Managing a successful return to work following mental ill health

Two office workers looking at a laptop

Occupational psychologist Susannah Robertson-Hart looks at the best way to support an employee returning to work following a period of mental ill health.

There is compelling evidence that work is good for our mental and physical wellbeing, but starting work, staying in work or returning to work following a period of ill health can be challenging for many reasons.

A number of changes to the role and workplace may have taken place during the absence – for example, the employee’s skills and knowledge may have become rusty – and workers may need to find ways to implement new strategies and ways of coping with their health condition in the workplace. Add to that the stigma, lack of knowledge and, at times, fear that still surround mental illness, and this can make returning to work a very daunting prospect for employees with mental health conditions, as well as for their managers.

It is well documented that the longer someone is out of the workplace, the more difficult it becomes for them to return to work and the less likely it is that they will return to work at all. Ensuring a timely and sustainable return to work is therefore critical for employees and employers alike.

Drawn from a number of years working in vocational rehabilitation and the field of wellbeing in the workplace, here are some of my top tips for managing a successful return to work following mental ill health.

Keep in touch during the absence

Managers often fear that if they contact someone who is on sick leave this will be seen as harassment or that it could make things worse. However, lack of contact or involvement could signal to your employee that you have “written them off” or have forgotten about them, and could make returning to work even more daunting.

Early, regular and sensitive contact with employees during sickness absence can be a key factor in enabling an employee to return to work more quickly. Remember, you do not need to be a medical expert in their health condition; it is about showing you care, asking the right questions and helping the employee take the steps required to return to work.

It can also be worth reminding employees of their responsibilities and the benefits to them of keeping in touch during a period of absence. Many returns can be successfully managed between the manager and the employee, but managers may feel the need to involve the occupational health service if they need help to determine the likely length of an absence or to gather more information on the health condition from a medical perspective.

Plan out the return to work

Prepare a detailed return-to-work plan in partnership with your employee. Document it, stick to your part of the bargain and monitor it.

The sooner some form of return to work can be discussed and implemented, the better. This does not have be a return to full hours or even full duties. There are a whole range of options for a phased return to work.

When collaborating on the return-to-work plan with your employee, make sure you document it in detail and agree when and how it will be reviewed – the likelihood is that it will need to be adapted over time to ensure it continues to be fit for purpose.

There is no standard period for a phased return to work. It could be over a few days, weeks or even months, depending on the nature of the situation. You can tailor something that works for both your employee and your business. The key thing is getting your employee back to some form of work at the earliest opportunity and building from there. Having a plan will help with sustaining the return to work.

Consider adjustments and accommodations

In order to achieve a timely return to work following a period of mental ill health, it may be necessary to make some temporary adjustments within the workplace. Most managers tend to be fairly comfortable discussing and identifying adjustments for employees with physical disabilities or barriers as the requirements are often quite obvious – for example, changes to the workstation set up for someone with a back injury or voice recognition software for someone who can no longer use their computer keyboard because of dexterity problems.

The discussion about adjustments for employees with mental health conditions is often avoided as it feels too difficult. However, it can be very simple and low cost to put in place adjustments for an employee with a mental health condition; adjustments that work for them and for the business. Do not get hung up on what the condition is, but have a conversation with your employee about what workplace barriers they feel are presented as a result of their condition and what the temporary – or permanent, in some cases – “workarounds” might be, given the requirements of their job role.

Make sure you understand the specifics of their job role as well as the effects of their mental health condition, so that you can come up with suggested adjustments, too. Every case will be different and it is important not to make assumptions about how a mental health condition will affect someone in the workplace. Two people suffering from depression, for example, may experience quite different barriers, as it will very much depend on their job role and how the condition affects them personally. Ask your employee about their experience of the condition and what changes they feel would help.

There is no “‘one-stop shop” for adjustments; you need to be creative, but also realistic, about what can be accommodated within your business or team. You may want to consider changes to your employee’s hours if they are experiencing tiredness due to medication or general fatigue, for example; you may want to look at flexibility in their place of work or a move to homeworking if there are issues with anxiety and concentration when in a crowded workplace, or you may find that additional breaks and somewhere to go for “time out” may help an employee who is feeling overwhelmed.

Different ways of communicating or allocating work, increased structure, memory aids, increased feedback and assigning a buddy or mentor are also adjustments you may find useful to consider. The best options will be identified through a process of discussion and negotiation with the employee.

Also, remember that many employees with mental health conditions will manage perfectly well in the workplace without the need for any adjustments or accommodations, but in the context of managing a return to work, it is important to consider them.

Initiate regular conversations about mental wellbeing

Managers often shy away from asking an employee with a mental health condition how they are doing for fear of “opening a can of worms” or getting an answer that they do not know what to do with. You probably would not think twice about asking an employee returning to work after breaking a leg how they are getting on.

Anyone can experience a mental health problem, so being able to talk about it in the workplace is important. The more conversations you can have with employees about their mental wellbeing – not just those returning to work – the more likely you are to identify issues and prevent further absence. You could make it a regular part of your one-to-one catch-ups to ask employees how they are coping with work and how they are doing more generally. It will not take long for this to become the norm and part of the culture of your team.

Consider your impact as a manager

As a manager, whether you realise it or not, you have a significant effect on the mental wellbeing of the people in your team. We all have a different approach and natural style when it comes to management, and it is important to consider how this may affect the people around you – especially someone who is returning from work following mental ill health. Consider the way you allocate work, how you communicate with your employee, the level of control and autonomy you give them and whether or not you balance challenge and support in your approach.

For example, I have just started in a new role at the BBC as the lead on mental health and wellbeing. At this early stage, I am taking time to see where we sit with our current mental health and wellbeing strategy. I will then aim to build on strengths, and over the coming months and years will be looking for areas where we can develop and implement that strategy to support the organisation’s needs.


About Susannah Robertson-Hart

Susannah Robertson-Hart is an occupational psychologist and mental health lead for the BBC's health and wellbeing team.

One Response to Managing a successful return to work following mental ill health

  1. Avatar
    alun charles jones 5 Jun 2014 at 9:49 am #

    Heelo Susannah,
    This is an informative sensitive and sensitive account of difficulties faced by managers and employees following periods of mental ill-health. I feel sure that your new role will allow you to combat stigma associated with emotional illness along with identifying personal and organisational antecedants.
    Alun Charles Jones