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Managing employee performance and mental health issues

How to talk to an employee who’s underperforming and struggling with their mental health

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Talking to an employee about their mental healthTalking to an employee about their performanceComing up with a performance planDismissing an employee with mental health issues

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  • One in six employees will experience a mental health disorder each year.
  • Not showing up, showing up and feeling unable to work, low productivity, and strained working relationships are common signs that an employee might be struggling.
  • Start by having an informal check-in with your employee that's separate from a performance review to find out how they're feeling.
  • Implement any reasonable adjustments that might help your employee feel more comfortable and productive, and if performance is still an issue, have a separate, sensitive conversation.
  • Work with your employee to build an employee performance plan that sets out clear and achievable objectives within a set time frame.

Mental health and performance management are interconnected in many ways. Around one in every six employees will experience a mental health disorder each year – but the sad truth is that plenty of managers won’t realise an employee is suffering until it affects their performance at work.

Managing underperformance and mental health problems can be a very difficult situation, especially if an employee takes time off work due to poor mental health at a time when their performance has slipped or they're on a performance improvement plan.

So what happens when an employee who is suffering from a mental illness is underperforming, either as a consequence of the mental illness or for other reasons?

How can poor mental health impact work performance?

Not showing up (absenteeism), showing up and feeling unable to work (presenteeism), low productivity and strained working relationships are common signs that someone might be struggling, and they all have an impact on the bottom line. Work can feel overwhelming, exhausting or all a bit pointless when you’re not feeling strong enough to cope with the day.

Looking after your employee and your business at the same time can be a delicate balancing act. And raising concerns about someone’s performance when they’re already under pressure is one of the trickiest situations you can find yourself in as a team leader. Luckily, you’re three conversations away from helping your colleague to feel supported towards a full recovery, and managing business expectations, too. 

There are three conversations to be had to help a struggling employee feel supported in their recovery and work performance

How to talk to an employee about their mental health 

Whether an employee’s told you that they’re experiencing a mental health issue, or you’ve noticed some changes in their behaviour and you’d like to ask how they’re feeling, an open chat is on the menu.

Separating this informal check-in from a performance review can help to prevent your colleague from feeling targeted if their health is having an impact on their productivity at work. 

How to have a conversation with an employee about their mental health

  • Find a quiet room
    If you’re meeting in person, reserving a private space that’s free from interruptions and distractions can encourage a more comfortable and honest conversation.  
  • Ask open questions
    Leave space for your colleague to talk, and take time to understand how their mental health is affecting them emotionally and practically at work – without jumping to solutions. 
  • Protect your own boundaries
    Keep the conversation focused on the workplace. Steer away from the causes of their poor mental health, or their home life, if you can. You need to be able to make objective decisions as their manager to support them best.   
  • Avoid giving advice
    his one’s tricky. But you can’t assume that their experience of depression or OCD is the same as your own or your friend’s son’s football coach from school. Giving the wrong advice can be annoying at best and dangerous at worst. As their manager, you also shouldn’t tell (or expect) an employee to seek treatment. That’s a highly personal decision, and for treatments like therapy, their wholehearted involvement is key to its success. You can point them helpfully towards any professional mental health support that your work provides, though, as well as any company resources on sick leave or mental health policies that might be relevant.     
  • Reassure them
    The fact that you know someone’s struggling is a good thing, because it means now you have an opportunity to support them better. You could share that a mental health issue will be managed in exactly the same way as a physical one, and it doesn’t change the way the business looks at them as a person or an employee. 
  • Ask what support they need
    This is a big one. As an employer, you have a responsibility to make reasonable adjustments for someone who’s experiencing poor mental health. That becomes a legal requirement if their mental health condition classifies as a disability. Reasonable adjustments might mean changing their working patterns, their environment or their responsibilities. Ask your colleague to think about which changes might be helpful – even small tweaks like starting an hour later can make a big difference to someone who’s not sleeping properly due to depression or feels unable to take busy public transport thanks to anxiety.

What if an employee won’t talk to me about their mental health?

It’s entirely up to your colleague whether to disclose a mental health issue to you or anyone else in the business. The only time they’re legally obliged to do this is if their mental health condition could put someone’s safety at risk in their role.

Unfortunately, if you’re not aware of an ongoing mental health issue and your employee won’t talk to you about it, then you’re far less able to support them when they fall behind. Make sure you leave the conversation open so they feel comfortable approaching you another time. You may need to get your company’s normal disciplinary procedure rolling if performance issues continue – but this is also a good pause point to reflect on whether mental health stigma is affecting your business.

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How to talk to an employee about their performance

Having a conversation about your employee’s mental health has hopefully given you a bit more context to think about their performance at work. 

If your colleague asked for reasonable adjustments to help them feel more comfortable and productive, then it’s a good idea to give these adjustments a bit of time to have an impact. You’ll probably find that their performance picks up naturally once their hours or responsibilities are more compatible with their mental health problem (or treatment).   

