I love this ad by Bell for their Let’s Talk campaign. It very clearly demonstrates one of the essential problems for managers: employees who try to pretend that everything is okay when they’re really dying inside. I only wish this ad ended with a call for managers to get real training in how to deal with depression in the workplace.

I manage a lot of people, and have since 2005. I’m in a privileged situation, because I’ve managed a significant number of people with mental illness while dealing with my own. It’s really hard for me not to know that you’re going off the rails, no matter how hard you try to hide it. So, I thought I’d write a post for managers about how to manage someone in their workplace who’s mentally ill.

First and foremost, get down on your hands and knees and thank whoever your higher power is if you have an employee who willingly told you that their mental health is going downhill, circling the drain, completely in the toilet. Ninety percent of your work is done. You may not realize this, but how you react to this conversation is going to affect how your employee looks at you and works for you for the rest of your time together.

There are two ways this conversation are likely to go, and both involve you having a supply of kleenex available.

1) Your employee walks in, says “hey boss, there’s some stuff going on in my personal life and I’m taking care of it but until it’s under control I’m going to need some help, and that help is going to look a bit like this [insert reasonable accommodation request here].

If this is the way the conversation goes, get back down on your hands and knees and thank whoever your higher power is that your employee is still able to be this proactive and to be a partner in their accommodation process. Do not (I repeat, do NOT) ask them what the issue is, or look at them askance. I’ve heard some horror stories, people. Apparently depression is just another word for laziness. Also, it doesn’t really exist. And people need to suck it the fuck up and get over it. Seriously. All of those people had employees.

Anyway, it’s your job to be sympathetic, discuss reasonable accommodation, walk the employee through whatever paperwork your HR department needs to make the accommodation kosher, and make it happen. Accommodations don’t last forever. They last until the employee’s doctor says they can end.

There’s another, slightly more legally risky approach that has the capacity to work really well or go horribly wrong. Depending on the dynamics of the team and how your employee is feeling, you may suggest that, if they’re comfortable with it, they disclose that they’re ill to their colleagues and that they need some help while in recovery. Illness is illness, it doesn’t matter if you can’t touch it, smell it, or feel a lump. Illness is illness, and your colleagues should step up and help out while you’re recovering because they’d want you to do the same for them.

Again, the successful use of this technique depends on a lot of factors. If the employee is together enough to ask you for help, they’re probably together enough to ask others for help, too. Suggest it, let the employee think about it, and have a follow up discussion. Don’t push it.

2) The second way this conversation could go is sort of along the following lines: Hey boss, I’m really unhappy getting a divorce my mother is sick my dog just died i think i have a lump and yeah my skin cancer is back and did I mention i have a disease which could kill me in 20-30 years? Help meeeeeeeeeeeeeeeee! I like to call this the over-disclosure discussion, which means that at least you can rest assured that they trust you to be sensitive enough with the information not to give them the skeptical look.

What do you do with this rapid fire dumping of problems into your lap? Look sympathetic. Ask if they’ve been to see someone to talk about everything. Note: You are not a therapist. Your first reaction when people are floundering should always be to get the employee to see someone who is a professional, be it a medical doctor or someone from the employee assistance program.

I don’t think I can stress the need for the employee to see a professional strongly enough. You need an ally. You cannot manage these problems yourself, or you’re going to end up on sick leave. You need a boundary. You should encourage the employee to go and talk to someone about how to manage these issues and working, and whether or not it’s possible to do both without some kind of accommodation. And any accommodation will require some kind of documentation from a medical professional.

You’ve given them a lot to think about. Please send that person home for the rest of the day so that he/she does not have to face his/her colleagues with a swollen and tear stained face and schedule a follow up for the next day. Usually, sober second thought and the embarrassment of having a breakdown in front of the boss is enough to spur someone to getting professional help. In fact, I think of the breakdown as a good sign. It is that employee reaching out for help, and asking you to point the way. You’re the guidepost.

Then we have the third kind of discussion, the one you have to initiate. This is generally because you’re a good manager and you’re observant and you noticed one of the following:
1) unusual displays of emotion or lack thereof;
2) unusual absenteeism;
3) unusual productivity or lack thereof.

