my employee is paranoid — can I help or is it not my business?

A reader writes:

I lead a small team of four: two assistants who I supervise, and one colleague at my level but who doesn’t have supervisory duties. Because we’re a small team that likes one another, our meetings usually end with personal chatter—nothing boundary-crossing, just normal friendly updates.

One assistant, Georgia, has a bit of a paranoid streak. She’s come to me with concerns that, say, a jogger she sees regularly near our building in the morning is following her, or an idea for our office to install a panic room in case of a shooter. We work in an area where muggings aren’t unheard of, so I can’t dismiss some of her concerns outright. When she hears me remind her of our security protocols and the safety measures that she can take, she’s usually satisfied. All of that is to say, it’s not really affecting her ability to do her job.

However, Covid has done a number on her. We’ve worked exclusively remotely for over a year and are just starting to come back to the office, slowly. Georgia has some family nearby, but otherwise, work is her only social outlet, so she’s been spending a lot of time alone in her apartment. Recently, as we finish meetings, she’s been telling us stories about how the FBI or ICE or “someone” is obviously in the apartment above hers, and they follow her from room to room—she can tell because she hears them banging or stepping around. She believes they have a camera in her apartment tracking her movements. She says she always sees the same cars following her while she runs errands. In short, she believes she’s being watched basically at all times.

I’ve been able to handle the workplace conversations about what we can and cannot do to keep her safe, but I’m at a loss how to handle this paranoia about her home life. It’s obviously way out of my league to diagnose this as a problem or provide mental health assistance. But I do care about my employee! Our company does have an EAP, but I’m not sure how to even have a conversation with her about this when she truly believes that these things are happening to her. (And who knows, maybe the FBI really is spying on her!)

Any scripts or advice you have about what to say to help Georgia out would be appreciated. Or is this an example of “it’s not affecting the work, so continue to be sympathetic and let it go”?

Aggh, this is tricky. You should be able to offer support and nudge Georgia toward the EAP, but you’ve also got to tread carefully as a manager.

If this were my employee, I’d go to HR for advice … so I asked the always excellent Suzanne Lucas of Evil HR Lady to weigh in. Here’s what she said:

“Mental illness at work is such a challenge because you are limited in what you can do. As for encouraging a call to the EAP, you have an advantage in that an EAP provides all kinds of help — mental health, legal, and financial. So, you can approach the EAP conversation from this angle: ‘Georgia, I’m really concerned about you. I wanted to suggest that you call our employee assistance program. They can help you figure out your rights and get you the help that you need.’

An EAP rep has much more latitude to suggest doctors and psychologists than a manager or HR person does. She may call thinking she’ll get an attorney to help her with her spying neighbors, but hopefully, they can set her on the right path.

If her paranoia is affecting her work, then you can insist on a medical exam. The guideline from the Equal Employment Opportunity Commission is that when the employer ‘has a reasonable belief, based on objective evidence, that: (1) an employee’s ability to perform essential job functions will be impaired by a medical condition; or (2) an employee will pose a direct threat due to a medical condition,’ you can require an exam.

A last resort is to contact her family. We collect emergency contact information for true emergencies and whether or not this qualifies depends on the situation. Please consult with an employment attorney before taking this route.

I will add only that if you work somewhere with HR, loop them in too. This isn’t the kind of thing you want them hearing about only after it blows up in some way. Which doesn’t mean it will blow up in some way; hopefully it won’t. But get them in the loop about what’s going on.

{ 224 comments… read them below }

  1. BlueberryFields*

    As someone who has dealt with someone close to me with paranoia, I just wanted to say take some time and check in with yourself! It can be emotionally taxing to be on the receiving end of it (and at times it made me question my own reality), so just make sure you have support (therapy, EAP, someone to talk to) if you need it.

    1. caps22*

      Good suggestion, thanks Blueberry Fields! I’m dealing with the aftermath of being around mentally ill family members much of my life, and it would have been easier had I sought assistance earlier.

      1. BlueberryFields*

        Glad you’re getting help now, caps22! It’s always easier to see in retrospect, isn’t it? (I feel the same way as you.)

  2. Rachel in NYC*

    Someone might have another thought. But if your employee does have issues with paranoia, I would think the language on referring her to HR or EAP is important. Something about how whoever might have advice for how to handle this or how to handle these kind of matters. (and if possible, give whoever some sort of heads up.)

    I can’t imagine it’s helpful to let her know that you think this is all in her head. Basically act as if what she is saying is perfectly normal.

    1. Threeve*

      This–perhaps in referring her to an EAP, you could present it as “you might find it helpful dealing with the stress caused by how unsafe you feel; for example, many people find the danger and uncertainty of the pandemic has them feeling anxious and unsettled and we want to encourage everyone to use the resources available to them.”

      Don’t address the paranoia at all. Being stressed out about real things is a perfectly valid reason to seek mental health resources, and you can present it that way.

      1. Retail Not Retail*

        That is a great way to frame it because either she knows the EAP is where therapists are already and would look at you like “oh you think i’m crazy?” or she doesn’t know and would feel betrayed when she did realize they weren’t whatever she assumed.

        Being honest about who they are is important.

        1. Self Employed*

          It’s definitely important to be honest (which includes “because you are stressed by what’s going on”–I like this framing.) Saying EAP will “help her with her rights” as though they are going to help her with whatever ICE/FBI agents she believes are following her is misleading and not honest.

          Tricking people into calling mental health services is not a good idea; they’re not going to react by thinking “oh, I guess I really do need some mental health treatment as long as I’m on the phone”, they’re going to feel betrayed and if she’s already paranoid, that is the last thing she needs.

          One of the “benefits” of the apartment complex where I lived when I started my business was a social worker to connect people to community resources. I thought maybe she would have leads for agencies I’ve heard of that provide technical support to disabled entrepreneurs, because my internet searches were junked up with MLMs preying on disabled people, “we can get anyone on SSI” lawyers, “how to start a wheelchair van franchise,” etc. Maybe she had an index of resources that would bypass all this garbage. I said I was “overwhelmed with my bookkeeping backlog” and needed help from one of those agencies that supports disabled entrepreneurs. She said she knew just who to call–“they can help anyone!” and scribbled a number on a notepad for me.

          I called the number, thinking it was a disabled entrepreneurs’ center, and it was the Suicide Hotline. I was furious and embarrassed at being tricked. I blurted out “sorry, wrong number!” and hung up, then realized they might dispatch 911 to my apartment for hanging up on them in case I was suicidal. (They didn’t.)

          Apparently the word “overwhelmed” is a buzzword for psych professionals that means “I am about to commit suicide.” I was not THAT kind of “overwhelmed with bookkeeping”–just embarrassed that it had piled up to the point where I realize I would not, in fact, be able to meet a particular deadline on my own. Presumably she knew I wouldn’t knowingly call the Suicide Hotline because her office had plenty of their literature, and she wrote their number down without any indication of who it belonged to and gave a weaselly description. So presumably she thought I would have a meaningful conversation with them when I was expecting to reach an agency supporting disabled entrepreneurs? Has anyone who was truly suicidal had a productive conversation with the counselor when they thought they were calling for takeout or a cab?

          All she did was make me decide not to trust her again. She clearly doesn’t care about being honest, and I don’t know what other words might seem innocuous to me that would make her call 911 thinking I meant something dire.

          OP, do not imply to the employee that your EAP will provide legal assistance with the people she believes are following her. Focusing on how stressed she is and making it seem ordinary to talk to EAP are much better.

      2. jblack38*

        As someone who works in the mental health field and used to work exclusively with individuals diagnosed with serious mental illness, this commenter’s script is perfect. Address the stress caused by how unsafe Georgia feels, and give her the EAP resource.

        Obviously if her stress/paranoia worsens, then a different plan of action might need to take place.

      3. MissMeghan*

        I like this, and it’s 100% true. The situation does seem to be causing a lot of stress for the employee.

      4. Happy Pineapple*

        This is a great script. Whether or not Georgia is imagining things doesn’t actually matter to the conversation with the boss, because her fear and the stress it causes are very real.

    2. Former HR*

      The OP and/or HR can use the EAP as resource to find the language to get her to use its resources and will alert them to expect a contact by her. The EAP itself will maintain confidentiality but, if the troubled employee does speak to a licensed professional, their rules of confidentiality will apply based on the any mandated reporting laws in the state.

      1. HR Exec Popping In*

        Yes, EAP can be very helpful for managers in dealing with employees in crisis just as much as they can help the employee.

    3. Chickaletta*

      I agree with all except the last part. I dealt with a neighbor I used to check on daily who was experiencing paranoia and hallucinations and talking to her openly and honestly about it was the best remedy. The few times I went along with her concerns only exacerbated them. She needed to know, and appreciated dearly, that someone was there as a reality check for her. If she told me that teenagers were breaking into her house to steal her silverware, or that someone was building an apartment above her one story house, or that her dead father had come in the middle of the night to trade cars, I would say “Louise, I think your hallucinations are acting up. That didn’t happen. Do you want me to go with you to look?” and later on check if she was taking her medication correctly.

      This is possibly the type of thing that will be ongoing and requires maintenance rather than a cure. Of course, at the beginning before the person becomes aware of and accepts that it is a mental issue, different tactics might be better.

      1. Momma Bear*

        The difference is that you are a neighbor/friend and OP is her boss. OP needs to tread more carefully.

        1. Marzipan Shepherdess*

          Good point! Also, it sounds as if Chickaletta’s neighbor is aware that she has a mental illness, is getting help for it (cf the medication) AND is open to Chickaletta’s being honest with her about it. All of this speaks well for both the neighbor and for Chickaletta (who’s clearly a concerned and caring friend) – but their relationship is very different from that of the LW and the paranoid employee.

      2. AnnonyMommy*

        I’ve dealt with this personally with a family member suffering from paranoia. Yes they need and appreciate “reality checking” but only after they are in treatment. I wouldn’t jump to “reality checking” with someone who may not be ready to receive it.

        When my family member was in her first episode, I could tell she was genuinely very scared so i listened to her and validated her fears without validating her delusions.

        1. Eether, Either*

          I, too, had a family member (my mother) with severe paranoia. Her psychologist told me NEVER tell her it’s not happening or make light of it. It’s real to the person who is experiencing it and by trying to tell them it’s not happening, frightens them even more.

          1. anon today*

            I had postpartum psychosis and agree strongly with this. If someone had told me I was imagining things (I was absolutely imagining things) then I would not have been able to trust them any more. On the other hand, someone who could say “That sounds really frightening” would have made me feel safer, and I would have been more inclined to take their advice.

            1. Vistaloopy*

              I had postpartum psychosis too! Anytime someone tried to argue with my delusions, it made it worse.

        2. BPT*

          Yes – currently dealing with a friend going through this. NAMI has been a good resource for me to get examples of how to talk to them (as I was obviously very much not perfect at doing it in the right way when it first cropped up, and still struggle). They say of course not to feed into the delusions or encourage them. However, they also say that trying to “disprove” the delusion can actually cause the person to retreat more into their delusion.

          I think the example I read was that the person going through psychosis said that they were convinced that helicopters flying over were monitoring her. When someone asked her “why would they be monitoring you? And do it in such a big and obvious way? That’s clearly not what they’re doing.”, the patient experiencing psychosis thought to herself “maybe what I thought doesn’t actually make sense…so then it must be an even bigger conspiracy than I thought in the first place.”

