Recognizing a Troubled Employee Kim Dyson, MA,LPC,MAC,SAP Licensed Professional Counselor Masters Addiction Counselor EMDR Trained Quote to Remember “When dealing with people, remember you are not dealing with creatures of logic, but creatures of emotions.” Dale Carnegie Mental Health Problems in the Work Place • According to 2010 U.S. National Comorbidity Survey 18% of employees in the workplace experience mental health disorders. • Mental health disorders often go unrecognized and untreated which damages an individual’s health, career and reduces productivity in the work place. General Signs of Mental Illness • Confused or Disoriented • Behavior Changes • Darting looks • Flat Affect • Talking to self • Withdrawn • Pressured speech • Sad or anxious mood • Poor hygiene • Panic • Inappropriate attire • Psychosomatic complaints Schizophrenia Symptoms • Impacts 1 out of every 100 people. Onset is late teens, early adulthood. • Symptoms Include : – Hallucinations – Delusional thinking – Apathy – Withdrawn – Poor hygiene Major Depression Symptoms • Sad, anxious, feeling empty, hopeless, pessimism • Decrease energy • Lack of interest in activities, work & sex • Sleep disturbance (insomnia or over sleeping) • Appetite and weight changes • Guilt, helpless, and thoughts of death • Suicide attempts • Problems with concentration, and making decisions • Hypochondria Manic/ Bipolar Disorder Symptoms • Increased energy • Decrease need for sleep • Increase risk taking • Unrealistic beliefs in abilities • Increased talking, physical, social & sexual activity • Aggressive response to frustration • *Depressed phase is similar to Major Depressive Disorder • *Rapid cycling can occur Anxiety Disorders Panic Disorders Symptoms • Women twice as high as men. • Include intense fear, heart palpitations, chest pain, shortness of breath, dizziness, poor concentration, excessive worrying, requiring excessive reassuring, panic attacks occur without warning Person is concerned that the attacks will strike again Anxiety Disorders Obsessive-Compulsive Disorder • Due to a short circuit in the basal ganglia • Two types: • Obsessions are recurrent thoughts, images, impulses that cause anxiety. They are illogical, at times repulsive and /or center on violence or harm. Ex. fearful of having a illness, pre-occupation. • Compulsions are behaviors that are repetitive- attempts at reducing the anxiety created by the obsessions. i.e. hand washing, counting, ordering. Post Traumatic Stress Disorder Symptoms: Exposure to an extremely stressful event. Painful memories, nightmares, suspicion, anxiety, depression, feelings of guilt and sleep difficulties Symptoms worsen with exposure to similar events Substance abuse is a common method to cope Psychosis • Senses can be affected: sight, hearing, smell & touch. • Like a LSD trip: a chemical firestorm • Central control system is down • It’s terrifying, confusing • Symptoms will go away with time or with treatment Personality Disorders Difficulty in holding steady work and relationships Difficult to change Can co -exist with other mental illnesses Perceiving events are skewed Range of intensity are inappropriate Impulse control Co-occurring Disorders Presence of both a mental illness and substance abuse disorder High prevalence rates 60% of persons with a mood disorder also have a substance abuse disorder 50% of persons with schizophrenia also have a substance abuse disorder Cognitive Disorders Symptoms: • Memory problems • Impaired Judgment • Disorganized • Failure to meet deadlines • Problems with time management • Difficulty following instructions Basic Communication Guidelines Simple content Be patient Low stimulation level Be pleasant and firm Don’t force Praise cooperative communication if person is behavior withdrawn Practice reflective listening Be consistent Know your non-verbal Don’t take actions or communication reactions personally Violence Incidence increases 60% if Greatest risk, males in late the mental illness is teens to early 20’s untreated. Past behavior best predictor Substance abuse Warning Signs Tremors Hyperactivity Rigid Posture Clenched jaws and fists Pulsing arteries Verbal abuse/profanity Characteristics of a Good Working System Shared Vision Involvement of both parties Established written documentation Formal and informal verbal communications Ongoing Commitment Facts About Suicide • 8 out of 10 suicides have given prior warning • Ambivalent about Death • Ambivalence is not the same as manipulation • Suicide Risk does not increase with Discussion • Substance abuse issues • History of mental illness • Talk of giving things away of value Facts about Suicide • A parent died by suicide increases risk by 50% • Prior attempts increases risk by 