Mental Health & Employment Helping People to Stay in Employment
Toolkit for Health Professionals March 2012
This toolkit is supported by the European Union Programme for Employment and Social Solidarity – PROGRESS (2007 – 2013)
Introduction
Introduction This toolkit is designed to provide health professionals with resources that can help people with mild or moderate mental illness to remain at work during treatment.
This toolkit has been developed by clinicians and researchers from the Andalusian Health Service, the Andalusian School of Public Health and Fundacion INTRAS in Spain, using insights gathered from health professionals, as well as employers and individuals with mental health conditions. This toolkit aims to reflect the themes that emerged and highlight areas of support for health professionals.
Mental ill health is a significant issue for health services across Europe. Around 1 in 4 people are likely to experience mental ill health at some point in their lives and this can have a serious impact on their ability to remain in employment. Being in work – particularly in good work – can help an individual during recovery and individuals do not need to be fully recovered to return to work. Good work can also provide a support mechanism for individuals during periods of mental health and mental ill health.
Themes emerging from interviews:
What is good work?
• Mental health conditions can present in a number of different ways and we need to develop a personalised approach to helping individuals to remain in work.
Being in good work can help a patient during a recovery phase and can also support their emotional resilience in their everyday life.
• Mental wellbeing and mental illness are part of the same continuum and individuals will be in different places during their lives due to a variety of bio-psychosical factors.
Good work is about a supportive and healthy environment where individuals feel valued and respected. A good workplace is one where: • All staff have some control of their working day
• Lots of people manage their mental health conditions and have successful careers – having a mental health condition isn’t a barrier to employment, but a lack of appropriate healthcare support to remain in work can be.
• Staff are able to make suggestions and influence activities
• The stigma associated with having a mental health condition will have more impact on an individual’s return to work than any other measure put in place by employers and it affects a patient’s work life more than any other aspect of their life.
• There is a safe and healthy working environment
• Staff are clear about what they are expected to do • Staff get feedback on performance
Focusing on developing and supporting good workplaces not only supports better public health, but can also deliver better emotional resilience for a patient and a good support network during a recovery phase.
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What is the toolkit?
Who is this toolkit for?
This toolkit contains guidance on what employers need to do in three inter-related areas of activity:
The toolkit is provided as a series of proposed best practice actions for health professionals to put in place to help promote good mental health through good work. It aims to help healthcare professionals consider employment as an important part of the therapeutic and recovery process.
• Prevention – Preventing poor mental health in the workplace; • Recovery – Support to individuals during recovery, whilst in treatment and off work; and • Return to work – How to help individuals manage their return to work and give them the support needed. The actions in these three areas are designed to help health professionals to support individuals to stay in employment and to focus on employment as both a means and an end to good mental health.
It also incorporates some clinical practice guidelines and support resources published by health authorities and professional bodies to support the intervention process. This toolkit is primarily aimed at health professionals who are responsible for patients with mild to moderate mental health conditions. The relevant health professional will vary, but in the UK will mainly be a GP. The toolkit is also useful for other healthcare professionals and providers, to help them support an individual or patient to remain in work.
Prevention
How to use the toolkit Return to work
Recovery
Crucially, the three areas of work are all inter-related. Supporting the development of good work and prevention of mental ill health can help to reduce the numbers of individuals off work and in recovery. Focusing on good support and treatment towards work can support the recovery process. Appropriate support to the individual and employer in the return to work phase can help prevent further mental ill health.
The role of health professionals Health professionals interact with individuals both when they are in and out of work. As a result, health professionals have a crucial role to play in supporting the individual to remain in work, or in experiencing a supportive return to work following a sickness absence. Helping a patient to remain in work, or supporting their return to work, will help develop their resilience to mental health conditions in future. Working co-operatively with the patient and the employer can produce beneficial long-term results for the patient, as well as supporting the health and wellbeing of other staff in the organisation. With a significant understanding of mental health conditions, as well as an understanding of the patient’s condition and problems experienced, a health professional is ideally suited to help both the patient and the employer work together to support the patient’s health and wellbeing.
