This page is for General Practitioners and other medical specialists, health and organisational psychologists, counsellors, therapists and other health care professionals
- Health professionals have a crucial role especially with regard to psychological distress and 'stress' problems. They exercise an enormous influence during the treatment and recovery of their patients but their role in assessing fitness for work and facilitating return to work may be impeded by a limited knowledge of their patients' work and a lack of access to workplaces and managers. It is recognised that this is caused by a number of specific constraints on, for example, GPs' involvement in work issues and generally drawbacks in the current system. These are being addressed at Working for Health.
- It is critical that everyone involved is working together – especially the health professional, the line manager and the human resource advisers. In this instance this means, inter alia, giving out the same messages of reassurance and expectation of recovery.
- Clinically stress can be sometimes seen as difficult. There are divergent views as to what is appropriate – some health professionals regard stress as inevitable aspect of life and not a clinical condition warranting time off. The fact is, it could make people feel incapable of going about their normal day-to-day activities. There is little point in these circumstances to force a patient to work and thus potentially worsening their condition. So the main question is, will this condition warrant or benefit from a period off work?
- Patient motivation and attitudes differ markedly. This needs to taken into account when discussing return to work options.
- Case data from occupational physicians and psychiatrists (HSE THOR reporting scheme) show close agreement as to the main causes of work related stress.
- Work related stress is not necessarily to do with individual vulnerability or predisposition – in this respect it differs somewhat from common mental health problems.
Your role in the Management Standards
- Familiarise yourself with evidence linking health and psychosocial factors (W2, Burton).
- You can use the Management Standards States To Be Achieved as a way of structuring discussions about work factors and return to work issues.
- Using this information you can advise employers about adjustments in the short term or changes that could be made to facilitate reintroduction of the person to the work environment so there is no relapse.
Your role with individuals
- The role of health professionals is to act as an advocate of the patient, to provide symptomatic relief and restore function, ask about the patients work, discuss return to work with the patient and employer (or their representative).
Advice to patients could include:
- How to go about taking steps towards returning to work.
- This could include an active ‘problem solving’ approach to discover what is holding the patient back from returning and suggesting strategies to overcome obstacles.
- Phased return to work, e.g. on reduced hours.
- Encourage talking to the employer about concerns so the individual can take the lead and ownership – this becomes part of the process of moving towards work.
- Use OH service if employer has one – agree to liaise with the provider.
- Help patient to discuss stress and any related issues – suggest strategies for dealing with these issues when they return – develop strategies for coping.
- Set tasks e.g. to investigate a possible new job direction – it is important to stay in work whilst looking for another post because it is easier to find a new job when you are in employment rather than when unemployed, both from the point of view of a prospective employer and the individual’s own motivation and confidence.