Depression commonly affects employees returning to work after a physical illness

Individuals returning to work following absence due to a physical condition such as back pain, cancer or heart disease are at risk of mild to moderate depression, yet those who do become depressed worry about telling their employers, according to a new report published by the Mental Health Foundation.

ëReturning to work, the role of depressioní details the findings of a research study carried out by Loughborough University, which compared the return to work experiences of individuals with heart disease, back pain and cancer to individuals with depression and anxiety.

The reportís findings, published today in the Occupational Health at Work journal, show that almost half (45%) of those with a physical condition experienced mild to moderate depression but were more worried about telling their employer about their mental health issues than their cancer or heart disease. Despite the fact that depression impacted on their well-being and ability to function at work, most felt unable to tell their line managers about the difficulties they were facing.

The study found that while most line managers were initially supportive when a person returned to work, they were not aware of the long-term effects of a serious physical illness or condition upon an employeeís ability to work and mental health. There was a consistent lack of follow-up by occupational health, line managers and human resources on employeesí general health and psychological well-being after returning to work.

Adjusting back to work after an episode of depression or anxiety

The report reveals that those returning to work after an episode of mental ill health find it more difficult to adjust than those with a physical condition, largely because line managers and colleagues have little understanding about depression and anxiety, and inadvertently the support provided to employees is poor. Furthermore, neither occupational health, human resources or line managers are adequately trained in dealing with psychological issues.

The study also found that gradual returns and reduced workloads were more commonly offered to those with physical conditions and illnesses. Stress management was only offered to a quarter of those experiencing depression, despite its known benefits in helping to alleviate its symptoms and job strain.

Good return to work management practice

The researchers behind the study did encounter examples of good practice. For employees who had been absent due to either a physical or mental condition, returning to work was made easier by good communication between line manager, occupational health and the employee, holding case conferences, planning individual return to work packages, and a positive employee attitude towards the workplace.

Organisations who provided fast-track health services to their employees, such as physiotherapy and cognitive behaviour therapy, noted an increase in early return to work. And support from colleagues was instrumental in improving a personís mental well-being. Those who had support from their colleagues found it easier to admit to having bouts of depression.

The research also discovered that shorter working hours, fewer job tasks or reduced workload were beneficial to those who received such adjustments. Those who did not receive any adjustments or were offered unsuitable adjustments without prior involvement in discussions, felt this was detrimental to their mental health and well-being.

Comment

Andrew McCulloch, the Mental Health Foundationís Chief Executive, said: ìIt is sad that many employers can deal better with life threatening and frightening illnesses like cancer than mild to moderate depression, because of stigma and lack of information. This research shows that managers are willing to help but they often lack the knowledge or skills required. Whilst the need for change is clear, this report is not about knocking employers. It makes clear the need for improved training for managers, and clear policies and procedures from HR.î

Recommendations

The report makes a number of recommendations and calls for:

Managers, occupational health and employees to work together both before and after an employee returns to work. ëCase conferencesí, involving GPs and insurance providers as well as managers and occupational health, were found to be crucial to developing individually tailored and efficient plans.
A longer period of monitoring, communication and support for returning employees following absence.
Employers to provide mental health training in order to promote understanding of depression and anxiety.

ëReturning to work, the role of depressioní was commissioned by the Mental Health Foundation and carried out by Loughborough University as part of the charityís grants programme. The report is available at www.mentalhealth.org.uk/return-to-work

New guide to help people in the workplace

The Mental Health Foundation has also published What works for you?, a new guide which gives practical advice about how to help a colleague in need. The guide provides information on common signs or symptoms of mental health problems, advice on how to listen effectively and on how to respond. It includes specific advice for managers and owners of small businesses, such as how to deal with an employeeís workload, sick leave and return to work arrangements. It also contains useful legal information.

For a free copy of What works for you? telephone the Mental Health Foundation on 020 7803 1101 (there is a small charge for bulk orders), alternatively download it from: