Emergency Contacts & Mental Health

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QUESTION From Preston in OH:

"What constitutes an 'emergency'? Are there privacy issues when it comes to mental health emergencies? When we hire employees they fill out the initail application which asks for an emergency contact name, relation and phone # but I'm wondering if I call that person due to a what appears to be a mental breakdown, will I be violating any law or right to privacy?  I have definitely called 9-1-1 and roomates before to help when there was a physical injury before (had a server fall down the basement steps last year and break her ankle) but not sure under what circumstances I could or should call their emergency contact."

 

HH ANSWER:

Thank you for your question! Of all the handbooks I've written (and edited) and policies I've implemented, I never considered mental health policy as much as I have recently. In the wake of more celebrity suicides and mental health PSAs, it has brought the disease of depression closer to center stage and made it easier to discuss with my 8yo daughter.

I explained that when someone has a source of physical pain, it's much easier to notice / identify but when the injury is on the inside, it's much harder for most people to see - so we have to be sure to talk about it. If you're bleeding from the neck or have a foot dangling from the end of a leg - you're sure to have someone recommend seeing a doctor right away...but if the pain is in your heart and the sad feelings are in your mind - no one may even notice until it's too late. At 8 years old - my daughter seemed to grasp this and put things she now sees on television  or online into what I believe is a healthy context...and one that may hopefully serve as a preventative for her and her own mental health. 

Most people from depression seem to mask their disease with a greater interest of not bothering others with their illness than an interest in getting treatment...which is one of the biggest problems IMHO. Once is progresses to the point of a breakdown or dangerous situation (or potentially dangerous situation) privacy is less of a concern to me than the safety of that persona and everyone around them.

If any employee or guest poses a risk…or you think they may pose a danger to themselves or others - that is justification for a 9-1-1 call.

As far as new hire paperwork goes - consider adopting verbiage that specifically includes: “whom may we contact in the event of an emergency or distress”. The permission to contact is inherent in that verbiage and it includes “distress” which I like since “emergency” can be debatable and may require an outcome / manifestation to prove it was indeed an emergency (more difficult to prove if an emergency is avoided by your action).

It should be noted that all of these things are subjective -but according to a healthcare professional friend of mine, “there is often, in most states, a good samaritan component to cases like these that the courts usually recognize in order to encourage the community at large to error on the side of caution.”

According to Psychiatrist Dr. Robin Gains "Most people may not realize that many mental health care issues can be addressed by general healthcare / primary care physicians making free clinics and good primary care providers invaluable. And that should be disseminated in every workplace”.

Historically, if there is a behavioral issue or attitude that threatens to interfere with their own work performance or the work performance of other employees, I would simply counsel the individual…try speaking with them to see what’s troubling them and then give them the rest of the day (or week) off / send them home.

If, during the discussion, you lean that they are having suicidal thoughts or say things like “I’d just rather not be alive” and agree (or offer) to go to the ER or their doctor - placing a follow-up call to make sure they got there is probably ok.

In this day and age, as employers we are often the emotional safety net for people. For many people, the workplace is the one constant in their lives and in many cases… more of a family network than their actual birth families. 

Any deterioration in level of functioning is concerning on a physical AND psychiatric level,. In fact, it’s a criteria for admission to a hospital.

Not getting out of bed, not being able to pay attention, sudden irritability, moving slower, suddenly not showing up for work after an exemplary attendance record— everyone has a bad day - this is not a “Bobby broke up with his girlfriend and is having a bad / down week”. This is more a sudden episode or change in behavior that is grossly out-of-character and as such, a potential sign of: depression, mania, substance abuse / addiction or even a physical anomaly. 

Maintaining a current list of available local mental health and substance abuse counselors and other mental health professionals, free clinics, etc… as “Wellness Contacts” on your employment / safety board is also another good idea since even more common conditions such as:  diabetes, chronic pain and high blood pressure can lead to mood swings and/or depression.

Hope that helps.