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To help our member cities navigate the human resources issues associated with creating a mentally healthy workplace culture, the League has compiled these frequently asked questions.

According to the Centers for Disease Control and Prevention (CDC), mental illnesses are among the most common health conditions in the United States. Public safety staff may have even higher rates of mental health conditions due to the nature of their work. Cities can take on the leadership challenge of creating a mentally healthy workplace culture by normalizing conversations about mental health, providing resources to address mental health issues, showing empathy and compassion regarding mental health concerns, and reassuring employees the city will make every effort to support them in obtaining any assistance needed.

Get answers to these frequently asked questions (FAQs):

Q1.What are some quick and easy ways to get started with promoting mental health in the workplace?

Q2. What is a mental health condition and how does mental health affect work performance?

Q3. How can we identify whether there are significant mental health issues or concerns in our public safety department?

Q4. How can we deal with employee performance issues or misconduct that might be associated with a mental health issue? How can we safely have this conversation without violating laws like the Americans with Disabilities Act (ADA or Minnesota Human Rights Act (MHRA)?

Q5. What do I say to an employee who tells me they are having a mental health issue like depression or anxiety?

Q6. What if an employee tells me they are on medication for a mental health issue? Can we allow them to keep working?

Q7. What if the employee has a suspected and/or diagnosed substance abuse problem?

Q8. How can the employee’s supervisor ease the transition back to work for an employee who has been absent seeking treatment?

Q9. What if we think an employee is having a mental health issue that makes it unsafe for the employee to perform their job duties?

 

Q1. What are some quick and easy ways to get started with promoting mental health in the workplace?

A1. Reduce the stigma associated with mental health issues or concerns and normalize conversations about mental health to help employees feel supported and safe.

  • If possible, have a person in a leadership position share their own struggles with symptoms associated with mental health and indicate their support for creating a work environment where it is safe to share and get help.
  • Implement and provide training on respectful workplace policies. Be mindful of language and actions that are disparaging of mental health conditions, such as using words like “crazy” or “insane” to describe events or people.
  • Provide written information, podcasts, and training to inform employees about mental health strategies and programs that promote mental wellness.
  • Review any policy, procedure, or practice with employees that pertains to employment issues associated with recovering from a mental illness episode.
  • Reassure the employee that their supervisor and human resources staff are available to help, and that the city will treat information about mental health issues as non public data (i.e., only shared with those who need the information to make employment decisions or have specific legal authorization).
  • Continually provide information about employee assistance programs (EAPs) and other mental health resources that are available. (The pandemic has increased the availability of telehealth services which include mental health counseling).
  • Consider implementing a program that allows or requires periodic mental health check-ins with a qualified medical professional.
  • Explain to employees that they are valued members of the team, that having symptoms of mental illness is hard, but you will help them through it the best you can.
  • Talk openly with public safety personnel about what help they think would be beneficial if they or a colleague have a mental illness. Discuss the process for helping public safety personnel keep working and get back to work during and after treatment. When possible include union representatives in the discussion.
  • Do – or at least consider and discuss doing — these things even in challenging situations, such as where the employee is under investigation and/or in the process of being disciplined for misconduct or performance issues or situations where the employee has damaged trust with supervisors, coworkers, and/or others.
  • Share that every situation may be different so there is no “cookie” cutter approach, but typically what the process will be:
    1. A discussion with a supervisor and/or HR sharing what is going on.
    2. Reassurance, support, and compassion.
    3. Working together with the supervisor, HR (if available), and others to develop a plan to keep working or take time off.
    4. Time off could include Earned Sick and Safe Time, sick leave, short-term disability or long-term disability depending on the severity of the illness, or Family and Medical Leave Act (FMLA) leave.
    5. Stress to employees that they won’t be labeled, that these types of illnesses are common in public safety, and that treatment can be effective in addressing mental health symptoms.
    6. The opportunity to have peer support if they’d like.

The American Psychiatric Association (APA) Foundation web resources includes an organizational assessment you can take online to determine where your organization can increase efforts to promote mental health in the workplace.

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Q2. What is a mental health condition and how does mental health affect work performance?

A2. A mental health disorder is a diagnosable condition affecting an individual’s mood, thinking, or behavior. There is a wide range of mental health disorders, but a few of the most common ones that can impact the workplace include anxiety, depression, bipolar disorder, schizophrenia, eating disorders, attention deficit/hyperactivity disorder, obsessive-compulsive disorder, substance abuse, and post-traumatic stress disorder.

