2010 Workers with Mental Illness: a Practical Guide for Managers

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3. Managing mental illness in the workplace

Contents

• 3.1 Effective communication strategies
• 3.2 Reasonable adjustments
• 3.3 Examples of reasonable adjustments to address the effects of a worker’s mental illness in the workplace
• 3.4 What do I do about performance concerns for workers, including workers with mental illness?
• 3.5 What should I do if I am worried about the health and safety of a worker with mental illness?

This chapter provides practical strategies for identifying reasonable adjustments to meet the needs of a worker with mental illness.

The vast majority of workers with mental illness succeed in their chosen career while managing their mental illness.

Some workers will choose to disclose their mental illness if they require workplace support. Others may choose not to disclose their illness if they feel they do not require any workplace support or fear an adverse reaction.

As a manager, you have a responsibility to assist workers with mental illness by providing changes which will enable them to perform their duties more effectively in the workplace (these are known as ‘reasonable adjustments’).

To do this effectively it is important to be informed about mental illness and have an understanding of:

• effective communication strategies (see section 3.1)
• reasonable adjustments (see section 3.2 and examples in section 3.3)
• what to do about performance concerns for a worker with a suspected or known mental illness (see section 3.4)
• what to do if you are worried about the health and safety of a worker with mental illness (see section 3.5).

3.1 Effective communication strategies

How do I talk about mental illness with my worker?

As a manager, you may grapple with how to describe and talk about mental illness with your worker. Becoming familiar with the words that best describe mental illness will enable you to effectively:

• talk with your worker about any mental health issues
• negotiate reasonable adjustments in the workplace
• obtain advice and assistance from external support services (without disclosing personal information)
• talk with allied professionals, such as GPs and other treating practitioners (with the approval of the worker).

Further information: Appendix C – How To Talk About Mental Illness.

When arranging to meet with a worker to discuss their mental health issues it is important to plan what you would like to talk about and how you want to discuss the issues. It is appropriate to offer the worker the option of bringing a support person to any meeting arranged with the purpose of discussing their mental health issues.

Further information: Appendix C – How To Talk About Mental Illness.

It is important to be aware of privacy obligations when talking to a worker about mental illness. Personal details will need to be kept strictly confidential unless the worker agrees for you to disclose the information to another person.

Further information: Appendix A – Knowing the Law; Appendix C – How To Talk About Mental Illness.

If you feel uncomfortable or unsure about how best to communicate with a worker regarding mental health issues there are a number of health professionals (e.g. psychologists, social workers or occupational therapists with a mental health training background) who can help you work out the best approach.

Further information: Chapter 5 – Where to Get Assistance.

What do I do if a worker is displaying symptoms of mental illness but they have not told me about any issues?

There is no legal obligation for a worker to disclose information about their disability. While you may find this frustrating, disclosure is often a difficult choice for a worker to make.

Disclosure is a personal decision that depends on the circumstances, the context, how the illness is being managed and how comfortable the worker feels about discussing the issue.

Many people with mental illness have weighed up these factors and made a personal decision not to disclose their disability while they are at work. This may be due to the following factors:

Performance

• they can successfully manage their job without having to inform the workplace about their mental illness
• they have developed support structures outside the workplace.

Attitudes

• they may be afraid that their disability will provoke unnecessary concern in others
• they may believe that managers may have preset and unrealistic attitudes about people with mental illness
• they may be afraid that they will be treated differently by their colleagues
• they may not have come to terms with their mental illness
• they may be afraid of being marginalised, particularly as mental illness is steeped in stereotypical attitudes.

Discrimination

• they have past experience of being discriminated against or denied opportunities or certain entitlements
• they may be afraid that their manager will focus on their disability and not their abilities
• they may be afraid that staff and management will treat them differently or negatively because of their disability
• they may be afraid that their manager will see them as a liability and a potential expense
• they may be afraid that they will be overlooked for promotions or other work-related opportunities
• they may be afraid that they will lose their job.

