5. How to bring up problems with work ability?

• In supervisory work, it is possible to face situations where it is worrying that an employee does not perform their work as before or the employee’s behaviour has changed, such as withdrawing from the group or feeling depressed, unusually tired or irritated. It is also possible that work is not done or it is overdue or you notice that the employee clearly does not enjoy their work. You may wonder why these changes are happening – whether it is work-related or another life-related situation, a temporary or more permanent change, for example.

• Signs of poor well-being are common and often do not tell what is going on, but need to be discussed.

• Most supervisors are concerned about bringing up the employee's well-being. From the employee's perspective, issues related to work ability are major issues related to livelihood. It is most likely that two people are be present in the conversation, both of whom are nervous.

Encouragement to raise the matter can be sought, for example, with the following aspects:

• Work-related matters and the fluency of the work are included in the work of the supervisor. For example, when someone is withdrawn from interaction, it is a work-related issue that the supervisor must address.

• Interest in the well-being of employees is a part of supervisory work, and employees generally see it as a positive thing.

• By asking, you will become aware of possible work-related shortcomings.

• Waiting does not usually resolve the situation, but makes it more complicated.

• You may not find a solution right away, but it often helps the employee that you, as a supervisor, are aware of the situation and show that you understand it from the employee's point of view.

Talking about difficult things can be easier with:

• Communication about the organization's operating models, such as the early intervention model: the supervisor does not need to justify why they are raising the issue.
• Questions about well-being on the performance appraisal form: it is easier for the employee to raise issues and easier for the supervisor to address them.
• Maintaining a conversational relationship: regularly ask how they are doing.
• Promoting issues related to well-being from the beginning of the employment relationship.
• The aim is to investigate, if necessary, in phases; the supervisor does not already need to know what to do.

Proven perspectives for addressing the employee's well-being:

• A show of concern – not an accusation
• Kindness and understanding
• Respectful attitude
• No assumptions
• A coaching approach – take the employee's own goals into account
• Listen more than you talk and have the patience to wait for an answer
• Mindset of “we are together searching for a solution”
• Accept that it takes time to find solutions.

• Prepare for the conversation by figuring out the exact reasons why the conversation is taking place.
• Have the conversation in a calm, private space. Sometimes, it can be easier for an employee to talk over the phone or video chat. Schedule an appointment with the employee:
  
  “I've been thinking about your coping at work and how you enjoy your work. I want to be there for you. I want to hear your thoughts. We could make an appointment.”
• More important than individual word choices is an attitude that aims to understand and seek solutions.
• In the discussion, start by explaining your concerns in concrete terms. Identify the change or worrying thing you have observed.
  
  “It was nice when we used to see each other in team meetings. In the last few weeks, you have not attended any joint meetings. I would like to hear how you are doing and help as best I can.”
  
  “Your work has been running behind schedule recently, I have been wondering what it might be about and how I can help.”
• Speak in the first person. State your observations and ask how the employee views the issue you are describing. Variations in efficiency at work are normal and everyone is sometimes tired. However, it is worth asking about any long-term worrying situations.
  
  “It seems to me that you have been tired and a bit down lately. How are you feeling?”
  
  “Your ability to cope with work is important to me. How are you?”
• Encourage speaking and listen and process what you have been told.
  
  “I am glad you told me, now we can think together about how we can find a solution.”
• Accept that the employee chooses whether to say something or not. Employees can tell as much as they want about matters related to their personal life and health.
• It may be that, in some matters, the employee wants to talk to someone other than the supervisor. For example, health-related expertise is available from the occupational health care service provider. However, matters related to work must be resolved with the supervisor.
• Finally, you can ask:
  
  “Can you think of anything else we should talk about?”

• In order to find solutions, the problem must first be located. Seemingly similar symptoms can be caused by, for example, difficult life situations, work-related injuries or job burnout or by factors related to health, such as mental health disorders.
• In addition to health, work ability is affected by motivation and skills as well as changes in work. Take these up as well. Lack of skills can lead to frustration or a feeling of inadequacy at work.
• Think about what could be the next step together. The supervisor is responsible for addressing work-related shortcomings. Even in a situation concerning personal life, work arrangements can often support the employee.
• Set better work fluency as the goal of the discussion. As a supervisor, you can ask what would help the employee in this. These things are not always easy to identify; you can arrange some time for reflection and schedule a new appointment.
• It may be that, in the discussion, it is revealed that the employee's poor health is caused by a workplace conflict or inappropriate behaviour.
• If the situation requires communicating with the work community, ask the employee what they wish to be told. For example, you cannot tell the work community about the employee's health against the employee's wishes.
• Write down what you have agreed on.
• Arrange a follow-up meeting to see if what was agreed helped and how to proceed.

• It is possible that, as a result of the discussion or otherwise, there is an impression that the employee's situation may be caused by a mental health issue, such as depression or job burnout caused by prolonged stress.
• Concerns about health status can be raised, but suggesting diagnoses is not part of the role or expertise of the supervisor. You can talk about your observations with everyday words, such as coping and focus. You can tell them that you have noticed a change.
• The supervisor may ask the occupational health care service provider for an assessment of the employee's work ability. As a supervisor, you can suggest that the employee make an appointment with the occupational health care service provider. You can also contact the occupational health care service provider together with the employee.
• If the employee's work ability has decreased, the situation can be considered in an occupational health negotiation with the occupational health care service provider.
• The aim of the negotiation may be, for example, to agree on ways of modifying or tailoring the work. The subject of discussion is the employee's work, not their illness.
• If the employee thinks that the work has caused them symptoms, they may also request an estimate of their workload from the occupational health care service provider.
• If the employee has been diagnosed with a mental health disorder and they tell you about it in the discussion, you can ask how the illness affects the employee's work from their point of view and what kind of work arrangements could help.
• The occupational health care service provider can only disclose matters related to the employee's health with the employee's consent or wish. The employee should discuss with the occupational health care service provider what they wish to be told to the supervisor. It is a good idea to highlight the reasons why changes are needed, for example, in work duties or working time.
• In addition to possible illness, the employee's work ability is affected by, for example, the employee's resources and skills and the workplace’s means of providing support and making work arrangements.

• It is sometimes difficult to move forward in a discussion. For example, the employee may say that everything is fine, but the supervisor clearly sees work-related problems.
• You can try to advance the discussion by asking about various specific work-related issues, such as working with colleagues, work-life balance and related practical arrangements, workload and other work-related issues and the impact of health on work.
• You can set a period to monitor the progress of work. Define together the issues to be monitored, the indicators of success and the means of monitoring. Make a memo of every conversation. The employee can invite a colleague or occupational safety representative, for example, to participate in the discussion and the employee or supervisor can also invite an HR representative.
• Sometimes, raising an issue can provoke a defensive response. Taking a time-out and arranging a new discussion may be necessary to give the employee time to think about things. For example, the idea of a possible illness may be difficult. The employee may need time to adapt to the idea.
• The employee is obligated to participate in legitimate medical examinations ordered by the employer. The employer has the right to request a work ability assessment.
• The situation is investigated at the workplace as far as possible while taking into account the employee's resources, the supervisor's skills and the Act on the Protection of Privacy in Working Life (759/2004), which governs the processing of health data at workplaces.
• If the employee refuses to co-operate in any way but there are clear problems in the way the work or workplace practices are carried out, the supervisor may remind the employee of the rules of the workplace. The ultimate means available are issuing a notice or a warning.
• Remember that, as a supervisor, you have the responsibility for the operations of your unit. This gives you the right and obligates you to deal with things that are not going well.