33% • Mental Illness increases the risks – 61% have Major Depression – 48% have Personality Disorders – 40% have Alcohol Use Disorder – 10% have Anxiety Disorder – 6% Schizophrenia Why Do People Die by Suicide? • Impulsive • Depressed • Escape from suffering • Communication problems • Loss of a loved one • Feels hopeless Intervening • Create a safe environment • Take turns communicating • Talk about a safety plan • Emphasize the positives • Evaluate the persons potential • Refer to the EAP Tips for Confronting the Employee • Private and confidential • Focus on job performance • Document declining performance • Maintain a supportive attitude • Give the employee a chance to “tell their story” • Be clear about all duties and expectations • Be fair and consistent Tips…. • Don’t make value judgments • Make no excuses for poor performance • Be prepared to meet with defensiveness • If the employee reports they are sick….refer to a medical professional • Hold to your convictions regarding their decline • Seize the opportunity to seek help for the employee Tips…. • Set up a follow up meeting • Explain how to utilize a EAP • Make a Management Referral when a employee is a Threat to Self or Others, Tested Positive for Drugs or Alcohol, Psychological Impairment, or Job Performance Deterioration How Can a Manager Deal with Difficult Employees • Evaluate the situation • Develop a plan • Act quickly • Confront the problem • Focus on the behavior • Be conscious of the employee’s feelings • Use disarming techniques • Know When You are in Over Your Head, call the EAP representative to set up an immediate consultation • If the employee becomes combative or threatening to self call 911 How to Document Poor Work Performance and Attendance • Note incidents: dates…time • Record behaviors observed • Include acceptable and unacceptable performance • All information is confidential, and discussed only with the employee and official company representative In Conclusion….. BayView Professional BayView EAP Associates Employee Assistance Program 450-2250 “Everything we shut our eyes to, everything we run away from…can become a source of beauty, joy, and strength if faced with an open mind.” ~Henry Miller APPLICATION OF THE ADA TO EMPLOYEES WITH MENTAL HEALTH DISABILITIES Celia J. Collins EEOC resolved 5000 charges of discrimination based on mental health conditions in 2016 and obtained $20 million for employees denied employment and reasonable accommodation. Increase in EEOC charges filed per common mental health disabilities 2500 2000 1500 2007 1000 2011 2016 500 0 Anxiety Depression PTSD Disorder From EEOC.gov The Americans with Disabilities Act • Prohibits employers from discriminating against qualified individual with disabilities in job application procedures, hiring, firing, advancement, compensation, job training, and other terms, conditions, and privileges of employment • Applies to employers with 15 or more employees • An employer must make a reasonable accommodation to allow a disabled employee to perform the essential functions of the job unless it can demonstrate that the accommodation would impose an undue hardship on the operation of the business. Statutory Definition of Mental Impairment Mental Impairment under the ADA – “any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities” Definition of Disability ADAAA (ADA Amendments Act of 2008) • “definition construed in favor of broad coverage of individuals” 3 Categories of Protection: • Impairment that substantially limits one or more major life activities • Record of a substantially limiting impairment • Being regarded as having a substantially limiting impairment Substantially Limited • EEOC regulations – “not meant to be a demanding standard” • Impairment is a disability if individual: • Unable to perform a major life activity; or • Restricted in the condition, duration or manner under which a major life activity can be performed as compared to the average person • Duration must be more than several months • Consider severity • Without regard to “ameliorative effects” of mitigating measures • Medication, medical supplies, equipment, or appliances • Prosthetics • Hearing aids and other hearing devices • Coping strategies Episodic/Remission • Conditions that are episodic or in remission are disabilities if they substantially limit a major life activity when active • Examples: • Manic Depressive Disorder • Bipolar disorder and PTSD Major Life Activities Typically Implicated by Mental Health Impairment • Thinking • Concentrating • Interacting with others • Sleeping • Caring for oneself • Working • Communicating “RECORD OF IMPAIRMENT” • Substantially limiting in the past • Includes individuals mischaracterized as having a disability