What are my responsibilities when a worker has not disclosed their mental illness?

A worker may choose not to disclose their mental illness to you, even when it is evident that they are not coping in the workplace.

If a worker is having difficulty performing the key requirements of their job, and this might be related to mental illness it would be prudent for you to:

• ask if there is any assistance or workplace adjustment that could assist the worker in performing their job
• offer the choice of seeking confidential support from an Employee Assistance Program or equivalent outside professional advice.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All (section 4.3.3)

Your main role in this situation is to:

• determine whether workplace adjustments can reasonably be made, based on how the worker is performing in the job (without needing them to formally disclose their mental illness)
• consider OHS requirements and privacy principles.

Further information: Appendix A – Knowing the Law.

In some situations, the fact that the worker has not disclosed their mental illness will limit or even prevent you from providing reasonable adjustments or support. In other situations, it will still be possible to proceed with an adjustment in the workplace to assist the worker regardless of their non-disclosure.

Broader strategies in the workplace with an emphasis on creating a safe and healthy work environment for all will also benefit workers with an undisclosed mental illness.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All.

What is my role if a worker’s mental illness impacts on other work colleagues?

There may be some situations where it is obvious that a worker with mental illness is not coping.

It is important for you to recognise that in some situations the impact of a worker’s mental illness in the workplace may be stressful for, or result in, concerns by work colleagues.

Where a worker with mental illness has significant periods of absence from work or is not performing at their normal work level colleagues may become concerned, angry or resentful about the impact on their workload and the workplace.

In addition, where a worker with mental illness behaves in an unusual or disturbing way, colleagues may become stressed, concerned or unsure about what to do.

While respecting the privacy of the worker with mental illness, you should:

• provide support to work colleagues to address workload concerns (as you would for any other worker who is absent or not performing at their normal level for health reasons)
• discuss concerns of work colleagues and try to resolve them
• ensure the safety of workers
• provide counselling or other support, such as access to an Employee Assistance Program.

Where the worker with mental illness has agreed that their disability can be disclosed to the workplace, you could also:

• provide information to work colleagues about the nature of the mental illness and encourage them to be supportive
• arrange for a mental health service to provide information and training.

In many cases, having a worker with mental illness will have little or no impact on the workplace.

What can I say to other work colleagues about a worker with mental illness?

It is important not to breach a worker’s privacy by telling colleagues about their mental illness unless the worker has agreed that you can do so. Even when permission has been given, the purpose for disclosing a worker’s mental illness to colleagues should be carefully considered.

In some situations, it is possible to avoid disclosing a worker’s mental illness by only mentioning details relevant to the workplace. For example:

‘Jesse will be on sick leave for six weeks.’

‘Brett has been asked to change his work duties for a specific period to focus on the following tasks which he has agreed to do.’

In other situations, the nature of the workplace adjustment may inadvertently lead to disclosure. For example, moving a worker’s workstation or allowing flexible work arrangements may result in colleagues questioning, speculating or gossiping about the reasons for the change. You should ensure that the worker has thought about what their colleagues may infer from any adjustments, and discuss what information could be presented to colleagues so that potential issues do not arise.

If the worker agrees to disclose their mental illness to work colleagues, a manager can explain the reason for the adjustments in a positive and supportive manner. Helping colleagues learn more about mental illness and its impact can prevent negative reactions or assumptions and result in a more supportive work environment.

Discussion between yourself and the worker with mental illness is essential in determining the parameters for disclosing a worker’s mental health status to their colleagues.

If the worker does not agree to let you disclose their mental illness, you will need to discuss what adjustments will be possible without such disclosure or making staff aware (or likely to assume) that the worker has mental illness.

3.2 Reasonable adjustments

Research has shown that effective, productive, healthy and safe workplaces are ones that:

• identify and implement workplace support and adjustments to meet individual workers’ needs
• implement effective, long-term broader organisational strategies to create an inclusive and flexible workplace.

