Can Mandatory Occupational Health Reduce Long-Term Sickness

How much time have you, or someone you know, had off work in the past year due to long-term sickness? 

There are 2.5 million people off work with long-term sickness, which has increased by 400,000 since Covid (ONS 2022).

Historically government policy has focused on initiatives to support people with long-term sickness back into work. According to a recent article in The Times, ministers are currently exploring ways to prevent people from leaving work in the first case due to illness. Several options are being considered, including mandatory access to Occupational Health (OH) services for all employees, including physiotherapy, workplace assessments, and healthy living schemes. The chancellor, Jeremy Hunt, is arguing for

“… further support through the tax system to encourage greater employer provision of occupational health services, as a means of reducing labour market inactivity.”. 

In other words, incentivising companies to offer OH services by enabling them to claim back against their tax bill.

So, What’s This Got to Do With Neurodiversity?

The 2.5 million people off work with long-term sickness makes an eye-catching headline for newspapers. But what makes up this figure? Before the pandemic, the most common cause for long-term absence was reported to be stress and acute medical conditions, followed by mental ill health, musculoskeletal injuries, and back pain (CIPD 2016). Darren Morgan, director of economic statistics at the ONS, suggests that

“The strongest increases in ill health [between 2021-2022] have been in the conditions related to mental health, particularly in the young, a rise in people having musculoskeletal issues – so a rise in people having problems connected to the back and neck”.

What isn’t apparent is the number of people with long-term sickness absence due to issues related to ND traits. How much of the reported stress or mental health-related figures are masking ND-related issues? We know there are high rates of mental health issues and stress among ND individuals. In recent years, mental health issues, such as depression and anxiety, have been included in the neurodiversity paradigm due to the potential impact on cognition, memory, and emotional regulation.

Either way, the government believes the answer is mandatory OH provision. The interest in Occupational Health is evident in a recent research grant seeking to develop innovative solutions that increase access for small and medium-sized enterprises (SMEs) and the self-employed (SE) to Occupational Health Services (OHS). The grant is offered by the Small Business Research Initiative (SBRI) and jointly funded by the Department of Work and Pension and the Department for Health and Social Care.

Such research and investment are promising, in principle. However, anecdotal evidence suggests that OH provision is patchy and often ineffective when supporting ND in the workplace. OH is often the ‘go to’ route for organisations seeking workplace adjustments, return to work and absence case management, involving return-to-work interviews, adjustment planning, and coordination. However, evidence as to the extent to which this service is suitable for ND workers is yet to be provided in empirical research. We do know that OH practitioners can have unconscious bias and unintentionally perpetuate ND stereotypes in their assessment and recommendations (Masuch et al. 2019). At neurobox we work directly with employers and employees who tell us that the OH route has been a ‘waste of time’.

So, What’s to Be Done?

Is it time for OH providers to address the assumption that physical disability and mental health conditions are the main cause of workplace absence?  Is it for OH providers to partner with ND specialists and workplace adjustment providers to deliver nuanced and tailored services? Research suggests that OH providers can provide relevant and effective solutions when there is input from neurodiversity specialists (Rafnsdottir & Heijstra 2009).

Are you an Occupational Health professional who would like to partner with a neuroinclusion specialist? Get in touch today.