Returning to work

and reasonable adjustments

Most people who experience an episode of distress or mental ill-health recover completely and can resume work successfully. Effective planning between the individual and the line manager will maximise the chances of success. So will support and monitoring at the early stages of return. You have made an investment in that individual and in most cases, a planned return to work will be more cost effective than early retirement.

In larger organisations managing mental health and employment including the recovery process will not just be down to the individual line manager but will involve collaborative working between other services, the GP, OH and HR.

This section offers advice on planning the return to work and monitoring how things are going.

Planning the return

You should develop, in discussion with the employee, a return to work action plan. Discuss whether any adjustments need to be made to ease their return (see below for some ideas).

You should discuss with the employee any factors at work that contributed to their absence that could realistically be changed or accommodated.

You will also need to discuss honestly the things you can change and those you can’t. Some organisational factors are out of your control. Can they be mitigated?

You can then agree how their progress will be monitored.

Before they return, brief the employee on what’s been happening – social life as well as work developments.

Reasonable adjustments

Some adjustments to consider

Almost no-one is ever fully fit when they return to work after an illness (physical or mental) and it takes some time to recover speed, strength and agility of both mind and body.

Waiting for people to be become 100% fit for their work before allowing them back is therefore unrealistic - it lengthens absences unnecessarily and may ultimately even compromise their future employability.

It is common sense to adjust work in the early days after an extended spell of absence to promote full recovery and to ease the individual back into productive employment.

In some cases applying ‘reasonable adjustments’ will be required to meet your duties under the Disability Discrimination Act. Remember however that not everyone who will be returning to work after an episode of mental ill- health is considered disabled under the terms of the Act. Whether they are disabled or not, making adjustments where necessary is good practice and can ease the return to work.

What is a ‘reasonable adjustment’?

Under the DDA, as an employer you have a duty to make changes to jobs and workplaces that will enable a ‘disabled person’ to carry out his/her functions as an employee or to assist an applicant for employment. These changes are known as ‘reasonable adjustments’ and are made to ensure that disabled people have equal opportunities in applying for and staying in work.

Whose responsibility is it to provide and implement the adjustments?

Most adjustments are made based on common sense following a frank and open discussion between the manager and the employee about what might be helpful and what is possible. Every reasonable adjustment is unique to the individual’s specific needs and abilities and whether the employer can accommodate them.

If necessary you should obtain a report from the employee’s GP, with permission, or consultant and in some cases, where applicable, liaise with the employee’s key worker/care co- coordinator to request advice as to what kind of adjustments may be required.

For larger organisations you can refer the employee to your occupational health department for an assessment and also ask the human resources department about potential adjustments and what would be reasonable. The individual should always be part of the discussion to ensure that the adjustment will be effective for them.

Adjustments should be agreed, not imposed.

What is reasonable?

The DDA does not actually define what is ‘reasonable’ as various factors need to be taken into account which will partly depend on the nature of the organisation. What is reasonable will be judged according to the following factors;

the extent of disruption, if any, that may be caused to your organisation or other employees by making the adjustment
how much the adjustment will cost and how much budget you have
whether it is practical to make the adjustment
how effective the adjustment will be in helping the employee do their job, and
whether or not you can get financial or other assistance to make the proposed adjustment from schemes such as the ‘Access to Work Programme’.

What is the ‘Access to Work Programme’?

The Access to Work programme offers help to people with a disability or health condition who are in or looking for work. It provides funding that is used to help remove the practical barriers that may prevent them from working on equal terms. This government funding could therefore be used to pay for the costs associated with making reasonable adjustments.

The amount of funding provided varies depending on need and is reviewed every one to three year. For more information about Access to Work go to www.direct.gov.uk.

See some example reasonable adjustments.

Returning to work

What to do when an employee returns to work

Above all make sure you and the team make the person feel welcomed back. You might consider a mentoring scheme with another employee so that the person returning can talk to someone who isn’t their manager.

Remember to;

make sure the employee doesn’t return to an impossible in-tray, thousands of emails or a usurped workspace.
be realistic about workloads - be aware that some people will wish to prove themselves and may offer to take on too much. Instead, set achievable goals that make them feel they are making progress.
take the time to have frequent informal chats so there is an opportunity to discuss progress/problems without a formal (and possibly intimidating) session. Do ensure however that the employee does not feel that their work and/or behaviour is being overly monitored or scrutinised.

Avoid;

making the person feel they are a special case - this can cause resentment both with the individual and with peers, and
failing to deal with their work whilst they have been off work. Check whether a backlog of unfinished work has built up and deal with this also.

Points to consider around staff who are on medication

If the employee is on medication they may experience distressing side effects. They may or may not feel able to discuss this with you. However it may be helpful to consider that it can be easy to confuse side effects with the illness. Any effects on work may be temporary and/or the person may only take medication for a short time.

For people with a longer-term problem, it may take some time and patience to establish the right medication and dosage. Hence the employee may not immediately know if medication will affect their ability to do the job.

It is important an employee continues with medication until they have discussed stopping it with their physician. You also need to make sure that any side effects they experience are considered against their job requirements. This is crucial in jobs where there are health and safety risks.

Managing reactions from colleagues and clients

Fear, ignorance and hostility from colleagues and clients can be a source of great distress. Many people who have experienced mental health conditions describe this as an area
of stigma and discrimination. A key theme of this resource has been the need for both managers and employees to think about how communications will be managed.

Usually, stigmatising behaviour arises more from fear and ignorance than ill will. People are not sure what to say and find it easier to avoid the individual or not to mention mental health.

It is advisable to;

try to talk to the employee and agree who will be told what, by whom and when. Think about the language you use. Be clear about confidentiality and boundaries
be guided by the employee’s wishes. Some people are prepared to be more open than others. Encourage the person to talk if they wish but don’t pressurise them to do so
treat people returning from absence due to mental ill health in the same way as those with physical ill health
watch out for hostile reactions - stamp out any hurtful gossip or bullying promptly, this is your duty under the DDA, and
treat mental health issues in a matter-of-fact way - they are common and should not be a source of office gossip or conjecture.

After a time, ask the employee how they are getting on with peers/clients. Review if there is any support that you can give, and consider mental health awareness raising for all.

Avoid;

shrouding the issue in secrecy, and
making assumptions about workloads and capacity to cope.

"I was in a psychiatric hospital for three and a half months."

"I remember when I walked back into the office it suddenly went silent. Nobody knew what to say to me. Out of 250 people, only a couple were able to talk to me about what had happened."

Diane Hackney, consultant, trainer and Shift advisor.

"I arranged some training for supervisors as there were problems around people returning from sick leave."

"Just getting supervisors to say - "I'm pleased you're back" and making people people feel welcome made a big difference. This seems like a small thing but often people on the front line receive no training and are unaware of how difficult it can be to walk back into the workplace."

Stephen Williams, Human Resources Consultant

What happens if the return to work is not successful?

The ‘return’ could either apply to a one-off absence or to successive attempts if a person has an ongoing illness.

In this scenario, try to go through the reviewing progress, options for making further adjustments and talking to the employee. Then talk realistically with the employee about the best way to move forward. For example, if all reasonable adjustments have been made in the current post, it may be necessary to consider transfer to another job.

Use normal procedures if it is a performance, attendance or conduct issue rather than one relating primarily to health or disability, and if matters cannot be resolved then you may have to move to termination. You should help the individual to move on with dignity and issues such as health related pension benefits (e.g. medical retirement) should be fully explored.

Next page: Examples of reasonable adjustments