Mental Health Referrals From Institutional & Workplace Advocates

Advocates in the workplace can also be trained to manage mental health crises at work. This involves learning to spot the signs that someone’s in crisis, initiating non-judgmental conversations, de-escalating the crisis, and coordinating emergency support.^[3]

Learning how to do this involves developing a sense of the appropriate language to use, the ability to assess urgency, and knowledge of the appropriate services to contact. For example, if you need to call 911, it’s important that you request officers with Crisis Intervention Team (CIT) training.^[3]

As mentioned, an awareness of legal rights is an important part of advocacy. If it’s necessary to call the police, you can do as much as possible to respectfully advocate for the employee to receive a mental health response. However, the officers will have broad discretion over next steps, such as whether the person is taken to the ER, issued with a warning, or arrested.^[3]

Additionally, being transported to the hospital can be very distressing, especially if law enforcement officers use handcuffs. If it’s safe to do so, it could be a better option to contact the employee’s family or friends to transport them instead.^[3]

A key part of being a workplace advocate is referring employees to appropriate forms of support. Having a good understanding of local clinics, therapists, and specialist services can make this process much easier.

Immediate support might mean referring an employee to 988, the national suicide and crisis hotline.^[3] However, most of the time, you’ll likely refer employees to workplace mental health support services, telehealth providers, or those in the local area.

Referrals to workplace mental health services typically follow a strict procedure. These types of services could be occupational mental health programs or workplace behavioral health services and are well-integrated into workplaces. For example, employee assistance programs (EAPs), which we’ll explore in more detail next.

Other workplace-specific forms of support include mental health resources from HR, which could provide a great deal of information about symptoms, treatment types, and lifestyle changes.

You might also refer employees to external services, which won’t require a strict referral procedure. In these cases, it’s just about having a conversation with an employee to discuss their options and getting the go-ahead to put them in contact.

Workplace mental health programs are becoming increasingly common, with the most common being an Employee Assistance Program (EAP) for mental health. These services can offer short-term therapy, assessments and evaluations, and referrals.^[4]

As an advocate, you should get familiarized with your company’s EAP, how it works, and the services it offers. Then, you can accurately inform employees about what they can expect. Remember, EAPs won’t be able to support everyone. Those with more severe or specific mental health conditions may need an external service, so make sure to communicate this to the employee and EAP, so they receive an assessment.

As an advocate, you should know what treatment employees are legally entitled to, as this can affect many aspects of their mental health experience. For example, whether they can take leave, how their medical information is protected, and what happens if they report discrimination.

Here’s a non-exclusive list of employee rights to give a brief overview of what they entail:^[5]

• Employees and job applicants cannot be treated unfavorably because of their mental health conditions. Therefore, employers cannot ask about mental health conditions before offering a job to someone. An employee also cannot be treated unfairly due to their mental health in any way throughout the course of their work.
• Those who work for covered employers and who have serious mental health conditions are legally entitled to take job-protected leave under the Family and Medical Leave Act (FMLA). This leave can also be used to care for a spouse, parent, or child with a serious mental health condition.
• In general, employees do not need to explicitly disclose the reasons for taking paid time off, sick leave, or personal days.
• Employer-sponsored health plans should not charge more for mental health services than for comparable medical services. This is in accordance with the Mental Health Parity and Addiction Equity Act (MHPAEA).
• Employees have the right to be free from retaliation (negative treatment) when requesting accommodations, taking FMLA leave, reporting discrimination, and raising concerns about their health plan’s coverage.
• Employers can only request medical information when it’s job-related, such as for reasonable accommodations or protected medical leave. However, health information must be kept confidential and stored separately from the employee’s regular personnel file.

Supporting both mental health leave for employees and their return-to-work transitions are important roles for advocates.

Both of these events carry risk for discrimination and unfair treatment. But, as mentioned, there are legal protections for both of these events. Understanding these legalities enables advocates to promote fair workplace treatment, even if it is managers who carry out the administrative components.

For example, advocates can support leave and subsequent reintegration by making recommendations for things like flexible or remote working to ease the transition.^[3]

Reasonable accommodations are protected by the Americans with Disabilities Act (ADA), and these can include a wide range of adjustments.^[6]

For example, someone may need to eat at their work station to offset the side effects of medication. They might also need more frequent breaks, a reduction of workplace noise, organizer software, or a modified job description, to name a few.^[6]

Crucially, reasonable accommodations can typically be made at a very low cost, encourage employees to return to work more quickly, and act as incentives to retain talented staff.^[6]