If underperformance is still an issue after the adjustments have kicked in or your colleague has taken time off for recovery, then an honest conversation can still be handled sensitively. Your colleague might already be stressed about ‘letting the side down’, and stress is exactly the last thing they need to feel better. But poor performance isn’t sustainable for any business, and there’s no reason that a mental health issue needs to hold them back indefinitely at work. 

How to have a conversation with an employee about their performance

  • Give lots of notice
    Let your colleague know in advance what the meeting is about. Sending a written agenda can be helpful to set expectations if someone experiences anxiety, for example. 
  • Ask whether they’d like anyone else present
    This might be a colleague, a mental health advocate or a union representative. Let them know this is their choice, and it’s simply to make them feel more comfortable (it’s not to make the review more ‘official’). 
  • Separate performance from personality
    his helps to keep things non judgemental. “You’ve missed 5 project deadlines this month” is an objective playback of your concern, whereas “You’ve been less focussed recently and you’re falling behind on your work” sounds personal. 
  • Be as specific as you can
    Make sure to give concrete examples of underperformance, and include areas to prioritise in any feedback. If the adjustments you’ve made to accommodate their mental health condition aren’t relevant to the examples you bring up, discuss whether there’s any other support you can offer that would help them to meet their targets going forward. 
  • Include their achievements, too
    Experiencing poor mental health can affect your confidence and make you more self-critical than usual. Make sure a performance review celebrates their achievements, as well as highlighting where they’re falling short. 

Having access to next-day therapy sessions can help employees to address poor mental heath and build resilience.

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What is an employee performance plan?

A performance plan is a good way to get things back on track, balancing the needs of the business with the best interests of your employee. 

This plan should set out clear and achievable objectives for your colleague to complete within a set time frame. That might mean showing demonstrable improvement in specific areas, or it might be a list of quantitative deliverables – the important thing is that you agree on it together.

For your colleague, part of committing to this plan is also showing a re-commitment to their role at work, and acknowledging that turning up but feeling unable to perform their job isn’t healthy or beneficial for anybody. 

How to build an employee performance plan

  • Keep goals objective
    Measure performance based on the requirements of the role, not on previous performance. 
  • Ask which responsibilities are important to keep
    It might be tempting to take certain responsibilities off a coworker’s plate if they’re experiencing mental health issues, but plenty of people find that the structure that work provides is actually helpful to manage their condition and stay motivated in work and other areas of their life.  
  • Check in little and often
    Rather than going a whole quarter before deciding whether your colleague has achieved their objectives, break projects into smaller deliverables with more regular progress check-ins to stop people feeling overwhelmed. This also gives you an opportunity to see whether the adjustments you’ve made are helping and how long they might be needed. Point enthusiastically towards any resources they can use to their advantage, like extra training, feedback from the team or any external mental health support on offer. 
  • Make outcomes clear
    If all adjustments have been made so that your colleague has every chance to succeed, and they have a fair playing field with others in their role, then make it clear that continued underperformance might result in disciplinary action. You might like to consider an extension to their performance plan before this happens, mind. 

How to dismiss an employee with mental health issues

Firing somebody from their job never feels good. Firing someone with a mental illness can feel especially difficult, and is obviously a very last resort for consistent underperformance issues. Thankfully, there are laws that protect employees with mental illness from being fired unfairly, so it’s not a decision any employer takes lightly.

The Equality Act 2010 provides protection from discrimination at work for anyone in England and Wales with a disability. That covers mental health problems if they have a ‘substantial, adverse and long-term effect on someone’s ability to carry out normal day-to-day activities’. In short, nobody can be dismissed just because they’re experiencing a mental health issue. 

It’s only fair and legal to consider disciplinary action or dismissal if any of the following apply:

  • Your employee’s mental health problems aren’t related to their performance or conduct issue
  • You’ve made reasonable adjustments to support your employee in their role and their performance remains a concern
  • The employee can’t do their job because there are no reasonable adjustments that can be made to perform their role safely or to the required standard

Read more about fair dismissal on the website.

Empowering managers to have difficult conversations

Managing someone through a period of poor mental health is a good opportunity to reflect on your own management style, as well as your company support policies. Some disorders may need a more permanent adjustment to the way you work with your team. You might need to be more proactive about helping someone with ADHD to prioritise their workload, for example, or you might need to consciously over-communicate with someone who experiences anxiety at work. If your business hasn’t got a mental health policy to support managers responding to issues as they arise, that’s a great place to start.

Becoming a more empathetic manager takes a bit of a conscious effort, but it might be one of the most important things you can do to protect the mental health and fortitude of your team and improve employee performance. Pointing managers towards an external resource like Spill can help build emotional intelligence and confidence in handling tricky situations, through targeted coaching sessions with a qualified therapist.

Therapy is also proven to be an effective solution to help employees build mental strength and resilience, and hopefully prevent any big work-disrupting performance issues ahead of time.

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