While one-in-five Australian adults at any point in time have symptoms consistent with a diagnosable mental health disorder (anxiety, depression and substance abuse in order of frequency), clearly most workers with these symptoms are still working – and should be.

While stress at work can contribute to a mental health disorder, paradoxically work keeps us healthy and can be therapeutic for mental health disorders.

Having a job to go to gives structure to the day, enhances self-esteem, provides interpersonal engagement, precipitates some physical exercise and gives less opportunity to engage in high-risk behaviours such as excessive drinking.

An increase in mental illness claims

We are seeing a massive increase in mental stress claims, with flow-on effects in terms of significant increases in workers compensation costs, loss of productivity and also a trend with those on leave for mental health to be off work permanently.

In New Zealand, 41 per cent of those on sick leave were for psychiatric/ psychological conditions, while in Australia 60 per cent of claims for sickness are for mild depression, and 40 per cent of workers report being ‘stressed out’ on a daily basis, with 12 per cent reporting chronic stress.

If a person is off work for 20 days, the chances of returning to work are 70 per cent; if they’re off work for 70 days the chances are only 35 per cent.

If you are unemployed, research has shown that you are more likely to die at a younger age from diseases such as lung cancer and cardiovascular disease due to worsening health habits such as poor diet and smoking and drinking excessively.

Returning to work can reverse worse health outcomes

What happens when a worker is on leave with a psychological issue or discloses a mental health issue? Embrace a philosophy of accommodating ill or injured workers to remain in the workplace where possible, thus embracing best-practice injury management is key.

Here is where a dedicated, documented ‘mental health return to work policy and procedures manual’ comes into its role – a document lacking in many workplaces.

Key aspects of this document could include:

• An organisational commitment to early return to work, adjusting the role to assist the worker in returning at least part time rather than prolonging sick leave to play it safe.
• Sources of mental health advice are identified within and outside the organisation when required.
• An outline of how supervisors should seek advice when an employee discloses a mental health issue, including what actions they should take, when they should take them and what will be supported by an organisation.
• Procedures for keeping contact with staff on sick leave, including when and how employees should notify absence and what is expected from the employee while on sick leave. The employee feels valued and maintains connection while the employer is aware of the reasons for absence.
• Clarify the expectations, roles and responsibilities of all parties involved in the return-to-work process, including employee, doctors, insurer, employer and so on.
• Clarify which reasonable adjustments can be made to retain an employee, including time off to attend appointments.
• Define responsibilities for putting a return-to-work plan into action and reviewing its progress.
• Provision for a return-to-work plan, involving employee and supervisor/line man- ager, with the agreement of everyone affected.
• Rehabilitation plan to allow for a staged return to work.

Case study

As an example, a small organisation realised that its high level of stress leave was placing added pressure on its remaining workers to ‘pick up the slack’ and work harder. They decided to implement some of these changes.

In one case, following a fortnight’s absence, the employer established phone contact with the employee. This was maintained, on a weekly basis, throughout their time away from work, and a home visit also took place.

Once back at work, weekly review meetings were held with the employee and access was given to management support. Open communication allowed the employee to highlight any limitations they faced and discuss their concerns.

Early intervention on behalf of the employer was crucial and provided the employee with the support they needed for their return.