Mental Health Conversations: Guidance for Leaders

We know that conversations about mental health at work can feel challenging, but they’re also some of the most important conversations you can have. In a recent episode of our Clear The Air podcast, Clearhead’s Clinical Lead Barry Kirker shared with us how leaders and HR professionals can approach these moments with confidence and care.  

Drawing on Barry’s clinical expertise and experience, this guide is designed to support you with questions to ask, how to assess risk, and what to avoid so you can create a safe, supportive space when your people need it most. 

Preparing Yourself 

Before you start, take a moment to check in with yourself. Do you have the emotional capacity and focus for this conversation? Do you have enough time if it runs longer than expected? 

From there, Barry recommends a do no harm mindset. Focus on listening, gathering information, and making a plan of action together.  

Questions that Open the Door:  

These supportive, open questions create space for someone to share what is going on and help you understand the situation better: 

• How long have you been feeling this way? 
• Do you know what brought it on? (better than “what brought it on,” which can imply they should know). 
• Have you experienced a high stress event? 
• What areas of your life is this affecting? How is it impacting your work? 
• Who do you have supporting you (e.g. family, partner, friends)? 
• What do you usually do to manage stress or cope with distress? What helps you? 
• Have you been getting professional support? 
• Is there anything I can do, or something the workplace can do to support you?  
• Would you like me to arrange a consultation with a therapist on your behalf?  

 These are not tick-box questions. They are conversation starters that show you are listening and willing to help. 

When Safety is a Concern:  

If you believe someone might be at risk of suicide or self-harm, it is important to ask directly and without judgement. Many people worry that asking directly about suicide might make things worse, but it doesn’t. You will not put the idea in their head. Asking openly is a proven way to reduce risk.  

• How bad have things got for you? 
• On a scale of 1–10, how would you rate your intent to die (10 = worst)? 
• Are these thoughts intermittent or constant? 
• Have you thought about how you would do it? 
• Do you have access to the means to do it (e.g. rope, gun, pills)? 
• Is there anything or anyone that would stop you? 
• Who would be most impacted by your death? 
• Have you ever tried to take your life before? How recently? 
• What was the last straw that led to you deciding to do it?  
• Was it planned or spontaneous? What happened that it didn’t proceed? 
• Do you think things could change or improve for you? (assesses hopelessness). 

Supportive Responses that Make a Difference:  

• Offer hope that support is available and things can improve. 
• Validate their feelings (e.g. “That must feel difficult” or “I can understand why you feel that way”). 
• Repeat key points. Distressed people may not take everything in. 
• It’s okay to interrupt gently if needed to contain or focus the conversation. 
• Thank them for sharing something personal. 
• Be clear about next steps and the limits of confidentiality. 
• Always seek their agreement and consent before taking action. 

Things to Avoid 

Even with the best intentions, some responses can cause harm. Barry emphasises avoiding: 

• Strong opinions or judgements (e.g. “You should leave him” instead of “That sounds like a difficult situation”). 
• Over-sharing your own experiences, it risks shifting the focus to you and makes boundaries harder later. 
• Making promises you may not be able to keep (e.g. “You’ll always have your job”). 
• Telling them to calm down or stop crying. Let them settle naturally, offer water or tissues. 
• Reinforcing harmful coping strategies (e.g. alcohol, self-harm). 

Conversations about mental health are rarely easy, but they are always valuable. As Barry reminds us, leaders do not need to have all the answers. What matters most is being present, listening, and responding with care. 

For the full discussion with Barry Kirker and guest host Lisa Young, listen to the Clear The Air podcast episode here.