What to Say When an Employee Tells You They're Struggling: A Guide for Leaders

Your people take care of everyone else. Who takes care of them?

This guide is for whoever decides how an organization takes care of its people: the founder, the CEO, the head of school, the executive director, the HR lead.

Sooner or later, someone on your staff will tell you, or one of your managers, "I'm not okay." What gets said in the next minute decides whether they keep talking. Whether that minute goes well depends on what you put in place before it happens.

Below: what to say when you're the one in the chair, what to teach your managers, and how to make sure every one of your people has someone.

Watch: What to Say When Someone Tells You They're Not Okay

Why Is This a Leadership Decision?

Globally, an estimated 12 billion working days are lost every year to depression and anxiety, at a cost of US$1 trillion in lost productivity (WHO). The cost shows up in your budget. The decision about what to do with it sits with you.

When someone tells a manager they're not okay, it feels like a one-on-one moment. It's also a test of what your organization does when someone is having a hard time. You've said your people matter. It's in your mission statement, and you mean it. The question is whether the manager in that chair knows what to say, and whether the person has somewhere to go next.

In its 2022 guidelines on mental health at work, WHO recommended manager training for the first time, to help managers recognize and respond to people experiencing distress (WHO, 2022). A manager can't arrange that on their own. Someone has to decide to make it happen. In most organizations, that's you.

What Should You Say in the First Minute?

Start with the five moves below. Use them yourself, then teach them to every manager who leads people. WHO describes the core skills as open communication and active listening (WHO). Here's what that looks like in practice.

Put your phone face-down. Close the laptop. Turn your chair toward them. Then:

1. Say thank you. "I'm really glad you told me." It took something for them to start.
2. Stop talking. Silence after that sentence is an invitation. Let them fill it.
3. Ask one open question. "Do you want to tell me more about what's been going on?" One question, not five.
4. Listen without fixing. Nothing needs solving in this minute. If you feel the urge to jump to a solution, sit on it.
5. Tell them this stays between you. They need to know this won't show up in a meeting.

Be clear with your managers about the limit, too. The training WHO recommends isn't meant to turn managers into mental health providers (World Psychiatry, 2023). A manager is a bridge, not a therapist.

What Can You and Your Managers Say Out Loud?

These conversations go better when managers have the words ready. Give them these five:

1. "I'm really glad you told me."
2. "You don't have to have this all figured out. I just want to understand what's going on."
3. "What would help most right now? Do you want to talk it through, or do you mainly need to be heard?"
4. "I can't promise I have the answer, but I'm not going anywhere."
5. "What's one thing that would make tomorrow a little more manageable?"

None of these require a credential. They require someone present, with their attention on the other person. Put them on the agenda for your next managers' meeting.

What Should Everyone Avoid Saying?

These three come from a good place. They still end the conversation.

• "At least..."

  It compares their situation to someone else's. They hear that their pain is smaller than they think, and they stop talking.

• "You just need to..."

  Nobody knows what they need yet, sometimes not even them. Advice before someone feels heard lands like a closed door.

• "I totally get it. The same thing happened to me."

  The intent is connection. What they hear is that the conversation is about you now.

A rushed fix does the same damage as silence. When someone sits down in front of a leader, they need to feel they matter to someone.

What If It's Bigger Than a Manager Can Carry?

Some conversations go past what any manager should hold. If someone has stopped sleeping for weeks, stopped eating, or said something that raises a concern about their safety, they need more than their manager.

The handoff can sound like this: "I want to make sure you have the right support, not just what I can offer. Would you be open to talking to someone whose whole job is to help with this?" Then name something specific: a counselor, a therapist, your employee assistance program or their doctor. Follow with, "I'll check in with you tomorrow."

Your part as the leader happens before that conversation. Make sure every manager knows exactly what clinical options your organization offers and how to reach them. A manager who has to go looking for the EAP number while someone sits across from them has already lost the moment.

This post is practical guidance for leaders and managers, not medical advice. If someone is in immediate danger, call emergency services. In the U.S., anyone can call or text 988 to reach the 988 Suicide & Crisis Lifeline.

What Happens the Next Day?

Check in. A sentence in the hallway or a short message works: "Hey, I've been thinking about you. How are you doing today?" It shows the conversation wasn't a one-off, and it tells them the door is still open. Most people need to hear that more than once before they believe it.

If a lighter load, a moved deadline or shift coverage was offered, follow through. If it can't happen, say why and say when. Your managers will follow your lead here. When you check in after hard conversations, they will too.

Who Takes Care of Your People?

We know you care, but you can't sit beside every one of your people. Some things never get said at work.

Think of a teacher caring for her mom through an illness while running a full classroom. Or a nurse quietly replaying a call he made last Tuesday. Even with a great manager and an open door, some of that stays unsaid at work.

That's why Forte gives every one of your people their own Forte Coach, a real person outside work who's with them for all of it, the hard weeks and the good ones. Everything lives in one app: they pick a time, their Coach calls them, and short exercises keep them growing between calls. Members can connect with their Coach as early as the next day, and they can keep the same Coach or switch any time (Forte Coaches).

Sessions are confidential. You see anonymized, organization-wide trends, never what any one person said. Coaches use Mental Fitness training, and you can see how Forte works step by step.

Here's how one executive leader described the decision on Forte's website: "Having a trusted person that you can go to, who is outside your direct reporting line, is an incredible way that we can care for our global team. That's why we chose Forte."

And here's how one Forte Member described the difference: "Before Forte, I felt seen but unsupported. After Forte, I feel seen and supported."

You become a place where everyone has someone in their corner. So your people feel as cared for as the people they care for.

Three Things to Put in Place Before the Next Conversation

1. Teach your managers the first minute. The five moves and five sentences above are a start, and WHO now recommends manager training.
2. Make the clinical path easy to find. Every manager should know your EAP, your health plan options and 988 without searching.
3. Give every one of your people their own Coach. A real person outside work, for the hard weeks and the good ones. Then use it yourself first. When the leader goes first, everyone follows.

Want to see what the third one looks like for your organization? Book a call.