According to the CDC, an employee’s mental health can impact their work performance in the following areas:

  • Quality of work they perform and level of productivity.
  • Level of interest and engagement in one’s work.
  • Ability to concentrate and screen out distracting environmental stimuli.
  • Ability to communicate effectively with coworkers.
  • Physical capability to complete tasks and to function normally.
  • Ability to accept feedback and adapt to change appropriately.

It may be difficult to know if a performance issue is a mistake, lack of training/knowledge, poor performance, or the result of a medical condition, including mental health disorder. That is why it’s extremely important to address poor work behaviors as quickly as possible. If an issue is a result of a medical health condition, including a mental health disorder, it is also extremely important to further discuss with the employee to explore potential reasonable accommodations. Ideas for potential accommodations can be found on the Job Accommodation Network (JAN), a great online resource.

You may want to ask a local mental health provider (including a substance abuse professional) to come speak to your supervisors about recognizing and responding to warning signs. It may be especially helpful to have a provider who works regularly with public safety employees speak to the city’s public safety staff.

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Q3. How can we identify whether there are significant mental health issues or concerns in our public safety department?

A3. The best way to identify potential medical concerns – including mental health concerns – is to have open communication and the trust of your employees.  They will feel comfortable coming to you with concerns and questions – hopefully long before any potential issues arise – and you can work together to find workable solutions.

You may be able to get some idea about the prevalence of mental health issues in your workforce by asking your health care or employee assistance provider for statistics on mental health claims and usage for your employee group. Keep in mind, those statistics will not identify specific employees, including the job title of employees. A well-designed employee engagement survey might reveal the existence of mental health issues, and this might be available by department if the city is large enough to protect individual identities.

According to the National Alliance on Mental Illness, common signs of mental illness in adults can include:

  • Excessive worrying or fear.
  • Feeling excessively sad or low.
  • Confused thinking or problems concentrating and learning.
  • Extreme mood changes.
  • Prolonged or strong feelings of irritability or anger.
  • Avoiding friends and social activities.
  • Difficulties understanding or relating to other people.
  • Changes in sleeping habits or feeling tired and low energy.
  • Changes in eating habits such as increased hunger or lack of appetite.
  • Overuse of substances like alcohol or drugs.
  • Multiple physical ailments without obvious causes (headaches, stomach aches).
  • Suicidal thinking.
  • Inability to carry out daily activities or handle daily problems or stress.

While the above may be signs of a mental health issue, the city should not take employment action based only on these behaviors. A supervisor or manager can speak with the employee about any of these behaviors when it impacts the employee’s work, focusing on the impact on the workplace. Employers can hold all employees accountable to workplace rules. If the city learns the employee has a medical condition, including a mental health condition, from the employee or from other information, the city will want to further discuss with the employee to explore potential reasonable accommodations, gather other objective information, and/or seek guidance by medical professionals, including the employee’s treating provider(s) and/or outside experts. Ideally, these events occur before any misconduct occurs that implicates discipline.

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Q4. How can we deal with employee performance issues or misconduct that might be associated with a mental health issue? How can we safely have this conversation without violating laws like the Americans with Disabilities Act (ADA) or Minnesota Human Rights Act (MHRA)?

A4. Understand that these can be complicated situations that often require legal assistance.

  • Identify the performance issue or potential misconduct as specifically as you can, including the behaviors that are contributing to the issue; be frank when you discuss the issue with the employee. It is a best practice to both discuss these issues (whether in person or via Teams/Zoom) as well as document in writing.
  • Be quick to address any behaviors that are not supportive of your organizational values.
  • Be consistent in your approach to performance issues.
  • Treat people the way you’d want to be treated under the same circumstances.
  • It’s important to provide compassionate accountability when challenging work performance. Using phrases such as:
    • I know this is hard. Let’s work on addressing these issues.
    • I can’t make this go away. But I’ll help you get through it by providing information and resources, coordinating benefits, etc.
    • Yes, you’ve lost trust. Let’s find some ways to help you earn trust again.
  • Ask the employee how you can help and what they need from the organization to avoid the performance issues in the future.
  • Do not refer to or assume there is a mental health issue unless the person brings it up (or if you learn additional information).
  • Be open to solutions that may help the employee such as hybrid work/telework, flexible scheduling, time off, reduced work schedules, etc.
  • Obtain additional information from the employee’s medical provider or an independent medical provider to help identify potential accommodations and/or address any safety issues. It may especially be helpful to work with medical providers who are experienced with working with public safety personnel, such as psychologists who regularly conduct pre-employment psychological exams.
  • If there are concerns about whether the employee can safety perform the job and/or there are concerns about misconduct, address those issues by addressing the employee’s work status, the value of a psychological fitness-for-duty exam, and/or other actions.

