stigma: How to Become a Mental Wellness Superhero. After you ask that question, pause and listen. Let the person have the space to answer. Answering this question can be really difficult for someone who is struggling. Mental health challenges are isolating, confusing, and frustrating, so be prepared for an awkward pause. Let them and the conversation breathe.
Another option is to say, “Help me understand.” After saying those three words, pause and listen, giving them space to answer.
Step 2: Keep the conversation going by asking open-ended questions: Who? What? Where? When? Why? How?
When you ask open-ended questions, you are enabling the other person to open up and share. If you ask a yes or no question, you will get a one-word response, and the conversation is unlikely to go anywhere.
One of Mike’s favorite open-ended questions to ask as a leader is, “What kind of flexibility do you need from me?” This is a great way to find out how to support the employee without prying into their personal life or mental health challenge.
After you ask your open-ended question, remember to pause and listen to give them the time and space to respond.
Step 3: Don’t give advice to someone who is struggling. Mike shares that a dear friend and mentor reminded him when people decide to give advice to someone in a conversation, they’re making it about themselves, not the other person.
Telling someone to “cheer up” or saying “everybody has bad days” will not be helpful to someone who is struggling. Mental health challenges are isolating, confusing, and frustrating. Be sensitive to that. Try to understand it from their perspective and steer clear of advice or platitudes.
Your goal should be to have conversations that may be awkward, but ultimately create a bridge of communication and compassion between you and your employee. Part of creating that bridge is letting them know you care.
Something you can do, especially in a situation where action needs to be taken on the person’s behalf, is to ask for their permission. Say, “May I have your permission to share my perspective?”
At the end of the conversation, remember to thank them for talking about it with you, and restate your commitment to confidentiality and to supporting them in being successful.
What to do After a Workplace Conversation About Mental Health
After the conversation, document what you discussed, and follow up on any actionable items immediately.
And finally, take care of yourself and your own mental wellness during this process. Conversations with employees about their mental wellness can be challenging and will impact you emotionally. Make sure to take time for yourself to recover and recharge after a difficult conversation.
If you have a hard time prioritizing your own mental health, the IGNITE Mini Course can help you create healthy self-care habits in 7 days. Get started with it today.
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