How to support employees with depression in the workplace

depression

Need to know:

Signs of depression in employees are not always easy to read.
Employers can help to remove the stigma of mental health issues by talking about these openly in the workplace.
Employers can educate employees on how to approach a colleague with depression.

Stress, depression or anxiety accounted for 40% of all work-related ill health cases in 2016/17, according to the Health and Safety Executive’s (HSE) Work-related stress, depression or anxiety statistics in Great Britain 2017 report, published in November 2017.

The report found that 526,000 employees were suffering from mental health problems in the UK during 2016/17, and from the findings it is clear that depression and other forms of mental illness are prevalent in the workplace.

Employers need to be equipped with the correct skills to know how to help and manage those suffering, but it is not always easy to know if an employee has this debilitating illness or whether they are struggling with other issues. A lot of the symptoms of depression are internalised and can be kept hidden from colleagues, such as feelings of emptiness and numbness, insomnia, negative thoughts or a sense of feeling down for long periods of time.

Laurence Davies, external training manager at mental health charity Rethink, says: “The trouble with mental illnesses such as depression is that the observable signs can be very subtle when they’re there, and often may not be visible at all. This inconsistency can lead to doubt and hesitation.

“Outwardly happy people can easily be depressed privately.”

Identifying symptoms of depressionIf the main symptoms of depression are not so easy to read, how can employers be sure that an employee is suffering from the condition?

There are visible signs of depression but because these are not so obvious, they can be overlooked, particularly in larger teams where colleagues do not always have the chance to form close bonds. It is easier to pick up minor changes in an employee's mood or work if the employer knows the person well, which is why training staff to pick up on even the smallest symptom can be advantageous.

Working with someone day in day out may mean employees may be able to notice the subtle changes more than someone higher up the ladder, especially if they have been trained to spot the signs, says Shaun Subel, strategy director at VitalityHealth. “Look for noticeable changes in behaviour or noticeable changes in work performance," he says. "For example, a reduction in quality of work or difficulty in concentrating, or simply completing a task. Some people become fidgety, those are the sorts of warning signs and it’s important for line managers to look at the little things.”

Other signs to look out for are colleagues who appear withdrawn or quieter than usual, colleagues making excuses to avoid social situations or work events, forgetting things, and losing or putting on weight.

Approaching an employee with depressionAn employer may have an inkling someone is depressed but it is almost impossible to know for sure until they have a personal conversation with them, so finding the best way to approach an employee is key.

Due to the stigma surrounding mental illness, an employee might be scared to admit they have a problem so approaching them in a sensitive nature and as tactfully as possible is essential to help them open up and discuss how they might be feeling.

If an employer has concerns that someone in their team is suffering from depression in silence then they should take the lead and sit down with them, ideally as an informal chat at the first stage, says Marjorie Wallace, chief executive officer (CEO) at mental health charity Sane. “[An employer] should approach this chat in a supportive and positive way by asking open questions and by, most importantly, listening to what the employee has to say," she says. "One of the key things to avoid is making assumptions and prematurely escalating the situation in a formal capacity, for example, a referral to a HR department.”

The important thing is the employee feels that they are in a safe environment and they are not being attacked, says Charles Albert, senior consultant at Aon Employee Benefits. “[Employers] want to let them know [they] want to have a conversation because [they're] concerned about their wellbeing and want to look after their best interests, so the way [they] position [the conversation] is important; choosing the right time and location," he explains. "Finding a really good, confidential and quiet spot is quite important, and being free from any distractions. The location is almost as important as the conversation itself.”

Educating employees to spot the signs of depressionHaving a mental health programme as part of a health and wellbeing strategy is relatively common these days. Introducing mental health champions within the workplace to support colleagues and reduce the stigma of mental ill-health is one way in which employers are providing such support.

Mental health champions are a particularly good way to reach out to the younger demographic in the workplace, says Subal. “Mental health champions, especially if they are within [an employee's] peer group are very effective, particularly when it comes to young employees," he says. "The younger demographic want to talk to colleagues on the same level as them. What it really comes down to is culture and removing the stigma around mental wellbeing. If the stigma is removed, the more likely people, regardless of their level, will raise their concerns around health and wellbeing."

