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Joanna Yarker

Kingston Business School

Associate Professor in Occupational and Business Psychology

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6 simple steps to support return to work after mental health-related sickness absence


A team of researchers at Kingston University, Loughborough University and Affinity Health at Work are developing a free-to-access toolkit to help employees and employers navigate through the return to work process following a mental health sickness absence. The toolkit will be launched online in February 2018 and evaluated over the coming year.

This article was written by Joanna Yarker, Rebecca Peters, Rachel Lewis, Emma Donaldson-Feilder and Fehmidah Munir.

This article highlights the important role line managers play in supporting return to work following mental health sickness absence and how the toolkit can help.

Did you know that the way an employee is treated during their absence and their initial return has a major impact on their likelihood of returning to work? 

Mental ill-health is one of the most common reasons of short and long-term sickness absence, affecting one in six employees in the UK (Council for Work and Health, 2014). However, studies have shown that the return to work process falls short too often with up to 20% of returning employees experiencing relapse or subsequently leaving work (Norder et al, 2017).

Early and effective intervention is vital to support employees to get back to work and help them stay at work.

However, many managers are unsure of what to do or what to say when mental health sickness absence occurs. A common response can be “I feel out of my depth” or “I don’t want to make things worse.”

Talking about mental health can be difficult, so people often choose silence in fear of saying the wrong thing. An employee’s manager is often the first point of contact when they are unwell and when they return so it is important that they have the skills and knowledge to support the returning employee.

In our toolkit, we propose six steps to help employees and managers navigate mental health sickness absence the return to work process:

1. Talk early on while the employee is off work

Communication in the early stages of absence can seem quite formal – requests for a fit note and confirming the sickness absence policy – which may lead to feelings of genuine care getting lost.

Talking early on can help the employee feel valued. Managers need to make sure that any communication at this stage is about the employee and their health, rather than when they are coming back.

If the line manager doesn’t have a good relationship with the employee, it may be helpful ask a colleague to check in and pass on their best wishes.

2. Develop knowledge and skills

Managing an absent or returning employee can be difficult, especially when there are so many pressures on line managers’ time.

Managers need to be encouraged to consider whether they have the skills to support the returning employee: our research, supported by BOHRF and CIPD, has identified a number of manager competencies that have been found to be effective for supporting returning employees.

If work played a role in the employees’ absence, it is important for the manager to consider how the rest of the team are coping and review how their work is designed and managed.

3. Maintain communication throughout absence

Maintaining contact throughout sickness absence has been found to improve the employees’ likelihood of returning to work. It can support a sense of belonging and help relieve the anxiety of returning to work for the employee, and can help the employer and manager with work planning.

It is helpful to agree up front how often (e.g. once every month) and how (e.g. email/ phone) communication will happen.

4. Preparing for return to work

All too often employees resume their full workload as soon as they return, and this leads to further problems.

Instead, gradual returns allow the employee to build up their confidence back in the role. Before the employee returns, it can be useful for a manager to think through how the employee’s role could be adjusted in the short term to make the first few days or weeks easier to manage. An informal coffee or phone call before the first day back may help to lessen the employee’s anxiety about the first day.

Managers can also start to think ahead to the return to work conversation – do they know what do, what to say and how to say it? If formal training is not available, a practice role-play can be helpful to prepare them and ensure that they are confident in discussing the employee’s return.

5. Return to work conversation

Setting aside time for a return to work conversation is important so that managers and employees can develop a plan to make sure that the return is an effective one.

Do managers have the skills, or even the office space, to make the most of this conversation? Do employees know when and where it will take place and what to expect? Our toolkit provides a conversation guide to help both manager and employee with this conversation.

6. Keeping healthy and productive at work

Many people who experience mental ill-health only experience it once. However, it is important to maintain an open dialogue and agree a plan for regular check-ins and reviewing work. Wellness Recovery Action Plans can be helpful for all team members, not just the returning employee; and regular reviews of the way work is designed and managed can work to give employees the best chance of staying in healthy and productive at work.

In addition, managers can support all employees by knowing a bit about mental health and the potential signs, signals and triggers. Everyone’s experience of mental health is slightly different, but the key thing for line managers to look out for is changes in behavior, attitudes, mood and so on.

If a manager notices uncharacteristic behavior in their employees, such as difficulty managing workload, coming in late, stopping going to the gym or taking lunch, or the way they interact with the rest of the team, it is time to check in and see if they are OK.

Would you be interested in contributing to our research? Each of the steps outlined in this article are explored in more detail in the toolkit, which provides employee and employer guides, checklists and templates. As mentioned, it will be evaluated over the coming year – to find out how it is used, what is useful (and what is not!). Please contact  if you are interested in learning more.

3 Responses

  1. These days, I think we can
    These days, I think we can begin to prepare ourselves that situations like this will occur more in the workplace. The solution is to encourage your employees to be more accepting of people who are recovering from such issues. It’s hard enough to admit that you have such mental issues, but it would be worse if people felt they have to keep such news in storage rather than seeking help for it!

  2. I heard a story from a close
    I heard a story from a close friend whose next-cubicle colleague committed suicide after more than a decade of serving that company as a manager. Apparently, he had just returned to work after a health-related episode. I guess the company management didn’t manage his return well enough to make him feel welcomed or at ease which eventually led to an even severe attack.

Author Profile Picture
Joanna Yarker

Associate Professor in Occupational and Business Psychology

Read more from Joanna Yarker

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