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So, how to tell the difference. As the number of referrals I am receiving for this issue are rising dramatically I can see how difficult it can be for employers to actually work out whether certain behaviours at work are due to a deteriorating performance scenario or failing mental health. So, how do you decide whether mental health is deteriorating resulting in poor performance? Considering the following 3 points will help you to decide and you may be surprised. 1.Length of Service. If the employee has been with you for some time and has been a good performer then ask why is performance changing now? In my experience good employees do not suddenly decide to become poor performers…and why would they? Has something changed in their home life? Look for a possible reason. Talk to your employee. 2. Working Longer Hours. Is the employee working longer hours, but appearing to be getting less done? Deteriorating mental health affects memory, concentration and cognition. Behaviours that are often associated with anxiety and depression such as poor time management, conflict, difficulty concentrating and making decisions may very easily be misinterpreted in the workplace as under performance. 3. Deterioration of Physical Health. Stress has a direct physical effect on the body, this occurs due to prolonged periods of pressure without time to recover. The body has an Inappropriate fight or flight response where cortisol and adrenaline are released into the bloodstream and damage to the body is the result. The employee may experience sleep disorders, headaches, raised blood pressure and weight loss or gain. There may be an increase in frequent short term absence. So what should you do? Making a referral to Occupational Health will provide you with clear actionable advice to help you manage this kind of situation in the workplace. The deterioration in mental health can be due to home or work pressures or a combination of both. Often employees do not realise how unwell they have become and resist treatment. Occupational Health can offer support and advice to the employee on these issues. Using the stress risk assessment approach is invaluable. Is discipline the answer? Sometimes employees are taken down the disciplinary route in the hope that performance will improve, but if there is a mental health issue, this only makes things worse. As a business you are entitled to apply your performance management process to someone with a mental illness so long as you remain compliant with all relevant acts and legislation, including the Equality Act. However, it is unlawful to dismiss someone due to mental illness and you can easily run into serious problems if an employee can prove a causal link between work and their mental health.