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How should I deal with an employee's debilitating anxiety?

The Question

I own a mid-sized, downtown Toronto company. One employee suffers debilitating anxiety that affects his decision making, attendance and co-workers. His lack of fortitude and constant need for attention is wearing thin. How do I approach him to seek help? There may be legal ramifications due to the stigma of being singled out. Creating a cause to dismiss rather than rehabilitate seems cowardly.

The Answer

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If you, as an employer, observe problematic behaviours in the workplace, it's time to act. I agree it's a delicate issue but if you address it empathetically, while maintaining strict boundaries, it will be better for every one.

No matter how sympathetic they are, anxious co-workers can have a disruptive effect. A low tolerance for stress, a tendency to think catastrophically and reassurance-seeking behaviours – questions such as "Am I doing okay?" – can be fatiguing to co-workers.

It's not your role to diagnose but it is your responsibilityto encourage that employee to seek help.

"Arrange a meeting in a confidential, private area at a scheduled time," said Ash Bender, clinic head of the work, stress and health program at the Centre for Addiction and Mental Health in Toronto. "You meet with them and provide very fair and objective feedback."

For instance, you could mention how long you've worked together and say you recently observed changes in behaviour and work performance. Then ask: "Is there anything you could tell me that would help me to better assist you at your job."

The goal with this first meeting is to create a forum for dialogue. Suggest an employee-assistance program, if you have one, or perhaps have human resources facilitate further assessment, if necessary. The employee also has to take personal responsibility by seeking help.

Do not end the meeting until you have achieved the following: urged the employee to seek appropriate care, provided information on additional resources, developed an agreed-upon action plan and arranged a follow-up meeting.

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After that initial meeting, do two things: document that conversation to yourself and send a written summary letter to the employee, stating what you have agreed. This will help the worker digest what transpired; it's amazing how two people can have totally different takes of a meeting.

It may be that you will need to modify the employee's duties or hours of work during treatment; that will send the message you are a fair and equitable employer. However, most employers typically require additional documentation from a medical professional before taking such a step.

"A supportive process is more likely to resolve in a successful outcome than a confrontational, adversarial process," points out Dr. Bender, a psychiatrist. "This could be a very valued employee and it sends a message to the office that we acknowledge these things and we try to address them."

The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to

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