It is important to talk to the person to identify the issue and to help them to get the assistance or support they need. A person who is distressed can, at times, respond defensively or out of character.  This difference in behaviour does not mean you are doing anything inappropriate and it is important not to panic. You should use the active steps below as a guide and advise of your duty of care to the individual. It is also important not to escalate matters prematurely or unnecessarily and to stay calm, keeping respect for the person and their dignity at the centre of your focus.

Whilst Occupational Health and the Staff Wellbeing team are not a crisis service, you may find it helpful and supportive to talk through the situation with a member of the Staff Wellbeing team in order to gain confidence for your decisions, if you are uncertain, and also to ensure the right signposting to sources of support. In some cases, a referral to Occupational Health may be necessary where the distress and/or crisis results in absence from work.

If you are a line manager you should also inform your relevant HR Business Partner, who will provide you with further guidance if required and appropriate signposting and a referral to Occupational Health may be appropriate, depending on the circumstances.   

The Active Steps below will also apply in cases where a member of staff is not physically in work but is in contact e.g. during sickness absence, precautionary suspension or annual leave.

1. It is best to help the member of staff identify and connect with what they can do for themselves –

• You can ask them if this has happened before and if they have a coping plan?
• Is there anything you can do to help them activate this coping plan?
• If no coping strategies in place, then do they remember what helped them when this happened before?

2. If they are unsure of what would help, assist them to identify –

• What they think they would find helpful right now? Make some suggestions, e.g.
  • Are there any colleagues who they might find helpful to talk to?
  • Are there friends or family members they would like to contact, or you to contact on their behalf?
  • Would it be more helpful to stay at work or go home*
  • Would time out (e.g. a walk, a drink of water or tea) be helpful, or would they just like to be on their own?

* Occasionally someone may be afraid be on their own at home if they are suicidal.  In this situation they should be discouraged from going home to an empty house.  It is ok to ask the individual if they feel suicidal and the individual’s response will inform your actions and any decisions you may have to make for them.  Point 3, 4 and 5 below apply where a member of staff is talking about an active suicide plan and they must be strongly encouraged to go to their GP or A&E and seek professional help.

3. If you have a concern but not a fear of imminent harm e.g. suicidal thoughts but not an immediate risk –

• Advise of your duty of care and ensure the member of staff is given information on the free and completely confidential 24/7 Employee Assistance Programme Inspire Helpline on 0800 086 9934. You can also refer the individual to the Inspire Wellbeing Hub which has a wide range of supports for all types of wellbeing issues.
• You can also advise of other sources of professional support e.g Samaritans 116123; Lifeline 0808 808 800 and the Here2Help App available on Android or Apple .
• Ensure the member of staff knows how to contact their GP or A&E if they feel at risk.
• Advise the member of staff on how and when you will follow up with them and agree best approach.
  
  

4. If signposting to sources of support is not helpful to the member of staff and/or there is no-one to contact and the individual remains distressed, ask:

• If they have already spoken to their GP about how they are feeling?
• Would they like to contact the surgery and arrange an emergency appointment? Would a Next of Kin or trusted external contact be able to accompany them to the surgery? Is this appropriate given their circumstances?
• If an appointment is arranged organise a taxi for the member of staff to attend the GP surgery or, if appropriate, for the Emergency Contact or external trusted contact to collect and accompany them. Confirm surgery details, date and time of appointment and with whom, if known.
• If the member of staff remains distressed but does not want to contact the GP and none of the options above bring resolution, you should advise them of the health and social care trusts provision of a range of mental health services in the community, at home and in hospitals:
  • Belfast Trust Mental Health
  • Northern Trust Mental Health
  • South Eastern Trust Mental Health
  • Southern Trust Mental Health
  • Western Trust Mental Health

5. If you are unable do any of the above either because the member of staff physically present (or off campus but in contact) is uncommunicative or uncooperative, or because you think that they are an immediate danger to themselves or others then you should contact the Emergency Services police/ambulance.

• For an incident that requires Security on campus – contact 2222 internally. Externally 02890975098 or 02890975099 

6. In the unlikely event where a member of staff advises of an immediate plan to harm themselves or take their own life:

• Mental health professionals advise that you should listen non-judgementally, give reassurance and encourage the individual to get appropriate professional help.
• If you are with the member of staff in person, do not leave them on their own. You may wish to ask a colleague to assist you.
• If necessary, contact emergency services if distress/crisis is as outlined at point 5 above. Otherwise, refer to point 4 above which may include contacting the individual’s GP or Emergency Contact or external trusted contact.
• Advise the member of staff on how and when you will follow up with them and agree best approach (e.g phone call or email within 24 hours).
• Where an individual is off work when they contact you and you have a reasonable belief that they are at imminent risk of harm, you should contact the emergency services to undertake a welfare check and the individual’s Emergency Contact to make sure the individual is safe. This also applies where a member of staff not in work has an agreed contact arrangement but cannot be reached after a reasonable number of attempts.  You should not attend the individual’s home.