Further information: section 3.3.1; Chapter 4 – Creating a Safe and Healthy Workplace for all.

In order to comply with relevant anti-discrimination legislation it is important that you adequately consider reasonable adjustments in the workplace for workers with mental illness. After all, adjustments enable a worker to carry out their job to the best of their ability, making them a productive member of your workplace.

What are ‘reasonable adjustments’?

Reasonable adjustments are changes to a job, which can be made to enable a worker to perform their duties more effectively in the workplace.

They should respond to the particular needs or issues of a worker and can include:

• offering flexible working arrangements (e.g. job rotation, variable start and finish times)
• changing some aspects of the job or work tasks (e.g. exchanging a single demanding project for a job consisting of a number of smaller tasks)
• changing the workplace or work area (e.g. moving a worker to a quieter work area)
• purchasing or modifying equipment.

Reasonable adjustments apply to all areas of employment, including:

• recruitment, selection and appointment
• current work
• career development
• training
• promotion, transfers or any other employment benefit.

Suggestions of possible individual reasonable adjustments are outlined below. Broader workplace strategies such as flexible work practices benefit many workers including those with mental illness.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All.

How do I identify and make reasonable adjustments?

Identifying and implementing reasonable adjustments for workers with mental illness is not a difficult process. There are four main points to keep in mind:

3.3 Examples of reasonable adjustments to address the effects of a worker’s mental illness in the workplace

Here are some options for you to consider if you need to support the workplace needs of a worker with mental illness.

As mentioned at the beginning of this chapter, many workers with mental illness will not require any workplace support. Others may require only brief or specific support, while some may require support over a longer period of time.

Effective actions will vary, depending on the individual needs of the worker, the nature of your workplace and the tasks associated with the job. The choice of actions should be guided by consultation with your worker and with appropriate professional advice.

3.3.1 Flexible working options

Flexible working options are probably the most effective strategy for meeting the workplace needs of workers with mental illness.

There are a wide range of flexible work arrangements that can be introduced, including working hours, tasks, responsibilities or location. Some examples are:

• variable start and finish times and days worked, provided core business hours are worked, the overall fortnightly or monthly hours are met and the essential business needs are achieved
• working from home, provided the allocated tasks are met and core meetings and events are attended
• ability to work part-time
• discretionary leave where additional sick leave provisions are made available to the worker
• offering the worker a variety of tasks
• offering a work area in a quieter location
• providing a privacy screen or arrangement to offer the worker their 'own' space
• changing or sharing responsibilities or tasks, such as providing administrative duties rather than telephone or face-to-face contact with customers.

It is important to consult with your worker. Discuss reasonable adjustments that would suit the job requirements and their own circumstances. A worker with mental illness may have already developed good strategies that can be adapted to their work environment.

If flexible work arrangements are considered, care should be taken to ensure that this does not lead to isolation from the workplace, colleagues and workplace support.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All.

3.3.2 Strategies to address difficulties with thinking processes (e.g. memory and
concentration)

Some workers may experience difficulties with their thinking processes such as:

• concentrating on tasks
• attention to work tasks
• memory
• processing information
• forming clear thoughts.

For workers experiencing difficulties with memory

Strategies that you can consider include:

• writing work instructions down rather than just telling a worker what to do; you may choose to email information and instructions about work tasks
• colour coding or highlighting specific information or tasks that you would like the worker to prioritise
• using diagrams, aids or models to demonstrate work tasks required; this can assist the worker to remember and process information more efficiently
• providing a diary or electronic organiser to diarise work tasks, requirements and/or deadlines
• making yourself available to discuss the progress of work tasks or nominating a colleague to act as a ‘buddy’ for the worker
• providing keyboard overlays to assist the worker remember special functions or shortcuts.

