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The Royal College of Psychiatrists Improving the lives of people with mental illness
 Work and mental health

Conversations in difficult circumstances

Is your organisation able to recognise when employees are struggling with a mental health condition?

You cannot assume that someone who needed little or no support to get a job will not need support to keep being productive at work.  As an employer you have to ask whether your organisation is capable of identifying when employees are struggling with a mental health condition and how your organisation responds to the issues raised. 


There are many sources of information, guidance and training for employers from senior staff to line managers and colleagues or co-workers.  This training is often in the form of modules which introduce mental health conditions, and provide information and guidance through the recruitment process to supporting staff at work.  It is worth looking at a range of these resources to see what fits your organisation’s needs best. 


The SHiFT line managers’ resource emphasises the importance of building action to promote mental health and well-being into good ‘normal’ management practice, for example during work planning sessions, appraisals or informal chats.  However, it is also important to be aware that these conversations have to take place in an environment where your employee feels it is safe to disclose their personal information.   You must be clear about confidentiality and who will be told what. You can clearly explain the limits of your confidentiality (personal information is confidential but issues that may have a health and safety risk to the employee or colleagues will need to be discussed further).


This resource also recognises that these conversations maybe upsetting to you and to your employee.  It has tips on how to deal with employees who may become upset, angry or tearful.  


Links to resources


Chartered Institute of Personnel Development (CIPD)

The CIPD has worked with the Health and Safety Executive (HSE) and Investors in People (IIP) on a project to develop practical help for Human Resource and line managers to tackle the issue of stress at work.  The guidance includes a competency framework designed to enable line managers to work on the skills required to reduce and prevent stress at work.  


Employers’ Forum on Disability

Employers' Forum on Disability is an employers' organisation focused on disability as it affects business. The forum includes employers from multinational corporations, Small and Medium sized Enterprises and the public sector. This link is to the line managers’ guides.  The ‘Attendance management and disability’ booklet includes sections on spotting the signs and trigger points to tips on preparing for a meeting with an employee when you raise the matter of sickness absence. 

Business link

This is the official government website for businesses of all sizes.  It is a free business advice and support service, available online and through local advisers. The section on ‘How to deal with stress’ includes information on Supporting employees with mental ill health. This website also includes a link to Health for Work Adviceline for small businesses.


Institution of Occupational Health and Safety (IOSH), Occupational Health Toolkit

IOSH has produced an Occupational Health Toolkit which provides a 'one-stop shop' for health and safety professionals and brings together information, guidance, factsheets, case studies, training materials, presentations and more to help you tackle occupational health problems.  The ‘Toolkit’ includes a module on ‘Stress’ which has a section on early intervention and corrective action.


Shaw Trust

Tackling the last workplace taboo

This website has been developed by the Shaw Trust.  This part of the website includes a checklist with ‘dos and don’ts’ when discussing your employee’s mental health condition.


Mental Health Foundation

What works for you, 2008

It can be hard to know what to do when someone you work with is going through a tough time or has a mental health problem. But knowing how to support your colleague can make a huge difference to how they cope. This booklet outlines how you can help and suggests where to go for further advice.



Samaritans is an established workplace training provider with a track record of some six years of designing and delivering bespoke, specialist communication skills courses for frontline staff and managers.  Whether you have training needs in the areas of improving working relationships, helping staff to handle difficult contacts or equipping them with Samaritans listening skills to improve relationships with service users and customers, we have training solutions that will suit you.  Some of the training modules can be delivered by distance learning methods.


The following links are for information and resources which are specifically about managing personal information.  Some of the information is aimed at employees or people with mental ill-health but will give an insight to employers into the issues faced by your employees in discussing their mental health condition.

Information Commissioners’ Office

This links to the ICO website with guidance and information for employers about the Data Protection Act.

The ‘Quick guide to the Employment Practices Code’ is aimed at small businesses and includes a section on the Data Protection Act in relation to the collection and use of information about workers’ health. 


Realising ambitions: Better employment support for people with a mental health condition

Rachel Perkins, Paul Farmer and Paul Litchfield

Department for Work and Pensions, December 2009

This review was commissioned by the Secretary of State for Work and Pensions to look at mental health and employment and to identify how Government could help people with mental health conditions fulfil their employment ambitions. 

Appendix 7 summarises the pros and cons of disclosing information about mental health at work. 



The section on work includes pros and cons on disclosing personal information to an employer to help an employee to decide what to tell, when and how. 


Work and Mental Illness Factsheet

This Rethink factsheet sets out the advantages and disadvantages for an employee telling an employer about their mental health.  


Time to Challenge: Time to Change

This programme is jointly run by MIND and Rethink.  The ‘Telling my manager’ section includes advice for an employee in working with their employer.  It draws on examples from the UK and overseas. 


Building a career of your choice

Waghorn, G., Harris, M., Cleary, C., King, J., and Lloyd, C. Canberra: Australian Government Department of Health and Ageing, 2008.

This booklet has a short section on ‘Managing personal information in the workplace’.  It gives examples of some of the benefits of disclosing information about mental ill-health and how to approach this.