Minnesota Cities Magazine
More from Jul-Aug 2016 issue

Mental Health Issues in the Workplace

By Mary Jane Smetanka

When people burst into tears at their desk, is it a sign of a mental health issue? Or are they just having a bad day?

What about shouting or being uncooperativeA silhouette of a head with gears in the brain and a magnifying glass over the head to illustrate a focus on mental health issues at work, showing up late day after day, or threatening a co-worker?

Each year, one in five American adults has a diagnosable mental disorder, according to estimates from the National Institute of Mental Health. That makes employee mental health issues an everyday reality for Minnesota cities. But dealing with them requires more than sympathy and good intentions.

Identifying a mental health issue
State and federal laws have created a minefield for employers, who must walk a fine line between respecting employee privacy and preserving productivity, morale, and safety for other employees. “I frequently talk to cities that are dealing with something having to do with mental illness,” says League of Minnesota Cities (LMC) Human Resources Director Laura Kushner. “It’s not easy.”

Federal and state laws protect employee privacy. And that means caution is warranted, she says.

“You can’t ask if an employee is having mental health issues, and as a general rule, employers don’t have any right to know the medical health issues of employees,” Kushner says. “They do have a right to expect a certain level of performance. But a lot of state and federal privacy laws come into play.”

Signs of possible mental health issues include unusual absences, leaving work early, emotional outbursts, mood swings, anger or irritability, changes in personal hygiene, and crying at work. Sometimes, Kushner says, affected employees seem to have lost interest in their jobs or are “just not the person they used to be.”

Sue Iverson, interim city administrator in Arden Hills, believes that in recent years municipal employees have been stressed by a double dose of cutbacks at work and the same financial and emotional strains that affect everyone during a recession. This means city employers are seeing more mental health issues than ever.

“There is stress from the inside and stress from the outside,” she says.

Over the course of a 30-year career in government administration, West St. Paul Assistant City Manager and HR Director Sherrie Le has dealt with employee mental health issues ranging from crippling grief to extreme anger.

“You have to tread very carefully, be open-minded and prepared, have resources available to use, and make sure that your supervisors know what to do, what to say, and what not to say,” Le says.

Legal guidelines
The federal Americans with Disabilities Act, Health Insurance Portability and Accountability Act, and Family and Medical Leave Act (FMLA), as well as Minnesota’s Human Rights Act all affect how cities deal with employees who are struggling with their mental health.

Privacy provisions in the laws that protect health information make it more difficult for cities to determine how serious a situation is or whether an employee poses a danger in the workplace. Anyone with a disability is protected under federal law. So if cities try to discipline employees for workplace behavior that results from an underlying mental health disability, confusion and even legal claims can result.

The laws can also affect city staffing. Under FMLA, an employee dealing with a serious health issue can take a leave of up to 12 weeks. All cities are covered by the law, but only cities that have 50 employees within 75 miles of each other are required to offer the leave. If the employee qualifies for an FMLA leave, it’s up to the city to figure out how to cope with that absence.

Tread lightly when intervening
Kushner suggests that before meeting with an employee who may be having mental health issues, city officials seek guidance from their city attorney or from League HR staff.

Help is also available from companies like Sand Creek, a Stillwater-based consulting and counseling firm with 550 offices across Minnesota. Sand Creek offers confidential counseling for workers in cities that retain the firm for employee assistance programs (EAPs). City officials can also consult with the company’s experts about sensitive employee issues.

The focus of a supervisor-employee discussion must be on job performance, Kushner says. For example, if an employee is repeatedly leaving his or her desk to cry in the bathroom, the discussion shouldn’t even mention that behavior. Instead, she says, the supervisor should say something like this to the employee: “In the previous week, you were missing every time I was looking for you for work purposes.”

“Some employees will just break down and say, ‘You’re so right. Here’s what’s going on,’” Kushner says. “Others won’t get so personal.”

Even if employees share personal information, supervisors should proceed carefully.

mental health illustration showing two heads with gears in the brain area“I would say, ‘Is there any kind of accommodation we can offer to make things easier, and would you like to talk to your doctor?’” Kushner says. If the employee doesn’t volunteer information, and the city has an employee assistance program, supervisors can give the worker that contact information with a reminder that the help is confidential.

Make resources available
It is recommended that cities make sure employees are aware of the resources available to them. Offering an EAP is ideal.

Most EAPs offer a variety of resources. Sand Creek’s staff includes psychologists, social workers, drug counselors, and others. The firm deals with issues that include family and parenting problems, depression and anxiety, elder care, substance abuse, and financial trouble. Help is available around the clock, seven days a week.

President and CEO Gretchen Stein says it is quite common for 5 to 10 percent of a city’s staff to seek out Sand Creek’s help. About 80 percent of those people do so on their own.

“There’s no charge, and it’s confidential,” Stein says. Employees and their families are covered. She says mental health issues have costs in the workplace that reach beyond the person who is struggling with a problem.

“It affects harmony, it affects morale, people may be walking on eggshells around this person,” Stein says. “It’s important for co-workers to reach out, or supervisors to say, ‘You know, I can see there’s a change in your work performance.’ We want people to get the help they need and be treated with dignity.”

Arden Hills retains Sand Creek as part of its employee benefits package. Iverson says the city brings a company representative in each year to talk to employees during open enrollment, and she keeps the firm’s cards and calendars around to pass out to employees. She says employees who were distracted at work because of outside issues have used Sand Creek to get help with everything from troubled teenagers to financial counseling.

“Our utilization rate is high,” Iverson says. “Everyone knows it is there; the program is working for people.”

Real life
Le, who has worked for several cities over the years, shared a situation she once dealt with in which the city’s EAP made a big difference. In this case, a woman who had been close to her mother struggled on the job after her mom died. Her supervisor advised her to take time off. She was referred to the Sand Creek EAP and after a couple of weeks, returned and resumed productive work.

“Her co-workers knew what was going on. They just understood that she needed the time, and picked up the slack while she was gone,” Le says.

Every case is different, she says. “You have to have some compassion and be flexible.”

In another case, an employee at one of Le’s previous jobs behaved in a threatening manner at work. The “way-out-of-line” behavior resulted in counseling and anger management classes, which over time, helped the employee get his temper under control, she says. To put everyone at ease, the employee even voluntarily discussed his problem later at an employee meeting.

“It helped [his co-workers] accept that no one was perfect,” Le says. “They reacted really well. It soon became a non-issue.”

Kushner thinks cities and the rest of society are still grappling with how to address mental health issues that were once considered too shameful or embarrassing to openly address. But she says the resources are out there to gradually change that.

“The stigma is not gone; employers are very embarrassed to talk about it, and employees are hesitant to discuss it,” she says. “We have a ways to go before we treat mental health issues the way we do physical issues. Cities need to find that right balance between empathy and accountability. You don’t want to play psychologist. Leave that to the professionals.”

More information
For more information on this issue, contact the League’s HR staff at hrbenefits@lmc.org or read the LMC information memo Reasonable Accommodations in the City Workplace, available at www.lmc.org/accommodate.

Mary Jane Smetanka is a Minneapolis-based freelance writer.

Read the July-August 2016 issue of Minnesota Cities magazine

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