For workers experiencing difficulties with concentration, processing information, forming clear thoughts

Strategies that you can consider include:

• allowing extra time to complete jobs, projects or tasks
• allowing short breaks when a worker needs to clear their mind
• providing room dividers, partitions, soundproofing or visual barriers to minimise distractions and enhance thinking processes
• reducing noise in the work environment
• explaining complex ideas as clearly and simply as possible – repeat and rephrase explanations and information
• providing flexible work arrangements, such as allowing short breaks from work to enhance thinking, and flexible start times to enable the worker to start work at their most productive time
• redesigning the requirements of the job, such as swapping complex tasks for a number of smaller ones that do not require as much intensive thinking and processing
• organising a mentor with similar skills, knowledge and experiences from within or outside the workplace to support the worker with thought processing strategies
• allowing the worker to use a portable CD player or MP3 player as a tool for minimising distractions and industrial noise and increasing concentration
• providing access to an external provider such as the Employee Assistance Program or a Disability Employment Services provider to assist the worker with thought processing strategies in the workplace.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All; Chapter 5 – Where to Get Assistance.

3.3.3 Strategies to address difficulties with organisation and planning

Some workers may experience difficulties with organisation and planning such as:

• planning or carrying out tasks
• managing multiple tasks
• meeting deadlines
• avoiding certain tasks.

For difficulties with planning tasks, managing multiple tasks, meeting deadlines, avoiding tasks

Strategies that you can consider include:

• developing a written plan of action with the worker that features achievable tasks with set times for completion
• providing a checklist of the tasks to be completed
• allowing extra time to complete tasks
• providing written information about deadlines
• reminding the worker of important deadlines through informal emails
• using email to provide written information about tasks and to provide informal support
• setting up informal support meetings to discuss progress, being careful not to treat these meetings as ‘performance’ meetings. For example:
  • clearly outline the purpose of the meeting at the beginning and end of the meeting
  • meet at an informal location, such as a café or quiet office area
  • do not formally record the outcomes of the meeting; inform the worker if you intend to take notes and the reasons why
  • be aware of your body language: folded arms and legs, limited eye contact and sitting behind a desk give the impression of a formal, rather than an informal meeting
• assisting the worker to manage multiple tasks by redesigning the work requirements so they can focus on a few specific tasks
• suggesting the use of a personal diary (hard copy or electronic), personal organiser or mobile phone reminder to keep track of required tasks and key dates for their completion
• rearranging job responsibilities/tasks, such as exchanging a single demanding project for a job consisting of a number of smaller tasks
• organising a mentor with similar skills, knowledge and experiences (from within or outside the workplace) to support the worker in organising and planning work tasks
• providing access to an external provider, such as the Employee Assistance Program or a Disability Employment Services provider to assist the worker in developing planning and coordinating strategies.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All; Chapter 5 – Where to Get Assistance.

3.3.4 Strategies to address difficulties with social interactions (e.g. avoiding working with colleagues) Some workers may experience problems with social interactions and you may see them:

• avoiding social interactions
• avoiding working with colleagues.

Strategies that you can consider include:

• not making social activities mandatory for all workers
• if the worker is required to regularly meet with colleagues, business representatives or the general public, swapping these tasks with less ‘social’ activities
• allowing the worker to work from home for a short period of time
• if the worker is located in a busy area, relocating them to a quieter part of the workplace
• providing a mirror so the worker knows when colleagues are going to approach them to avoid getting startled
• allowing telephone calls during work hours to external support people such as their doctor or family member
• providing access to an external provider such as the Employee Assistance Program or a Disability Employment Services provider to assist the worker to develop social strategies in the workplace.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All; Chapter 5 – Where to Get Assistance.

3.3.5 Strategies to address difficulties with physical symptoms (e.g. pain) and functioning (e.g. fatigue)

Some workers may experience problems with physical symptoms and functioning, as a result of their mental illness or medication, such as:

• blurred vision
• pain, tremors or stiffness
• heart attack symptoms
• being sleepy and fatigued
• functioning best at certain times of the day
• turning up late for work.

