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Dealing with absence due to mental health issues

23 April 2019, at 9:30am

How to manage cases of post-traumatic stress disorder, which seems to be an increasingly cited reason for absence

Managing sickness, especially mental health issues such as anxiety and depression, is often a difficult situation at work and it can add considerable strain to your practice management. Seeing the term “post-traumatic stress disorder” (PTSD) on a GP’s fit note can be even more alarming.

Fit notes from GPs commonly cite stress, anxiety, depression and low mood as reasons for sickness absence. However, recently we have seen a growing trend for PTSD being stated as the reason for absence.

In speaking with occupational health sources, they are witnessing an increase in GPs stating PTSD as the reason for the absence as opposed to stress or other mental health problems. They believe that this is to ensure that employers take heed of the seriousness of the ill health and are spurred into action

What should you do if you receive a fit note stating PTSD?

First of all, don’t panic. As with any good absence management process, you should:

  1. Keep a record of the absence including dates and times and the reason
  2. Ensure you have a clear policy which includes how the absence should be reported, the purpose of “return to work interviews” and details of how absences are managed – including any triggers which may lead to a formal process

Many fit notes stating mental health as the reason for the absence tend to be long term: four weeks or longer. It is advisable to take action immediately. Arrange to meet the employee to discuss their absence and what support they are currently receiving and refer them for an occupational health assessment, if appropriate.

If you do refer them for an occupational health assessment, following receipt of the report, meet the employee again to discuss the report and identify whether any steps are needed to support the employee’s return to work.

Where this is not possible, explore whether it is necessary to consider a further review period. In some cases, it may be appropriate to consider whether a managed exit from the practice is required.

Maintaining contact with an employee

Once occupational health has indicated the employee can return to work, it is recommended that you consider the following:

  • A phased return to work and discussion of any recommendations from occupational health, such as whether they are fit to perform all their duties or if any adjustments are needed
  • If they are taking any medication, whether there are any side effects, such as tiredness
  • The support available during the first weeks or months after their return, and how progress will be monitored
  • Actively monitoring the situation for a period of time once they are back to work to make sure that they are coping adequately with the day-to-day work and its associated pressures

For further information, please contact Elaine Fisher at: EFisher@eaglehr.co.uk