Why do leaders need mental health first aid techniques?

Today, we are leading anxious workforces, with many employees grappling with stressors such as social isolation, inflation, an uncertain economic outlook, the lingering effects of the COVID-19 pandemic, and rapid technological advances.

In addition to lacking training with regard to emotional well-being, many leaders have been taught that employees’ personal problems are none of their business. However, younger Millennials and Gen Zs have grown up in a culture that increasingly recognizes the importance of mental health and generally views therapy as a normal and accepted part of life. Hence, younger employees are more open to discussing mental health.

No one expects bosses to conduct therapy sessions with subordinates; as the phrase “first aid” suggests, the goal is to provide rudimentary, on-the-spot care until the individual can get professional help, if it’s necessary.


Look for these common, unhealthy mental patterns.

Avoidance: This is common when experiencing anxiety. Many people worry about making presentations, for example, possibly because of how they will be perceived or because they have a fear of public speaking. Therefore, they may request not to present. In the short term, this alleviates their worry, but over the long term, it perpetuates their anxiety. The next time they have to speak to an audience they will be just as anxious—and often the anxiety, fed by avoidance, is more intense.

Reduction of activity: This is typical when experiencing depression and low mood. A leader may notice that an employee is not attending team meetings—or is regularly arriving late for work—and is disengaging socially. For example, an employee feels unappreciated or unfairly treated. The person decides to do less, reinforcing feelings of lethargy and disconnection.

Perfectionism: Believe it or not, the need to perform at the highest level is associated with anxiety. When we believe that a task must be done perfectly, we might abandon tasks that we realize we cannot finish to that standard. Or we avoid even starting a task for fear of doing a subpar job. We get paralyzed and become even more concerned that only perfection is acceptable.


Acknowledge when we see a problem. Then create a safe space for dialogue.

If we recognize that an employee or team member is struggling mentally, we can start by acknowledging the employee’s distress, thereby increasing the individual’s own awareness of their mood and validating their feelings.

Next, we can encourage employees to consider the questions below. These questions help the employee (1) tap into their emotions; (2) connect to their physical response; (3) identify their thoughts; and (4) understand their resulting behavior.

Emotions: What am I feeling right now? How would I describe my mood?

Body: What’s happening physiologically? Am I holding tension in my body (clenched jaw, high shoulders)? Am I breathing faster or harder than usual? Is my heart racing?

Thoughts: What is going through my head at the moment? What thoughts am I having? Can I make them stop for a while or is my mind always racing?

Behavior: What am I doing? Why am I doing it? How am I reacting to my thoughts, feelings, or bodily sensations? Am I avoiding anything?

Also, we can encourage employees to respond introspectively if they are not comfortable sharing.


Help by expressing empathy.

Although leaders do not provide therapy or counseling, they can learn to apply therapeutic relationship skills. The most important of these is empathy, which is a strong guiding principle in building up relationships.

Empathy is not about offering sympathy but rather about being committed to fully understanding someone’s experience. It requires a conscious effort of perspective taking. Empathy can help a person in distress feel less alone and more understood.


Help by offering cognitive reframing.

When leaders initiate conversations with employees about their well-being, they can introduce techniques that facilitate and encourage changes to employees’ mental health. One tool is cognitive reframing, a process of replacing unhelpful thoughts with a more realistic and balanced view of a situation. Cognitive reframing can be an excellent tool when employees (and leaders) feel stuck. There are three key steps to this process.

First, identify the unhelpful thoughts. Next, evaluate the thoughts. Finally, foster an alternative and more realistic perspective.

For example, reframe this thought: “If I take vacation time, no work will get done, and I’ll have so much to do when I return!” Instead, create a more helpful thought: “There may be a lot of work to do when I return from vacation, but I need a break to replenish, and others are available to support me if I need them to.”


Nevertheless, be careful not to overstep.

By no means are leaders expected to formally treat employees or provide therapy themselves. Instead, the goal is to encourage collaborative conversations around mental health at work.

This requires a relationship of trust in which confidentiality is maintained at all times and any personal information shared during discussions remains completely private. Exceptions may be made only when a disclosure indicates the potential for harm to the individual or others. This confidentiality protocol should be clearly communicated to employees, and managers should formally commit to it.

Furthermore, leaders should be guided by the employee in terms of the depth and detail of information shared. Indeed, a leader should not inquire about someone’s life outside the office unless the employee broaches the topic. Some individuals might be willing to disclose personal details, while others might prefer discussing their feelings in more general terms.

Finally, be sure to understand what mental health services your organization offers and be prepared to guide employees to those relevant resources.

First Aid for Mental Health