Those in the healthcare industry are bound to be ahead of the curve in understanding that mental illness is not a character defect and can be a serious health condition that requires intervention. Despite having a good comprehension of the importance of good mental health hygiene, healthcare professionals tend to fare badly in terms of psychological self-care. While nurses and physicians are at a higher risk of suicide than the general population, this article is focused on employees and how can take the mental health of employees in crisis into account when talking to individuals about their performance at work. Given this past year, just about everyone associated with providing health care, when asked, will tell you they are burned out and tired. Overall, it seems most are facing challenges both professionally and in their private lives, unlike anything we have seen before.
Maybe this is because, for those who choose a career in healthcare, caring for others comes easier than caring for oneself. Whether it’s staff shortages, compassion fatigue, or the high-stress/high-stakes, nonstop nature of patient care causing the self-care crisis among healthcare professionals, it can sometimes be hard to know what to do as an employer or manager to make sure that your practice runs smoothly while also playing a positive role when it comes to encouraging vulnerable members of your team to seek adequate care if they need or want it.
The first step is to spot that there may be a problem and think about what you might say that would help an employee seek self-care. With all that in mind, here are a few ways to spot, address, and take action when one of your employees experiences a mental health crisis.
Why is this hard on managers?
If it was as easy as just telling someone that they might need some help, none of this would be an issue. The truth is that hearing your employee is in crisis is hard because we care about our employees, but, on top of that, as a manager of people, we must also be the ones to tell them if they are not performing their work well. This leaves managers in the unenviable position of trying to take a balanced approach. How do you say, “Look, I care about you but if you don’t stop snapping at people and catch back up on all your work, you are at risk of losing your job too.”
Keep in mind that an individual seeking help is often the culmination of concerns expressed by a combination of friends, family, and co-workers that allows someone to recognize they might need to seek some help. Your part in this is just one piece of a much bigger puzzle. It’s not your job to solve all the problems for them, nor should it be, but it is in your interest to help an employee see that they need help as early as possible and encourage them to seek help.
What a crisis looks like
While there are a number of mental illnesses that can manifest while at work, here are some signs that often indicate a mental health crisis in progress:
- Expressing hopelessness
- Feeling trapped
- Feeling like a burden
- Extreme guilt
- Big mood swings (euphoria, rage, or tearfulness)
- Increased alcohol or drug abuse
- Reckless behavior
- Hallucinations or paranoia
- Poor personal hygiene
- Social withdrawal
- Difficulty concentrating
Notice some of these issues, like unkempt appearance or alcohol abuse that could look a lot like poor performance, could be symptoms of any one of a number of very serious mental illnesses. Your dental hygienist could have neglected to fill out several patients’ charts because she’s careless, or she is having difficulty concentrating because of a panic disorder. That’s why it’s so important to speak directly with the employee– to actually sit down and talk candidly about changes that you’ve noticed in their job performance or personality within the context of the job duties. This allows them to let you know whether they are in some kind of crisis where you might be able to talk to them about getting counseling.
How to address it
Though your first impulse might be to feel as though you are being invasive or too personal, it’s absolutely okay from a legal standpoint to tell your employee that you’re worried about them. As far as interventions go, “I’m very concerned about you,” might be a much easier place to start than, “Why don’t you take showers anymore?”
After expressing your worry, outline the things you’ve observed that have you concerned. It might be helpful to use the FIRR Method to organize your thoughts in a judgment-free manner. In the FIRR Method of conflict resolution, owners and managers are instructed to focus on the facts and refrain from offering opinions when confronting employees about problematic behavior. If an employee is having difficulty focusing, saying, “You’re not paying enough attention lately, Alex,” may cause the employee to feel judged and become defensive. Using the FIRR method, employers focus on stating the facts and leaving judgment and value statements behind. Like so: “Alex, you trailed off while I was speaking to you in yesterday’s huddle. Today you left two patient intake forms partially filled out. It makes me wonder if you’re having trouble focusing.”
The Reality of Mental Health Access
If your employee is having a mental health issue but is not an immediate risk to themselves or others, it’s important to encourage them to seek help but understand that things sometimes become tricky. When it comes to seeking long-term mental health services, the reality is, your employees may find themselves hitting a wall. While there are usually emergency services such as hotlines and mobile crisis units for emergencies, particularly for uninsured individuals offered on a sliding scale, most employees of small medical and dental practices will not fall under this category or have these services available to them. Forget making “a” phone call to get help, employees trying to find a therapist who takes their insurance may end up calling 20 different therapists in one day and still may not be able to make an appointment!
For most employees in the healthcare industry, therapists and counselors are not readily available namely because so many therapists do not take insurance. The few who do may not be a good fit for the employee for any number of reasons such as being too far away, not having the right specialty, or being of subpar quality. Faced with paying over a hundred dollars an hour for treatment, most employees simply aren’t able to pay for consistent care out of pocket. In plain speak, there simply are not enough therapists who work with insured patients or enough access to qualified mental health professionals.
The important thing to remember is it is not your job, nor should it be, to solve the crisis of the nation’s mental healthcare system. Remember you and your workplace are just one small piece of the puzzle. The rest may involve the employee reaching out to family, looking into community resources, religious counseling, and other complementary services. Your job involves helping the employee understand their mental health has disrupted their work-life in a big way, has prevented them from performing the essential duties of their job, and, as a result, has become a priority in their life that needs to be addressed.