Dr Mike McPhillips Consultant Psychiatrist Nightingale Hospital London NW1 2 Lower Sloane St London SW1 Experience 16 years of fulltime private practice in Central London NHS in Chelsea private in Chelsea and NW London ID: 604116
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Reasonable Adjustments and Mental Illness in the Workplace
Dr Mike McPhillips
Consultant Psychiatrist
Nightingale Hospital, London NW1
2, Lower Sloane St, London SW1Slide2
Experience
16 years of full-time private practice in Central London (NHS in Chelsea, private in Chelsea and NW London)
Adult Psychiatrist & Addictions specialist, inpatient and outpatient
Medicolegal work, several EA/Tribunal Reports per year
Reports are generally hard to obtain, EA work is rather
specialised
and needs a working knowledge of the Act and some medicolegal experienceSlide3
Mental Health and the workplaceFrom DWP Framework document, 2009
1 in 3 employees
1 in 6 has a diagnosable mental disorder, mostly Depression and Anxiety
Only 1% have SMI (Bipolar/Schizophrenia)
Commonest cause of prolonged sickness
leave (42% of those on long term benefits)
86 percent of benefit claims > 3 months
Work is associated with better mental health, greater happinessSlide4
Attitudes to Mental Health, UK
25% think mentally ill should have fewer job rights
Many employers believe none of their staff are affected
Only 40% would knowingly employ a sufferer
33% of employees feel they work for a supportive
organisation
66% of psychiatrists’ patients feel discriminated against at workSlide5
Relevant Experience
Dually qualified Adult Psychiatrist/Addictions specialist
16 years of private practice in Central London
Treated and reported on DDA/EA cases since 1996
5-10 new instructions per year plus numerous cases from own practice
NHS services remain patchy and difficult to access, reluctant to provide reports/opinionsSlide6
Reasonable Adjustments in Mental Illness
Need to reflect that mental illnesses:
Are fluctuating
(varying from day to day and even from hour to hour)
Are episodic
(weeks and months for depression/, bipolar, minute-to-minute for anxiety)
Are sometimes situational
(OCD, panic attacks, social phobia)
Impair social function as well as physical abilitySlide7
Wellness and Recovery Plan (WRAP) Mary Ellen Copeland, 1995
A structured and agreed written plan of how to keep well at work
Signs that you are getting unwell again
Sleep, tiredness, anxiety, unrefreshing weekends, neglecting hobbies, exercise, diet
Triggers that make you unwell
Deadlines, long hours, difficult clients
What to do if you get unwell
Early intervention, flexible supervision, mentoring
How to get back on track after you have been unwell
Phased return, restricted duties, balanced lifestyleSlide8
A tale of two mothers, model care:Ella, 30, primary school teacher, SW London
Diagnosis: Depression with panic attacks, phobia of crowds, public transport
Adjustments:
Reduced and rearranged workload
Phased return
Reduced hours to avoid rush hour
Use of parking space at school
Time off for appointments with therapist, Dr.
Regular mentorship with Head
Observance of Ella’s privacy at all times re: fellow staff, pupils, parents
Slide9
A tale of two mothers: poor careAnna-Maria, 35, Graphic Designer, SW London
Diagnosis: Depression with anxiety
Adjustments:
Were resisted. 2 x
Occ
Health Assessments, A-M pronounced fit for full-time work without reference to her psych. reports.
Psych report needed, verifying EA status and supporting adjustments
Reduced hours, eventually 4 days per week
Ability to arrive at work at 0800 and leave at 1730Slide10
How to lose friends and alienate peopleJohn, 45, Banker, SW London (1)
Diagnosis: Depression
Adjustments:
Phased return
Reduced responsibilities (project work)
OH assessments, EA status identified
HR assessments
Mentoring with Manager
Time off for therapeutic appointments
Reduced hours to avoid rush hour
Slide11
How to lose friends and alienate peopleJohn, 45, Banker, SW London (2)
Problems:
Resistance to him missing early am and late pm meetings
Holding team meetings on his non-work days
Querying him avoiding rush hour or work from home
Tactless and public remarks about his mental health
Negative annual appraisal, his first ever, based on his work performance during the period when he
was depressed
Forcing him through a grievance procedure over this
issue
Outcome:
John now has a lawyer, has joined a Trade Union and is considering Employment Tribunal ProceedingsSlide12Slide13