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This document is for guidance only. It includes a list of actions, examples and resources, in order to guide health professionals to support people with mild to moderate mental health conditions remain in work. • Don’t re-invent the wheel – many resources are already out there for you to help patients and there are plenty of examples of good practice that can be easily adapted to each case. • Throughout the process, it is recommended that health professionals support open communication and coordination between the employer, the patient or individual and any relevant organisations that can support the patient. • In the three phases it is essential to consider the importance of agreeing the design and redesign of the intervention plan with the individual. • Any recovery and return-to-work plans should promote flexibility and consider the changing circumstances and needs of individuals.
Prevention This section includes actions to prevent mental health problems in the workforce, considering the positive public health benefits of employment. If appropriate, measures can be taken by health professionals to promote mental health awareness and prevent mental ill health. This can reduce the number of people who fall out of work and can improve an individual’s recovery process. This phase is structured in four sections: - Information and awareness-raising of the value of work; the fight against stigma of mental ill health in work; and psychosocial risk factors at work. - Actions to promote mental health and stress prevention. - Actions for early detection of mental health problems in the workforce. - Actions to monitor workplaces with a high incidence of mental health problems.
Actions for Practitioners
Examples
Resources and support
Support awareness campaigns in local health centres and in education centres (e.g. through posters, videos, leaflets).
Time to Change: time-to-change.org.uk
Help to raise awareness amongst colleagues through mental health and employment awareness training. Try to attend training that includes examples and case studies from individuals who have a mental health condition and have managed to remain in work.
See Me: seemescotland.org.uk
1. INFORMATION & PUBLICITY Help to improve awareness and understanding of mental health in the general population. Focus on the importance of work in promoting and maintaining good mental health and wellbeing.
Provide information on mental health and employment to patients who identify difficulties in the workplace. This could include leaflets, Help to reduce the stigma of mental ill health in the workplace. information packs or directing them to further support. Promote websites with positive information about mental health and the links to employment and also websites that provide resources for advocacy. Engage in campaigns that help to reduce the stigma of mental ill health (e.g. through posters in local health centre etc).
Early signs of mental distress: mind.org.uk Mental health problems at work are common: mind.org.uk Information and advice: mind.org.uk Understanding mental health problems: mind.org.uk Promoting mental health and well-being in workplaces: ec.europa.eu/health/mental_health
Provide information and help to raise awareness of the psychosocial risk factors linked to the workplace.
Provide information to the patient and the employer of psychosocial risks in the workplace. This includes promoting helplines about mental health in the workplace. Use informative materials on mental health and psychosocial risks of the workplace to aid a consultation with a patient and to support the employer. Provide links to websites with information and resources on mental health and psychosocial risks related to the workplace. Provide information on stress, mobbing and bullying in the workplace. Try to differentiate work pressure situations from work harassment.
Tackling the effects of stress: mentalhealth.org.uk Transmitting the European Framework Agreement on Harassment and Violence at Work: eur-lex.europa.eu Psychosocial risk factors: hse.gov.uk/msd Psychosocial factors at work, personality traits and depressive symptoms: bjp.rcpsych.org Rise in Psychosocial Risk Factors in the Workplace: eurofound.europa.eu/ewco United Kingdom Focal Point of the European Agency for Safety and Health at Work: osha.europa.eu/en Advices for workers about psychosocial risks and work-related stress: osha.europa.eu/en Prevention of Mental Disorders: who.int/mental_health Public health interventions to promote positive mental health and prevent mental health disorders among adults: nice.org.uk Health Impacts of Psychosocial Hazards at Work: An Overview: who.int How can health professionals support the HSE Management Standards?: hse.gov.uk/stress Health For Work Adviceline (0800 0 77 88 44)
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Actions for Practitioners
Examples
Resources and support
2. PROMOTION: Promote resources that support positive mental and physical health, as well as coping strategies, in the workplace. Be aware that there may be complexities in implementing support in the workplace.
Support and help to deliver programmes to promote healthy lifestyles in Five Ways to Wellbeing: the workplace (e.g. physical activities, balanced diet, rest and sleep etc). mind.org.uk Five Ways to Wellbeing: Promote activities that strengthen the social support network of neweconomics.org individuals – including team-building activities and better engagement Shiftwork and Health: eurofound.europa.eu
between employees of all levels.