Giving employees the confidence and a platform to speak up will help to create a more open workplace where they feel comfortable to discuss their mental wellbeing. “Work can be a big source of stress in a person’s life, so it’s important for employers to regularly ask staff how they are managing to give them the confidence and opportunity to speak up," says Wallace. "Creating a culture where staff feel empowered to speak up early can be one of the greatest preventative measures of mental health problems deteriorating. We know the longer people leave getting help for a mental health problem, the worse it can become.”

Supporting employeesOnce it has been established that an individual is suffering from depression, steps need to be taken to ensure they get the help and support they need to help them on their road to recovery. "It can be extremely helpful to offer CBT [cognitive behavioural therapy], counselling and other talking therapies to staff who may benefit," says Wallace.

However, smaller organisations may not have the same resources as a large employer, which may limit the mental health support and treatment they are able to offer to employees. "Consulting employees on what they feel they might best benefit from is a good place to start," says Wallace. "Workplaces may also consider offering opportunities for team building as this can be a therapeutic exercise in building trust, resilience and confidence in others."

When working on guidance and support, employers should not look for a one-size-fits-all solution, says Alberts. "What works for one person might not necessarily work for another and some [employees] might need to try a few things before they get to actually know what works for them, and what will help them get better. Therefore I recommend a initial clinical assessment; it's really important and to make sure they have someone they can call on at any time, and make sure someone is keeping an eye on their progress."

Employers can also promote employee assistance programmes (EAPs) which can be they are an effective prevention tool for mental health issues that may require shorter-term counselling. "Most of us have mental health challenges of various degrees," says Alberts. "EAPs are so effective helping to prevent those issues into turning into something more serious but we know not enough people are reaching out to EAPs on a regular basis [...] Many people only put up their hand and say 'I need help' when it is at a more advanced stage."

Helping employees settle back to work after absenceIf an employee has taken a few days off or has been on long-term sick leave due to depression, it is important that employers take special care to integrate them back into the workplace. They should treat an employee’s return to work in the same way that they might following physical illness, says Davies. "Maintain an open dialogue to establish what they feel they are able to manage and go from there," he says. "An employee returning from surgery would struggle to return to a full schedule immediately and mental illness is no different. Remember, in returning to work they haven’t just become 'better'. Recovering from mental illness takes time, and it will be important for them to feel like they have [the employer's] acceptance and understanding of their situation."

Employers can also make use of occupational health services which can advise on the impact an employee's absence or reduced capacity has on the workplace, as well as what adjustments would be most appropriate from a mental health perspective to integrate an employee back into the workplace. Under the Equality Act (2010), an employer has a legal duty to make 'reasonable adjustments' to an employee's working environment.

A further option is to enable employees to return to work with the option to undertake flexible -working hours; for example, returning part-time, or starting later in the day, particularly if any medication can result in drowsiness. An employee can also request support from a colleague in the short or long term and a place they can go to take a break if needed.

As mental wellbeing continues to be a key concern for UK employers, measures to support this should be firmly on the organisational agenda. Aon Employee Benefits' Benefits and trends survey 2018, published in January 2018, for example, showed an increase in the number of employers reporting employee stress and mental health-related illnesses from 55% last year to 68% in 2018. Employers can ensure that they are providing a workplace environment that supports employees good mental wellbeing by investing in and actively promoting initiatives to help employees with depression.

Parents-to-be and new dads are not immune to anxiety-related depression

Depression can take many forms. In its Paternal Depression Symptoms During Pregnancy and After Childbirth report in April 2017, JAMA Psychiatry found that it is not just new mums that can suffer from postpartum depression, but that new dads are also susceptible to the illness in what is generally assumed as a ‘happy time’.

There is also evidence to suggest that the anxiety of becoming a new parent can bring on symptoms of depression.

Employers should also bear in mind that mothers may require support either during pregnancy or upon returning to work following maternity leave if they have suffered from post-natal depression.

Effectively communicating mental wellbeing support initiatives and making them easily accessible to employees at the early stages of developing an issue, no matter what their circumstances are, is essential says Charles Alberts, senior consultant at Aon Employee Benefits. "Line managers play an important role in early intervention: reaching out to have a conversation, offering support such as adjusted working hours to fit around new family commitments, and signposting the benefits and services available can help ensure employees access support more quickly," he says.

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