Strategies to deal with pain, tremors or stiffness, blurred vision, other physical symptoms

Strategies that you can consider include:

• reducing writing tasks by enabling the worker to tape record meetings
• introducing assistive technology to enable the worker to reduce keyboard activity and reading from a computer screen (e.g. speech recognition software allows a person to use speech to access all functions of the computer)
• providing training to the worker about accessible computer functions, such as enlarged print options
• reducing physical activities by identifying less physically demanding tasks
• providing short breaks to relieve any physical symptoms
• providing flexible work options such as part-time work, use of annual or sick leave to structure a rest day after two or three days consecutive work
• allowing work from home for a period of time to allow work and rest throughout the day
• breaking up more demanding tasks with interludes of less strenuous tasks.

Sleepy/fatigued/turning up late for work

Some workers with mental illness function best at certain times of the day as they may have had disrupted sleep or be groggy due to the effects of medication.

Strategies that you can consider include:

• identifying with the worker the most productive time of the day for them to complete work tasks
• structuring work and work hours to match their most productive time of the day
• allowing the worker to have input into rostering arrangements.

3.3.6 Strategies to address absence from work

A worker may be absent from work due to medical appointments.

Strategies that you can consider include:

• providing limited paid time off if a worker has to attend medical appointments during work time
• organising a time-in-lieu arrangement for long appointments and/or if the financial viability of the organisation is affected
• encouraging the worker to organise medical appointments on a quieter day of the week, grouping appointments together or booking appointments at the start or end of the working day to minimise the impact on the workplace
• providing a limited number of cab vouchers to assist the worker to attend medical appointments.

Other reasons for absences may include not being able to cope in the work environment.

Strategies that you can consider include:

• meeting with the worker to identify the reasons for the absences
• exploring alternatives to being absent for a whole day, such as:
  • using a quiet room for breaks
  • taking a part-day absence
  • if the worker works part-time, allow them to swap with another day in the week, if this suits them
  • offering flexible work hours such as part-time, job sharing or working from home for some or all of the time
  • providing a quiet area to enable the worker to talk to a support professional by phone during the working day
• organising to meet with the worker to discuss work levels and report on any essential work priorities that need to be attended to while they are on leave
• organising an informal meeting when the worker returns to provide an update of work matters that have occurred during their absence
• ensuring that the worker does not return to a stressful situation such as a backlog of work, emails and requests for work.

If there is a continued pattern of absences, the reasons given are questionable and/or the worker fails to follow procedures, a more formal approach of managing the worker’s performance may be required.

3.3.7 Strategies to address difficulties with emotions (e.g. anxiety and frustration)

Some workers may experience problems with their emotions, which can include feeling:

• frustrated
• stressed
• anxious
• angry
• sensitive to feedback
• worried about work
• on edge, restless
• low mood.

If a worker is exhibiting feelings of frustration, anger, annoyance and restlessness

Strategies that you can consider include:

• avoiding being drawn into arguments
• reminding the worker of basic rules of behaviour in the workplace, such as treating everyone with courtesy and respect and not displaying violent/threatening/bullying behaviour
• allowing flexible timing of breaks to enable the worker to use stress management techniques to cope
• encouraging the worker to walk away from frustrating situations and confrontations
• demonstrating more positive responses to frustrations at work (e.g. you can encourage the worker to outline their issues using ‘I feel’ statements rather than ‘you’ statements, which can incite more frustration and anger)
• letting the worker know when there is a positive change in behaviour, such as saying to them ‘you handled that situation well’
• allowing telephone calls during work hours to external support people, such as their doctor or family member
• taking immediate action if you are worried a worker is in danger of hurting themselves or others, physically or psychologically; in these situations, whether the person has a mental illness or not, you have an obligation to try to prevent risks to health and safety
• providing access to an external provider such as the Employee Assistance Program or a Disability Employment Services provider to assist the worker to develop strategies to manage their emotions in the workplace.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All; Chapter 5 – Where to Get Assistance.