          According to what I’ve read from NAMI, it’s helpful to respond to clear delusions with “huh. That’s not what I would have thought when I saw XYZ. My interpretation would have been [innocuous reason based in reality].” That way you’re not telling them flat out that they’re wrong, but it shows them there may be another interpretation out there to what they are seeing. And of course validate feelings without necessarily validating their perception of things. It’s hard and definitely does not come naturally, so I’d always suggest looking into resources like these.

          1. BPT*

            And to add to that – I’m sure it varies person to person what is effective. Not to say there is one answer for every person dealing with these issues. But it’s a good place to start.

        3. Grades White Collar Homework*

          I have a long-time acquaintance (can’t really call her a friend) who slips into this kind of paranoia on the regular. There are “the people” who follow her from apartment complex to apartment complex, always moving in above her or next to her, just to spy on her, knock on her windows and doors, loiter near her car so she’s afraid to go anywhere, etc. Literally every time she has moved, it’s because she’s trying to get away from “the people”.

          Trying to [gently] talk to her about how unrealistic it would be for someone(s) to break leases over and over just to keep following her, for *decades*, not only lands on deaf ears but gets her agitated, angry, and defensive.

          So does talking to her about safety measures she can take to protect herself from “the people”. She doesn’t want to hear about lighting, having her cell phone out and ready to dial 911, talking to apartment management, or calling one of her friends when “the people” are acting up. She just repeats over and over that there’s nothing she can do, that they won’t stop no matter what.

          Whenever she brings it up, I just say, “Hmmm… sorry to hear you’re still dealing with that.” I, of course, mean her paranoia but she can interpret as dealing with “the people”.

      3. Rachel in NYC*

        And it sounds like your neighbor knew she had hallucinations, where OP doesn’t know about her employee’s knowledge of the issue. And arguably she shouldn’t.

        I’m pretty sure about that.

        1. Scarlet2*

          Agreed. People who suffer from delusions tend to get very defensive when others try to reason with them (and paranoid tendencies could definitely be exacerbated by this), unless they’re already aware they have a mental illness, which does not seem to be the case here based on the letter.

      4. KayDeeAye*

        Yeah, the difference is that your neighbor knows that she has these problems, while the OP’s employee very well may not. That makes an even bigger difference than the neighbor vs. employee thing, IMO.

    4. No Name Today*

      I agree it’s critical. Alison’s quote from Suzanne shows how to frame the suggestion without even mentioning medical assistance much less mental health. Excellent phrasing.

      1. Not So NewReader*

        Yep, I agree. It’s a one in a million thing but what if something was actually going on. I see plenty of cases online where a woman (or man) was stalked and no one believed them. It could be something is actually going on and the level of stress is causing her to explain it poorly. Again, perhaps one in a million long shot, but I don’t wanna be that jerk who pooh-poohs another person’s serious concern.
        Suzanne’s advice is excellent because it responds to the employee as if the problem is any number of possible scenarios. It does not draw any conclusion as to what the problem may be. And it also offers OP a way to start to back out of these conversations. OP, after this you can start to say, “I can’t give you legal advice or safety advice, etc., you really need to talk with people who are experts on these things. I am not. I know about [your department/work group] and that is pretty much where my expertise ends.”

        I think sometimes people look at their boss as this “all-knowing” person who really “has their life together”. Sometimes, not often, a person can decide that their boss can figure out so much stuff that the boss should be able to figure out the employee’s life stuff, too. And as we know, this is not true. This is why I became comfortable saying some topics were way out of my league. It needed to be said and said out loud.

        An older friend seems to be sliding into dementia. What use to be an easy conversation about x or y, I now feel I must redirect her back to her family. “Oh Son would know the answer to x!” Or “Granddaughter probably can help with y.” So these redirects to other people can be necessary in personal life as well.

  3. Mental Lentil*

    I have worked with people like Georgia. Inevitably, they have all gotten fired because they’ve said or done something that frightened other employees.

    It would be a kindness to help her get the kind of help she ultimately needs, but this is a very tricky situation. My heart goes out to OP.

    1. Fran Fine*

      My heart goes out to Georgia. Living alone in total isolation when you’re already struggling with paranoid thoughts can’t be easy (and as someone who has also been home alone for the past year plus with no real interaction with people outside of my coworkers, classmates, and family – all of which is sporadic – it can get really damn depressing, which I imagine exacerbates this kind of thing).

      Good luck with this, OP. You’re very kind to want to help.

      1. Littorally*

        Seriously. Even people who were perfectly fine and healthy before the pandemic have had their mental health torpedoed by the last 14 months. If she was struggling with paranoia to begin with, it’s easy to see how this would have torpedoed her mental health big time.

        I hope Georgia can get the help she needs. While her paranoia has to be difficult and draining for the OP, and could escalate to her being unable to keep working, it’s got to be so hard to be her right now.

        1. Anon for this*

          I feel this so hard. I generally have issues with reality being slightly “loose,” in which things can seem unreal and can cause paranoia. Normally, it’s not much of an issue at all because I know what’s happening intellectually and can lean into that. With the pandemic though, I’m having more issues and as much as I miss human interaction, I’m glad I don’t have to navigate this at my job in-person.

          Thanks for caring, OP, and I hope Georgia gets through this.

    2. Nesprin*

      This is an important point- Georgia is both a Georgia problem and a Georgia’s coworker problem. While making sure to get Georgia to the resources she needs, it’d also be very wise to check in with her close coworkers and making sure that she’s not scaring them as well.

      Having worked with 2 different versions of Georgia, making sure that if she does become a coworker problem that she can be fired and that there’s good communication about safety is an important thing in a very scary situation.

      1. Usagi*

        Absolutely this! At a previous job, myself and three other employees walked out because an employee had some mental health issues and the employer only worked to protect them. This employee would lash out suddenly — to be fair, they would genuinely apologize later — which was scary for the other employees. Several of us, at different times, went to supervisors and HR to ask what could be done: it wasn’t that we wanted this employee fired or anything like that (we liked them overall!), but we just didn’t feel safe. Every time, we would be told some variation on “this person’s mental health is a protected class and so we will not do anything about it.” About a year into all of this, the employee knocked over the fridge in the break room and barricaded themselves in, and when the company still didn’t do anything about it, a few of us just up and walked out since we felt unsafe.

        Rereading that it sounds like I’m heavily siding with the other employees, I’m not! Georgia deserves support from OP too. But it’s so easy to forget that, as Nesprin and Mental Lentil have said, it’s very possible that they’re feeling uncomfortable with the situation too.

      2. Sola Lingua Bona Lingua Mortua Est*

        While making sure to get Georgia to the resources she needs, it’d also be very wise to check in with her close coworkers and making sure that she’s not scaring them as well.

        I’d be more worried that the exhaustion is the toll Georgia will take on her coworkers, not fear.

        1. Anon for this*

          Yes, I think this is a concern. I’m sometimes a flake at work, not directly because of my mental health but because of my spouse’s. They have intermittent attacks of suicidal thoughts which are very scary. I know that coworkers at past jobs, however personally sympathetic, must have thought “Not _another_ crisis during which Anon is distracted and inefficient and we all have to cover for them.” I’ve been trying not to get that reputation at my current one, without complete success.

          1. Sola Lingua Bona Lingua Mortua Est*

            Not only that, but there’s only so many times you can take a crisis seriously. Living around someone like Georgia is like living in the “Boy Who Cried Wolf” story that never ends.

  4. The Crowening*

    Oh man. I had someone with an issue like this on my team once. It did impact the work. The person was obsessed with being watched through their work computer. They could barely get any work done. When they were told their computer had been checked by security and was fine and so they should now focus on work, they told me the management must be working with the spy who was watching them. It was sad, and frustrating. The person desperately wanted the job but was unable to focus on work, with all their energy spent on trying to avoid being “seen” electronically.

    1. The Crowening*

      This employee did eventually scare me by telling me if they ever caught the spy, they’d kill them. And I thought, 1. why are you saying this to me in a workplace? and 2. what if one day you decide I’M working with your spy? It was so unnerving.

      1. Trek*

        Wow! How terrifying! Did they fire that employee or did they quit? How long did you have to deal with them? Very scary.

        1. The Crowening*

          They were with us for a month. Our HR tried to do things by the book, understandably. I was documenting my fingers off because every day was a new series of frustrations and unnerving experiences. They didn’t want to have conversations in their office, because the spy was listening. They couldn’t talk to me with my purse nearby because my cell phone was in it. It was one thing after another. They did eventually get fired… but most people in our workplace had no idea why because they hadn’t been seeing and hearing it all.

    2. Krabby*

      Yes, we had two people with similar issues this year and it’s so hard. They both got the idea that their work computers were being used to monitor them and eventually quit. One was living with a partner who helped mediate the situation a little, but the other one was living alone and had no support system locally. She cracked open her laptop and tried to microwave a bunch of different pieces. She sent it back to us with a really nasty note telling us where we could stick our “monitoring equipment.” It was really tough because we were the only people who could see what was going on with her (her emergency contact was her landlord), but it became clear that any further action on our part would just exacerbate things.

      1. LabTechNoMore*

        To be fair, there are a lot of employers that do monitor employees’ work laptops with the sudden proliferation of WFH among workplaces with strong butt-in-seat cultures. And if that kind of productivity monitoring software is being used, flat-out asking ones manager if that’s the case might not yield a straight answer.

        1. ratatatcat*

          Right (and I’m actually genuinely quite curious to know how as an employee you could tell if there’s monitoring software/etc on your computer) but I do think there’s a fairly big leap between saying “I don’t agree with this sort of software, I think the company are using it, and I am going to quit over it” vs cracking that work laptop open and microwaving bits of it.

  5. Anonnie*

    At my university, this is almost exactly one of the training scenarios that all staff must take each year and the right answer would be, “If safe to do so, physically walk with the individual over to the University Counseling Center immediately.” University-age is prime time for psychotic breaks to happen and that level of paranoia is grounds for professional evaluation.

    1. Charlotte Lucas*

      Yep. I used to teach Freshman Comp, & if we referred a student for counseling, they would be seen right away. (Never had to myself.)

    2. Boof*

      I get that but it’s different with an adult at work – there’s a broad range from “a bit paranoid and quirky but ultimately ok” to “so paranoid will be unable to function and possibly do things that are harmful to self or others*”
      *usually not likely to be aggressive unless they’ve already had a clear aggressive streak but, for example, one person took apart a furnace in the winter leaving their mom, who they lived with, without heat.

    3. Prof_Murph*

      Allison’s suggestions are spot on and definitely think that’s the way to go. Echoing Anonnie’s point, Georgia’s age has relevance. If she’s anywhere in early adulthood (under 30), these are pretty classic signs of paranoid schizophrenia and without treatment, symptoms are likely to get worse. Offering resources and kindness (without specific mention of mental health) is the way to go.

  6. Humpty Dumpty*

    OP, I just want to say thanks for caring about your employee. In my (non-work) experience there is very little one can do about paranoia unless the person wants help. I would tread very lightly and steer clear of suggesting any mental issues to Georginia unless you are sure it would be accepted well.

  7. JayJay*

    This is tough. I have had several situations like this at work and there is never a great outcome. It’s a tough line to walk because someone with paranoia can really alarm co-workers and managers, but you have to be careful not to get into territory that could be discrimination on the basis of perceived or actual disability.

  8. Detective Amy Santiago*

    My very first thought was to wonder if she’s fallen down some rabbit hole of internet radicalization in the past year. If that’s the case, there won’t be much, if anything, OP can do to help her.

    My second thought was wondering if she’s got CO2 poisoning. I’ve read stories like this where that was the culprit of someone’s sudden paranoia and odd behavior. Maybe OP could send out some kind of general “safety awareness” thing to the whole team that includes info about this? It would be a more general way of nudging her to check into it without directly bringing it up or addressing her rampant paranoia.

