Most managers don’t avoid mental health conversations because they don’t care. They avoid them because they don’t know what to say, or they’re worried about saying the wrong thing and making it worse.
This article is part of our practical guide to workplace mental health training for UK employers.
That hesitation is understandable. It’s also costing people the support they need. Research consistently shows that a large proportion of employees would rather say nothing about their mental health at work than risk the conversation, even though most of us spend more waking hours at work than almost anywhere else.
So this isn’t really a confidence problem. It’s a clarity problem. Once a manager knows what to actually do, the conversation gets a lot less daunting.
Why these conversations feel so hard
Workplaces have spent decades operating on the unspoken rule that personal life and work life stay separate. Add to that a lingering stigma around mental ill health, and you get a culture where people quietly manage their struggles alone rather than risk being seen differently by colleagues or their manager.
That stigma has a real cost. People who feel they can’t speak up are more likely to delay getting support, more likely to withdraw from their team, and more likely to see their performance and wellbeing decline together rather than separately. None of that is good for the person, and none of it is good for the business either.
The good news is that this is changeable. Culture shifts when individual conversations start happening differently, one at a time, led by people who know what to do when someone opens up.
Everyone has mental health
It’s worth saying plainly: mental health isn’t something only some employees have. Everyone has mental health, in the same way everyone has physical health. It fluctuates. Most people will go through a period where theirs is more difficult to manage, whether that’s a few weeks of poor sleep and low mood or something that meets the threshold for a diagnosable condition.
Once that’s understood, the conversation stops being about identifying who is or isn’t a “mental health case” and starts being about checking in with people, full stop. That shift in framing alone makes the conversation far less loaded.
A framework that actually helps: REACH OUT
Most guidance on this topic tells managers to “listen” and “signpost,” which is true but not always practical when you’re sitting across from someone who’s just told you they’re struggling. We built REACH OUT with our clinical team specifically so managers have something concrete to follow in the moment, not just a principle to remember.
- Recognise risk. Notice changes in someone’s behaviour or wellbeing before they escalate. This is usually the first sign something needs attention.
- Engage without judgement. Start the conversation and listen with genuine empathy, not an agenda.
- Advise and reassure. Offer practical, grounded advice and reassurance rather than platitudes.
- Connect to support. Help the person connect with the right support, whether that’s internal or external to the organisation.
- Help them take next steps. Encourage action and support their progress, rather than leaving it entirely in their hands.
- Open door approach. Make sure they know you’re available whenever they’re ready to talk again.
- Understand your role and limits. Know where your responsibility ends and a professional’s begins, and signpost accordingly.
- Take care of yourself. Supporting someone else’s mental health takes something out of you too. Look after your own wellbeing so you can keep showing up for others.
The model exists because clinical experience told us managers needed more than encouragement to listen well. They needed a sequence they could actually follow under pressure, in real time, with a real person in front of them.
Starting the conversation with a colleague
If you’re not in a management role, you can still make a significant difference simply by how you ask the question. Asking “how are you?” twice, rather than once, often gets you past the automatic “fine thanks.” The second ask signals you actually want to know.
If someone does open up, you don’t need to have the answers. You’re not there to fix anything. You’re there to listen, and then to help them find the right support, which is really the Connect to Support and Help Them Take Next Steps steps of REACH OUT in action.
Showing a small amount of vulnerability yourself also helps. A simple “I’m a bit overwhelmed today, but getting there” does more to open a genuine conversation than a closed off “I’m fine.”
Talking to your own manager about your mental health
You’re never obliged to disclose anything about your mental health to your employer. But if it’s affecting your work, your relationships with colleagues, or your day to day capacity, a conversation is usually worth having, both for your own support and so your employer understands what’s going on.
Going in with a little preparation helps. Think about when and where you’d like to have the conversation, what you’re comfortable sharing, and whether there’s anything specific that would help you, whether that’s a change to your hours, your workload, or simply knowing your manager is aware.
Talking to your direct reports
As a manager, the most useful thing you can do before any conversation happens is build a basic working knowledge of common mental health conditions, so you’re not starting from zero when someone opens up.
A simple, low pressure way to check in regularly is to ask someone to rate how they’re feeling out of ten. It gives people an easier way to communicate than searching for the right words, and it gives you something concrete to follow up on over time. There’s no right or wrong number. It’s a starting point for a conversation, not a diagnosis.
When a more serious conversation is needed, a few small things make a real difference: choosing a private, comfortable setting, sitting alongside someone rather than directly opposite them, and asking open questions like “how are things going for you?” rather than ones that invite a simple yes or no.
Why clinical depth matters here
A lot of workplace mental health training focuses on awareness, which matters, but awareness alone doesn’t tell a manager what to actually do when someone is struggling in front of them. That’s the gap REACH OUT was built to close, and it’s why our training team is made up of practising therapists, clinical hypnotherapists and a serving paramedic, rather than generalist facilitators. The advice managers take away has to hold up in a real conversation, not just on a slide.
Andy, our founder, built much of this approach from his own experience of living with anxiety, panic disorder and depression. He knows what it’s like to be on the other side of a conversation like this, and that perspective runs through everything we teach, not as a marketing line, but as the reason the training exists at all.
Practical support for your organisation
Every manager who completes REACH OUT training also gets access to our learner app, so the framework stays close at hand long after the training session ends, not filed away and forgotten.
If you’re responsible for wellbeing in your organisation and want a practical, clinically grounded way to help your managers have these conversations with confidence, our Mental Health First Aid training is a good place to start. You can also read more about how we approach training or get in touch to talk through what might work for your team.