This article was written by Dr Nick Kendall, medical advisory board member for Health & Case Management Ltd (HCML).

Failure to spot crucial signs of musculoskeletal or mental health problems in employees is jeopardising recovery and the probability of returning to work.

It is well known that the most common health problems affecting the UK workforce are musculoskeletal complaints and mental health issues. Common musculoskeletal problems are back pain, neck pain, and arm or shoulder pain, and common mental health problems are anxiety, depression and stress.

According to Office for National Statistics figures for the UK labour market in 2011, musculoskeletal problems accounted for 35 million lost days, while minor and serious mental health problems combined caused 14 million days of absence.

However, the vast majority of this type of absence can be minimised by identifying these problems at an early stage and ensuring any treatment is appropriate. Crucially, treatment can range from simple self-help programmes to more intensive physiotherapy or counselling, but only by adopting an evidence-based approach can the best care pathway be determined.

The key imperative for all employers of any size is to have the ability to identify struggling workers and help them to stay at work or facilitate as early a return as possible. This requires a simple problem-solving approach to managing the relevant obstacles to full participation at work.

How to spot the signs

In every workplace, staff will inevitably experience common health problems. Naturally, in identifying people who are struggling with symptoms at work, it is very important to distinguish between genuine concerns and informal ‘grumbles’ that everyone makes from time to time. The responsibility for making this distinction lies with line managers. They must be ready to quickly identify symptoms which could escalate if not dealt with rapidly.

The most likely way employers will recognise that someone else at work is struggling will be because their behaviour or productivity has changed. Are they moving and doing tasks in an awkward or uncomfortable way? Has their productivity dropped below the normal level? Importantly, are these changes becoming consistent?

Anyone without a medical qualification cannot and should not attempt to diagnose musculoskeletal or mental health problems. However, they can note and discuss changes in areas such as performance and productivity and listen to other colleagues’ concerns.

Mental health issues in particular can be difficult to pinpoint; people are individuals and each day is different from the last so, there is no simple formula or checklist. Employees may have mental health problems at work if they are:

• Working more slowly than usual
• Missing deadlines
• Calling in sick frequently
• Increasing absenteeism
• Expressing irritability and anger
• Having difficulty concentrating and making decisions
• Appearing numb or emotionless
• Withdrawing from work activity
• Overworking
• Forgetting directives, procedures and requests
• Having difficulty with work transitions or changes in routines

These signs could also be present when a worker or colleague has a relative or friend with a mental health problem, or other serious health issue.

Facilitating return to work

Employers must implement a proactive approach to keeping staff at work, or facilitating their early return to work. Promptly identify sickness absence – whether this is reduced hours or full absenteeism – is important.

In the management of these conditions it is essential that employers avoid ‘medicalising’ common health problems and minor injuries. Usually, the instinct is to seek the help of medical experts and initiate a treatment programme. Yet the majority of problems improve without intervention and do not require extended rest, time off work or health treatment. In the early stages it is always best to remain positive and optimistic – using a goal-oriented approach to keeping the person engaged in the workplace.

When workplace adjustments or special arrangements are required these should be planned for as temporary – that is, the employee, their line manager and colleagues should be expecting recovery. Think days or a week at a time, not months. Workplace changes that are open-ended or long-term do not set the right expectations, and create a mindset which can encourage unnecessary absence.

Finally, make someone clearly responsible for a person’s staying at work or returning to work, and consider taking an independent opinion on whether treatment or rehabilitation is necessary. To assume it is can be unnecessarily costly and reinforce the notion that a person is unwell which can exacerbate the problem.