    Either way, this is definitely a rough situation and the EAP is probably the best place to direct her for help.

    1. Butterfly Counter*

      I think that certain kinds of mold can cause similar reactions. It might be environmental, as you’re suggesting.

    2. Caterpie*

      Ooh, the internet rabbit hole scenario is very sad if so. I immediately thought of the “gangstalking/targeted individual” thing too. The coworker needs more help than their workplace can realistically provide if that’s the case, but linking the coworker to available resources is a good start.

    3. Sylvan*

      I also wondered about online weirdness, especially the gangstalking community. (They believe there are large numbers of people surreptitiously watching them and harassing them. I can’t begin to explain this! Please look it up if you’re curious.)

      1. ThatGirl*

        Wow, this sounds … similar to what I went through with a friend of mine a few years ago. She got extremely paranoid and while some of what she said sounded plausible, some of it was just so sad and it seemed like she was losing her grip on reality. This was not that recent, but …oof. In her case there wasn’t much I could do to help her, and we’ve since lost touch.

      2. Grizabella the Glamour Cat*

        Yikes, talk about a rabbit hole! I had never heard of this, so I googled a little. And like I said, yikes.

        I’m pretty resistant to this kind of conspiracy mongering. I grew up in a house with a paranoid schizophrenic* relative who would do things like trying to stop people watching TV when she was having a psychotic break (because she was convinced that the neighbors could see us on TV if we had ours on). As a result, my built-in paranoia b.s. detector gets set off pretty easily. But I can easily see how certain kinds of people could get sucked into this kind of stuff and how terrifying and paralyzing it could be for them. YIKES.

        *officially diagnosed, by multiple mental health professionals, not just my personal opinion

      3. Self Employed*

        I remember this was one of the reasons I stopped being active on Quora–I was tired of people asking me to answer questions about gangstalking and narcissistic abuse.

    4. nonegiven*

      There was a series of paranoid posts on one of the sub reddits years ago. It turned out to be carbon monoxide poisoning.

      1. Pikachu*

        This is exactly what I thought! The guy thought his landlord was sneaking in and leaving random post-it notes around his apartment, but he was writing them himself and didn’t remember. I believe he also posted that he had bad headaches.

        That story was literally the reason I finally got around to installing CO2 detectors in our house.

      1. Virginia Plain*

        Yup, if you had CO2 detectors in your house they’d go off every time you breathed out!

        1. PeanutButter*

          Also carbon dioxide is heavier than air, so if people have a source or leak in/near their house, they tend to suffocate and die as soon as they enter a place where it has pooled.

    5. ErinWV*

      A medical explanation is plausible. Did anyone read Brain on Fire by Susannah Cahalan? She had severe paranoid and manic episodes and was institutionalized, and they ultimately discovered that the cause was encephalitis.

    6. Ruth*

      I work in an early psychosis clinic and the CO2 poisoning theory is unlikely. This is likely mental illness, especially since there is a clear trigger (isolation of the pandemic). Stress is known to precipitate psychotic disorders or make psychotic symptoms worse

      1. TardyTardis*

        But isolation from the pandemic means she’s not leaving her home; and if she’s sick from the CO, she’s likely afraid to open her windows. Also, if she has mold in her house, the same thing could be true.

  9. still a bit scared*

    I do not wish to fear-monger, or add to any stigma to mental illness. But I have had a similar situation at my work-place where the paranoid person’s behavior escalated dangerously. I, and many others had noticed that something was off, but had no idea how to handle it. We just assumed it wasn’t something dangerous to others. Well, the paranoid person ended up going to jail for threatening behavior with a gun and the manager (and her superior as well) were traumatized. The person was released from jail (and quite likely with no medical treatment for the underlying condition) after a while, and the manager shared with me that she is scared every day ( with reason, since the person had threatened her personally). A year or so later, a friendly colleague told me her new colleague yelled at her for “always watching me!” and made other strange, unfounded accusations. I got scared for her and told he she should really discuss it with her manager. In the end, the new colleague appears to have been fired (quite possibly for a different reason). It is very frightening, surprisingly common, and I don’t know if anybody knows how to handle this right.

    1. PT*

      Yes, this was my thought. What if Georgia brings a “self defense” device to work and uses it when she is startled by what she believes is a stalker?

      1. c-*

        Usually in these cases the person is likelier to hurt themselves than others. My mom suffers from diagnosed persecution delusions (thinking people spy on her, that she’s the victim of a conspiracy, etc.) and she has very seriously threatened family members, with no intention of following through, because she’s afraid of them and believes it’s the only thing that’ll make them go away.

        Of course, that is in itself harmful as well as fucking scary, because you don’t know that they don’t mean it! But if Georgia gets a weapon into the office, she’s more likely to accidentally shoot or stun herself than someone else. If she gets to the point of carrying weapons around, I’d be more worried about her threatening or having already threatened her coworkers with harm, so be on the lookout for that. In my part of the world, being a danger to yourself or others (including threats) is grounds for immediate involuntary internment into a mental health facility.

        I know from experience that these things can escalate to dangerous levels if left untreated, but hopefully Georgia is not there yet and will be able to get help before reaching that point. So, yes, threats from Georgia may* happen in the future, but they are not an immediate concern.
        * or may not, not every case evolves in the same way.

  10. Blisskrieg*

    Oh–poor lady! I just feel so badly for Georgina. I have a family member who was unable to work because of paranoia. It’s just such an unusual situation when someone is divorced (all or in part) from reality. The advice seems very sound. I hope we get an update!

  11. Jillzie*

    I would tread VERY CAREFULLY here.

    The multiplicity of coinciding factors is what makes this scenario appear to be imagined by someone with mental health issues. That said… do keep in mind how, every day, WOMEN in all kinds of situations find their real and serious concerns discounted or outright dismissed—until the worst does happen (and it’s then too late to help.)

    Consider the optics here among other staffers. It may be that at some other point, a female staffer might face ONE of those concerns—someone stalking them, concerns about invasive security cameras, intrusive law enforcement agencies (when they’re innocent of crimes,) etc. You don’t want women to outright ignore their instincts about safety in a given situation, for fear of being judged and ignored. You also, of course want to somehow show empathy—with no hint of mockery—toward staffers that may in fact be mentally unwell. Because in that case, surely the optics should be that you are concerned for the person’s wellbeing (and of course that of any coworkers that could be impacted by their behavior,) first and foremost.

    1. Bob's Your Uncle*

      Yes, this. It’s not impossible, although unlikely in this case, that she is being followed or stalked somehow. But even if that’s not the case, flat out dismissing her concerns will only add to her paranoia.

      1. Aaron*

        And it could be both, too. I have a friend who both has to to deal with abusive family members *and* has schizophrenia. Just because you’re paranoid doesn’t mean the “gift of fear” has no value.

    2. Ask a Manager* Post author

      That’s what I thought was so brilliant about Suzanne’s advice — she’s referring her to resources that can help no matter what’s going on.

    3. a clockwork lemon*

      All of the scenarios you’ve described are wildly different from the question in the letter. There is a colossal difference between being stalked and being subject to law enforcement surveillance, and both of those situations are wildly different from the behavior LW describes about her employee.

      It’s not bad optics or telling someone to “ignore their instincts about safety in a given situation” when they’re asking for panic rooms to be installed in the office to prevent against hypotheticals. It’s also not bad optics for a company to be up front and realistic about the fact that if their employees are under government surveillance for some reason, there’s nothing the company can do about it other than remind the employee that the EAP can provide attorney referrals.

      The optics should be about making sure employees know that the company will support unwell employees, but equally that the company will not allow unwell employees to make their colleagues feel uncomfortable or unsafe.

      1. Observer*

        All of the scenarios you’ve described are wildly different from the question in the letter. There is a colossal difference between being stalked and being subject to law enforcement surveillance, and both of those situations are wildly different from the behavior LW describes about her employee.

        This is a true. And I think it’s useful for the OP to recognize that. It’s also NOT useful or good optics to treat the complaints of someone who is clearly struggling with reality as just the same as concerns brought up by someone who actually has solid reason to be worried, or even someone who just has “a feeling” that they cannot completely nail down but is specific and who is not paranoid or otherwise struggling with an inability to read reality.

        But in a way, it doesn’t really change the response to this comment – The OP should most definitely treat Georgia with respect and not a hint of mockery. Which is exactly how the OP seems to be trying to deal with it.

      2. Jillzie*

        Re: “All of the scenarios you’ve described are wildly different from the question in the letter.” Sure. I think I spelled that out. When I mention optics, it’s also that while OP and some staffers may know the full picture of this employees mental health predicament, others may not. They may have only heard part of their story—in the elevator, talking about feeling unsafe about some stalkerish man jogging around the workplace. Or they might be talking about an ICE stakeout around someone who has family whose been grabbed by such an operation. So, taken individually as scenarios, by those who don’t spend the kind of time around this employee to assess their whole picture (to see where things likely would not add up,) you don’t want them to feel like “if I tell someone about that creepy vendor who keeps showing up at my parking spot at the end of the day, they’ll think I’m crazy.” As noted in the original advice, focusing on resources can mitigate that concern. I’m just suggesting to be aware of how any actions may come across.

        1. Self Employed*

          I’m a member of a Rapid Response Network (who are dispatched to witness ICE activity because they have no power over citizens) and in my community, there was so much legitimate fear of ICE that we started getting calls pretty much any time people saw an unfamiliar, unmarked white van. I’m sure a lot of contractors wondered why all those white women with smartphones were so interested in their work vans! But sometimes, the white van really is ICE. Members of the network would get up early to witness prisoner transfer behind the Target store in an immigrant neighborhood, from white vans to buses to go to the ICE processing center in a rural farm town south of the city.

      3. TWW*

        Maybe I’m also paranoid? My workplace has rooms designated as places where employees should retreat, lock the door and barricade themselves in the event of an “active shooter.” We have a drill on that procedure annually. Seems prudent to me.

      4. Anon for this if I may*

        Firstly I absolutely agree that the advice wisely doesn’t presuppose whether Georgia is justified or not in her suspicions, because that’s not the point and in either case, she needs support and deserves respect and not to be mocked.
        However speaking from direct experience, if the FBI/ICE were conducting surveillance on her, given all the times/things she believes she has noticed, they would doing an exceedingly shoddy job of it. And from my knowledge of the field, those agencies are a lot better than that.
        If anything the combination of different purported followers (an active shooter requiring a panic room would presumably be a terrorist or spree killer or other violent criminal rather than a government agent on duty, and is not necessarily after her personally unlike a stalker or a spy) makes it seem less likely to be “real” – you’d be very unlucky to be stalked AND under govt surveillance AND have the misfortune to be caught up in a shooting.
        But as stated, it doesn’t matter as OP shouldn’t and doesn’t intend to try and reason Georgia out of her beliefs (things are way past that) and ultimately it doesn’t affect how she is best advised to behave here. I’m only saying all this as a rebuttal to “maybe the FBI really are after her”.

    4. Observer*

      Alison is right.

      Also, there is never a good reason to approach a situation like this with mockery or disrespect. The OP doesn’t need to think about whether Georgia is objectively likely to be right or not to start from a place of compassion and respectful behavior.

      1. Maggie*

        In the late 90s/early 00s, I had a cousin who was kind of an internet pioneer. He built a lot of his own stuff, including a server, which was really unusual at the time. And you know bc what? The FBI WAS watching him! Today we all love to laugh about “the time the FBI tried to arrest CousinName,” but… i’m just saying there’s always a 1% chance the person really is being watched. Stalking is a terrifying crime that can be related to domestic violence and more. Just present options, like Aluson says, if the stories are moderately plausible. Seeing the same car/van constantly can really be real and scary.