Support and promote recreational and leisure activities, especially within Occupational Health Toolkit: and between different organisations. Stress: iosh.co.uk Support and promote training for individuals in coping with everyday How To Look After Your Mental difficulties and the stress of daily life. Specifically, support coping Health: mentalhealth.org.uk strategies to deal with work-related stress. Workplace Health Promotion for Promote online resources to deal with stress at work (e.g. case study Employees: osha.europa.eu/en videos, learning relaxation techniques, coping strategies etc) and NICE public health guidance 22. supporting good mental health. Promoting mental wellbeing through productive and healthy working conditions: guidance for employers: nice.org.uk/PH22 Help for SMEs: Psychosocial Issues: osha.europa.eu/en Stress: osha.europa.eu/en Work related stress: hse.gov.uk/stress Working together to reduce stress at work: hse.gov.uk/stress Exercise and Depression: mentalhealth.org.uk Occupational Health: A manual for primary health care workers: who.int/occupational_health
3. EARLY DETECTION: Consider efforts to improve early detection of mental health problems within the workforce. Specifically, consider individuals who are referred to, or come into the healthcare system for a general physical health problem.
Use screening questions and / or work appraisals to aid the detection Primary Care Guidance: Early of mental ill health. In particular, pay special attention to individuals intervention in psychosis – suffering from sleep disorders and somatisation / somatoform disorders. Looking after bodies as well as minds: mentalhealth.org.uk Identify the risk factors associated with mental health conditions. Examine the patient’s medical history and aim to reduce the likelihood of dual pathologies such as alcohol or substance misuse. Specifically, focus on preventing a dual pathology during difficult situations.
Prevention of Mental Disorders: who.int/mental_health Mental Health Services: nhs.uk Workplace Stress: bupa.co.uk/individuals Stress: bupa.co.uk/individuals Mental Wellbeing: bupa.co.uk/individuals
4. SURVEILLANCE (PUBLIC HEALTH): Support the monitoring of sickness absences in workplaces, especially within workplaces with a high incidence of employees with mild to moderate mental health conditions.
Use systems designed for health professionals to identify particular work Sick on the Job? Myths and Realities about Mental Health environments with high incidences of workers with mild to moderate mental health conditions. and Work: oecd.org Engage with employers where they may need advice or support to help them identify high incidences of mental health conditions.
Primary Care Guidance: Early intervention in psychosis – Looking after bodies as well as minds: mentalhealth.org.uk Early signs of mental distress: mind.org.uk
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Recovery The process of recovery restores an individual’s ability to return to work and to self-manage a condition. Providing good support throughout this process can help people to return to work sooner, thereby aiding and accelerating the recovery. This section provides resources and actions to support individuals in their recovery, whether they remain in work or have taken a temporary sickness absence. As a result, consideration should be given to different types of treatment that does not necessarily require the patient to take time off work. Also worth considering is the support of the family and the patient's personal actions - requiring both a whole environmental assessment and a structured design of the treatment plan throughout the treatment and recovery phase. It is essential to consider at this stage the value of agreeing a treatment plan with the patient and the design and redesign of the intervention plan, which promotes flexibility, consideration of the circumstances and the changing needs of people and their environment. Is structured into three types of actions: - Stock assessment of the health, environment and workplace of the patient, providing a diagnosis and information to the patient. - Actions dealing with implementing the treatment plan. - Actions dealing with the end of the process of care, which emphasize the prevention of relapse.
Actions for Practitioners
Examples
Resources and support
When performing a general clinical assessment, include initial screening questions to identify major mental health conditions.
Clinical and Public Health Guidelines: nice.org.uk/guidance
1. PATIENT ASSESSMENT: Assess the patient's physical and mental health, including an assessment of environmental factors.
Perform an additional assessment of general health and wellbeing of a patient (e.g. prevalence of disease; substance abuse; recent stressful events; previous episodes of mental ill health; previous treatments and management strategies used prior to a crisis etc). Assess a patient’s social support and care (e.g. living conditions; family and friend support network; social isolation; ability to self-manage and self-medicate; ability to cope etc). Consider a range of treatment options for the patient, the duration of current symptoms and any current treatments (e.g. psychological, pharmacological, social prescribing etc) when performing an assessment.
