Recognize the Signs: Addressing Behavioral Health in the Workplace

By Dan Jolivet, Terri L. Rhodes

Jan. 15, 2019

addressing behavioral health workplace
Be prepared about how to spot signs of behavioral health problems and the appropriate ways you can respond.

An estimated 23.2 percent of Americans aged 18 and older experienced symptoms of a diagnosable mental health or substance use condition in 2016. At the same time, fewer than half of those diagnosed with a behavioral health condition received treatment. When left unaddressed, these conditions may contribute to various workplace challenges, including loss of productivity, low morale and turnover.

Although behavioral health conditions are prevalent, there remains a lack of understanding in the workplace on how to properly support them. Given that employees spend a great deal of time at work, this presents you with the opportunity to better assist those with a behavioral health condition to foster trust and aid in recovery.

Understanding the typical progression of a mental health or substance use condition and its corresponding symptoms can help you better identify employees in need and connect them to available resources. While these conditions often begin with a relatively mild impairment that has a minimal impact on the employee’s performance, symptoms can progress and ultimately hinder their work.

Be prepared by knowing how to spot the signs and the appropriate ways you can respond. The following five stages explain the cycle of behavioral health conditions that an employee may progress through and tangible ways you can help:

  1. Risks emerge

A challenging aspect of behavioral health conditions is that they often begin without being noticed. In fact, a manager may confuse the symptoms of a health condition with poor performance. While conditions may be hard to identify at this stage, it’s important for employers to create a safe climate and culture for employees to speak out and seek help.

All managers should be trained on how to document performance on a regular basis, noting any observed performance changes. Managers should also be familiar with resources the organization has available to support employees, such as management coaching and employee assistance programs.

  1. Symptoms escalate to impact performance

In the second stage, an employee’s symptoms may increase to a moderate level and are more likely to noticeably impact work performance. An employee may be absent more frequently or request an accommodation under the Americans with Disabilities Act to help them cope with the situation.

Referrals to an EAP are more common at this point, and the employee may be more likely to seek treatment on their own. Absence management approaches may also help employees address issues and stay at work in this stage. That’s why stay-at-work disability management strategies, such as referrals to workplace resources and accommodations, are best initiated at this point.

  1. An increase in severity

In this stage, the employee experiences severe symptoms that could directly impact their work performance and abilities. Performance problems and employee absences may escalate to the point where they require a disability leave. In many cases, the need for accommodations to support recovery becomes more visible to employers.

For those who are able to stay at work, it’s important to work with the employee to develop accommodations tailored to their specific limitations or restrictions. Proactively implementing accommodations may help keep an employee engaged in their work, successful in their role and supported by their peers. For employees who require a leave, being supportive of the employee’s FMLA application also is important.

Also read: 5 Practical Ways to Support Mental Well-being at Work

  1. Chronic impairment

At this point of an employee’s condition, they may continue to experience severe or chronic symptoms and apply for long-term disability benefits. The employee may also start seeing themselves as “disabled,” struggling to find a sense of purpose or meaning in life.

During this stage, goal-directed case management and return-to-work strategies are generally initiated or continued. But the impact is generally lower than during the previous stages. With earlier interventions, there’s a better chance that the employee will return to work.

  1. Recovery occurs

The last stage is where employees begin to see their condition improve — either through treatment or as part of the natural course of the condition. But with the proper employer response and intervention, recovery can occur at any stage in an employee’s journey.

Recovery before severe or chronic symptoms develop often depends on an employee connecting with timely and effective care and support. Effective support can empower the employee and rebuild confidence.

Given that mental health and substance use conditions are common in the Unites States, it’s important to address this issue through effective services and support for your employees. Research shows that only 50 percent of employees return to work after having been out of work for six months. When you’re prepared, you can intervene earlier and increase the chances that the employee will return to work.

Being prepared for a behavioral health condition means supporting employees in their time of need. Without the proper strategies, resources and assistance, an employee’s work performance may suffer. By offering your employees various programs and benefits, you can help ensure a timely and safe recovery and return to work.


Dan Jolivet is the Workplace Possibilities℠ practice consultant at The Standard, where he previously led the Behavioral Health Case Manager team and managed the psychiatrist and psychologist peer consultants.

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