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Richard Frost

Devon Partnership NHS trust


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Line managers: the importance of talking about mental health


When it comes to supporting staff who are experiencing a mental health condition, there is no reason at all why a line manager should automatically know what to do. Yet, that can often be the expectation and it’s an expectation held by both employee and manager alike. 

Managers are there to manage not to be counsellors or therapists and for some those are boundaries which are difficult to maintain. Some managers desperately want to help and support their staff, yet can be drawn in to situations beyond their capability.

Some employees may become over-dependent on a supportive manager because they really value the fact someone is interested in them. On the other hand, many people find it difficult to talk about mental health issues with their manager and many managers struggle to provide appropriate and helpful responses.

In this article, we’ll explore some of the issues and consider some practical suggestions and information.

Let’s talk

It’s important to understand the reluctance to talk:

  • Fear of the response – many staff members worry about whether disclosing such issues will go against them and/or that others will be dismissive or gossip
  • Lack of relevance or connection – if someone is struggling with issues outside of work then they may not feel it’s anything to do with their manager
  • Not recognising the signs – sometimes it’s hard for individuals to acknowledge they are having difficulties - although many people have good insight
  • Self-imposed pressure to cope – and that asking for help equals ‘failure’. We all feel there are times when we ‘should’ or ‘ought’ to be able to cope with something – but asking for help is a strength and often the first step towards recovery.

But’s let’s take a moment to look at the same issues from the manager’s perspective:

  • Fear of the response – the manager may not want to have the conversation because of how their staff member may react towards them
  • Lack of relevance or connection – if someone is struggling with issues outside of work then the manager may feel it’s nothing to do with them: ‘I’m not going to open up that can of worms…’
  • Not recognising the signs – it’s common to read signs of mental distress as being inappropriate behaviour or poor performance and react with a disciplinary approach. Helping managers to spot signs is crucial.
  • Self-imposed pressure to cope – managers will want to be seen by the rest of the team as managing what’s happening and may also worry about what senior management will think if they are perceived as not doing so.

There are always two sides to every conversation.

Trust and relationship

While it goes without saying that building up trust is integral to any manager-staff relationship, the reality is that it can be difficult at times. We all relate to different people in different ways and feel we can talk to some people about some issues more than with others.

It may be that the line manager is not the best person to provide support (especially if that manager is seen as ‘the cause’) and other help will be valuable – for example, an alternative manager, occupational health, HR or employee assistance programme.

Regular 1:1s with staff play an important role. These occasions (ideally, once a month at a diarised date and time) work well when the conversation is not just about tasks and targets but covers the ‘how are you?’ issues too. 

Agreeing who needs to know what is also important. As already mentioned, the manager may need to seek further help and guidance so agreeing this will be useful. Similarly, it may be that the rest of the team should be told something – it’s better they know something rather than nothing to put a brake on any rumours or gossip. Yes, confidentiality is important so agreeing exactly what is to be said is vital.

Keep talking

The UK-wide Mindful Employer initiative, which is run by Devon Partnership NHS Trust and available to any employer of any sector or size has produced some helpful resources:

  • Mindful Employer Line Managers’ Resource – a practical guide to supporting staff with a mental health condition 
  • Making Work Work – a document to help support the conversation
  • Keeping Well at Work - a booklet for staff, which complements the Line Managers’ Resource

All the above – and more - can be downloaded from

Providing mental health awareness training for line managers is widely recognised as being important in this area of concern. Mindful Employer provide workshops for both managers and staff and these can be delivered to any employer on site.

Finally, take a look at a short film about having the conversation called ‘Let’s Talk.’

Once the talking has started, keeping talking.

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Richard Frost


Read more from Richard Frost

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