In essence, you’ve noticed something off about your employee. People don’t normally change overnight, so don’t beat yourself up if you didn’t see anything for the first few weeks. And sometimes people have transient depression that lifts after a few weeks. But for the love of god, don’t let a change of behaviour/comportment go undiscussed for months.

This is how I like to start these conversations.
Hey [name]. How are you doing?

It’s so innocuous. You’d be surprised at how many managers never ask that question and actually want to hear the answer. Actually listen to the answer.

Because you look like you care, the employee is going to lie. They all lie. It’s self-preservation. Don’t take it personally.
Employee: Fine! Thanks! (Usually said very brightly.)
You: Are you sure? I’ve noticed that you’ve been a little [quiet/more energetic/reserved/absent/less engaged/less willing to share work/more bossy/more controlling] than normal. Is everything okay at home? Is there anything going on that we can help you with?

This will go one of two ways:

The first is when you’re going to need kleenex. You paid attention to them. Close enough attention to see that they’re hurting. For someone who is lost, drowning, in agony, suffering in a world that seems to consist only of their own pain, this is huge. You have just become a reason for them to live. (Don’t worry. It’s not that stressful.)

Once the crying has ended, talk to them about going to see a professional, what the team can do to support them, and
any accommodation required to get through this tough time. Schedule a follow up for the next day. They’re going to want to hug you at the end of the meeting, so brace yourself.

The second way this meeting could go is really hard. It’s a painful, negative response where the employee perceives your question as an attack. If this happens, when you have a minute, think about how you worded the question and the statement of what seems to be a little off. If it was as neutral as possible, don’t sweat it. If not, you’re now stuck managing a really hostile situation for the foreseeable future.

When your world is sliding out of control and into the pit of depression, you try to control as much of it as you can. So if you really thought you had this work thing under control and someone noticed your cracks, that means there’s something really wrong and oh my god that can’t be because I’M NOT SICK.

Yeah, that’s right. You’re inevitably going to deal with employees who are so scared of the idea of having a mental illness that they’ll do anything they can to avoid actually naming it. Or getting help for it. (Pause again: is this a fact of life in your workplace? If it is, you may want to use your influence as a manager to try and change that.)

You know what you can do with employees who don’t want to admit they’re sick? Nothing. In fact, it’s actually worse then nothing. You have to ride them into performing like everyone else because if they won’t admit that there’s a health problem, then they have to be treated like they’re not sick, just unproductive/rude/tempestuous/etc.

If you’re humane, this activity is going to just about kill you. It feels like crap. It goes against everything you hold dear about being a manager. But you really have no choice. It’s called managing, and it sucks. But eventually your employee will either get better or will admit that they need some help, at which point you can work with them on reasonable accommodations until they get better.

Here are my top tips for managers who are trying to manage their people who are hurting:
1) Remember that depression is an illness, and for people who are depressed it hurts like a knife stabbing you repeatedly in the chest, kicking you in the balls, and ripping out your intestines.
2) Have some compassion, but with boundaries. You need to be there for your family, the rest of your team, your friends. You cannot let yourself be subsumed by someone else’s illness.
3) Get your employee into the medical system. Don’t try to solve their problems. You’re not trained at this, and as nice as you are, you’re no social worker, psychologist, or psychiatrist.
4) Remember that you’d happily put someone with cancer on part time status, or have them work from home to avoid contact with other peoples germs, or work on less stressful files. Again, depression is an illness and often requires accommodations exactly like rheumatoid arthritis, heart disease, or cancer.
5) Be conscious of how to communicate with your employees. If you use derogatory language about mental illness, they’re never going to feel supported by you and will fight any conversation you may have about it. Be an example and make sure you stop any derogatory or inflammatory conversation by others about mental illness. Raise awareness. Invite people like me to talk to you and your team.
6) Be observant. Talk to your people. Know what their normal is. Know when to push and when to back off.
7) Don’t try to be an expert. HR has people to provide you with legal type advice. And your company’s employee assistance program is available for you, too. They can help you set boundaries and deal with the challenges that come from being compassionate and having rules that you need to follow.
8) Care.

If you do this, I can guarantee that when your sick employee crawls out of their depression hole, they will be loyal to you and your organization forever. Why? Because you helped them when they were down. You were part of the solution. You were part of the reason to live. Be that reason. You can do it. I believe in you.