Identification of common mental disorders and management of depression in primary care: nzgg.org.nz Tools for health professionals: workingforwellness.org.uk/res ources/health-professionals/ The Warwick-Edinburgh Mental Well-being Scale: healthscotland.com
Use appropriate rating scales and standardized questionnaires. Perform a specific assessment of Explore with the patient their personal work history. the patient's work environment. Evaluate the role that the workplace may be playing in the development of the disorder (e.g. exposure to psychosocial risks in the workplace, obstacles and difficulties, workplace stress etc).
Work related Stress: hse.gov.uk/stress
Determine if the work is the cause of the condition, or is an aggravating factor – this will affect the treatment and interventions chosen. Consider whether the condition means that the individual must take time off from work.
Help for SMEs: osha.europa.eu/en
Offer to liaise with an occupational health provider if the organisation provides this service to help you assess the working environment. Assess the support available to patients when they are at work. This includes, but is not limited to, line manager support, occupational health (if provided), colleagues and any social network support.
Take the stress test: nhs.uk/Livewell/workplacehealth
Stress: osha.europa.eu/en How can health professionals support the HSE Management Standards?: hse.gov.uk/stress The Warwick-Edinburgh Mental Well-being Scale: healthscotland.com
Evaluate with the patient the work role against the HSE stress management standards of demand, control, support, relationships, role and change. Describe and explain these to the patient. Use appropriate rating scales and standardised questionnaires. Attempt to identify the history Use standardized criteria and diagnostic classifications (ICD-10 and and origin of the illness as well as DSM-IV). any precipitating factors. Develop a hypothesis about the condition and begin to design a treatment plan. Consider whether the condition is due to: a) a domestic situation; b) a working environment with a high psychosocial risk; c) an interaction between a domestic incident or event and the working environment.
The Warwick-Edinburgh Mental Well-being Scale: healthscotland.com Good Occupational Medical Practice: facoccmed.ac.uk Taking work and employment seriously: rcpsych.ac.uk/mentalhealthinfo
Manage the expectations of individuals. Sometimes a patient may come for a consultation with the idea of solving complex problems at work, or may seek solutions to their personal life. Manage these expectations by providing information on what support you can deliver and what they should expect. Avoid value judgements about the responsibility for the patient’s health where the individual is subjected to a stressful work environment. At the same time, attempt to ensure the patient does not feel guilty about being ill and / or taking time off from work. Ensure that the patient is given reassurance and information about their recovery and that, where agreed, this information is consistent with what is supplied to the employer. Mental Health and Employment. Toolkit for Health Professionals | 7
Actions for Practitioners
Examples
Resources and support
1. PATIENT ASSESSMENT (cont): Provide information to patients, Inform the patient about the outcome of the assessment in an promoting their responsibility and environment of privacy and confidentiality. involvement in the care process. Respond directly to their demands and expectations of the assessment. Ensure you answer all questions they have clearly and give them the opportunity to come to you with any further questions. The basic information that should be supplied to a patient includes: - the clinical aspect of the illness; - the possibility of gaining a second opinion from another health professional; - the need for a treatment plan; and - the involvement of the patient in the treatment plan.
How to Look After Your Mental Health: mentalhealth.org.uk 10 Ways to look after your mental health: mentalhealth.org.uk How to Overcome Fear and Anxiety: mentalhealth.org.uk Making a WRAP (Wellness recovery action planning): imhrec.ie WRAP: recoverydevon.co.uk
2. TREATMENT PLAN: Discuss the patient's treatment plan with the patient directly.
The treatment plan should include returning to work as an agreed outcome. Work should be seen as a resource in the treatment plan and as an aid to recovery. Agree the treatment plan with the patient. This should include: - the professionals who will be involved in the treatment; - the support and resources available to the patient (e.g. psychological interventions, pharmacological treatment, psychotherapy etc); - the expected duration of the treatment; - the possibility of coordinating the treatment plan with a representative from the patient’s workplace.