If a worker appears sensitive to feedback, highly anxious, prone to excessive worry about work Strategies that you can consider include:

• providing praise, positive feedback and encouragement as often as appropriate
• couching feedback in positive terms and discussing negative feedback in private
• delivering any negative feedback in a constructive manner (ensure the issues are work-related; do not engage in long discussion; and be clear about the issues and strategies)
• organising a mentor with similar skills, knowledge and experiences from within or outside the workplace to support the worker in areas such as managing work without getting stressed
• minimising anxiety prior to meeting by providing advance notice to the worker about the topics to be discussed and their role in the meeting
• allowing the worker to provide written responses rather than verbal responses and feedback
• providing access to an external provider such as the Employee Assistance Program or a Disability Employment Services provider to assist the worker manage their emotions in the workplace.

Further information: Chapter 4 – Creating a Safe and Healthy Workplace for All; Chapter 5 – Where to Get Assistance.

If a worker is acting out of character and behaving inappropriately (e.g. inappropriate language, clothing or contact with colleagues or actions)

Strategies that you can consider include:

• providing flexibility, such as small breaks during work, to relieve the build up of stress
• helping the worker understand the difference between what is reality and what is not
• minimising stress if the behaviour seems to be set off by stress
• gently and matter-of-factly disagreeing with strange ideas
• providing clearly documented and discussed guidelines about appropriate behaviours in the workplace
• considering behaviour contracts.

3.4 What do I do about performance concerns for workers, including workers with mental illness?

As a manager, you may be unsure how to deal with performance concerns for workers, including workers with a suspected or known mental illness.

You are entitled to apply your standard performance management system to all workers where you have a legitimate concern about their performance.

However, as part of that performance management system, you will need to:

• take into account personal circumstances that may contribute to a worker’s performance issue, as you would for all workers
• consider whether a mental illness may be contributing to the poor performance
• consider the seriousness of the performance concern (as for more serious matters, such as violence, there may be no option but to take strong disciplinary action regardless of whether there is a reason, such as a mental illness)
• consider whether the performance concern relates to a key part of the job or if the work could be adjusted to address or avoid a recurrence of the particular concern
• encourage and enable the worker to discuss the performance concern and whether there are any health issues that may have impacted on their performance.

Where a mental illness has already been disclosed to you, discuss with the worker whether their illness has had an impact on their performance and how it can be addressed in future.

Where you already know that a worker has mental health issues (or they raise this during the performance process) it may be advisable to cease the performance management process at that stage. This will enable you to focus on the possible impact of their mental illness in a more a supportive and sensitive manner.

You could, for example, make it clear to the worker that:

• you have a performance concern about them
• their behaviour or performance was unacceptable
• you are aware or suspect they have a mental illness
• you would like to discuss how they see their mental illness impacting on their work and performance
• you are willing to explore whether there are reasonable work adjustments that could be made to accommodate the particular impact of their mental illness without compromising core job responsibilities
• you wish to make it clear that while the behaviour/performance was unacceptable, you are willing to explore whether there are options to prevent it occurring again, rather than it becoming a formal performance management process
• if the performance issues cannot be resolved, or reasonable adjustments cannot be made or do not work, you will need to revisit the issue as a performance concern at that point.

If the worker has not disclosed a mental illness, it is still possible for you to explore ways to adjust their work to try to avoid the performance concern occurring again or to pursue the normal procedures for unsatisfactory performance.