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Q5. What do I say to an employee who tells me they are having a mental health issue like depression or anxiety?

A5. There’s no perfect way to handle this type of conversation but here are a few guidelines:

  • Thank them for trusting you enough to share this with you.
  • Reassure them that they did the right thing by confiding in you.
  • Let them know you may not have all the answers they need right now but you will do your best to answer their questions and provide information about resources.
  • Let them know they are not alone. Many people experience these illnesses and with help they can get better.
  • Ask them if they need any accommodations to help them be able to safely perform the essential functions of the job (as identified on the job description) and, if appropriate because of the context, if they need a medical leave.
  • Take good notes about discussions and ask questions and follow up in writing after the discussion to document what was discussed.
  • Give them a timeframe in which you can get back to them.
  • Tell them you will check in with them periodically to see how they are doing and commit to doing so. Avoid asking sensitive and personal questions about symptoms, treatment, and relationships but be open to listening if they want to share.
  • Do not offer opinions about diagnoses or symptoms; leave that to the mental health provider.
  • Show concern and empathy but don’t make promises about what you or the city can do for them, just offer that you will be there to help them figure out what the city/you can do to help; if there are performance issues, you may need to emphasize the city will need to enforce certain standards of behavior and performance.

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Q6. What if an employee tells me they are on medication for a mental health issue? Can we allow them to keep working?

A6. Most modern medications for mental health issues will allow an employee to keep working safely, so the city should proceed carefully and not overreact to the fact an employee may be on a medication for a mental health condition or other condition. A national health interview survey from the Center for Disease Control (CDC), showed that in 2020, 16.5% of those surveyed had taken prescription medication for their mental health.

Every medication can carry its own risks and side effects, not just medications for mental health symptoms. Different classifications of medications have different side effects or withdrawal symptoms from discontinuing a medication, and starting or stopping a medication should be done under supervision of a medical provider.

Cities can require periodic documentation about medication usage from public safety employees in general and, in some circumstances, for a specific employee if it’s job-related and necessary for a business reason such as to ensure the individual is fit for duty upon return to work. Cities will want to be careful to be consistent and not discriminate against those with mental health conditions. If the city has a consistent policy of requiring public safety staff to report medication usage, medications taken for mental health symptoms should be treated the same as other types of medication with regard to reporting and requirements for a medical provider’s note, and should not require more scrutiny than other types of medication. A best practice is to make sure the medical provider has a copy of the employee’s job description to help them make judgments about whether the employee can safely perform job duties while on medication.

If a medical provider has stated that an employee can safely perform the job contingent upon them continuing to take medication (or participate in other treatment), the city can require that the employee provide documentation of compliance – and can implement consequences for failure or refusal to do so.

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Q7. What if the employee has a suspected and/or diagnosed substance abuse problem?

A7. If the employee volunteers information about a substance abuse problem, they may already be receiving or seeking treatment. If that is the case, you and the city may be able to help support them in their treatment and recovery by providing time off or other flexibility around scheduling. If they are not yet receiving treatment, you can encourage them to seek it and help them find resources for getting the treatment.

However, it is also important to check your own internal police department and city policies regarding drug and alcohol use and to seek HR and legal assistance with these issues. Employee substance abuse issues are complicated and often governed by multiple laws. For example, drug and alcohol testing is only allowed in Minnesota when it follows strict legal guidelines (e.g., the city must have a written policy, must follow certain testing protocols, etc.). There are also some additional considerations with Minnesota’s recent law legalizing recreational cannabis.  While employers can continue to prohibit the use, influence, possession, sale, and transfer of cannabis in the workplace – and cities can test public safety employees for cannabis – the city has to follow specific procedures and has to work through other issues .

The law also may provide protections for past use of illegal or drugs or current/past use of alcohol, depending on the situation.

It also can be difficult to separate substance abuse issues from performance issues, and this separation is sometimes important to effectively dealing with performance issues. For example, if an employee is often late to work, this is a performance issue, but it could be associated with a substance abuse issue because the employee is experiencing the effects of alcohol abuse. The performance needs to be dealt with regardless of the substance abuse issue, but they are related. Helping an employee get treatment may help with the performance issues associated with the substance abuse.

