Supporting a Struggling Employee: A New Hampshire Manager’s Guide to Mental Health, Substance Use & Recovery at Work

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When an employee seems like they’re struggling, managers often get stuck between two bad instincts:

and

Usually, neither is the job.

A manager does not need to diagnose depression, addiction, anxiety, or anything else. The job is to notice what is happening at work, respond to safety or performance concerns, communicate clearly, and make sure the employee knows what support may be available.

Managers should focus on observable behavior, workplace impact, safety, expectations, support, and next steps—not diagnosis.

What should I do right now?

What managers should actually pay attention to

• repeated lateness
• repeated absences
• missed deadlines
• noticeable decline in work quality
• unexplained disappearances during shifts
• increased conflict
• inability to concentrate
• major behavior changes
• falling asleep at work
• unsafe behavior
• appearing impaired
• repeated mistakes after previously reliable performance

Any of these behaviors can have many explanations. Substance use is one possibility—not the only one.

Possible alternatives may include:

• grief
• depression
• anxiety
• sleep problems
• caregiving stress
• medication changes
• medical illness
• financial or relationship stress

Stay with what can actually be observed.

The conversation: what to say

Then use a specific example:

Then:

Alternative:

What usually makes this worse

Avoid:

• Are you an alcoholic?
• Are you using again?
• asking what medication someone takes unless appropriately handled through HR/occupational processes
• diagnosing someone
• demanding personal history
• promising confidentiality beyond the manager’s authority
• threatening consequences that will not be enforced
• gossiping with the team
• moralizing

Performance and health can both matter

Recovery-friendly does not mean consequence-free.

A recovery-friendly workplace addresses performance and safety while also making treatment, recovery, and support easier to access.

If an employee discloses a substance-use problem

Possible next steps:

• HR
• Employee Assistance Program
• health-insurance resources
• leave options
• occupational health
• recovery-support programs
• treatment referral
• accommodation process

Managers should not become the employee’s counselor or recovery sponsor.

If an employee says they are in recovery

Possible needs can include:

• schedule flexibility for treatment/recovery meetings
• time for medical appointments
• different break timing
• temporary shift adjustments
• access to an EAP
• privacy around health information

Do not assume someone is unsafe simply because they are in recovery.

Accommodations and the ADA

Some mental-health conditions and substance-use disorders may qualify as disabilities under the Americans with Disabilities Act depending on the circumstances.

Managers should not improvise accommodation decisions.

Possible accommodations may include:

• modified schedules
• time for treatment
• shift changes
• other reasonable changes that allow essential job functions to be performed

Employers generally do not have to:

• remove essential job duties
• lower legitimate performance standards
• excuse illegal drug use at work
• ignore legitimate safety requirements

The Job Accommodation Network (JAN) is a free national accommodation resource.

This guide is educational and not employment-law advice.

Mental health matters too

Employees may be dealing with:

• anxiety
• depression
• trauma
• grief
• relationship problems
• financial stress
• chronic pain
• sleep problems
• caregiving stress

Sometimes substance use is connected to these problems and sometimes it is not.

Managers do not need to resolve that clinically.

A workplace that makes support easy to access can help people seek help earlier.

A simple manager framework

Support + accountability

Support and accountability are not opposites. Good workplaces can do both.

What if I suspect impairment at work?

Follow the organization’s established policy.

Do not perform a personal clinical assessment.

Depending on policy/job context, next steps may include:

• removing someone from safety-sensitive duties
• involving HR
• arranging safe transportation
• following testing procedures
• documenting observed behavior
• contacting emergency services when appropriate

The specific response depends on workplace policy, job duties, collective bargaining agreements, federal requirements, state law, and the circumstances.

What if the employee refuses help?

An employee does not have to accept counseling simply because a manager recommends it.

Managers can still:

• address workplace behavior
• maintain performance expectations
• follow safety rules
• document concerns
• offer available resources
• follow HR/policy procedures
• leave the door open for future help

You do not have to decide whether someone is “ready for recovery.” You need to manage the workplace fairly and consistently.

Returning after treatment

Managers can help by:

• focusing on current performance
• maintaining privacy
• clarifying expectations
• checking whether approved accommodations are working
• avoiding stigma or jokes
• providing normal feedback
• reconnecting the employee with HR/EAP resources if problems return

Returning to work can be an important part of recovery.

Recovery-friendly does not mean ignoring relapse

A relapse may mean the recovery plan needs more support. It does not automatically mean the person is incapable of working.

At the same time, safety rules and legitimate performance standards remain in place.

Build the system before there is a crisis

Employers should establish resources before managers need them. Managers should know:

• Who do I call in HR?
• Do we have an EAP?
• What behavioral-health benefits exist?
• What happens if someone appears impaired?
• Who handles accommodation requests?
• Do we have naloxone?
• What treatment/recovery resources can I give someone?
• What information must remain private?

If nobody knows those answers, the middle of a crisis is a bad time to invent them.

New Hampshire workplace resources

For an overview of care options, see the NH Mental Health & Substance Use Help Map.

About this guide

Written by Ken Haberland, LCMHC, MLADC, H&H Counseling

Last reviewed: October 2026

This guide is general educational information. It is not employment-law advice, medical advice, an HR policy, or a substitute for consultation with qualified HR/legal professionals.

Workplace policies, federal requirements, collective bargaining agreements, safety obligations, and individual circumstances vary.

You are welcome to print, share, or link to this guide.

Where H&H Counseling fits

H&H Counseling provides outpatient counseling for adults and couples in Tilton and Concord, New Hampshire, with telehealth throughout New Hampshire.

H&H may work with adults dealing with:

• anxiety
• depression
• substance use
• recovery
• relapse prevention
• trauma
• stress
• relationship difficulties
• major life changes

H&H Counseling is not an EAP administrator, employment-law consultant, or workplace-policy provider. Employers should continue to use their own HR, legal, safety, and EAP processes.

Public work phone: 978-547-8633