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Mental Health

A Case Study - mental ill health in the workplace and the benefits of early intervention

It is undeniable that in today’s society, complex sickness absence is on the increase. 

We are never too far from the next news story about the dire straits of the NHS and our social care system is at breaking point. 

There is another health related topic that has a direct impact on employers and that is the growing challenge of mental ill-health and it’s in the workplace.

This is an article with a very serious message and I make no apologies for that.


We know that mental health illness is a growing issue for employers. 

In a survey conducted in 2016 by the Chartered Institute of Personnel and Development in partnership with Simply Health, stress and mental ill-health were quoted amongst the top 5 most common causes of short and long term sickness absence. 

From my own experience, 80% of the long term sickness or poor performance cases I have handled over the last 3 years have been mental-health related.

The most common diagnoses being anxiety, stress, depression, mental disorders often leading to behaviours such as alcohol and substance addiction, breakdown and suicidal tendencies. 

And the sources of these issues are deeply complex. 

I am saddened by cases where an individual is in such a dark place, they are contemplating suicide and yet they are placed on a waiting list for therapy with the NHS which may take between 4 and 6 months to materialise.  I see no evidence of anything other than this waiting list getting longer and longer as the diagnosis of mental ill-health becomes more prevalent.

Sickness absence and poor performance is a very difficult and expensive issue for employers and the smaller the business is, the more acutely this is felt.

Mental health does not discriminate, it can happen to anyone or any business.

Usually the first indication of something not being quite right is that the employee’s performance standards start to become inconsistent or they slide.

If you are aware enough to notice the signs early AND you have the experience and the relationship with the person that they will open up to you, then there is a good chance you can support them by nipping issues in the bud early and giving them some good counsel.

In the cases I have been involved, this has not been the case. 

Either the manager simply did not see the signs or they lacked the confidence on how to tackle the issue.

I want to share with you a case that has a happy ending and to demonstrate that it doesn't have to end badly.

We were asked to support a business in the management of such a case in 2016.  The employee was considered a valuable asset to the business and signs of mental ill-health were not evident. 

The employee had a mental breakdown and was signed off work with anxiety and depression.  The business owner knew he was out of his depth and called us for professional guidance.

We guided the employer on the following three things from the outset:

  • how to agree and maintain an appropriate amount of ongoing contact with the employee
  • how to approach the topic of financial support during the period of sickness
  • a plan of action to set up a welfare-type meeting with the employee and a companion

Using our experience and expertise our support had the following beneficial effects:

  • it gave the employer the confidence that someone had his back
  • it gave the employee assurance it was being dealt with professionally and
  • it also sent a message to the workforce that the boss was taking his responsibilities to his staff very seriously, which is all good for engagement. 

We facilitated the welfare-type meetings, ensuring that:

  • the right things were discussed, sensitively and the right questions were asked, with empathy
  • the culture of the business was being upheld in their actions
  • precedents were not set that could not reasonably be replicated and sustained
  • a referral to an Occupational Health specialist was made at the right time

During the process of handling long-term sickness absence a referral to an Occupational Health (OH) provider is invaluable. 

Not all OH’s are equal so do your homework to find a good one.

What does the OH do?

  • Access the relevant medical records for the employee and do their own assessment of their fitness to perform their job. 
  • Provides a written, plain English report to the employer indicating whether the person they have referred is medically fit to do, or return to the job that they were employed to do. 
  • Informs the employer what adjustments may need to be considered to assist the employee to return and carry out their work.
  • Tells the employer if the employee’s condition is covered under the Equality Act - which is important to protect yourself from a constructive dismissal claim for discrimination on the grounds of a disability.
  • The OH will tell you if the employee's condition is mild, severe, temporary or permanent.

Yes there is an investment to make for this - normally anywhere between £200 to £500 per referral assessment. 

Consider this investment against the cost of an expensive discrimination claim or the cost of having to re-hire someone to fill someone’s shoes who was once an outstanding performer but is now suffering because of something outside of work affecting their mental health.

So how do HR and OH work together?

HR manage and oversee the correct sickness procedure and ensure the right contact is happening.  

HR ensures the right meetings are being arranged and the right discussions are being had with the employer and employee.

When the time is right, HR facilitate the referral to the OH and then liaise with the OH to understand the report findings.

HR can then guide the employer on their options for either supporting the person back to full health and capability at work, or whether there is a case for dismissing them fairly on the grounds of long term incapability.


Back to the case study above.  After a few months, the employee returned to work.  Through their own journey of medication and therapy they got better and with a phased return and some adjustments, they got back up to full speed at work. 

The employer was happy - he got his valued employee back who was more engaged and motivated because of the support his employer gave to him during his illness. 

This is a success story for both parties because of the professional expertise that they both engaged with - ourselves and the medical profession.

Done well, the HR expert, the OH, the employer and the employee collaborate to achieve a win-win outcome for the employer and employee.  Personally, there is nothing more satisfying than a success story, especially where a successful recovery from a mental health illness is concerned.  

If you have a concern about the mental health of a member of your team, then I recommend that you get some advice as soon as you possibly can.  We can assist with referrals to Occupational Health and therapists in counselling and psychology as well as guide you through the sensitive path of managing long term ill health absences.

Tracey Murphy

Published on: 12th April 2017
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