Dr Maze


regular comment for managers on workplace health issues

Workplace Interventions for Common Mental Health Problems

Mental health and musculoskeletal disorders are “the big two” causes of sickness absence in the UK working population (about 40% each in the absence statistics). Each year, about a quarter of the UK population experience some form of mental health problem such as depression, panic attacks or stress. The economy loses about £11.6bn annually, due to time off work with these conditions.

The British Occupational Health Research Foundation (www.bohrf.org.uk ) funds high quality research that has direct application to the workplace. They have been looking at the effectiveness of “Workplace Interventions for Common Mental Health Problems.” Earlier this week, they launched their Evidence Review at the Royal College of Physicians in London. A secondary launch is planned for next Friday at the Royal College of Surgeons in Edinburgh. The study was sponsored by First Assist (www.firstassist.co.uk ) and carried out by the Sainsbury Centre for Mental Health.

Many employees with mental health problems end up losing their jobs. The report found that counselling could help staff to stay in work. Cognitive behavioural therapy (CBT) was particularly effective. This method deals with the way you think about your problems as well as focusing on your behaviour.

So what can you do? Employers have a key role in preventing job loss and in reducing employee sickness rates. Creating a mentally healthy workplace is as important an investment as any form of staff training or development. If you’re worried about cost, it will pay for itself. Employers need to develop policies to help workers with mental health problems. Supervisors should contact employees off work with mental health problems at least once every two weeks. Early interventions should be used as much as possible – an eight week course of CBT can make the difference in helping your staff remain at work.

Workers’ representatives also support this approach. Hugh Robertson, head of health and safety at the Trades Union Congress (http://www.tuc.org.uk ), welcomed the report saying, “Most employers are doing very little in this area. They don’t know what to do if someone is off work, whether to contact them or not, so often they don’t.”

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Up and running again!

I’ve not posted here for a while, due to a combination of time constraints and some “accidents” with the software (messing about when I didn’t know what I was doing). Everything seems to be running again now, so I’ll try to post at least once a week from here on.

For now, here’s a common problem most managers face at some time or other: “I have an employee who says he can’t attend work because he hurt his leg and his doctor told him to stay off it. What do I do now?”

Sample Responses:

1. Before it happens, have you put in place a policy that requires the employee to keep in touch with the company during his absence?

2. Do his terms of employment require him to attend your occupational health provider for a review of his capability for work at reasonable hours appointed by you?

3. Are you prepared to offer him alternative duties that are within his capabilities for the duration of his incapacity?

4. If you don’t retain or have access to an occupational health advisor, you may have to write and ask the GP exactly what he means by saying that the employee should refrain from work.

  • If he means “all work” can he offer you some justification for such a drastic restriction?
  • Outline the nature of the contractual duties and ask whether any of these are within the employee’s capability.
  • Suggest that as the problem is related to standing/walking, you can offer work that does not require this. Outline the other job tasks that you might be able to offer the employee – sitting job, reduced daily hours, etc. Ask whether there is any medical objection to him doing these specific tasks.
  • Ask for a realistic time scale for the restrictions and when you can reasonably expect him to be able to resume his full duties.

Note – you must be prepared to abide by your promised restrictions and not renege on the deal once the employee is back at work. Otherwise, you will lose all credibility with the local GPs and with your employees.

5. You may wish to arrange a one-off assessment by a local occupational physician (OP), and you are entitled to accept that opinion as superceding the GP’s opinion where the two are at variance. The GP may have no knowledge whatsoever of the workplace and will have had input from only one source (the employee). The OP will have been briefed by you and will have a wide familiarity with similar workplaces, so may be able to make a more balanced assessment.

Of course, the problem with the leg may not be the real problem. There may be other issues going on in the background and we will cover such situations on another occasion. The important thing to observe here is that sick pay should only be granted for medical incapacity. Social or domestic reasons for absence may be equally valid, but should be covered by compassionate leave or other special leave, whether paid or unpaid.

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