The manager’s mini playbook for supporting mental health 

Who this playbook is for

Built for line managers in SMEs, this guide reflects real workplace scenarios and practical decision-making. It supports managers to act early, use the right resources, and follow consistent procedures that protect employees, teams and the business.

Use this playbook as a day-to-day reference for building a healthier, more resilient team culture - where mental health is taken seriously, support is offered early, and boundaries remain clear. The long-term benefits include stronger trust, fewer escalations, and a healthier team culture.

It’s especially useful for managers navigating mental health conversations in hybrid, high-pressure or changing work environments.

Mental health matters in every workplace

Since the pandemic, stress, burnout and mental health struggles have become more common. These pressures increasingly affect people’s day-to-day working life, not just isolated moments at work. And more often than not, it’s line managers who spot the signs first. 

Mental health in modern working life

Many of these challenges show up as mental health problems that affect how people feel, behave and perform at work. For most people, early support and clarity from their line manager can make a real difference. This is especially true when expectations, workload or role demands change within someone’s job.

This includes a wide range of mental health conditions, each affecting people differently and requiring an individual response. Mental health is closely linked to physical health, and challenges in one area often affect the other at work. Building a better understanding of these differences helps managers respond appropriately rather than relying on assumptions.

You don’t need to be a counsellor. But you do need to feel confident recognising when something’s not right, starting supportive conversations, and finding the balance between care and compliance. 

Why it matters 

The pandemic, hybrid working, and cost-of-living pressures have all left their mark. Breathe research showed a sharp rise in reported stress and poor mental health at work. For SMEs, this isn’t just a “wellbeing” issue - it impacts absence, performance, and team morale. 

Never make assumptions about people experiencing poor mental health. For some employees, this may involve ongoing mental health problems that need consistent, structured support rather than one-off conversations.

The rise in cases post-pandemic highlights just how individual each situation can be - and why early, supportive intervention from managers matters. Without support, some employees may struggle to cope with pressure that previously felt manageable.

The business impact of mental health

Early support doesn’t just reduce risk - it can also boost productivity by helping people stay focused and engaged. Supporting good mental health at work helps reduce absence, improve engagement, and create more resilient teams. It also plays an important role in staff retention, as people are more likely to stay where they feel supported and understood.

Simple strategies like regular check-ins, clear priorities and realistic workloads help keep pressure from building unnoticed. In some cases, early signposting to a mental health support service (like Mind) can help employees access guidance before problems escalate.

Open conversations and early support also help reduce stigma around mental health at work.

Spotting early signs 

Mental health issues can present in different ways for each person, which is why it’s important to look for patterns rather than single incidents. These differences are often shaped by a mix of personal, work-related and external factors. This is a useful moment to start thinking about what support might help - and whether a check-in would be useful.

People experiencing mental health difficulties may show subtle changes before problems become more visible.

Mental health struggles don’t always look the same, but there are common indicators.

Early warning signs managers should look for

• Behaviour changes → someone suddenly quieter, or unusually short-tempered.

• Withdrawal → avoiding meetings or social interactions. 

• Defensiveness → overreacting to small requests or feedback.

• Presenteeism → physically present at work, but struggling to concentrate or complete tasks effectively.
   

How to start the conversation 

Active listening is key - giving someone space to speak without interruption builds trust and encourages openness. Line managers often fear saying the wrong thing. These communication skills help managers respond with empathy while staying calm and professional.

Creating psychological safety

Creating a calm, respectful space helps people feel comfortable sharing concerns early. That sense of safety often determines whether someone opens up, or stays silent. Encouraging open communication helps managers spot concerns earlier and respond before problems escalate.

What to say and what helps

But the simplest openers are often the most effective: 

• “I’ve noticed you seem quieter than usual - how are you doing?” 

• “I wanted to check in. Is there anything making work harder for you right now?” 

• “What support would help you most at the moment?” 
   

Don’t be afraid to ask if someone is OK. These conversations can help people manage stress early and reduce stress before it escalates into longer-term absence or performance issues. A simple, open question is often the starting point. You don’t need to fix the situation - showing care and willingness to listen is what matters most. 

Balancing care and compliance 

Managers have a duty of care to the individual - but also to the wider team and the business.

Employers also have responsibilities to apply policies fairly and consistently across the organisation. In the UK, this is underpinned by the Equality Act, which sets out employer responsibilities around fairness, reasonable support and non-discriminatory treatment at work.

That means sticking to process, even in sensitive situations. In some cases, this may include exploring reasonable adjustments to help someone stay well and perform effectively at work. This may also involve reminding employees about available support such as the employee assistance programme, which offers confidential help alongside formal workplace processes.

Supporting mental health while following process

Clear processes help managers support people consistently while protecting the wider team and the business. This consistency also supports fair treatment in line with the Equality Act, without requiring managers to interpret the law themselves.

Case Example 1: 
An employee began harassing their manager with hundreds of messages. When suspended, they disclosed poor mental health. Despite repeated offers of support (OH, EAP), they refused to engage. Eventually, capability procedures were used fairly to bring the situation to a close. 

Case Example 2: 
Another employee accused colleagues of “hacking” their devices and leaving nails under their car tyres. Instead of framing it as “suspension,” the manager (guided by HR) suggested “taking a short period of paid leave while we investigate.” The softer phrasing diffused tension, while process protected both sides. 

Key takeaway: Support with empathy, but don’t avoid fair procedures. Boundaries matter. 

Support toolkit 

You’re not alone - managers can (and should) lean on resources: 

• Occupational Health (OH): impartial advice on adjustments and capability. 

• Employee assistance programme (EAP): confidential counselling and support that gives employees a safe, external space to talk.

• Mental Health First Aiders (MHFA): trained colleagues who can listen and signpost. 

In some organisations, trained support workers or wellbeing champions may also be available to provide guidance and signposting.

You may also have internal training or manager guidance on mental health, absence and support pathways - use it alongside this playbook.

You can read Breathe’s blog ‘5 ways to support your employees’ mental health’ here.

• Stress risk assessments (HSE): structured way to identify triggers and set practical support. 
   

External resources, such as a mental health support service, can provide additional guidance beyond what managers can offer internally.

Natalie emphasised: “HR and managers aren’t medically trained. That’s why tools like OH and risk assessments are so valuable - they give you clarity and protect the business.” 

Breathe’s HR Partner network can help you with tools like these - reach out to one of our Breathe Partners.