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Breege asked...

Tags: Stress

In my organisation we have a growing number of cases reported as stress and supported by GP sick note. On investigation the underlying problem is related to illness of family member and as a result of caring and worrying about their family member they are unable to come to work and with their GPs sympathy now have the support for absence on sick leave. I would appreciate any advice you can give a line manager on how best to deal with this situation.

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The Answer

This is a very difficult situation for you as a line manager, but also for the GP! I often find patients coming in with stressful family situations, but the stress is having an impact on the patient’s own mental health. As doctors, we are not supposed to give sickness certificates (or ‘fit notes’ as they’re now called) unless the patient themselves is unfit for work. However, we have to rely on what the patient tells us, and I am all too aware that a few may exaggerate their symptoms to get time off. If I carry out a validated test for depression and the results tell me that the patient is suffering from severe depression, for instance, I have to take that diagnosis at face value or accuse the patient of lying. Until there is a completely reliable test to tell if patients are telling the truth, this problem is likely to remain. However, the new ‘fit notes’ do give the option of certifying the patient fit for work on the basis of workplace adaptations, modified duties etc. I often discuss with patients whether they might be able to work partly from home rather than being off sick. Larger companies have occupational health departments, internal counselling etc. which can also allow a more tailored approach to keeping the patient at work, but I am aware than by no means all companies have this.

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