        1. Observer*

          Please. As I said below, if the FBI (or any other agency is watching her), should WOULD NOT KNOW ABOUT IT. The reality is that these folks know their business and there is no way an amateur would ever be able to figure out that she’s being tracked – till they try to arrest her, if they do. On the other hand, if she were the kind of professional that can spot professional surveillance, there would be NO WAY that she’d be having these conversations with her boss.

          1. Courageous cat*

            Yeah. I don’t know that we need to be talking about the extremely rare exceptions where maybe just maybe she really is being tracked – doesn’t seem like a helpful train of thought to me

          2. WS*

            While this is almost certainly the case, I did have a co-worker in a previous job who was being watched by the police, because her ex-husband was a police officer and got his mates to keep an eye on her as part of ongoing abuse and control and a custody battle. She was not being paranoid, and several similar cases have been reported in the media since then. However, the EAP is still the right suggestion.

    5. BlueberryGirl*

      I completely agree that it is critical to treat the employee’s concerns with respect and grace; however, in my experience, there is a very clear difference when you’re speaking with someone who is suffering from genuine paranoid thinking vs reasonable fears. I think part of what makes the EAP such a great suggestion is that it is a source of help for all sorts of things and doesn’t dismiss the employee’s concerns. However, you also have to be careful not to encourage the thinking by agreeing with the employee that something might be possible. It’s a really tough line to walk and I’m not sure the best way to walk it.

      1. Charlotte Lucas*

        I like the fact that the solution is to address the fear. What’s causing it might not be real, but the emotion is, & EAP can help with that, no matter what the root cause is.

  12. Yes Ma'am*

    Oh my heart, I feel terrible for everyone here. Sadly there’s bound to be more situations like this though I think, after the past year. A year at home alone with limited social interaction and your cortisol levels through the roof almost daily over the stress of living in a pandemic is good for no one. Throw in a pre existing paranoid streak and you’ve got poor Georgia. I truly hope we get an update from op saying Georgia was able to get some help.

  13. Caterpie*

    Ooh, the internet rabbit hole scenario is very sad if so. I immediately thought of the “gangstalking/targeted individual” thing too. The coworker needs more help than their workplace can realistically provide if that’s the case, but linking the coworker to available resources is a good start.

  14. Happy*

    I’ve had 3 family members acting paranoid like this. It’s SO tough because they were not thinking logically and wouldn’t listen to reason. In one case, I believe the problem was undiagnosed bipolar and the other was onset dementia. They are much better with treatment. In the workplace … so hard! I have no advice other than what’s already been offered. Good luck!

  15. Rusty Shackelford*

    As for encouraging a call to the EAP, you have an advantage in that an EAP provides all kinds of help — mental health, legal, and financial. So, you can approach the EAP conversation from this angle: ‘Georgia, I’m really concerned about you. I wanted to suggest that you call our employee assistance program. They can help you figure out your rights and get you the help that you need.’

    On the one hand, this is kind of brilliant. On the other hand, what are the odds that the EAP liaison will recognize what kind of help Georgia really needs, and get her to accept it?

    1. AnotherLibrarian*

      It depends on the competency of the EAP people, of course, but it is a place to start. Good counseling centers are trained to listen for concerning language when people speak with them. The challenge here is that it is nearly impossible treat anything like this without the willingness of the person who has the paranoia to be treated. I wish the OP luck, they are in a tough spot.

      1. Self Employed*

        Riiiight, like when someone says “overwhelmed by bookkeeping” they know 100% this means suicidal intent. Not just “whoa there is more bookkeeping than I can reasonably do without someone who knows what they’re doing helping me”.

    2. 911 Operator*

      I don’t work for an EAP, but I do work somewhere (911) where we get a lot of calls from people suffering from similar issues to Georgia who want to report being stalked and harassed. Along with, of course, people who are reporting non-mental illness related stalking and harassing. These tend to be very basic phone calls, just getting enough information to get the name, address and a quick description of what is going on, and it’s usually pretty apparent when someone has this level of paranoia.

      I agree it would likely be very difficult for anyone, EAP or otherwise, to work on getting her to accept the help she needs. But recognizing it likely wouldn’t be much of an issue.

      1. Ace in the Hole*

        I just want to let you know how much I appreciate the competency and quick thinking of 911 operators. Because of the neighborhoods I live and work in, I end up calling to report emergencies several times a year at least. All the operators I’ve talked to have been incredibly helpful.

        And I agree that people in these types of positions are trained to notice when something is “off.” I once made a call while someone was threatening me and could hear what I said – I had to fake that I was calling my boss to let him know I’d miss work. The dispatcher realized what was going on in just a few seconds and was able to get the necessary information from me without alerting the aggressive person.

    3. Em*

      Hi! I do work for an EAP — I’m the person who first answers the phone when someone calls in, and I train people for the same job.

      You won’t get a counsellor on the line right away when you call an EAP, precisely because we offer so many different kinds of help — you get a call centre agent. I can’t speak for all EAP providers, obviously, but at mine (we’re global), these agents all have a certain amount of education and are weeded pretty aggressively at the interview stage for listening skills and thoughtfulness. In my interview, for instance, I had to roleplay a conversation with a client who told me something it’s very difficult for me to be empathetic with and which would be a shocking thing to hear outside of a roleplay situation.

      We spend a lot of time listening to calls before we’re set loose on actual clients ;) We’re taught to listen for tone of voice, significant phrases, hesitations, and so on. On every call, we actively ask people if they have any reason to fear for their safety (mostly we’re looking for self-harm possibilities, but we also get a lot of cases of domestic violence) — if they say yes, they get number one priority and connected right away to someone who IS a clinician. If they aren’t sure — same thing. If they say no, but hesitate, we ask questions along the lines of “you hesitated a little there; are you comfortable giving me a few more details about what’s going on?” and if we have reason to doubt that “no”, then — same thing.

      I will say that for a lot of the things that can cause paranoia, a lot of EAPs are not going to be able to do more than the first step. We’re a short-term service; counselling, not psychiatry. We do have another branch that IS more intensive, which is for “as a condition of your ongoing employment, you are going to follow this counselling program which is covered” things.

      I’ve had people like Georgia call me. As a non-clinician, what I or my colleagues have done is:
      a) listen to them. From the post, she sounds really afraid. That’s an awful way to live, and very isolating. So we’ll give her a chance to talk about it.
      b) If we think she’s at risk, or if she tells us she is — and she might, given what she says! — we’ll transfer her to a clinician.
      c) Validate her feelings. That’s not the same as saying “yes, I believe there are people following you.” I mean saying “that sounds really scary. I imagine it’s very stressful and exhausting to deal with.” She might not be right about people following her, and I can’t decide that. She’s definitely right about the way she’s feeling.
      d) Suggest an appointment with a therapist. Not about paranoia (see above re: short-term counselling), but I’d pitch it to her as something that’s going to give her some tools to cope with stress and maybe help her sleep a little better, or even just give her someone to talk to. My goal here is to get her in touch with someone who is better-qualified than I am to think “hey, maybe this is ____________” and who’ll know how to help her.

      As an EAP liaison, I probably don’t know what kind of help she really needs. That’s okay — neither does her manager, and probably neither does Georgia. Navigating the various types of help is a lot and frequently kind of opaque. But that’s not my job :p My job is to get her to someone who DOES know, or who can at least start.

      1. Lizy*

        This is so incredibly helpful to hear, simply because I had no clue what it means to be referred to an EAP. Alison, I’d love to see/read a post expanding on EAPs. How does one get referred? What IS an EAP? How is it supposed to be used?

        1. Banana phone*

          I’d be happy to talk to the clinicians and managers at my job if you need a volunteer.

        2. Em*

          Hi Lizy!

          For most EAPS, there’s a good chance you don’t actually need to be referred if you’re eligible. (Some places only provide it after you’ve been there a certain amount of time, or only for full-time employees, or whatever; your HR will have information about that.) Most of the calls we get are from people who got our number from a poster in the break room or on the company website or wherever, rather than being handed a business card by their manager and being told to call us.

          So, for how to use it — call the number! Sometimes there’s a chat option as well, which I love. Even if it’s just “hey, I wanted to know what’s available.” rather than “I actually need help right now.” We love calls like that — it makes for a nice low-stress break. We’re also used to people having no idea how their EAP works, so we’re pretty good at explaining things.

      2. Silverose*

        Another person who works for an EAP here. Supervisors and HR representatives can also call the EAP and refer employees who are high risk to the counseling service – these are considered mandated referrals, and are the exception to the usual EAP confidentiality because the employee getting help has become a condition to continued employment at that point, so the referring person (whether it’s the supervisor or HR rep) needs confirmation that the employee has followed through on receiving services. This usually occurs in cases of substance use, but may also occur for severe mental illness that affects work performance. These types of referrals are not common – most employers prefer a gentle nudge rather than requiring their employees to get mental health counseling, especially since the EAP counseling is limited in duration and only intended for short-term intervention, not long-term treatment – but they do happen. Supervisor/HR referrals at my company start with a consultation between referral source and clinician, then consultation between employee and clinician to determine best steps moving forward and best type of counselor match for the employee – who ultimately gets a lot of say in who their provider is, otherwise they wouldn’t buy into the counseling process enough to get much help out of it. The referral source doesn’t get notes from the counseling sessions, just confirmation that the employee followed through with attending the referred counseling, and reason for any delays in connecting employee to counselor (specifically whether it was on on our side, contracted provider’s side, or the employee’s side).

      3. Keymaster of Gozer*

        Don’t know if this means much, but as a person with schizophrenia your approach is by far the nicest and best way I’ve encountered.

        1. Em*

          That does mean a lot. It’s really rare that I’ll talk to the same client more than once, so it’s nice to have some confirmation. Thank you.

      4. Glad it is 2021*

        Your explanation of the EAP process (at least where you work) is very appreciated. This is a timely thread, as well for some personal things and is encouraging me to reach out through my employer’s EAP. Mental health is still so stigmatized I hope for better approaches and understanding of stress and mental health on all spectrums to be more normalized in work cultures. I’m also heartened by Alison’s and the ‘Evil HR Lady’s’ responses and the Op’s question in sincerely seeking out the best healthy way forward in trying to match the employee with help.

        I work in an industry (probably like many others) where mental health is highly stigmatized and employees can have real concerns of their managers limiting their employment and actually damaging the employees’ reputation if the employee tries to seek help; at the very least the manager will create situations within the employee’s work and job where there is a way for the employer to tell that employee’s coworkers the reason for them being out or having an altered work schedule if treatment coincides with normal work scheduling. This does not hold true for every manager in my agency (it has actually become very progressive in It’s approaches with employee well being in more populated areas, just some old guard holdouts in rural areas or managers who are approaching retirement age).
        Thanks for your explanation and advice, I’m further encouraged to reach out to my EAP to look for options in regular therapy to have a better perspective other than the culture I currently work within (especially this year, there was a manager led morning work meeting in which management actually brought up the topic of statue toppling to the workers – everyone including management at the meeting was white male and over the age of 40 and came from some construction related background- and the talk progressed into expression of distaste at their heritage being canceled and then somebody mentioned that if this happened in this area that they had a good strong length of rope – this is a rural area in a red confederate heritage heavy state; there were many more instances this past year of “shop talk” amongst people I work with that in other industries may have had someone calling HR but are normalized in my workplace). I also had a manager commit suicide two years ago at my previous branch who was responsible in his manager role of my career development and personally my spouse is dealing with his parents mental and physical health sliding steeper towards dementia, so I am wanting to explore my options through my EAP and health insurance of getting matched with a beneficial therapy. My spouse is still reluctant to ask HR about FMLA possibilities for helping him have time to care for his parents, he works in the industry I do and his manager will comply with the law but seems to spread around to the workplace reasons for people using time off (at least for the employees who are under age 50).

