OCCUPATIONAL HEALTH REPORTS
People with mental health problems

A. Requests for Information from OH Staff to Mental Health Professionals

1. Background to enquiry

• Relationship of enquirer to patient and employer
• Outline of patient’s work
• Special work requirements (e.g. client facing, emotionally challenging, safety critical, etc)
• Nature of employment issues (e.g. attendance, performance, discipline, etc)       · 
        

2. Information to be sought

• Outline of clinical condition (not normally detailed psychiatric report)
• Treatment plan including details of any medication
• Estimate of clinical prognosis
• Perceived barriers to return to work or progress of other employment issues
• Suggested means of overcoming barriers
• Flags for any significant risk of harm to the patient
• Do not ask for opinion that the mental health professional is unqualified to give
• Do not ask for an opinion on fitness for work
• Do not ask about pension scheme entitlement (e.g. medical retirement)·        

·        

3. Procedural issues

• Confirm that request has been agreed with patient by clinician
• Enclose signed, contemporaneous consent form (AMRA extract desirable)
• Give timescale for response required (to be consistent with AMRA)
• Flag that failure to respond may disadvantage patient·   
• Confirm fee payable and any invoice requirements

OCCUPATIONAL HEALTH REPORTS
People with mental health problems

B. Reports from Mental Health Professionals to OH Staff

1. Background to report

• Relationship of author to patient
• Means by which relationship first established (e.g. GP referral)
• Duration and frequency of contact (individual and team)
• Whether report based on consultation and/or clinical records

2. Body of report

• Provide the information requested and add the following if relevant:
• Outline of clinical condition (not normally detailed psychiatric report)
• Treatment plan including details of any medication
• Estimate of clinical prognosis
• Perceived barriers to return to work or progress of other employment issues
• Suggested means of overcoming barriers
• Flag any significant risk of harm to the patient
  
• Do not repeat unsubstantiated allegations by the patient as fact
• Do not suggest causal links between work and health without firm evidence
• Do not make employment recommendations unless qualified to do so
• Do not comment on financial matters (e.g. sick pay or medical retirement benefits)
• Ensure that opinion is justified by rational argument and is not reported as fact
• Remember that clinical risk aversion often results in job loss
• Remember that keeping a job is much easier than finding a new one
• Remember that unemployment is a potent cause of mental ill health

3. Procedural issues

• Ensure that the consent provided is appropriate and contemporaneous
• Offer to show, or give a copy of the report, to the patient before it is sent

OCCUPATIONAL HEALTH REPORTS
People with mental health problems

C. Reports from OH Staff to Employers

1. Background to report

• Reason for referral 
• Means by which information gathered (personal assessment and/or 3^rd party report)
• Date of assessment or 3^rd party report
• Other information available (e.g. previous OH records, sickness absence, HR records, etc)
• Consent to consultation and report·         ·        

2. Current position

• Outline in general (lay) terms of medical condition and clinical management
• Any material delays in treatment envisaged
• Nature of current functional incapacity
• Employment support in place
• Perceived barriers to return to work or progress of other employment issues  

3. Specific questions

• Answer any specific questions posed by the employer (provided they are appropriate)

4. Future plans

• Manager support during absence (regular contact usually beneficial)
• Estimated return to work date
• Temporary adjustments/restrictions to facilitate rehabilitation which might include:
• Phased return
• Assistance with travel difficulties
• Limited attendance – short days / short weeks
• Restricted workload – volume, complexity, targets and deadlines
• Buddying, coaching and increased support
• Time off to attend treatment sessions
  
• Longer term adjustments/restrictions (may require contractual changes) sometimes indicated:
  • Revision of job content and responsibilities
  • Change of shift patterns or contracted hours
  • Change of job role with suitable and sufficient training
  • Planning for relapsing/remitting conditions (e.g. mental health passport)
  • Likelihood of future regular and effective service

5. Procedural issues

·         Plans to obtain additional information (e.g. 3^rd party reports) for supplementary guidance

·         Access to any company support services (e.g. private healthcare, employee assistance, etc)

·         Applicability of any pay or pension issues (e.g. sick pay extension, medical retirement, etc)

·         Potential application of the Equality Act with respect to disability

·         Merits, or otherwise, of any occupational health review

·         Offer to show, or give a copy of the report, to the patient before it is sent

You might also want to look at the sections on ‘reasonable adjustments’

• Developing and putting in place reasonable adjustments