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The Royal College of Psychiatrists Improving the lives of people with mental illness

 

Supporting good communication between health professionals, employee and employer


In the links below you will find some helpful pointers on writing reports and sharing information between occupational health staff, mental health professionals and employers.

 

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 3rd party report)
  • Date of assessment or 3rd 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. 3rd 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’

 

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Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.

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