        I work in an industry which is heavily dominated by a “quasi militaristic” founding and is still a predominate culture of a “good ol boys club” which higher level managers term the agency to reflect (the agency training course I graduated from in 2018 was the first class in 70 years to have a gender make-up of half female to half male; with most of the training classes being composed of normally 70% – 90% men). The reason I even mention this, is to help illustrate that my agencies culture is very slow to change and keep up with modern view points. They do obviously incorporate training and comply with regulations and laws on a level where they are required to mention access to health assistance and are required to approve sick leave for employees, but in practice most of the managers approving this for the employees are reluctant and will actually mention in meetings to employees co workers and peers the illness or situation of employees who are approved for sick leave or the managers will state that a reason a project didn’t get done is because they were shorthanded due to such and such employee being out sick and then mention something about why that employee is not in. This also contributes to a culture where employees are reluctant to seek ANY type of mental health help, including regularly scheduled therapy sessions, which can be helpful just to get a person through a temporarily stressful situation.

    4. Banana phone*

      I work for an EAP company. We have trained clinicians on the phone AND we send clients to licensed clinicians. Chances are if the client is talking about it, they will know at least “oh dear something big is going on here” assess for danger, get them to appropriate professionals.

    5. Exhausted Educator Was Exhausted*

      Here’s my experience as one data point. I called my employer’s EAP to ask for a referral to counseling to deal with months/years of work-related stress. It had built up for so long that I almost immediately started sobbing as I explained to the person who had picked up at the EAP’s 800 number why I was calling. She was completely unruffled and compassionately but directly asked me a couple of questions along the lines of whether I was thinking of harming myself. Considering that people at the other end of that 800 number don’t know whether they are going to be asked about roofing contractors or auto insurance providers or what, it was pretty impressive. I think she transferred me once to connect me with someone to help specifically with the counseling referral, but they made the whole process as easy and transparent as they could have. Probably not everyone would be so lucky to have a top-notch experience with an EAP, but ones who seem competent to pick up on potential mental health issues from the first conversation do exist.

  16. Observer*

    I’m not sure how to even have a conversation with her about this when she truly believes that these things are happening to her. (And who knows, maybe the FBI really is spying on her!)

    The rule I give people about those support calls that tell you that “tech support / Microsoft / Whoever has noted problematic traffic” from your computer or the like: “No one who tells you they are monitoring your web traffic is telling the truth. And no one who is monitoring you traffic is telling you about it.”

    Which is to say that when you frame your thinking about this, understand that what she is saying is utterly implausible. Not because why would they be following her, but because if they thought she was worth the resources it’s highly unlikely that she’d know about it.

    1. Jane*

      This is true to a point and highly likely to be true in this case – that said, not all stalking or monitoring is done with the intention of actual surveillance. It can also be done specifically to freak out and/or discredit the victim.

      I’d assume there’d usually be additional context pointing that direction ( a vindictive ex, etc.), but professional surveillance isn’t the only form.

      That said, Occam’s Razor certainly points towards paranoia in this case.

      1. Observer*

        I’d assume there’d usually be additional context pointing that direction ( a vindictive ex, etc.), but professional surveillance isn’t the only form.

        Yeah, but again, you need to take stock of reality. There are a lot of things that a vindictive ex can do. Blanketing her apartment with cameras to track her every move is not likely to be one of them.

  17. Trek*

    My former boss described a situation where he watched a woman become more and more unstable. He was reaching out to HR and CORP-both in another state- asking for help. She would tell people she disagreed with that she was reporting them to the highest level of Federal Court. She would sometimes talk to herself and argue with someone while alone in her office. She would greet my former supervisor completely normally and was always happy to see him but couldn’t work with anyone because she would become so upset and bring up federal court. Finally one day after HR had a few conversations with her on the phone he received a call to take his entire team but her to lunch. it was barely after 11 but he gather everyone up and they quietly left- not an open floor plan so less noticeable- and they were seated across the street while an ambulance showed up and a member of her family and they escorted her out of the building. He never heard anything about it afterwards but he was told after HR spoke to her and agreed something was very amiss they reached out to her family who was willing to take action.

    1. Liz*

      Sounds like this was handled the way it should have been. My first job; and I’m a bit foggy on the details as it was 30+ years ago, and I don’t know any of the back story as I didn’t work with her directly, there was an employee who had some kind of a breakdown. From what I recall, she spent the night at the office, didn’t go home, and ended up being hospitalized for a number of months. She did come back, but I remember feeling badly for her. I’m also not sure how they got her out of the office, but I know it was done without a lot of fuss, and as quietly as possible.

  18. Concerned*

    Unfortunately this is timely… I have a young relative in-law (not a parent figure) who has started sharing delusional content on private social media. It’s been flirting with the line of QAnon style content for a while, but the red flags are increasing… seeing connections where there aren’t any, conspiracy theories, anti-govt, anti-vax, etc. There is a history of serious mental illness in the family. They are not receptive when family tells them it’s not sensible (not uncommon in clinical delusion). Unfortunately they live in a different city than the entire family, are single, and really only interact at work. I’ve wondered if it will get to the point where they can’t hide it from coworkers and what would happen if it did, as it’s difficult for the family to intercede from afar, or know for sure if/when they become a danger to themselves. All of this complicated by the fact that the relative works in education, around minors. I wish there were more resources to help.

    1. Jane*

      Unfortunately, from what I’m seeing and hearing re: the Q-Anon world, pre-existing mental illness isn’t necessary to cause this. Loneliness and boredom seem to be the main risk factors.

      1. Concerned*

        Very true to anyone else reading this. I’m being intentionally vague, but our relative has moved well past “run of the mill” awful 2020 QAnon, only mentioned it as I suppose background as to why it wasn’t on our radar as possible early signs of mental illness earlier. I don’t think the two have helped each other though.

  19. Exhausted Trope*

    When I read the letter, I immediately thought of dementia. My family went through this with my MIL and it was truly frightening. I won’t share the details.
    OP, not being family, there is not much you can do for your staff other than the advice given, unless she threatens harm. I’m sorry.

    1. MCL*

      My grandmother regularly hallucinated a peeping tom when she was early in her struggle with dementia. She lived all by herself, and it really frightened her. We were so early in the journey that we didn’t learn until later that hallucinations, in her case auditory hallucinations, are an early sign of dementia. However, there are all kinds of illnesses and conditions that can cause hallucinations and delusions (and very real situations that are not made up in the slightest). Hopefully steering Georgia to EAP will help start her journey to help with whatever is causing this, or to help her deal with the stress. It sounds truly frightening for her.

    2. allathian*

      Yes, this happened to my grandmother as well. Shortly before she went into a care home for dementia patients, she kept insisting her next-door neighbor broke into her apartment at night and moved stuff around so she couldn’t find it. This was just her dementia talking, because she couldn’t remember where she put things. She also had some delusions, and kept insisting that her leg didn’t belong to her, but to someone else. She was finally taken into care when she went outdoors in the middle of winter in her nightshirt and socks, during the day. We’re lucky a neighbor found her in time, or else she would’ve frozen to death. At the time, my parents were at work and my sister and I were at school, and we would have been too young to do anything about it in any case.

      That said, if Georgia is still able to do her job more or less as she always has, dementia is unlikely to be the cause of her paranoia. I hope she gets the help she needs.

  20. Becca*

    Many people have addressed concerns for Georgia already. My concerns are also for the strangers she could cause great harm to. Regardless of the personal experiences, someone jumpimg to such harsh conclusions about a person in a parking lot or somethimg else is such a danger that it needs to be well looked out for.

    1. Biziki*

      While I’m not saying your concerns don’t have merit, many studies have shown the people with mental illnesses (if that’s what’s going on with Georgia) are far more likely to become victims of violence rather than perpetrators, even more so than the general population. But regardless of who may be at risk, Georgia receiving the support she needs and deserves helps everyone.

      1. Ace in the Hole*

        I realize that statistic is typically cited to reduce the stigma of mental illness, which is critical for getting people the empathy and support they need (and deserve).

        That said, it’s also rather misleading because it’s a false comparison. The question isn’t “are mentally ill people more likely to be perpetrators or victims?” The question is “do a higher percentage of mentally ill people take violent actions than people without mental illnesses?” The answer to both questions seems to be “yes” based on the data I can find, although it is difficult to find good information.

  21. House Tyrell*

    I’m not going to armchair diagnose her with anything but I used to work in behavior intervention with adult students and we had patients who were like this -who had almost identical beliefs that the government was watching them, that the jogger in the neighborhood or the car parked across the street were actually the FBI or NSA stalking them, etc- and she definitely needs to get medical assistance as quickly as possible so try to get to to seek help and utilize benefits like the EAP and if she needs inpatient treatment then work with HR to make sure that she is not penalized for missing a few weeks of work. What you can do now at least in your interactions with her are to make sure you are not denying her paranoid beliefs when you speak to her. Don’t tell her that she sounds crazy or is wrong, but also don’t agree with what she is saying or confirm it. You can use language like “it must be really scary to feel like you’re being watched, and hard to sleep if you hear them. Are you sleeping well?” or “I’m sure it’s frightening to think that you aren’t safe in your home, is there anyone you do feel safe around?”

    1. Chickaletta*

      As someone who has dealt directly with a person experiencing paranoia/hallucinations, I 100% agree with not confirming or going along with what they’re saying. Your wording is great because it’s doesn’t dismiss or show disrespect towards what her employee is experiencing, but it doesn’t throw fire on the flames either. It is indeed a delicate line to walk when speaking with someone who is experiencing those things in the moment.

    2. Sylvan*

      This is what a friend with schizophrenia has said is helpful, too, if you notice something’s not quite right with them.

    3. BlueberryGirl*

      Yeah, when I was in college I had a dear friend who had a breakdown and was extremely paranoid. There was an incident and I regret that my friends and I, as unaware 19 year olds, didn’t work harder to get them some help before it got bad. I often look back at the conversations we had and I think, “Yeah, there were a lot of warning signs.” I hope the Letter Writer can be the employee some help. This is such a scary situation for everyone involved.

      1. RagingADHD*

        Please don’t blame yourself. These issues are very difficult for experienced adults to deal with. Nobody would expect teenagers (even if legal adults) to have the knowledge or ability to address this competently.

    4. Chilipepper*

      I will add to House Tyrell’s wording – I was taught to say, “well, we will have to agree to disagree about that, now about those TPS reports . . . ”
      This is wording for coworkers who are not trying to recommend an EAP or anything, they just don’t want to get into long convos about the off work topics.
      And it keeps you from either agreeing or disagreeing with the comments.

  22. Glenn*

    Persecution delusions can get really bad in some cases. If she’s confiding in you, she could have you playing a role in these delusions (ex. Thinking that people are conspiring against her but OP is on her “side”).

    “If you don’t want to call the police about the cameras because XYZ, maybe the EAP can help in some way.”

