Helping Workers with Mental Illness Remain Productive

photo of Dr. Couserby Gregory P. Couser, MD

Supervisors and co-workers know how to respond when an employee returns to work after a heart attack. But when an employee’s absence is known (or thought) to be the result of mental illness, the situation can feel confusing and uncomfortable. But in many aspects of return-to-work decisions, the situations are not that different.

Occupational medicine physicians (sometimes in consultation with mental healthcare providers) ask the same questions to determine whether and when a worker recovering from a mental illness should return to work, such as

  • What is the employee’s diagnosis? Clearly, the diagnosis is related to what an employee may be able to do on the job. A psychiatric diagnosis alone—such as major depression—does not mean an employee is unable to work.

  • What work can the employee do today? An occupational physician evaluates an employee’s capabilities in relation to the specific jobworker consulting with doctor duties. With a mental illness, mental / emotional capacities that are key to functioning in a workplace will be assessed: 1) understanding and memory, 2) sustained concentration and persistence, 3) social interaction, and 4) adaptation.

  • Does an impairment prevent the employee from performing essential job functions? Employees with impaired mental functioning can still work (the concept of “impairment,” a medical term, is sometimes equated with “disability,” an administrative term). The occupational medicine provider works to clearly describe an impairment and suggest job accommodations where needed.

Work is therapy; it’s such a significant part of our lives that it’s part of the treatment plan. Because it not only affects our socio-economic states but our sense of self, it’s not surprising that time away from work—even as little as 2-4 weeks—can contribute to development of a “disability mindset,” with an entirely altered identity and diminished coping skills. In my experience, the longer a person is away from work with any illness, the less likely he or she is to return.

Sometimes supervisors express concerns about “bothering” someone who is recovering from mental illness, but they shouldn’t. Keeping in contact with employees can help alleviate self-doubt that comes from not working and promote the positive feeling that they’re still part of the team.

As Medical Director of the Employee Assistance Program at Mayo Clinic in Rochester, Minnesota, Greg Couser and his staff provide education, consultation, training, and basic counseling to more than 30,000 employees. This bulletin is based on an article by Dr. Couser in Current Psychiatry.

November 2013


UI HealthWorks is a member of the WORKSAFE IOWA Occupational Medicine Associate Network, the only university-affiliated network of occupational health providers.

WORKSAFE IOWA is an outreach program of the Department of Occupational and Environmental Health in the College of Public Health at The University of Iowa.