The situation is likely even more complicated when the city suspects an undiagnosed and untreated substance abuse problem and the employee has not come forward to acknowledge it. The city may want to consider obtaining additional documentation and/or sending the employee for an evaluation by a substance abuse professional if there is enough documented cause for doing so. For all these reasons, it is best to seek guidance from your HR professional and city attorney.

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Q8. How can the employee’s supervisor ease the transition back to work for an employee who has been absent seeking treatment?

A8. First and foremost, the hope is that supportive outreach was done between you and the employee during their time off, while receiving treatment.

  • Welcome the employee back.
  • Let them know they are a valued member of the team.
  • Make sure the employee is up to date on any necessary trainings or credentials.
  • Communicate and document any requirements for the employee’s return to work.
  • Do not pretend like nothing happened; acknowledge the fact they have been gone and discuss how to smoothly transition back to the workplace.
  • Do not ignore the person because you are worried you will say something wrong; treat them like you would someone who has been out with a broken leg.
  • Make sure they know you are there if they need anything and the best way to reach you, then make yourself available when they need you.
  • If the city has a formal peer support program where individuals have been properly trained to offer support and assistance, ask the employee if they would like to have a peer assigned to help support them in their transition back to work.
  • Do not share medical information with other employees; you can share that the person was out on a leave and that you are sure they would appreciate being welcomed back and told they were missed.
  • If there were performance issues or misconduct before, reiterate the expectations of the job and conduct any necessary training.

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Q9. What if we think an employee is having a mental health issue that makes it unsafe for the employee to perform their job duties?

A9. If there is an imminent threat that an employee will harm themselves or others, the city should immediately contact law enforcement and take additional steps to ensure safety.

If a city employer believes that an employee is unable to safely perform the job because of a mental health or other medical condition, the city should consider the employee’s work status, whether to obtain additional information from the employee’s medical provider, and/or require the employee to undergo a fitness-for-duty exam. Specifically, if there are concerns about whether an employee can safely perform their job, the city will want to consider whether to place the employee on leave (such as paid administrative leave), place the employee on light duty, or otherwise alter the employee’s status pending a fitness-for-duty exam. The city will also want to consider other issues related to an employee’s status – such as whether the employee will be required to turn in the badge and firearm, whether the employee will be prohibited from accessing physical buildings, email, the computer network, etc.  While the city can take these actions based on an employee’s conduct, statements, and other objective information, the city will want to be careful not to impose blanket policies, such as locking out of email all employees who go out on leave for a mental health condition, but not a physical condition.

In order to require an employee to undergo a psychological fitness-for-duty exam, state and federal law require that an employer has a reasonable belief the employee’s psychological condition is hampering their ability to do the job or that they are posing a safety risk (direct threat) to themselves or others. It is important the city compiles and reviews objective evidence such as firsthand accounts of the employee’s behavior, the employee’s own statements, and available medical documentation. The employee must also give informed consent to release the results of the evaluation to the employer; if the employee refuses, the city may be forced to take action based on the information it has, which could include disciplinary action up to and including termination.

Public safety employees may be understandably worried that such an exam may seriously hamper or even end their careers. Creating a work environment that is supportive of employees with mental health issues, or employees who have sought mental health treatment, can be a critical component in helping an employee feel it is safe for them to cooperate with this type of exam. Furthermore, employers and public safety leaders should be careful to avoid any bias with regard to mental health conditions and instead rely on objective evidence, such as the opinions of medical providers and observed workplace behaviors. Many conditions, including mental health conditions, are treatable with counseling, medications, or other treatment and will not prevent an officer from safely performing their duties.

As a rule, supervisors and others in the chain of command should not make promises about job security in any performance discussion. This is particularly important prior to receiving the results of a psychological evaluation because the city will need to evaluate its ability to make any needed accommodations, and there may be mental health issues that cannot be accommodated. The city can, however, assure the employee it will do what it can to support the employee while keeping the employee, coworkers, and the public safe. The city needs to follow through with that promise, however, or it will soon lose credibility with employees.

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Summary

In summary, it’s important and impactful to recognize and reward public safety personnel for the courageous service they provide to the community. One of the best ways to do this is by creating a compassionate, accountable work environment. Forming strong liaisons between public safety leadership, employee unions, the city’s administration, HR, and legal teams to destigmatize mental health conditions and promote public safety mental wellness will help to create a work culture where public safety employees can thrive.

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