  23. ThisHappenedToMeOnce*

    This exact thing happened with a former co-worker of mine! She was sure the FBI was tracking her car, would whisper to you to be careful or they might get you, too, and said God was telling her things she wasn’t allowed to repeat. Her husband talked to her doctor as a heads-up and got her to the doctor under some ruse … and she had a thyroid imbalance! I know this sounds crazy but the doc put her on thyroid meds and she was COMPLETELY FINE! She asked us one day “Was I acting weird a few weeks ago?” and we said “Oh, you just seemed like you were really tired” … and that was it. I don’t think she has any idea how terrified we all were for her, and how distraught her husband was, or how weirdly easy the solution turned out to be.

    I dunno how that helps here but maybe this is what a good EAP rep can address.

    1. Lacey*

      This is a good point. A friend of mine would seem intelligent and witty one day and then the next, she would be contradicting herself mid conversation and was strangely combative. It was like that from the start of our friendship, so I just thought that was her, but it got worse over time. Then, she went to the doctor for something routine and discovered she had some kind of massive vitamin imbalance and it was messing with her cognitive function.

      Once she got it straightened out she was just the smart, fun version of herself. The other stuff was from the health problems!

    2. BadWolf*

      At a certain age, UTIs (urinary/bladder infection) can throw people into a state that seems much like dementia. I add this not to diagnose Georgia, but to add the hope that sometimes it’s a not an intractable descent into something hard to diagnose and/or treat. If OP can help nudge Georgia in the direction of help, the resolution may be easier than this type of situation often feels.

      1. OyHiOh*

        Yes, I know someone who is struggling with chronic UTI’s and the cognitive deficit of untreated UTI’s (particularly in cis feme women over mid 50’s-ish) is real and devestating.

      2. Charlotte Lucas*

        Yep. It’s a real problem with senior citizens.

        I’ve also known 3 people who had bad interactions between asthma medication & mental health maintenance medication. In one case, the person ended up checking herself in to an inpatient mental health center. (She also became paranoid & obsessive.)

        1. JanetM*

          Years ago, I had severe reactions to two different blood pressure medications — one made me full of rage and another made me depressed and suicidal. In both cases, my husband was researching involuntary commitment. Fortunately, in both cases, stopping the meds stopped the reaction.

      3. Savannah*

        My grandpa had chronic UTI’s in his 80s and 90s and we would often find him on the roof ‘sniping for nazi’s’. A dang miracle he never fell off but he did make all the EMT’s take off their uniforms to talk him down multiple times.

        1. Toads, Beetles, Bats*

          OMG Savannah. There is so much to love and fear and cry about in this story.

      4. Tired of Covid-and People*

        The first step in dealing with unusual behavior, especially if it represents a change, is a thorough physical exam.

    3. RagingADHD*

      An in-law of mine has a medical condition that prevents them from absorbing vitamin B-12 from food. They are dependent on shots. After switching doctors, the new practice failed to schedule the shots or follow up on them, and my in-law forgot about it. They became intensely anxious and paranoid after several months of missed shots.

      They believed that they were being followed by the police and would soon be arrested for some unspecified thing they’d done wrong. They would have a panic attack every time they saw a blue car, believing it was a police car.

      As soon as their medical team figured out the vitamin deficiency and rectified it, they became themselves again.

      1. Thursdaysgeek*

        Interesting. My bro-in-law has the same issue with B-12 and needing shots, but if he doesn’t get it, he gets increasingly depressed. I don’t think he could last several months without them, either, as I think he needs a shot every 2 weeks or so.

      2. Not So NewReader*

        Lack of B12, like so many other things, can really mess a person up. They can become someone else.
        OP, hopefully your employee’s situation is easily resolved.

  24. Super Anon for This*

    In high school, my best friend started starting at the air vents in our classroom and told me there were cameras watching her. I didn’t know what to do, so I eventually told her parents when I realized a) this was serious, and b) not going away. She had a brain tumor. Please suggest the EAP so this person can get help.

    1. Pipe Organ Guy*

      Many years ago, the department I worked for had a clinical skills exam for 4th year medical students, and it used standardized patients in various scenarios. One station was a mental health case, and the standardized patient’s script had that person displaying just the sort of behavior you describe. (No space here to go into it, but medical schools have been using trained, standardized patients to teach and evaluate medical students in various ways.)

    2. Blazer205*

      Similar situation with my best friend except she had been using meth and was high. I didn’t know the signs at that time so I believed her. No matter the cause, help is warranted in this situation. But not assuming it’s MH problems is important. That could put her off as the stigma associated with such is still unfortunately a major influence.

  25. Elizabeth West*

    Oh jeez. Poor Georgia. :( I hope she does talk to the EAP and gets some help. I’m sorry you’re dealing with this, OP; it’s hard when you want to help but you’re not sure what to do and also have to be conscious of workplace issues.

  26. Red Panda*

    I’ve never managed anyone, OP, so I can’t imagine how difficult these dynamics would be. One thing I would suggest is to avoid making decisions based on a fear that Georgia might become violent (unless things do seem to be escalating in that direction). The connection between mental illness and violence is not as strong as society would have us believe. I am hoping the EAP route proves useful!

  27. Delta Delta*

    I’m a lawyer. I used to be a public defender for a long time. I represented more than my fair share of seriously mentally ill people. I pretty quickly learned how to tell mentally ill clients that I was the wrong person to talk to about various MH concerns, but that I wanted to make sure they did talk to the right people, and would tell them to call (insert appropriate person here). What worked for me – because of my own personal style as a human being – was to say, very empathetically, that it sounded like the person was having a rough time with (insert issue here), and that I wanted to make sure they talked to the right person about it. I’d stress that although I’m good at a lot of things, figuring out that particular problem isn’t one of those things. But, that I was on their side in making sure they got the right help.

    Georgia might not take at all kindly to the idea that OP thinks she’s “crazy” (I would bet a dime Georgia says this). OP may want to frame this in terms of Georgia’s being worried or stressed out, and talking about *that* but not about the substantive parts of Georgia’s statements.

    1. Robin Ellacott*

      That sounds perfect. We deal with this in a work setting too sometimes and this is what we do.

      In the case of a coworker, I would use a similar tone and suggest calling EAP, as ours has many types of expertise available, and they direct you to the best person for you. However this might depend on what options your program includes.

  28. Autistic AF*

    Georgia’s support needs may be out of the scope of EAP. I’ve had to (and been able to) use those services several times over the years and I found those supports have been cut. Georgia’s situation seems more complex than 6 or 10 sessions of CBT can reasonably address. This has helped with superficial issues in my experience but doesn’t go deep enough to get at the root cause, and so the superficial issues reappear. OP’s company EAP might be better than this and it should still be the first step, but contingency planning in case it’s not would also be good to consider.

    1. Natalie*

      I would never assume the EAP could actually treat her paranoia, I think the idea is that they will hopefully have the resources and training to convince her to see an appropriate doctor.

      1. Autistic AF*

        That makes sense, but the appropriate doctor is often unaffordable or poorly accessible (e.g. long wait times), in which case it’s still a matter of contingency planning.

    2. virago*

      Two people who work for EAP services — Em and silverose — have commented and have explained in detail how they might talk to someone in Georgia’s situation and where they would refer her to. They know what they are equipped to address and what’s outside their wheelhouse.

      1. Autistic AF*

        Thanks for that… Counseling services have always been done through EAP in my experience, though, so when I say that this might be out of the scope of EAP I’m referring to everything offered and not just the person who works the toll-free number.

  29. Relatable*

    Oh wow, this hits close to home, and it was really helpful seeing these comments because my best friend exhibited the same behaviours. She insisted she was being followed, neighbours were watching her through windows 24/7, grocery store employees had a code they’d use to alert covert ops she was there (it was a standard greeting or question), helicopters followed her and her family, and a certain race was particularly in cahoots. Very detailed evidence. She ended up home bound with blackout curtains and her husband & 2 pre-teens did all errands or anything outdoors without her.

    My first forays into recommending mental health were met with extreme push-back and suspicion. So I moved to try to brainstorm other like professionals; social worker, victims services, who could review her evidence with her to help her make sense of it. I was completely out of my league. Same for her family who settled into a routine of mostly humouring her… “yup, that helicopter is definitely going the same way we are,” or “that grocery store manager really dismissed your complaints.” She ended up completely ghosting me when she discovered I started dating someone the same race as the one she was suspicious of. I tried to assure her but that seemed the death knell of our friendship. So difficult. But these comments do give me comfort though I know my friendship is not work related. Miss her exuberance and worry about her, though I try to keep tabs where I can without making it worse for her. It’s tricky and people with paranoia need far more help than even those close can provide, never mind managers.

  30. TWW*

    Maybe it’s because I’ve known people who suffered from more severe delusions, but her fears/anxieties don’t seem that bad to me.

    I like that idea of vaguely mentioning the EAP as resource when she starts talking about the FBI spying on her, but I think reporting her to HR (or calling her emergency contact!) would be too much.

    1. Mental Lentil*

      We are asked to take letter writers at their word. So I’m assuming that OP’s view is correct.

      But not taking action? No. As others have pointed out above, this could be an issue with her physical health. You get help when you notice something is wrong, such as chest pain, instead of passing out on the floor with a potential cardiac arrest.

      1. TWW*

        I’m not suggesting taking no action. I’m agreeing that pointing Georgia toward EAP is the correct action.

        In my opinion, acting on the assumption that she is suffering paranoid delusions is incorrect. What if her upstairs neighbor really is spying on her? I know there are plenty of real paranoid people, but there are also plenty of real stalking victims.

        I agree that we should take the OP at their word, but why not also take Georgia at her word?

        1. nonegiven*

          Every week there is someone on r/neighborsfromhell talking about their upstairs neighbors following them from room to room everyday, along with the usual ones that don’t pick up their dog’s poop and the people playing death metal at 4am.

    2. Observer*

      Perhaps if some of the people you know had gotten help sooner things might not have gotten so bad? We can’t know. But the idea that you ignore clear signs of a problem because it’s not at the point where it’s TOTALLY debilitating or presenting a clear and present danger is not sound (outside of contexts like involuntary commitment.)

    3. Natalie*

      It’s not “reporting her to HR” like you’re trying to get her into trouble. The LW is a manager, dealing with a situation that has legal and logistical ramifications. You loop in HR at that point because they need to be aware. They will generally also be more familiar with the company’s benefits and procedures than any bog-standard manager is going to be.

  31. katherine*

    The mention of ICE is giving me pause — I don’t know all the details in the OP’s situation, but what is Georgia’s background? Specifically, is she a person of color and/or Latina? For a lot of communities, unfortunately,
    being caught in an unannounced, sudden, often indiscriminate ICE raid is orders of magnitude more plausible than the FBI spying on a person not in the public eye — and after four years of the Trump administration, still very fresh in many people’s minds. COVID did not help, as ICE ramped up raids late last year.

    If this is the case, I’m worried that framing this specific thing as “paranoia” would come off dismissive or insensitive.

    1. Natalie*

      No one has suggested that the LW frame this to Georgia as paranoia. Nor is that how mental health professionals generally recommend handling people with delusions.

    2. Observer*

      I think you are missing an important point (in addition to what the others have said.)

      There are a lot of people who have bad experiences that leave trauma. And it’s quite possible that Georgia is one of them. It doesn’t mean that her current concerns and fears are reality based. It could help explain where some it comes from and why her particular fears take this particular form. But it still sounds like she’s gone from reasonable concerns to non-realistic hyper vigilance and is into real paranoia.

      It’s worth noting that she’s describing very detailed and targeted surveillance. This is not just the fear of getting caught up in an immigration raid.

      Believe me, I get it. I grew up in a community of refugees from Stalinist Russia. As an adult I’ve worked with a lot of refugees from the FSU as well as from some other countries with significant secret services. So, yeah, I get the trauma. But this is NOT among the functional responses to that kind of stuff.

