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What are the missing links between sickness absence and returning to work? Helen White-Knight investigates

The £16 billion yearly bill for sickness absence is a hot topic for any large employer and, as is now becoming clear, much of that can be attributed to mental ill-health. Employers are examining their policies and how these are managed in an attempt to keep costs down. As with so many HR issues, it’s one thing for those at the top, setting time scales and writing it into the staff handbook, and quite another for the HR rep. Having to tell a sick person their job might be at risk because they’ve been away too long is not a pleasant prospect.

I’ve heard from frantic line managers dealing with employees returning to work after sickness absence too soon – clearly not well enough to be there – who refuse to stay away because their sick pay has ended and they can’t afford more time off. Then there are employees coping with chronic ongoing conditions that have exhausted treatment avenues through the NHS, and whose private medical cover doesn’t stretch beyond the acute phase.

People with post-traumatic stress disorder (PTSD), for example, have been caught up in some kind of traumatic situation and left with crippling anxiety. This can be hard for others to relate to, however, because of the specific nature of the cause of the PTSD. Fearing nobody else will understand, they are desperate to restart life and return to work, but feel unable to get themselves across the threshold and face those difficult conversations with well-meaning colleagues.

For most of these situations, the anticipation is much worse than the reality. However, while researching people management sites for this piece, I found too many articles focused on how to manage people who took extended sickness absence out of the business and not enough exploring why people don’t come back, or how to support them even after an extended period away.

Deterrents to sickness absence return

Employees naturally fear the speculation of others around their sickness absence. Some colleagues will say “she’ll never return”, or “she’s not up to the job”, because taking time off for sickness of any kind is still (wrongly) synonymous with weakness. Hardly surprising that the longer their absence continues, the more others’ perceptions will start feeling like an obstacle.

It can be all too easy to take off “just one more day/the rest of this week/until the end of the month”, and begin imagining rumours being whispered around the office. For someone in a vulnerable state of mind, these are the kinds of thoughts that can become all-encompassing, and so the cycle continues. When they do return, the notion of having to work doubly hard to prove their worth and reassure others that they’re still capable takes over.

People don’t always know how they’ll feel when they start working again, and the inevitable adjustment period can feel like a huge pressure. As a result, they start avoiding responsibility and become reluctant to make promises, in case they find it too difficult to cope. There’s also the guilt some people feel for having been away; sometimes leaving others to take on their workload. It can all build up until the smallest thing becomes a reason not to go back. Even the prospect of a jammed email inbox can be a deterrent – especially if stress was part of the reason for that person’s absence.

Alignment of policies, HR and line managers

Maintaining contact during absence can be a minefield – good managers don’t want to appear untrusting or pushy, and employees don’t want to have to speak to their manager every day if there’s nothing new to say. Mistakes at this early stage can be make or break, so working out expectations for contact should be done in partnership, with a view to it being a supportive tool. Good processes around return to work and collaboration between line manager and HR can make a big difference in how successful the experience of returning to work is for an employee.

Economic necessity can force employees to return to work before they should. Once full pay drops to statutory sick pay, there is added pressure from the prospect of financial hardship. Returning too soon can be catastrophic for the employee and their colleagues – especially if there are behavioural issues or if the illness was directly linked to work.

Organisations should look at all the options when crafting return to work policies. These could include preventative elements, such as guidance for line managers on having honest conversations with employees around financial planning. Employers should also consider options for actively supporting staff about to go onto statutory sick pay, which could include referral to advisory services. While most policies limit the scope for individual discretion – for example, extending the cut-off point for individual pay – they should also recognise that treatments for mental illness are far less accessible than for physical conditions and so recovery can be slower.

Phased returns should be built into policies. These can work well when there are issues with fatigue or physical symptoms that may have an effect on tolerance of being at work. They will work best when applied flexibly – employees can’t know in advance how they’ll feel day to day, or how the return will affect their energy levels and impact their recovery. Putting pressure on a person to perform, whilst sometimes providing motivation, can also feel overwhelming – and this goes both for managers keen to have a key resource back in operation, and the employee themselves, who may want to push themselves harder than is beneficial.

Line managers and employees should consider agreeing a wellness plan, setting out both the employee’s needs, and the support the manager can offer them. Managers should also take the wider team into account as part of the plan, manage their expectations and encourage them to support their returning colleague.

Being back at work shouldn’t be about an expectation of 100% productivity right off the bat, so consider giving staff the ability to switch off their inbox whilst absent. Nobody needs to come back to thousands of unread messages and the anxiety that creates. As a general rule, if something is really important it will have been dealt with by a colleague, so there’s little point in spending that crucial readjustment time wading through old emails weeks or months later. Everybody should be thinking about whether the email they’re sending is really necessary and be conscious of how the tone and frequency of their communication affects others’ stress levels – particularly when recovery should be a priority.

Solid support

The most important thing for anyone returning to work after mental illness is to know that they will be supported by their employer and colleagues. This can only happen with good communication, founded on well thought-out return to work policies, good support mechanisms and services that balance both individual and business needs.