Returning to Work After a Mental Health Related Absence

Hannah Giles is a counsellor, vocational rehabilitation and disability management specialist, with 18 years’ experience working with people with health conditions and disabilities in an employment and therapeutic context. As director of Reficio, she works with companies and individuals to support mental health, and build supportive and inclusive working cultures and environments filled with happier, more resilient employees. 

Going back to work after a period of poor mental health can understandably feel daunting and overwhelming. It’s natural to have concerns about how you might cope, how your colleagues may react to you, or what changes might have taken place whilst you were away. The good news is that taking steps to ensure the right support is available both inside and outside of the workplace, can help you through the process, and provide a sense of personal control. 

For many people, returning to work is a major step in recovery and moving forward. But it’s important to acknowledge that mental health exists on a continuum, not as absolutes of being entirely well, or at a point of crisis. As you return to work, you may still be experiencing symptoms of poor mental health, and returning to your job, or to a new job or workplace, can be a hugely positive factor in ongoing recovery. A well-managed return to work will promote a sense of achievement and purpose, whilst providing you with vital structure and social interaction. 

Planning and Preparing for a Return to your Pre-Absence Employer

Planning and preparing for your return to work will increase your motivation and make it feel like more of an achievable milestone. There are a few things you could consider, such as keeping in touch with colleagues by email, phone or social media, and getting up to date with workplace news. This can help to allay some of those anxieties about being out of the loop and lessen tendencies to catastrophize or jump to conclusions.

Arranging an informal workplace visit (or in this day and age, a Zoom/Teams call) is also a great way to re-familiarise yourself and check in, rather than the first time you walk through the door or turn on the laptop being straight back into ‘work mode’. If physically going into a workplace, you may want to ask a colleague you trust and get on well with to take you in, or meet you outside the building, so that you don’t feel alone in making this first step. 

Feeling supported and listened to is key in managing a successful return to work. Knowing what you will be doing and what is expected of you will help to reduce anxiety and feeling overwhelmed, so ask your manager to plan your work schedule and tasks with (not for) you during the first few weeks. Ask if you need to catch up on any training or work with a buddy or mentor if there have been any significant changes.

Check in every week as a minimum to let them know how you’re finding things and what support you need, if any. Approaching the conversation in terms of what helps and hinders you can be particularly useful; for example “I find it helpful when you write in bullet points as this makes it easier for me to follow” or “it is difficult for me when there are last minute changes to the day’s schedule”. Take notes throughout the week so that you don’t feel under pressure to remember everything on the spot. Notes would also be useful for any return to work planning meeting meetings, to ensure you cover all your questions and concerns. You could ask someone you trust to help you to prepare for any meetings.

Also, have a chat with your employer to find out if they have support services available, such as an Employee Assistance Programme (EAP) where you can access confidential and impartial counselling and advice, or if there is access to an Occupational Health team and/or Mental Health First Aiders. EAP programmes can usually offer fast access to counselling, which could either support you during the return to work itself, or down the line should you feel you might be slipping downwards on the mental health continuum. If such resources are not available via your employer, have a plan of where you can access support in the community, and be sure to keep trusted family and/or friends up to date with how you’re feeling. 

Think about your routine

As part of your return to work planning, think about your routine. In the days or even weeks leading up to your return, aim to go to sleep and wake up at the same time each day, as if you were going to work. Keep to regular mealtimes and avoid napping during the day. Also think about any medication you might be taking and if necessary, adjust the timings of this, in consultation with your GP. 

Particularly if returning to work with your existing employer, ask if it is possible to return to work gradually. This is often referred to as a ‘graduated’ or ‘phased’ return to work, and would involve working fewer hours on certain days, building up to full-time over a period of a few weeks.  

Starting with a new employer

If you’re thinking of starting your first job, or getting back into work after a period of unemployment, start by thinking about what you might like to do, and/or where you might like to work. Try to have an open mind, as this will give you more options. If you’re feeling stuck, try the backwards career planning or lifestyle-focussed approach. Think about how you would like your life to be and what you would like to achieve, and trace the steps back from the end goal. This will let you know what you need to do first to get on the pathway. Each step towards a goal or vision is a positive in itself and gives hope for continuing recovery. 

Reasonable Adjustments

‘Reasonable adjustments’ or ‘workplace accommodations’ are changes that an employer makes to help you manage a health condition or disability at work. Putting reasonable adjustments into place is a widely recognised practise across the globe, however the law/qualifying criteria surrounding this varies from country to country.  It is good practice for employers to support you within what is reasonable for your role, and many will do so in order to retain employees. 

Try suggesting changes to your employer that you think will help you. Even small changes can allow you to feel more able to do your job, such as installing specialist equipment and making adjustments to the working environment, adjusting working patterns and hours, working from home (or an alternative location, or, returning to the office), providing training, or changing the recruitment process to be more accommodating.

Mental health wellbeing is a journey

Remember that you are on a journey with your mental wellbeing, and returning to work is a part of that. Share experiences, ask for tips, advice and support from friends, family, and colleagues who may have been through similar, but don’t ever compare your experience to theirs. You are unique, with a specific set of individual needs. It will help you to feel less anxious if you are proactive and take some ownership in the process, and accept what you can and cannot influence and control. Exploring with your employer how your needs might possibly be met is a strength, not a weakness, and communication is key.

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