  32. Sunflower*

    I deal with this type of paranoia: shootings, terrorist attacks, bombings, random stabbings, things like that. It’s 100% because those are the only shows I enjoy watching and my therapist told me I needed to stop.

    So I did, and it helped IMMENSELY! I thought it was BS at first but after a while, I stopped thinking about that kind of stuff.

    Just recently I started re-watching Homeland and booked a flight, and my first thought was the airplane going down in some type of crazy terrorist attack.

    I don’t think there’s much you can do for your coworker, except perhaps asks if she watches shows/movies related to that stuff and you’ve heard how it can make someone more paranoid.

    1. Not So NewReader*

      I had a friend who loved horror. I mean beyond saturation levels of reading horror novels.

      She had zero ability to trust her family, her docs, her bank, her attorney, just about everyone in her life. Everything that happened had 27 layers of complexity for her. Yes, there were other things going on there, too. But I suggested as a starter to put down the horror books. “Oh no, that’s not a problem.” Just like a half of a pot of coffee at night was not a problem and so on….
      All these little things add up. It starts out benign. We don’t notice any difference. But the years roll by and we toss in a few more habits and the next thing we know, these seemingly benign things are a problem.

      1. Sunflower*

        It’s totally true! Crazy how much we’re affected by what we intake.

        I was on a plane heading back from Europe once and someone left a little suction mirror on the mirror of the bathroom. The flight attendants came on the overhead and were asking this person to “identify themselves.” No one fessed up, then they started going around asking people who left it. I was legit FREAKING OUT, thinking the mirror was a bomb. Some of the flight attendants looked worried but then finally one calmed me down saying that it’s standard procedure to not touch things that people have left.

        I had been watching “Blacklist” during the flight and had to switch it over to “Bird Cage” with Robin Williams.

        Nothing ended up happening, but no one confessed to owning or placing the mirror there. My husband thinks the mirror was left by someone on a previous flight and they didn’t catch it. But for real, who puts a suction mirror in the bathroom? What were they doing? Tweezing eyebrows or popping blackheads?

      2. Dust Bunny*

        I often wonder if cases like this are some underlying issue that latches onto (horror, in this case) because it provides a context through which the person can “scratch that itch” instead of just living with nebulous anxiety all the time. Basically self-medicating with caffeine and adrenaline. This doesn’t sound all that different from a couple of friends of mine who are not-quite-pathologically into conspiracy theories and/or fundamentalist forms of various religions. All of them have a lot of unresolved feelings about the general state of their lives and having this other thing looming over them all the time seems to both provide a framework for their anxieties and allow them to avoid addressing them.

        I was super into horror as a teenager and it was definitely an anxiety and escapism thing.

    2. Scarlet2*

      I think that kind of question should come from the employee’s therapist and not her boss though.

      It’s also a bit of a shot in the dark. I am a horror/true crime aficionado and have a lot of other friends who are as well and, if anything, it tends to alleviate our anxiety. I actually read an article a while ago that said horror is often used as a coping mechanism by anxiety sufferers, so I don’t think we’re total outliers.
      Does consuming this type of media have a deleterious effect on some people’s mental health? Definitely. But mental illness comes from a lot of different places and I don’t think this kind of speculation is really helpful (and definitely not OP’s place to probe).

  33. Sunstar*

    From reading the comments — I’m surprised how common paranoia seems to be at work. My ex-boss told me about a former employee who was obsessed with being watched at work. It started small enough, believing someone read her e-mails, and ended up with her thinking that people were listening to her through the electrical sockets. Apparently she had a psychotic episode shortly after that and had to be admitted. I was younger and laughed about it at first, but ex-boss felt really guilty about not realizing how bad it was sooner.

  34. Anonononononymous*

    Going anonymous for this one

    I spent several years with the FBI tapping my phone. (I wasn’t involved in anything illegal, just very radical politics at the height of the “war on terrah”. If you weren’t being surveilled back then you just weren’t trying.) Also knew the Feds who attended our meetings/vigils/protests by sight. Everyone did. They aren’t nearly as professional or as discreet as you might think. I’m sure if I’d have said something at work, some of my co-workers would have thought I was paranoid.

    So, offer her the EAP. Try to be compassionate. Consider many of the potential health issues other posters have brought up. Don’t let her scare or hurt anyone. But also know that she might also be perfectly fine and telling the truth. She needs to not make it a thing at work.

    1. Grades White Collar Homework*

      I don’t know, I kinda feel like yours is a completely different situation.

      Saying, “I am politically active and attend meetings, vigils and protests on the regular. Pretty sure the FBI has me on a watch list. I see them at the events I attend. Wouldn’t be surprised if my phone was tapped. Ha, I should FOIA them to get a copy of my file,” isn’t going to read as you being paranoid to the point of delusions.

      And if your co-workers were at all familiar with your off-hour activities, they’d likely just nod their heads in agreement with you.

  35. Ferret*

    Now I’m wondering if I seemed paranoid at a previous job. I had several incidents that were like what you describe in the workplace (not the part about feeling like she’s being watched at home though).

    However, the reason was that I didn’t feel safe at work. I was in a large building by myself and I guess that just sent my mind into red alert. I imagine she could be dealing with something similar since you say your office is in a bad area (again, only talking about the office stuff). I guess the line between paranoia and vigilance is a bit hard to tell sometimes. Maybe that jogger did something to make her feel uncomfortable. And sadly, is an active shooter plan really that out of line these days? (Maybe dedicating a whole room to it doesn’t make sense but still.)

    I don’t know. Now I’m realizing maybe I’m the paranoid one. Haha. Oops. Thankfully, I haven’t had that issue since working in an environment I feel safer in.

    1. Grades White Collar Homework*

      There’s a large distance between “active shooter plan” and “build an impenetrable panic room”, tho.

      My office has an active shooter plan. We are well aware of all of our exit options and of potential hiding places. Of course, if the shooter is one of us, they would know all that stuff, too.

      But there aren’t many (any?) companies that are going to pay $50K to $500K to have a panic room built that will hold only a handful of people.

    2. Not So NewReader*

      FWIW, I’d be concerned about anyone working in a larger or even medium building alone. I don’t think that is good practice on the part of the company/organization.
      Some friends have dogs. I have suggested bringing their dog to work where possible.

      I am glad you got to a safer environment.

    3. RagingADHD*

      If you notice, the LW wasn’t seriously concerned about Georgia’s mental health until she started claiming the FBI was tracking her from the upstairs apartment.

  36. Charlotte Lucas*

    I think there’s an amount of vigilance that most people with a well-developed sense of self-preservation will have. Based on the OP’s letter, it sounds like Georgia has been steadily moving from hyper-vigilant to (potentially) self-destructive paranoia and wants to keep her from getting all the way there.

    I don’t get the feeling that there isn’t an active shooter plan, but that Georgia wants a panic room, too. And that she’s increasingly seeing danger everywhere. I hope she gets the help she needs.

  37. Blazer205*

    Also rule out drug use and insomnia. I had a friend years ago who was extremely paranoid. I was young and didn’t know the signs so I believed her. People were watching her etc. Turns out she was using methanphetimine. (I know I misspelled that, sorry) Also any strong stimulant affecting sleep for a period of days can increase paranoia and hallucinations. Especially if tendencies are already there.

  38. Elspeth McGillicuddy*

    I’m not saying you should come back to in-person early, but if being at home alone exacerbated Georgia’s issues, it might help her to do more in-person work, if possible.

    1. This is scary*

      That also puts the people at work at risk. If she’s thinking people are watching her in her home and want to hurt her, she is one step away from “defending herself against a coworker who is in on it”

  39. Mstr*

    Delusions can also be a symptom of a stroke in which case the proper course of action would be to call an ambulance. I think this question would be better answered by a medical professional rather than an HR department or an advice blogger. I would love a post where this is answered by an EMT or any other medical expert.

    1. anonymous cantaloupe*

      I think you have missed the point which is that employers are limited in what they can do or suggest in a way a medical professional would not be.

      1. Mstr*

        If someone falls down the stairs and hits their head, you can call 911 just as you could if someone is exhibiting delusions. A medical professional could weigh in on what immediate help should be given in this specific situation — when certain symptoms occur you take appropriate action — you make sure an epileptic won’t choke, try to give CPR, etc … a first aid/emergency services response could be called for when delusions occur and I think a medical expert would tell you, “yes, get this person to an emergency room if xyz” or at least “there are times when an emergency room is the best option here.” Let’s ask a medical expert not office staff.

        1. Mstr*

          You do not actually do or suggest anything yourself, you call a medical expert and let them handle the situation. If the person is having a stroke or paranoid to the extent of harming themself or others … those situations have urgency (and pointing them towards a chat with a therapist several months down the line isn’t sufficient).

          1. Ask a Manager* Post author

            The issue is that employers are subject to legal constraints on what they can and can’t do when something isn’t an immediate medical emergency (like a heart attack — something that requires treatment this very moment, today).

          1. Sarah*

            This could absolutely be an emergency for her coworkers. Someone this paranoid poses a real threat to their safety

            1. RagingADHD*

              Georgia working from home poses zero danger to her coworkers, and nothing she has said so far indicates that she’s taking or intends to take any dangerous actions.

              You don’t call emergency services for things that could possibly become an emergency, just like you don’t give people the heimlich maneuver if they could possibly choke.

            2. Keymaster of Gozer*

              No more than working with a schizophrenic poses a real threat to your safety.

            3. Blue*

              It really doesn’t, in an overwhelming majority of cases. People with even severe psychotic illness are almost never a danger to anyone other than themselves – they are just people who are very frightened and alone. And I know some of them read this column, and it doesn’t help them to hear that people think of them as threats.
              Really – every statistic bears this out: people with psychotic illness are not a danger to you.

              1. Keymaster of Gozer*

                It’s why I never admit to having schizophrenia at work. I’m practically guaranteed to have one or more people say they don’t feel safe around me after.

                Hell of a stigma to live with let me tell you.

            4. onco fonco*

              Just because you can imagine something happening doesn’t mean it’s at all likely. For every person with severe mental illness who makes the news there are very, very many suffering quietly and doing no harm to anyone. Treating the current situation as an emergency for Georgia’s coworkers is like calling an ambulance because someone’s eating grapes and could choke. Know that it’s a rare possibility, sure, know what to do if it ever happens – but that’s all. Overreaction could cause Georgia irreparable harm.

        2. 911 Operator*

          Please note I am saying this as someone who works at 911 myself and I’m not looking for a political debate. But it’s important for people to consider the current optics of calling 911 (and ergo, in most cases, the police) for mental health crises (or what could be) currently. We’re in a state of transition right now and trying our best to refer scenarios like this to more appropriate agencies but it is really specific to your area and to the individual responders how well things like this are handled. And many ambulance companies have policies that they cannot/will not respond on mental health crisis calls without police, so it’s not necessarily up to whoever is calling 911 to determine what kind of help and response this person receives.

          Could Georgia’s behavior be the result of a medical issue? Sure. It’s very very unlikely it is of an emergent needs an ambulance right away type, particularly because this behavior is an ongoing pattern. Your advice, while I believe well-intentioned, could end up being very harmful for Georgia.

          1. Keymaster of Gozer*

            Police often get sent out to psychiatric emergencies in the UK too and their response is….generally not great.

          2. Self Employed*

            Thank you. My metro area has had way, way too many shootings of people after 911 was called for a mental health crisis. We now have a “mental health crisis team” but guess what? They won’t talk to the person until the police determine the person is not a threat. Except the police just confront them and escalate the situation so they seem to be a threat.

