In today's fast-paced world, mental health challenges are increasingly prevalent. With approximately one in four adults experiencing mental health issues in any given year, coaches are highly likely to encounter clients who are dealing with mental health concerns. This reality presents both opportunities and challenges for the coaching profession. 
 
The Growing Mental Health Landscape 
The global increase in mental health issues has been particularly notable in recent years. Factors such as workplace stress, social media pressure, and global uncertainties have contributed to rising anxiety and depression rates. The HSE reported that during 2022/23 the main reason for working days lost was stress, depression or anxiety, at nearly 20 days absence compared to 14 days for musculoskeletal disorders¹ As coaches, we need to recognise that many of our potential clients may be managing mental health challenges while seeking coaching support. 
 
The Coaching-Therapy Interface 
Understanding where coaching ends and therapy begins is crucial for ethical practice. While both disciplines support personal growth and development, they serve distinct purposes: 
 
Coaching generally focuses on moving forward, setting goals, and achieving specific outcomes. 
Therapy is geared more towards addressing the past, dealing with trauma, deep seated emotional issues, treating mental health conditions, and providing clinical support. 
 
The differences are not always obvious though and many coaches will attest to coaching sessions flowing between what could be described as coaching and therapy. The challenges then are to be able to recognise when does something fall outside of the coaches competency and experience level, when and where to refer to a suitable therapeutic service and very importantly when to recognise if there is a mental health crisis that needs immediate help. 
 
As Verity Symcox outlined in her article ‘Let’s Talk – About Mental Health and Mental Illness’² the symptoms of mental illness are too similar to many of the regular, acceptable challenges clients bring to coaching’ so how do coaches recognise, without any specific mental health awareness training, if their client needs referring to therapy or other professionals. 
 
Recognising Mental Health Issues 
Coaches who aren't mental health professionals can still learn to recognise potential signs that a client might benefit from therapeutic support: 
 
Persistent low mood or anxiety affecting daily functioning 
Difficulty maintaining basic self-care routines 
Expression of hopelessness or suicidal thoughts 
Significant sleep, appetite changes or disordered eating 
Inability to focus on coaching goals due to emotional distress 
 
When to Refer 
The International Coaching Federation (ICF) provides clear guidelines about referring clients to therapy.³ 
Coaches should consider referral when: 
 
The client's issues fall outside the coaching scope of practice 
The client's challenges require clinical intervention 
Progress in coaching is consistently hindered by emotional or psychological barriers 
The client expresses thoughts of self-harm 
 
Dual Support: Can Coaching and Therapy Coexist? 
In many cases, coaching and therapy can work complementarily. Consider: 
 
Clear Boundaries: Ensure roles are clearly defined between coach and therapist 
Distinct Goals: Maintain separate objectives for coaching versus therapeutic work 
Regular Assessment: Continuously evaluate the appropriateness of dual support 
 
Discrimination Considerations 
Refusing to coach someone solely because they have a mental health condition could be discriminatory. The Equality Act 2010 outlines protected characteristics, one of which is disability such as a mental illness. It’s therefore important to establish how far the mental illness is affecting the client and their ability to engage with coaching, the coaches capability and experience and whether therapy would be a more appropriate intervention. 
 
The law says someone is disabled if both of these apply: 
 
they have a 'physical or mental impairment' 
the impairment 'has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities' 
 
The second point above may well preclude a client from a coaching approach however, it’s not straight forward because someone with diagnosed depression or anxiety may still want to focus on self-care and wellbeing activities, something that the right coach is well placed to help with. 
 
Consider: 
 
Focus on whether the client can engage meaningfully in coaching 
Assess if coaching goals are appropriate and achievable 
Consider if adequate support systems are in place 
Maintain clear professional boundaries 
Capability, competence and experience of the coach. 
 
Best Practices for Coaches 
To navigate mental health considerations effectively: 
 
Develop Mental Health Literacy 
Attend mental health awareness training 
Learn about common mental health conditions 
Build a network of mental health professionals 
Know where to refer clients especially in the case of a crisis. 
Monitor your own competency boundaries 
Seek supervision when needed 
Regularly update your mental health knowledge 
 
Creating Safe Spaces 
Coaches can support clients with mental health challenges by: 
 
Creating judgment-free environments 
Maintaining confidentiality 
Using inclusive language 
Showing empathy while maintaining professional boundaries 
Being transparent about coaching limitations 
 
Conclusion 
As mental health awareness grows, coaches must be prepared to navigate these waters professionally and ethically. It can be a complex landscape that is ever changing. While coaching isn't therapy, coaches play a vital role in supporting client wellbeing by knowing their limitations, recognising when to refer, and creating inclusive practices that support all clients appropriately. 
 
Good coaching practice isn't about excluding clients with mental health challenges, but rather about ensuring they receive the most appropriate support for their needs, whether that's coaching, therapy, or both. 
 
 
Tagged as: Coaching, Mental Health
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