A practical guide for managers on recognising warning signs, having supportive conversations, crisis protocols, return-to-work planning, and self-care when supporting employees through mental health crises.
Supporting Employees Through Mental Health Crises: A Manager's Practical Guide
Introduction
At some point, most managers will support an employee through a mental health crisis โ a panic attack at work, disclosure of suicidal thoughts, sudden deterioration in behaviour or performance, or a colleague not returning after a breakdown. This guide provides practical, evidence-based guidance for these situations.
Recognising Warning Signs
Behavioural Changes
Increased absence or lateness
Withdrawal from colleagues and team activities
Uncharacteristic errors or missed deadlines
Difficulty concentrating or making decisions
Emotional outbursts or visible distress
Changes in appearance or self-care
Increased alcohol or substance use (observable signs)
The Key Principle
You are not diagnosing. You are noticing change. The question is not "what is wrong with this person?" but "this person seems different from their normal โ how can I check in?"
Having the Conversation
The ALGEE Framework (Mental Health First Aid)
Approach, assess, and assist with any crisis
Listen non-judgementally
Give support and information
Encourage appropriate professional help
Encourage other supports (social connections, self-help strategies)
Practical Tips
Choose a private, quiet space
Use open questions: "How are you doing? I've noticed you seem a bit different lately."
Listen more than you talk โ silence is okay
Do not try to diagnose, counsel, or fix
Validate: "That sounds really difficult"
Ask about practical support: "What would help you right now?"
Signpost to professional support: EAP, GP, crisis lines
Follow up โ do not have one conversation and forget
What NOT to Do
Do not say "everyone feels like that sometimes" or "just think positive"
Do not share what the employee tells you without their consent (except in safeguarding situations)
Do not assume you know what they need
Do not avoid the conversation because it feels uncomfortable
Crisis Situations
Panic Attacks
Stay calm and speak slowly
Help the person to a quiet space
Encourage slow breathing (in for 4, hold for 4, out for 4)
Do not crowd them
Wait with them until the attack passes (typically 5โ20 minutes)
Follow up the next day
Disclosure of Suicidal Thoughts
Take it seriously โ always
Ask directly: "Are you thinking about suicide?" (asking does NOT increase risk โ evidence from Dazzi et al., 2014)
Listen without judgement
Do not leave them alone if they are in immediate danger
Call emergency services (999/911) if there is an immediate risk
Connect them to crisis support: Samaritans (116 123 UK), 988 Suicide & Crisis Lifeline (US), Lifeline (13 11 14 Australia)
Follow your organisation's safeguarding protocol
Sudden Deterioration at Work
Prioritise the person's safety and dignity
Offer to arrange transport home if they cannot work
Contact their emergency contact if they consent
Document what happened (factually, without judgement)
Arrange a follow-up meeting within 48 hours
Return-to-Work Planning
Phased Return
After a mental health-related absence, a phased return is best practice: