Coaches have a professional responsibility to be able to:

  • Identify the signs and behaviours that may indicate concern about a client’s mental wellbeing or possible mental illness.
  • Recognise when we can support the client to bring about change.
  • Know when coaching is not the most appropriate intervention.

We all have mental wellbeing in the same way as physical wellbeing, although both are hard to define.  The definition I like is wellbeing as a balance between our challenges and our resources, whether these are psychological, social or physical (Dodge, 2014).



If we consider different elements of psychological resources – self-acceptance, purpose in life, personal growth, environmental mastery, autonomy and positive relationships (Ryff, 1989) we can clearly see where coaching can add great value.

However, mental illness and mental wellbeing are different, and we all exist along a continuum (Keyes, 2002).  The ideal place is the top right quadrant, with no diagnosis of mental illness and good mental wellbeing. Without being able to access helping coping strategies we can drop down into the lower right quadrant.

If someone demonstrates symptoms that suggest they are in the lower left quadrant, they require medical intervention and coaching is unlikely to be appropriate at that time.  In the top left quadrant people can be leading full lives, despite the diagnosis of a potentially disabling mental illness, through a combination of interventions.



The stigma still prevalent in our society can inhibit positive movements up the mental wellbeing axis.  As a coach we create a safe place and listen without judgement, so could encounter situations where a coaching session is the first time issues are articulated.  A helpful outcome of this may be seeking appropriate medical help. Alternatively, if the client has milder symptoms of anxiety or depression coaching could be beneficial.

But what if we become aware of things that give us serious cause for concern? At the extreme end, concern that the client may be at risk of harming themselves or others.

What should we look out for?

The key thing is change.  If we have got to know a client we may notice changes, if it is a new or potential client it may be harder. Look out for:

  • Physical changes including tiredness, weight changes, complaining of headaches or digestive problems.
  • Psychological changes including decreased motivation, lack of clarity in thinking, talking about ‘brain fog’, more emotional and appearing anxious
  • Behavioural changes may include lack of care in appearance, anger, withdrawing, not progressing actions, restless and intense activity.

Our challenge is that there is a complex matrix of links between wellbeing, motivation, purpose, confidence, etc.  Our task is to make a judgement call as to the best outcomes for our client and get the balance right between being wary of not venturing into areas where we are not equipped or qualified; and using our coaching expertise to enable the client to build their resources and move up the mental wellbeing axis.


  • Check your contracting process to cover any disclosures or awareness that needs action beyond the coaching session and may require breaching confidentiality
  • Familiarise yourself with the symptoms that may indicate poor mental health.
  • Depending on your knowledge and experience of coaching and any therapeutic interventions, decide your approach to risk, and how you would deal with situations where you were concerned.


Marion Hewitt is an award winning coach, Fellow of the CIPD and trainer accredited with Mental Health First Aid England.  Through her company Protea Solutions she delivers mental awareness and Mental Health First Aid training as open courses and within organisations. Her coaching specialism is working to build confidence and credibility coaching for HR professionals which draws on her background within HR.