As with all workers with performance issues, you need to:

• address your concerns with the worker in a sensitive manner by identifying work-related adjustments to assist them meet the inherent requirements of the position
• provide a timeline to implement the work-related adjustments
• ensure that you and the worker are both clear about the requirements of the job and standards for performance
• undertake disciplinary action or termination if:
  • it is not a result of mental illness
  • it is directly related to performance or an inability to perform the key requirements of the job
  • it occurs after considering whether reasonable adjustments are possible.

If poor work performance continues after the identified timeline you may decide to recommence the disciplinary process with the worker.

3.5 What should I do if I am worried about the health and safety of a worker with mental illness?

There may be occasions where you are worried a worker is in danger of hurting themselves or others. In these situations, whether the person has mental illness or not, you have an obligation to take action to try to prevent risks to health and safety.

When a worker is at risk of harming themselves^[15]

Almost 2000 Australians die by suicide each year. You may come across a worker who you think is at risk of suicide. This can be a difficult situation but there are a number of practical things you can do to help.

There are a number of factors associated with higher risk of suicide, including:

• talking about feeling hopeless and helpless
• being socially isolated
• having a recent loss, such as a relationship, job or death of someone close
• making a previous suicide attempt
• having a friend, family member or work colleague who has died by suicide
• having mental illness
• behaving in a risky manner, such as taking drugs, alcohol abuse, or driving recklessly.

SANE Australia identifies four basic steps to assist in helping a potentially suicidal worker.

1. Let them know you are concerned and that you are there to help
2. Ask if they are thinking about suicide and if they have made any active plans to do so. Remember:
   • talking about suicide will not make them take action; asking shows that you care
   • asking will help them talk about their feelings and plans – the first step to getting help.
3. Take action to get help now:
   • tell them that there are other options to suicide
   • don’t agree to keep their suicidal thoughts or plans a secret
   • don’t assume they will get better without help or that they will seek help on their own
   • If the person is thinking about suicide, encourage them to:
     • make an appointment with a GP – offer for someone to go along with them
     • contact a counsellor or Employee Assistance Program, family member or friend
     • contact a specialist helpline for information and advice.

Further information: Chapter 5 – Where to Get Assistance, section 5.2.

• If they have made a plan to end their life:
  • check if they are able to carry out this plan. Do they have a time, place or method?
  • contact the Psychiatric Emergency Team or Crisis Assessment Team (CAT) at the local hospital and the police on 000; report that the person is suicidal, has made a plan and you fear for their safety
  • stay with the worker or arrange for someone to stay with them until they are linked with appropriate professional help.

4. Take care of yourself:
   • it is emotionally demanding to support someone who is suicidal
   • find someone to talk things over with, including family, friends, others or a Helpline.

When a person is at risk of harming others

A very small number of people with mental illness may become aggressive just as a minority of workers without mental illness may become aggressive. Unfortunately, the media tends to focus on the few people with mental illness who become violent. In fact, violence accompanying mental illness is not common and is usually associated with untreated illness. It is actually more common for a person with mental illness to be the target of aggressive and violent behaviour.

If a worker shows aggressive behaviour in the workplace it is important to:

• stay calm
• talk in a calm, slow but firm manner
• keep at a reasonable distance
• suggest the worker sits down to help them feel more at ease; you should also sit down and not stand over them
• try to calm the situation and create some trust by offering a cup of tea or coffee
• give a firm command, such as ‘stop please’
• if they do not stop, leave the worker alone in a safe environment where they are not at risk to themselves or others, until they have calmed down
• take any threats or warnings seriously
• contact the police or security if you are concerned about the safety of the worker and/or co-workers; tell them the person has or may have a mental illness and requires medical help, ask them to send a plain-clothes police officer if available, so the person will feel less threatened
• contact the worker’s treating practitioner, if known
• access your nearest appropriate medical practitioner.

If you believe that the worker poses a health and safety concern in the workplace, you have a duty of care to take action to prevent any risk.

Further information: Appendix A – Knowing the Law.

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^[15] Australia (2008) Fact Sheet: SANE Steps: How to help when someone is suicidal