WRAP: recoverydevon.co.uk Making a WRAP (Wellness recovery action planning): imhrec.ie Mental Health Recovery Star: outcomesstar.org.uk/mentalhealth/ The Value of a WRAP: rcpsych.ac.uk/mentalhealthinfo
Jointly decide on the treatment in relation to the patient’s employment activities. Discuss with the patient if they will take a sick leave or remain in employment. This decision should be consistent with the prior assessment about the patient’s work, social support network and personal environment. If the patient agrees to taking a sickness absence, discuss and agree about the likely duration of the absence. To facilitate the rehabilitation process, design the treatment plan around the positive aspects of returning to work. Promote discussion of the treatment plan with the patient and their workplace, facilitating shared decision-making during the care process.
If the patient has provided consent, discuss the treatment and care process with the employer. Contact the employer through the patient.
Keeping in touch: shift.org.uk/employers/lmr
Offer to discuss the care process with the employer’s occupational health services, or directly with the patient’s supervisor.
Employment Handbook eve.ie
Offer the patient the option for the occupational health service or line manager to call and discuss the condition and the treatment plan.
Managing how personal information is shared – Royal College of Psychiatrists rcpsych.ac.uk/mentalhealthinfo Telling someone about your mental health problem: time-to-change.org.uk/take-action
Advising patients about work: dwp.gov.uk
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Actions for Practitioners
Examples
Resources and support
See the section below about "Return to work".
Is work good for your patients’ mental health?: support4doctors.org
2. TREATMENT PLAN (cont): When the individual takes a sickness absence, ensure that the return to work remains an important element and outcome of the care process. During rehabilitation repeatedly reassess whether the individual is ready to return to work.
Repeat the assessment processes described above when necessary and discuss with the patient any positive changes. If the patient decides to remain in work during treatment, ensure that their progress is regularly reassessed and if a different treatment course is necessary, inform the patient directly.
Work Star: outcomesstar.org.uk/work/ Suggested adjustments: rcpsych.ac.uk/mentalhealthinfo Work and Mental Health: rcpsych.ac.uk/mentalhealthinfo Advising patients about work: dwp.gov.uk
Provide any intervention based on the "step care" model (offering the patient the various support and resources available, from low- to high-level professional intervention).
Offer one or a combination of several of the following interventions: - Psychological and psychosocial interventions of low intensity (e.g. individual self-help guide based on the principles of Cognitive Behavioural Therapy, online CBT, therapy groups, physical exercise programme, self-help groups for people who share a health condition).
Be Mindful GP Toolkit: mentalhealth.org.uk Forum for Mental Health in Primary Care: rcgp.org.uk/mental_health
- Pharmacological interventions. - High intensity psychological interventions (e.g. individual CBT, relaxation therapy, group-based CBT, behavioural therapy, psychological counselling, brief psychotherapy and cognitive therapy such as "mindfulness"). - Preventive interventions in situations where the patient may pose a risk to themselves or others. Make treatment easily accessible Adapt treatment times to support the patient to remain in work or return and flexible. to work. Adapt any drug treatments to the patient’s job role – e.g. consider drug treatments that would not affect the patient’s ability to perform their current job role. Use the assessment and description of the job role you have previously obtained.
Royal College of Psychiatrists’ suggested adjustments: rcpsych.ac.uk/mentalhealthinfo Paths to Personalisation in Mental Health: nmhdu.org.uk
Working together to support If the patient consents, contact the organisation to provide support for a people recovering from mental ill temporary workplace adaptation to suit the individual during treatment. health at work: rcpsych.ac.uk/mentalhealthinfo
Continuously assess the individual during treatment, taking into consideration the social functioning of the individual and any reported changes in job performance.
Consider follow-up visits or consultations with the patient, with time for feedback from the patient and, where appropriate and agreed with the patient, other individuals. Ensure any feedback provided by others (e.g. line managers, friends, family) is reported back to the individual.