View the flowchart

Many people will experience a panic attack at some point in their lives.  However, the first time this happens can be frightening and disconcerting. Symptoms of a panic attack can be very similar to those of a heart attack.  If in doubt, please contact 999 immediately.  If the member of staff knows they are having a panic attack you should remain with them and help them to manage their breathing.  

If the individual is aware that they are having a panic attack they may have a number of techniques for managing this themselves. Panic attacks can last for around 20 minutes but will generally peak after 10 minutes. The best thing you can do in this situation is to simply sit with individual, providing them reassurance and support and letting them know you are there if they need further help.  The following may also be of help:

• Remind the individual that the attack is not harmful but a normal response to something their brain has perceived as a threat. Assure them that it will be over soon.
• Get them to focus on their breathing and suggest they try to breathe from their diaphragm; breathing in for 2 counts, holding for 2 counts and breathing out for 2 counts.
• If they are unable to focus on their breathing, then try holding your hand out flat in front of their eyes (about a foot or so away). Ask them to focus on your hand and then move it up and down a short way very slowly.  This will take their focus off the panic experience and slow their breathing and thought processes down.

Dealing with an individual under the influence of alcohol or substance is very difficult and comes with increased risk and unpredictability.  A member of staff under the influence of alcohol or drugs is a safety risk and the University has a duty of care in this regard:

• You should familiarise yourself with the University’s Alcohol and Substance policy
• Where there is reasonable belief that the employee has attended work under the influence of alcohol or a substance they should be sent home as soon as possible and informed that they must not drive.
• If you are the line manager, you should arrange that a taxi is organised for the individual to get home safely. However, after discussion with the member of staff, where they do not wish to comply you should not physically intervene but contact their Emergency Contact.
• Should the member of staff leave the premises, and you have reasonable belief they will drive you should notify the emergency services.

Whatever happens, ensure you check in and follow up with the member of staff to see how they are doing, following the Do’s and Don’ts above.  It may be that further support is required.  Contact is important and once the distress/crisis event has been mitigated or resolved, a contact plan should be agreed to ensure ongoing support, where necessary. As the individual’s line manager or the relevant HR Business Partner, you may want to consider the following:

• Would a management referral (or further referral) to Occupational Health be helpful at this point?
• Would reiterating the counselling provision through Inspire Wellbeing be helpful?
• Do you need to consider completing the Stress Management Risk Assessment template under the Stress Management Policy and Guidance?
• Any other short or long-term work-related issues that you can reasonably address with the member of staff

In some cases an individual’s distress/crisis event may have an impact on other colleagues or the wider staff team.  In this instance, the relevant HR Business Partner in liaison with the Staff Wellbeing Officer (gary.kane@qub.ac.uk) can engage Inspire Wellbeing to facilitate an individualised or team programme to specialist support.

Staff Wellbeing can be reached via email at staffwellbeing@qub.ac.uk  The Staff Wellbeing Programme contains a range of mental health and other wellbeing programmes to support staff across the University.  There is also training provided for staff involved in working with and supporting students.

Dealing with situations as described above can be difficult regardless of the outcome.  It is important that you support your own wellbeing and self-care.  The Public Health Agency’s Take 5 steps to wellbeing is a helpful resource and support continues to be available to you through the Employee Assistance Programme.   

You can access training and awareness on mental health and wellbeing support to ensure you feel you have the tools, skills and confidence to deal with these scenarios.  The Staff Wellbeing Programme contains a range of programmes such as:

• Mindful Manager
• SafeTALK
• Mental Health First Aid
• Mental Health Awareness
• Stress Management
• Personal Resilience
• Suicide Prevention.

• Stress Management Policy and Guidance (including Stress Management Risk Assessment Toolkit)
• Alcohol and Substance Misuse Policy

• Employee Assistance Programme – 24-hour service
  Inspire Wellbeing
  Tel: 0800 086 9924 (free)
  www.inspiresupporthub.org

• Lifeline – 24-hour helpline
  Tel: 0808 808 8000 (free)
  www.lifelinehelpline.info

• The Samaritans - 24-hour availability
  Tel: 116 123
  www.samaritans.org/samaritans-ireland

• Here2Help app
  www.eastantrimcounselling.com/here2help
  Android
  Apple 

• Health and Social Care Trust – Mental Health and Wellbeing Support:
  • Belfast Trust Mental Health
  • Northern Trust Mental Health
  • South Eastern Trust Mental Health
  • Southern Trust Mental Health
  • Western Trust Mental Health

The support mechanism through the Employee Assistance Programme – Inspire Wellbeing does not apply to Extended Workforce (QWork) and contractors/third party partners.  However, the principles and other signposting set out above should be used for anyone on campus in distress or in crisis.