Much has been written over the last month or so about Mental Health, and rightly so.  It has now overtaken back pain as the principal cause of workplace absence in the UK.  Anything which encourages an environment in which mental health issues may be more openly discussed and genuine sufferers’ sense of isolation or embarrassment reduced must be a good thing.

The recent Stevenson/Farmer report (under review in our Thriving At Work series on this blog) contains numerous recommendations to Government, employers and the public sector about the handling of employees with mental health conditions, but sadly none to the employees themselves.  I wonder, for the reasons below, if that is not an opportunity missed.

Recognising fully that this will potentially strike a rather jarring note in the prevailing mood, we cannot ignore the reality that some employees claim stress or anxiety or depression or “low mood” as a response or defence to the prospect of a difficult meeting with their employer.  They may then claim to be too sick to attend the meeting in question and so the employer’s performance management, grievance or redundancy consultation process is stopped in its tracks, to its inevitable and growing frustration.

The problem here is the traditional Catch 22 – the employee won’t be well enough to meet until the difficult circumstances go away, and the difficult circumstances will not go away until the employee is well enough to meet.  It is a very short step from there to extended absence and the consequent more or less vertical decline in the prospects of a successful return to work.  So something has to give.  If it is the employer, then it risks sending a message that if you wait long enough at home, you can avoid redundancy or disciplinary or grievance conversations altogether, a precedent which it would clearly be impossible to countenance.  Therefore (within limits), it has to be the employee.

Some help may be at hand for the employer.  A big hand, please, for the Health and Work Handbook produced in collaboration with the Royal College of GPs and the Society, and separately the Faculty, of Occupational Medicine.  Although the Handbook was written pre-Equality Act 2010, it still seems little known-of among employers, hence our mentioning it here.  It is written as guidance to doctors in OH and primary care roles, so employers are not its intended audience.  Nonetheless, its recommendations concerning “meeting-induced stress” of this sort will be music to their ears.  In fact in stereo, since in December 2012 the Faculty of Occupational Medicine issued its own Ethics Guidance covering similar ground in similar terms, recently updated and a snip at £35 on the FOM website.

The common thrust of the two documents is that in most cases it is a mistake for both parties to let things slide because the employee has some reactive disorder preventing a proper exchange with his employer.  There is a chance that his (perhaps fully understandable) emotional reaction to the disciplinary or redundancy summons will escalate into a full-blown mental health complaint, and/or that in not getting on with the matter, the employer risks causing insult or injury to other affected employees left in limbo as a result.  The Handbook says that in these cases “it is likely that the effects of an unresolved dispute on the employee’s mental health may be greater if the proceedings are postponed” and crucially “an employee may be unfit for work but fit to engage with the management process“.  The 2012 FOM Guidelines echo this – “it will often be the case that the worker will find the proceedings distressing, but…delaying the process for a prolonged period will be likely to be more damaging to his health, especially his mental health, than continuing with it“.

Between the two documents, the employer is advised to ask OH and/or the GP these questions:

• Is the employee capable of understanding what the proceedings are about, or telling right from wrong?

• Will it be detrimental to the employee’s health to attend a meeting?

• Is he/she able to instruct a friend or representative to represent his/her interests?

• Does the employee have the ability to understand and follow the proceedings?

• Can OH or the GP provide any guidance as to how best to proceed with the meeting to make it easier for the employee to attend and be supported?

The view of both sets of guidance is that it will only be on the rarest occasions when OH or the GP will be willing to say that an employee is too sick mentally to understand what the difficult meeting is about.  Cynics might say that sometimes it is precisely because he does understand it that he has gone off sick.  The FOM Guidance reminds OH practitioners in particular that in addition to consideration of the employee’s health, they also need to bear in mind the “needs of the employer to reach a conclusion in the interests of the organisation and the other workers“.  It notes too that the Acas Code of Practice accepts that “a meeting may eventually be held in the worker’s absence if all reasonable attempts to facilitate attendance have failed“.  How soon you can do this will depend on the facts of the case – if there is some material financial cost or distress caused to others by the delay, you may reasonably push for an earlier in absentia conclusion than would apply otherwise.  So you are not pushing at a completely closed door in trying to make progress during the employee’s absence.

Lessons for employees

So here are the recommendations which the Stephenson/Farmer Report could perhaps have made to employees with possible mental health conditions who are asked to attend difficult meetings:

(i) in asking you to attend such a meeting the employer is not doubting that you are too unwell to work;

(ii) attending the meeting may be unpleasant but will generally be in your own best interests, at least so far as your health is concerned;

(iiii) if there are things your employer could do to make the meeting easier for you, please say so.  It may or may not be possible to accommodate you on all this but your employer should certainly be seen to consider it;

(iv) the difficult issue is very unlikely to go away with more time out of the workplace but your chances of a successful return will certainly reduce;

(v) if you can’t or don’t attend the meeting your employer is ultimately entitled to make decisions affecting you without your input.