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Should you ‘triage’ your mentally ill workers?

18 June 2014

Should you ‘triage’ your mentally ill workers?


When resources are limited and you want to optimise treatment, triage is a smart concept.

Typically used by paramedics at the scene of an emergency, it involves prioritising treatment, according to likelihood of recovery, by dividing patients into three groups:

  • Those who will recover without medical care
  • Those who won't recover even if they have medical care
  • Those who will recover only if they receive medical care

The aim is to optimise results by allocating treatment in the most effective way, but it’s also a model that’s becoming particularly relevant for employers struggling to deal with the increasing number of employees affected by a mental health issue.

But how can you assess which individuals failing to attend or perform at work will benefit from some kind of treatment, determine who is unlikely to recover whatever support you provide, and who will recover anyway?

How to accurately assess each individual

With GP’s more likely to be prescribing medication to address the symptoms of a mental illness, than doing anything to identify or address the underlying cause, there’s much to be gained by getting a chartered psychologist to provide a very clear picture of the individual’s health in relation to work.

In much the same way that a physiotherapist can identify what the employee is and isn’t physically capable of doing, a good psychologist can establish what the employee is and isn’t emotionally capable of doing.

When we piloted this approach with Norfolk County Council [click here to read the case study], we used chartered psychologists to carry out individual psychological assessments on 15 employees affected by a mental health issue, all of whom wanted to be helped.

The findings of the psychological assessments were shared with the Council – only with the individuals consent - to reveal a variety of personal and work related issues preventing them from attending or performing at work. Six had been off work for between 3 and 52 weeks, while the remaining 9 were attending work but struggling to fulfil their duties.

The clinical insights provided revealed that no one had a mental illness as such. Instead they were struggling with long-standing common mental health disorders, such as anxiety and depression, that had been triggered in some way.

In the event that the individual needed treatment to recover, we also gave the council a clear indication of costs and the likelihood of recovery.

“It’s my belief that without the psychological assessments, most people wouldn’t have got back to work or performing. It’s saved money being spent on wasted management time, decreased productivity and replacement staff costs.”

Paddy Lorenzen, occupational health and well-being manager, Norfolk County Council

Determine the case for providing treatment

By looking at the cost of treatment, prognosis for recovery, ongoing absence, recruitment and temporary staff replacement costs, Norfolk County Council was easily able to make the business case for investing in treatment for two employees. Both were successfully rehabilitated, saying the psychologist supporting them was the first person to really understand what they were going through and essential to their recovery.

Two more participants were deemed so affected by depression they met the criteria for ill health retirement, while three more were dismissed with the option to return, if and when they recovered, when the assessment showed they needed extensive treatment for only a limited chance of recovery, which the council considered to be an unreasonable adjustment.

All six employees who were absent returned and are now fully performing at work. Three more were successfully redeployed into other areas of the council, in a way that enabled them to reduce their level of responsibility and grade.

The remaining two resigned when the findings of the assessment gave them the opportunity to reflect on what they were and weren’t capable of doing at work.

In conclusion, the triage approach taken enabled the Council to get over half of those taking part in the pilot back to full performance and concluded all other cases, saving money being spent on wasted management time, decreased productivity and replacement staff costs.

Read the full story here