  40. AnonForThisOneTime*

    I agree with calling the family if your other efforts don’t work and you feel she’s spiraling. Of course, you should consult with an attorney and HR before doing so, but please don’t assume something that is obvious to you is obvious to her family. I had a cousin who had a mental health crisis in her mid-20s. She had already kind of grown apart from her parents, talked to them less than once a month, so when things spiraled very quickly in about 6 weeks, they had no idea. By the time her friends reached out to my aunt and uncle, she had lost her job and was on the verge of becoming homeless. They learned later on that her employer had concerns but was afraid of invading her privacy. If they had been able to get her into inpatient treatment when it first became clear how serious things were, it would have saved a lot of heartache.

    1. AnonForThisOneTime*

      And just to be clear, I’m talking about contacting a person that the employee has designated as an emergency contact, not digging into her past to find family members she hasn’t given you contact info for.

    2. Sopranistin*

      I came here to say this, too. My grandmother had dementia. She was still working retail at age 70. After she was diagnosed, we learned that people at her workplace had noticed her strange behavior but never said anything. We sincerely wish someone had told us, we could have gotten her help sooner.
      We spend most of our waking hours with coworkers. They notice things our family do not.

  41. Maree*

    I’m not an expert in this area but do have some experience in dealing with a family member with paranoid delusions (schizophrenia). My take:
    1) Don’t get sucked into the plausible deniability (maybe someone is…), whether it is true doesn’t really change your part in this.
    2) Focus on Georgia’s lived experienced. Her lived and real experience is that she is afraid of xy & z. It doesn’t matter if it is true (see 1), your response is to her fear.
    3) Normalise her feelings. It is normal to be terrified if you think you are being monitored/watched. Any sensible person would feel the same. Her fearful response to delusions is normal.
    4) Tell her that you are worried about her (you are!), that you want to help her but don’t know how (you do). Suggest the service that can help. Make it easy to take you up on the offer. (Would she like to phone now? Would she like you to go with her? Is there someone else she would like to have with her?) You might have to repeat this step more than once, extreme stress interferes with cognitive function and she may not be in a state to process things the first time.
    5) Keep an eye on the people who have regular contact with her. Dealing with paranoia is exhausting and stressful – your other employee may need assistance as well to deal with this.

    Good luck and thank you for being caring about this situation. You are doing a good job in a difficult situation, your employee is lucky to have you as her boss.

    1. Keymaster of Gozer*

      As someone with schizophrenia who has in the past had paranoid delusions: these are fantastic tips.

      Even if it isn’t schizophrenia or similar.

  42. Rage*

    Former EAP employee here (worked at one in an admin capacity for almost 15 years). We had 2 clients I recall who had significant paranoia: one man, one woman. In both cases, it got to the point where HR was able to directly send them to us as part of a formal referral due to workplace impact.

    The man’s case was actually easily remedied, by moving him from the “over-time, over-budget, high-stress” project to a lower stress one, and his symptoms virtually disappeared. His workplace was incredibly supportive, willing to do anything to help him. It was just beautiful to see how everything came together.

    The woman…it was more difficult. She was convinced we were part of the conspiracy, and therefore immediately suspicious of anybody or anything we recommended. Fortunately for us, her husband was firmly on our side and desperate to help his wife, but it was a long road for her. (Again, her employer was amazingly supportive.)

    You should contact the EAP for direction for you/your organization in this situation. They can advise you (or you & your HR) throughout this process. There might already be an avenue for a formal referral that you haven’t already recognized. And they might also be a useful support tool for the other employee(s) who may be impacted (as Maree mentioned above).

  43. Tussy*

    This sounds like a psychiatric emergency requiring as early intervention as possible. You need to call her emergency contact. EAP is not equipped to handle this. I am speaking as someone who has lived experience with paranoid schizophrenia. Do not wait it out to see what happens, it has already reached the point of “she needs medical help now.”

    Honestly I feel like this wasn’t a good question for this site. This is a question for people with experience of this serious mental illness, not for a general workplace blog and as much as Alison can give good advice on office norms or what managers and hirers might be thinking. If you need advice you need to call a helpline for mental health information or a career’s support line, not an advice blog. I don’t blame you for writing in, and I’m sure Alison did the best she could with her HR knowledge, but please don’t wait and see.

    1. Ask a Manager* Post author

      It sounds like I needed to make this clearer in the response, but employers have legal restrictions on what they can and can’t do in terms of medical intervention. That’s the whole reason it’s tricky.

      1. Keymaster of Gozer*

        It’s similar in the UK too. The absolute only time I would be authorised to contact emergency contacts would be if the person was in danger to themselves or others for a psychiatric issue. As someone WITH a psychotic disorder that’s kinda a relief really.

        Managerial side I totally get the desire to help your staff in any way out of a bad situation. Schizophrenia side I want to say that unless you trained psychiatric persons well trained in handling things and it’s not an emergency then just don’t.

        If it *does* become an emergency (person literally can’t operate in normal daily life or work because their paranoia has taken over) then yeah, you gotta get them out the office. Emergency contacts.

  44. Keymaster of Gozer*

    Bit late to this (UK time zone) but here’s my perspective as both a manager and someone with schizophrenia who has suffered paranoid delusions. I am NOT saying that she has schizophrenia btw, just what works for me.

    If I’m really paranoid about something untrue (blood drinking plants in hedgerows 2004) to the extent that it’s affecting my daily life, my relations with others and causing me to be seen as ‘nuts’ then I can’t be reasoned out of it. It actually increases the problem when people say it’s all in my head or try to explain how it’s not true because then I put you in a category of ‘liar’. Also, don’t go down the rabbit hole of trying to get me to fully explain it, my brain will invent even worse stuff. However, acknowledging that I’m scared, that my feelings are real and gently steering me to medical help works.

    (Analogy for what it’s like having schizophrenia: that part of you that dreams and you have weird stuff happens in a dream? That bit sometimes crosswires into my waking mind)

    If it’s not a schizophrenic delusion and I’m getting overly paranoid about something else the same tactic works.

    As a manager, I wouldn’t do anything to someone I’d hate to have done to me. No trying to force medical intervention (and for the love of god don’t call the police), try to not let rumours of ‘X is really mentally unstable’ percolate (some will, but don’t encourage it). Gently steer toward help, but maybe also try to give something else to occupy attention (aside from my antipsychotic meds, diverting my brain toward a project or work that takes brain power has done wonders). But ultimately that is all you can do. I’m really sorry from both sides of management.

    1. Deets*

      Thank you for sharing. It’s important to not rely on assumptions in the LW’s case so I love the idea of LW trying a tactic that would work in multiple situations.

      1. Keymaster of Gozer*

        Yeah, sadly I got a lot of experience in dealing with paranoia (grandmother had full blown paranoid schizophrenia 24/7)

    2. whatchamacallit*

      My grandmother had depression with psychotic features and it’s so true, you can’t reason people out of delusions. She would become convinced of things like she was going to lose her house, and family members would take out all the paperwork, show her how she owned her home, no one was taking it from her, and besides that her family was not going to allow her to be homeless. Ten minutes later she would be freaking out about the same thing. I have struggled with similar depression throughout my twenties now and I’m not proud to say the few times family members suggested help it really made me just dig in deeper and get indignant, and I was also just really embarrassed by the “crazy” thoughts I was having that wouldn’t go away. Plus the longer I went untreated, the more severe it got. It’s like, I already knew I was believing things that were untrue, telling me they were untrue and laying out why they didn’t make sense would not have been helpful to me.

      1. Keymaster of Gozer*

        Yeah, in the depths of our paranoia or depression having someone tell us we’re entirely wrong about X can either lead to judging them as a liar themselves or having it fuel feelings of worthlessness because I must be thick as clay to have people telling me I’m making stuff up.

        I was once so convinced that there were plants that ate people in hedgerows that I’d not even go near a garden or fields. It got worse, but what got me the help I needed was someone just acknowledging how terrified I was, that whatever was causing it my emotions were real, and that there’s help if I just want to feel a little bit less panicked about the situation 24/7.

        And that got me to my doctor, who got me to the psychiatric team.

  45. L*

    Okay, so here’s my story of being paranoid at work. I was being stalked for years by a guy mostly online but knew who it was. I had tried to contact police and they couldn’t do anything or wouldn’t do anything. I was anxious as hell. I got fired from the restaurant I worked at because I was basically wigged out all the time. He ended up sending a bomb threat years later after I moved, to the Hamilton Ontario city hall. He got arrested then. I talked to people from back then and they were like, we thought you were crazy. I wasn’t. I still have PTSD from the experience.

    1. Boof*

      Yeah it’s really hard to get the authorities to pay attention to stalking, even when it’s got red flags all over the place for “will probably hurt someone” (ie, constant stream of death threats) seems like they’re more interested in cleaning up after the fact… may be changing up these days a little with the highly public cases but it was my experience too 10 years ago only got attention when they threatened to shoot up a school THEN suddenly the illegal death threats against me (slowly escalating for years) became worth paying attention to (by the FBI, ultimately)

    2. CommanderBanana*

      Right?? I volunteered on a call line for sexual assault victims and a lot of calls were from people who were being stalked and it was astonishing how often they told me that no one believed them. And they were literally being followed, photographed, cyberstalked, etc.

  46. Veryanon*

    It’s very tricky dealing with situations like this, because if you start treating the person as if they are mentally ill (even if they are) and they have not disclosed any medical conditions to you, you may be violating their rights under the ADA. I always recommend focusing on the behavior and job performance. If the behavior is problematic, you can coach the employee on the behavior and suggest the EAP or other resources that you may have, which, as noted, are kind of catch-all resources that don’t specifically target mental health issues.
    I think we are just starting to see the tip of the iceberg in terms of mental health issues as people try to work through all the fall-out of the past year.

  47. Keyboard Jockey*

    I scanned the responses and didn’t see this mentioned, but most EAP programs will offer a consult to managers of employees that may be having difficulties. Calling EAP yourself to see what kind of options you might have could be informative for you and how you frame this to her.

  48. whatchamacallit*

    Oh this is so sad. I wish I had good advice. Before I finally got treatment for depression, I would have very terrible delusions where I became absolutely certain the police were after me and I was going to jail. Noises outside my apartment door were the FBI coming to get me. But I also knew none of these things were true and absolutely never voiced them out loud as thoughts because, obviously, everyone around me would think I was insane. It was affecting my productivity and focus because I was spiraling so badly and I finally dragged myself to a therapist because I knew I could only stall for so long before it was noticeable I was not getting through my work fast enough. (It runs in my family, unfortunately, my grandmother had the same problem, usually around finances, even when she knew she was not struggling financially.) Anti-depressants have been a godsend to me. I don’t know how to suggest anything here, mainly because a) your employee seems to really believe her delusions, instead of fighting them and b) the only person able to convince myself to get help was myself. Sending a blanket reminder to everyone that their health plan covers mental health services (if that’s true) and emphasizing how hard COVID has been on everyone mentally might not hurt?

  49. Tomalak*

    My main reaction here is how great it is she is in a job where her mental health issues aren’t stopping her getting the job done – and that she has a boss like the letter writer who is concerned, rather than searching for a way to get rid of the “crazy person”.

    I lived with someone like this at university, convinced we were all talking about him the minute he left the room. I have known slightly two others who, in the early 20s, developed severe psychosis and their life quickly unwound. Even if there is nothing else the LW can do, the LW is already doing a lot by providing her with a stable job and income, which her condition will no doubt make much harder. I am not saying keep her on out of pity – but clearly that is not the situation anyway.

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