Small Business Guide for Supporting Employees with Mental Health Conditions or Substance Use Disorder in the Workplace

Create a supportive work environment for employees with mental health conditions or substance use disorder in this guide.

Many employers understand that recruiting and retaining top talent is important to success. Ensuring employees have the support they need is especially important for small businesses, as these American workers play a vital role in a business' growth and development. Lower turnover and higher productivity are especially important. Supporting workplace mental health and well-being is one of these powerful recruitment strategies. Small businesses can use cost- and resource-effective methods to support employees, which includes addressing mental health and substance use disorder needs.

Seven Ways to Support Employees

This guide offers small businesses seven practical ways to foster a healthier and more productive work environment.

Promote a Healthy Work-Life Balance
Treat Workers Fairly
Promote Open Communication
Lead by Example
Accommodate and Support Recovery
Provide Resources and Access to Support
Learn More About Mental Health and Substance Use Disorder at Work

1. Promote a Health Work-Life Balance

A healthy work-life balance is important for maintaining employee well-being and productivity. Employees experience reduced stress levels, improved mental health, and increased job satisfaction, which leads to higher creativity and loyalty. Workers with demanding workloads can experience increased stress levels, which can negatively impact mental health or contribute to an increased risk of substance use disorder.

Small businesses can support employees by promoting a healthy work-life balance. Ways to do so may include:

Encouraging managers to model positive mental health by taking breaks and using leave
Providing time off and reinforcing its use
Communicating openly about workload with workers
Promoting workplace flexibility in when, where, and how work is done

2. Treat Workers Fairly

A small business leader or manager might mistakenly think that they should withhold opportunities for advancement or change assignments to protect employees with mental health conditions or substance use disorders from stress even if the employees have not requested this. But employers must understand and uphold the organization’s commitment to holding all workers to the same performance standards and offering the same opportunities to succeed.

Employers with 15 or more employees must comply with the requirements of Title I of the Americans with Disabilities Act (ADA). Title I of the ADA prohibits employment discrimination against qualified people with disabilities, which could include those with mental health conditions or substance use disorder, in many employment practices. These practices include, but are not limited to, recruitment and hiring, pay and benefits, performance management, and other areas. The U.S. Equal Employment Opportunity Commission, the enforcing agency for Title I of the ADA, provides information to small businesses to help them understand their responsibilities as employers.

3. Promote Open Communication

Open communication about mental health and substance use disorder is essential to supporting employees who experience these conditions. Encouraging workplace initiatives in a straightforward way sends the message that these challenges are a part of life. The National Alliance on Mental Illness (NAMI) suggests that managers foster a culture of respect and encourage the use of positive language. A manager or leader who asks, “How are you doing today?” regularly lets employees know they are willing to listen. This simple action can help people become more proactive in accessing resources and requesting accommodations or changes in how they work.

Small businesses can find free educational resources that enhance communication. NAMI, for example, offers a collection of fact sheets, guides, and educational videos for leaders, managers, and employees to learn more about and promote creating a mentally healthy workplace. Communication about available supports, whether workplace- or community-based, is vital. The availability of these resources and the methods for accessing them lets employees know they are highly valued and supported at work.

4. Lead by Example

Managers and leaders who model mental wellness and openly discuss mental health or substance use disorder are more likely to encourage employees to prioritize their well-being. In the EARN webinar Supporting the Mental Well-Being of Gen Z Workers, a Gen Z worker stated, “I think knowing that someone in a higher position than yourself has taken advantage of [mental health] resources and has benefited from them can go a long way in showing people, hey, you know, it's OK. Someone at a higher level in the company than yourself has taken advantage of these resources, and it was good for them.”

In a small business, where everyone works closely together, open communication in which managers share their experiences with mental health or substance use disorder signals to employees that it is safe to seek the resources and support they need. This open discussion can be pivotal in retaining highly skilled Americans with disabilities.

5. Accommodate and Support Recovery

Small businesses should be prepared to accommodate employees. Reasonable accommodations are adjustments or modifications that enable people with disabilities to perform the essential functions of a job efficiently and productively. Many can be offered at low or no cost and do not require extensive resources. Accommodations for mental health or substance use disorder include offering flexible scheduling, allowing time off for treatment, or providing a private space for employees to take leave to attend virtual support meetings during work hours. Several resources are available to help small businesses:

The ODEP-funded Job Accommodation Network (JAN) provides information and tips on accommodations.
EARN and JAN created Supporting Employees with Substance Use Disorder: A Guide for Employers to help employers develop policies and procedures to respond effectively to substance use disorder in the workplace. It also helps employers effectively hire, onboard, retain, and advance employees. A companion guide is available for workers with substance use disorder.
The ADA National Network provides additional information on the ADA and employment.

If you have an employee who would benefit from additional resources beyond what is already provided, consider contacting your state vocational rehabilitation (VR) agency. These agencies can assist with identifying appropriate accommodations or supports.

6. Provide Resources and Access to Support

Ensuring employees have access to resources and support is a powerful way for organizations to demonstrate a commitment to fostering a productive workplace. Assess whether your small business has a health care plan and if it covers specific services, including treatment and support for substance use disorder. EARN developed a health care plan checklist to help organizations evaluate their plans and ensure they are mental health-friendly. A small business that has an employee assistance program or access to one can offer excellent resources.

Linking employees to community resources is an important way to support them. Community mental health resources are available in communities across the country. The Substance Abuse and Mental Health Services Administration (SAMHSA) also offers help to find local assistance for issues with mental health or substance use disorder. Resources include how to find support, find information about treatment, and how to pay for treatment. SAMHSA’s National Helpline provides referrals for substance use disorder treatment and mental health referrals to find help for employees who are in crisis. An employee can call or text 988 to access a suicide or crisis hotline that provides 24/7 confidential consultation at no cost. SAMHSA also offers an opioid treatment program directory by state to help locate resources. Sharing these resources with employees who do not have access to mental health benefits through health insurance can help provide a road to recovery.

7. Learn More About Mental Health and Substance Use Disorder at Work

Addressing misperceptions around mental health and substance use disorder and creating a supportive workplace can be done with education and training. Offering information on these issues is an effective way to equip employees with the knowledge and skills to recognize signs that they may need to prioritize their mental health or seek support for substance use disorder.

Many organizations offer free online resources and training to help small business managers and employees learn about mental health, connect with others, and find assistance:

The Campaign for Disability Employment's "Mental Health at Work: What Can I Do?" features a series of video public service announcements, free posters, and a Workplace Mental Health Guide (for mail order or download). The campaign's tools are designed to educate company leaders, managers, coworkers, and people with mental health conditions about the roles we all can play in promoting a mental health-friendly workplace.

JAN offers an instructive video to demonstrate effective tactics for supporting an employee with a substance use disorder.
JAN and EARN offer two informative guides on substance use disorder and the workplace: Supporting Employees with Substance Use Disorder: A Guide for Employers and A Guide for Workers with Substance Use Disorder: What You Should Know.

Training can also increase the acceptance of people living with substance use disorder and ensure managers are more prepared for these sensitive conversations. More importantly, managers and business leaders gain knowledge of readily available resources to support their employees effectively.

Access more information and strategies by visiting EARN’s:
Workplace Mental Health Toolkit Small Business Toolkit Substance Use Disorder in the Workplace

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