A mental health crisis can be triggered by events inside and outside of the workplace, including personal conflicts, pressure to produce, the news, family issues, financial worries and stress, in general. Mental health crises can arise suddenly and unexpectedly, leaving colleagues and people in workplace leadership uncertain about how to respond. We want to take this opportunity to provide some reminders about appropriate steps to take when an employee experiences a mental health crisis at work. An emergency response is warranted when someone is in immediate danger of harming themselves or others.

When an employee experiences a psychotic episode, symptoms may include hallucinations and/or delusions, incoherent speech and/or behavior that is inappropriate for the situation. Psychosis is associated with mental health conditions such as schizophrenia, bipolar disorder and severe depression. In some cases, it may be triggered by substance use, extreme stress, trauma or physical conditions affecting the brain.

An estimated 6 million American adults have panic disorder, a type of anxiety disorder associated with panic attacks, according to Mental Health First Aid and the National Council for Mental Wellbeing. Physical symptoms of a panic attack may include shaking, sweating, numbness, dizziness, heart palpitations, chest pain, shortness of breath, and chills or hot flashes. These can also be symptoms of a heart attack. It’s important to quickly assess the situation and call 911 when the underlying cause of symptoms is unclear.

It is not fully understood what causes panic attacks. Genetics, experiences involving trauma or major stress, having a disposition that is more prone to negative feelings and changes in brain function are believed to be contributing factors, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). While anyone can experience a panic attack, people with panic disorder experience repeated occurrences and may suffer from anxiety and social isolation in anticipation of the next one.

SAMSHA supports a national, 24/7 helpline to provide immediate intervention during a mental health crisis: 1-800-662-HELP (4357).

De-escalation

Mental health first aid is about providing support and encouragement, not attempting to diagnose or treat an employee’s condition. Experts recommend reassuring an employee in crisis that help is on the way. If feasible, the person may be instructed to take slow, deep breaths, which has a calming effect.

Employers may rely on professionals trained in mental health first aid to assist with de-escalation. The training involves a five-step process:

1. Assess the risk of self-harm.
2. Listen with empathy and without judgment.
3. Provide reassurance and information.
4. Encourage obtaining professional help.
5. Encourage self-help and other support strategies.

There are also courses available via the National Child Traumatic Stress Network on psychological first aid and skills for psychological recovery that are designed for those who respond to disasters.

Follow-up

Many companies offer employees access to medical, mental and behavioral health professionals who can assist with the development of a comprehensive assessment and treatment plan in follow-up to a critical situation. WorkCare assists employers with first response in the workplace and the management of referrals to employee assistance programs (EAP) and clinicians who provide mental health fitness-for-work assessments. There are also free or low-cost resources available in most communities for those who do not have access to an EAP.

In addition to leaning on experts, employers are advised to educate themselves about common disorders. Employers should ensure that affected employees are not discriminated against due to their condition and that they receive the time they need to recover and safely resume work and activities of daily life. Check WorkCare’s resources page to learn more about topics like this and other ways you can support employee health, safety and overall well-being.