It’s no longer a secret that the world is suffering from an epidemic of poor mental health. Positively, a much-needed torch has brought light to the issue through major studies digging into the scale of the problem. For example, the World Health Organisation has estimated that 12 billion working days are lost every year to depression and anxiety. In response to the results of such major studies, emphasis has been placed on the duty of care organisations have to support and protect the mental health or their employees, or students.

Organisations are encouraged to create a safe and healthy environment, implementing policies, procedures and training that will help address concerns and promote an open culture around mental health. But what happens when a member of staff or student experiences problems while they’re off-site and out of reach? How can support be provided when they’re overseas and far from home?

Understanding the bio-psycho-social model

All mental health issues need to be considered within the context of an individual’s wider life. This includes their work, family, social and romantic lives, but also their physical health and work environment. A framework to base your understanding of mental health problems is the bio-psycho-social model. How these three realms interact, and the imbalances within them, are what causes mental health problems.

For example, in “good” mental health the biological influences on your body and mind are balanced. Good nutrition, exercise, sleep and a lack of chronic illness all have a positive effect on our mental state. Social factors including romantic relationships, family life, friends and socialising, as well as relationships with colleagues, all play a huge role in the make-up of our psyche. Psychological history also plays a large role in mental health. For example, someone’s physical health and social life might be excellent, but a history of childhood trauma might mean they suffer from issues around anxiety.

Causes and manifestations

A mental health crisis is when the balance in a person’s life starts to become unstable which leads to a deteriorating mental state culminating in an acute crisis. The crisis presentation takes many forms but can involve unusual or aggressive behaviour/speech, suicidal thoughts and self-harm behaviours, problems with alcohol or illicit drugs, or becoming increasingly isolated and withdrawn.

Why and how poor mental health manifests itself, is never textbook or straightforward. For some, their mental wellness will wear away gradually, over time. For others, the impact will be more sudden.

Think about an employee visiting an overseas office, in town to pitch to an important client. They are jetlagged and exhausted from all the recent late nights preparing for this meeting, the late alcohol-fuelled nights entertaining the client, and general high workload. At home, they might be under similar pressure, experiencing difficulties within their personal relationships. Their colleagues notice a change in this employee’s demeanour. For example, they might lose track of what they are saying in important client facing interactions. This could be a subtle sign that an acute mental health crisis is brewing.

Another scenario to consider might involve illegal substances. At Healix, we once provided crisis support to an American student who experienced a psychotic incident while experimenting with drugs during a trip through Malaysia. She was in a foreign country and became paranoid, feeling extremely unsafe. We used our expertise and the reach of our medical and security teams to assist the student, not only with the medical help she required but to ensure she felt safe and was ultimately able to return home to receive appropriate medical and psychiatric support.

How to provide support if someone is experiencing an acute mental health crisis

Do:

Remain calm and compassionate: Approach the situation with empathy and understanding; a calm demeanour can help de-escalate the situation.

Ensure immediate safety: If the individual is at risk of placing themselves or others in immediate danger call emergency services immediately.

Provide a safe space: If possible, take the person to a quiet and private area to talk where they may feel more secure and less exposed.

Know your limits and when to call in professionals or emergency services: Recognise the boundaries of your role and expertise. Do not attempt to provide counselling if you are not qualified. Instead, facilitate access to professional services.

Follow up: After the immediate crisis has passed, continue to check in with the individual to ensure they are not feeling isolated and are receiving the support they need.

Do not:

Do not dismiss their feelings: Avoid downplaying their emotions or telling them to “calm down”. This can make them feel misunderstood and unsupported.

Do not leave them alone if they are at risk: If there is any indication that they might harm themselves or others stay with them until professional help arrives.

Do not ignore the situation: Pretending that nothing is wrong or hoping the issue will resolve itself can potentially lead to deterioration in the situation. Address it upfront and call in the help you need.

Do not rush the conversation: Rushing them can cause additional stress and hinder communication. Instead, allow the individual to speak at their own pace.

Do not make judgments or assumptions: Do not make assumptions about the employee’s condition or how it should affect their life or work. Mental health issues are complex and individualised and judging or minimising their experience can be both harmful and discouraging.

Understanding and recognising limitations

The challenges of acute mental health incidents are complex, and multi-layered. When an employee experiences a mental health crisis, it can be a difficult and sensitive situation for both the individual and the employer.

For employers, it’s crucial to first and foremost handle any situation with empathy, understanding and proactivity. However, it’s essential to also recognise that while employers can provide support, they are not mental health professionals and need to be aware of their own limitations.

The right support and training can help employers to navigate a live situation, and feed into an organisation’s ongoing Acute Crisis Response plan. Training up selected employees as Mental Health First Aiders is also a useful measure, who can be on hand to support in different locations or areas of the business.

Ultimately, an employer must offer compassionate assistance while respecting the individual’s privacy and autonomy where possible. It’s a difficult balance to strike and is best approached with the guidance of professionals.