Mental Health Recovery Star: outcomesstar.org.uk/mental-health/
Pocket Guide for Mental Health and Employment: workplacementalhealth.co.uk
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Actions for Practitioners
Examples
Resources and support
3. ENDING THE TREATMENT AND CARE PROCESS: Discuss and agree with the patient when the treatment and care process will come to an end.
Explain that the care process ends when the patient experiences an improvement that allows them to conduct daily life in a satisfactory manner.
Support the prevention of a new episode of mental ill health through working with the patient and, if agreed, with the employer.
Develop a list of recommendations with the patient and, if agreed, the employer, friends, family and support groups to help prevent a further instance of mental ill health.
How To Look After Your Mental Health: mentalhealth.org.uk
recurrence of mental ill health. Clearly identify symptoms that could predict a relapse in the list of recommendations.
How can health professionals support the HSE Management Standards?: hse.gov.uk/stress
Encourage the development of the patient’s coping skills, social networks, early identification of symptoms of mental ill health and a supportive work environment.
Regaining occupational function: rcpsych.ac.uk/mentalhealthinfo
Remember that returning to work can be an element of the recovery, rather than an end in itself.
NICE public health guidance 22. Where identified, recommend the development of individual coping Promoting mental wellbeing skills and strategies with the patient and within the workplace (if agreed). through productive and healthy This should be included in the list of recommendations. working conditions: guidance for employers: nice.org.uk/PH22 Support the individual and others to recognise early signs of a
Support the strengthening of the patient’s social network and list this as a recommendation for the patient. If the patient agrees, submit recommendations to the patient’s workplace for practices that can promote good mental health, or help to reduce mental ill health. Include in the submission to the employer potential changes to the working environment, conditions of work or potential flexible changes that an employer could make that might also benefit other staff. Provide access to links or information that give other examples of potential adjustments in the workplace.
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Early signs of mental distress: mind.org.uk Understanding mental health problems: mind.org.uk Self-help guides: mind.org.uk Self-help leaflets: ntw.nhs.uk/pic/selfhelp
Return to Work In this section, the recommended actions are designed to support the individual to return to work during treatment. The return to work process should be planned jointly with the patient and, where appropriate, with the employer or employer’s representative. This is so that the return to work becomes part of the recovery process, supporting the individual in the workplace to maintain good mental health and to help prevent mental ill health. Lessons learnt from the return to work process can also help to create healthier work environments and prevent further mental illness in the workplace, not just with the returning patient. Actions in this section are divided into two types: - Planning the return to work; and - Maintaining good work and a healthy workplace.
Actions for Practitioners
Examples
Resources and support
1. RETURN TO WORK PLANNING: Work with the patient to identify the patient's strengths and weaknesses that can aid or hinder the return to work. Identify any barriers to work and help to address these. Barriers can be personal, social, environmental or based directly at work (i.e. an individual employee).
Discuss with the patient and identify personal strengths that can help the individual adapt to and return to the workplace.
Workplace Health Promotion for Employees: osha.europa.eu/en
Make a list of the positive benefits that work and working life can bring to the patient – this can include a larger social network, increased self-confidence and an organised structure to the day.
Return to work: shift.org.uk/employers
Work with the patient to identify family and social support networks that can aid the individual in their return to work. Identify workplace-based support that can aid the individual – this can include occupational health support (if this is provided). This can be with the patient or, if agreed, through contacting the employer.
Advising patients about work: dwp.gov.uk Occupational Health: A manual for primary health care workers: who.int/occupational_health
Identify any difficulties directly related to the job or the workplace – this can include, but is not limited to, workload, time pressures, availability of in-work support, management or the working environment. If a patient tries to extend a sick leave beyond what is necessary, discuss with the individual why this is and whether any difficulties or challenges have been missed. Work together with the patient to Consider national regulations governing the return to work after sick leave. jointly agree the return-to-work Discuss with the patient and plan the return to work date. If applicable, plan from the treatment discuss the option of a phased return period. perspective. Plan how the patient will conduct their first day and how they will Ensure that the return-to-work is interact with colleagues and line managers. based on current legislation and Prepare the patient for a variety of responses from colleagues. accepted best practice. Consider, where agreed, writing an email or letter to colleagues and line managers indicating the return to work. Agree with the individual if they would like someone to join them on their return to work. Plan with the patient whether they would like to meet a colleague or line manager prior to their return to work. Organise with the patient how they will resume their regular job roles – either immediately, or through a phased return. Provide the patient with cognitive behavioural or coping strategies to address fears and concerns about their return to work. If the patient consents, contact the workplace to aid any support available in the workplace (e.g. occupational health, line managers etc). This can be done through providing information about the patient’s needs and requirements. Remain in contact with the employer to offer continual support. Support the patient when their working environment does not facilitate their recovery (either by the inherent characteristics of the job or by an unfavourable working environment that is hard to improve).
