Managers’ response to mental health issues amongst their staff

Background: Many organisations are implementing mental health training for managers to facilitate better communication between managers and employees suffering from mental health problems. Much of this training focuses on improving managers’ mental health literacy and reducing stigma. However, it is unclear whether this focus is appropriate, or whether other targets, such as improving skills and confidence should be given greater consideration. Aims: To test whether knowledge, attitudes and confidence are associated with managers’ behavioural responses to mental health issues amongst their staff. Methods: Managers from a large Australian fire and rescue service completed a questionnaire addressing their knowledge, attitudes, confidence and behavioural responses when managing employee mental health issues. The relationship was assessed using logistic regression. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Eighty-five managers responded (response rate 66%). Managers’ confidence was the strongest predictor of their behaviour. Managers who felt confident discussing mental health were significantly more likely to make contact with an employee who was suspected to be suffering from a mental illness (odds ratio 15.79 95% CI 3.03-82.31, P < 0.01) or was on sickness leave for mental health reasons (OR 19.84, 95% CI 2.25-175.15, P < 0.01). Non-stigmatising attitudes towards mental illness also significantly predicted contact with a staff member off work due to mental health problems (OR 5.22, 95% CI1.21-22.54, P < 0.05). Conclusions: Our findings suggest that manager mental health training should focus on building their confidence and reducing stigma in order to have the greatest chance of altering workplace practices.