Returning to work: howsyourbusinessfeeling.org.uk Discussing returning to work with the individual: shift.org.uk/employers Return to work: shift.org.uk/employers Examples of return to work adjustments: shift.org.uk/employers Keeping in touch: shift.org.uk/employers Dealing with my mental health: hse.gov.uk/stress Representing and supporting members with mental health problems at work: tuc.org.uk
Jointly assess with the patient the options that are available and support them in the decision-making process.
Getting a Job: time-to-change.org.uk
Provide therapeutic support for a decision that might involve a change in job.
Working out what might be right for you: rcpsych.ac.uk/mentalhealthinfo
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Looking for a job: nhs.uk/Livewell/mentalhealth
Actions for Practitioners
Examples
Resources and support
2. MAINTAINING GOOD WORK AND A HEALTHY WORKPLACE: With the patient’s help, identify any support or workplace adjustments that could be made to help maintain good health at work and help prevent mental ill health. Manage the patient’s expectations of any adjustments that can be made and ensure these are reasonable adjustments.
Identify and discuss with the patient any support that is currently available in the workplace (e.g. line managers, colleagues, occupational health service etc).
Promotion of mental health: mentalhealth.org.uk/
In conjunction with the patient, assess any potential reasonable adjustments to working hours or responsibilities. These should depend on the abilities of the patient and the degree of autonomy the patient has at work.
Managing an ongoing illness whilst at work: shift.org.uk/employers
Identify times and places available in the workplace that allow patients to focus on their mental health (e.g. using techniques such mindfulness). If the patient consents, offer the workplace information and / or sources of support to promote good mental health at work and prevent situations that might harm the health of the worker and that of other colleagues. Provide this information to the employer directly or to the occupational health service of the employer. Suggest reasonable adjustments that could be made and explain what has been discussed with the patient.
Mindfulness: bemindful.co.uk
NICE public health guidance 22. Promoting mental wellbeing through productive and healthy working conditions: guidance for employers: nice.org.uk/PH22 Help for SMEs: Psychosocial Issues: osha.europa.eu/en Stress: osha.europa.eu/en Examples of workplace changes: shift.org.uk/employers Making Adjustments At Work for People With Mental Health Problems: healthatwork.org.uk How can health professionals support the HSE Management Standards?: hse.gov.uk/stress Time to Change: time-to-change.org.uk
“Pleasure in the job puts perfection in the work.” Aristotle
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This publication is supported by the European Union Programme for Employment and Social Solidarity - PROGRESS (2007-2013). This programme is managed by the Directorate-General for Employment, social affairs and equal opportunities of the European Commission. It was established to financially support the implementation of the objectives of the European Union in the employment and social affairs area, as set out in the Social Agenda, and thereby contribute to the achievement of the Lisbon Strategy goals in these fields. The seven-year Programme targets all stakeholders who can help shape the development of appropriate and effective employment and social legislation and policies, across the EU-27, EFTA-EEA and EU candidate and pre-candidate countries. PROGRESS mission is to strengthen the EU contribution in support of Member States’ commitment. PROGRESS is instrumental in: • providing analysis and policy advice on PROGRESS policy areas; • monitoring and reporting on the implementation of EU legislation and policies in PROGRESS policy areas; • promoting policy transfer, learning and support among Member States on EU objectives and priorities; and • relaying the views of the stakeholders and society at large For more information see: ec.europa.eu/progress The information contained in this publication does not necessarily reflect the position or opinion of the European Commission, which is the Contracting Authority. Partners