6. How to support employees with symptoms or illness?

When an employee’s health affects their work, the supervisor can support the continuation of work with work organization and a solution-oriented and understanding attitude.

When examining the situation of an individual employee, it is important to identify the situation where work has contributed to the onset of the illness, for example, through excessive stress and burnout. In addition to solving the individual's situation, wider actions are needed at the workplace.

Workplace surveys on psychosocial stress factors carried out by the occupational health care service provider, personnel surveys and risk assessments provide additional information.

Supporting employees with symptoms or illness

As a transient experience, stress is completely natural, and as an occasional phenomenon, it can also give you energy to be creative and complete your tasks.
Job burnout is a prolonged experience of imbalance between work input and satisfaction received from it.
Symptoms of job burnout include chronic fatigue, psychological distancing from work and an experience of impaired cognitive and emotional control.
In accordance with current practices, job burnout is not classified as an illness, and it does not entitle you to Kela-compensated paid sickness absence. Workplaces may have different policies, so ensure that you know your local rules.
Job burnout can lead to illnesses, aggravation of an illness and even incapacity for work. Job burnout has been shown to cause abnormalities in how the brain functions. Job burnout can also occur at the same time as an illness classified as a mental health disorder or a physical illness.
Individual support for exhausted employees is not enough in the treatment of job burnout. Instead, a concrete change must be made in the factors that led to burnout. Recovery from job burnout usually requires changes in working conditions, the work itself and the activities and mindset of the employee.
Individual risk factors for job burnout include a strong commitment to work and a strong sense of duty.
The occupational health care service provider has the expertise to support an exhausted employee and their supervisor and to examine the characteristics of the work.

Mental health disorders include illnesses of varying seriousness that present problems in thinking, emotional life and behaviour. The most common work-related mental health disorders are depression and anxiety disorders.
The susceptibility to mental health disorders or psychological symptoms is affected by both genetic factors and events that take place during one’s own life time. Various life events can both improve and consume resources. Major life events are associated with an increased risk of mental health disorders.
Mental health disorders are diagnosed based on their symptoms. Diagnoses are, in a way, a matter of agreement – a diagnosis is made when a person has a certain number of symptoms that have been defined as the criteria for the diagnosis in the medical classification system in use at the time.
Symptoms associated with depression include a prolonged feeling of being depressed on a daily basis for most of the time, loss of interest and pleasure in things that have usually felt attractive or brought pleasure, reduced resources or exceptional tiredness.
Anxiety refers to a fearful or worried mood or restlessness and agitation and it is often associated with a variety of physical symptoms, such as palpitations or dizziness. Anxiety can be related to specific situations.

The so-called 30-60-90 rule defines the activities of the employee, occupational health care service provider and employer when the sickness absence continues for more than 30 days.
In addition, the workplace may have instructions on how to communicate during sick leave. This has been shown to be a good idea.
The visibility of instructions and discussing them is useful: the supervisor does not need to justify their actions separately.
Returning to work is facilitated by the fact that the workplace has an operational model of support for returning to work, which describes, for example, the workplace's practices of communication during sick leave and the available options for work arrangements.
The upper management's view and communication that returning to work is supported and everyone's work ability is considered valuable contributes to the success of the return.
The possibility of a gradual return to work improves the success of the return.
If possible, it is good to discuss the return to work already at the beginning of sick leave. The aim is to tell the employee that they are welcome back when their health allows this.
When a sick leave is prolonged, it is good practice to communicate by phone, for example. The theme of the discussion is how the employee is doing. At the same time, the supervisor can share news from the workplace. However, it is good to consider the perspective of the employee on sick leave: Avoid expressions that the employee may experience as being pressured toward a quick return to work. An employee may feel guilty, for example, if the supervisor tells them how difficult and busy it is at work.
Before returning to work, it is advisable to arrange an occupational health negotiation or otherwise discuss the return to work. The supervisor's questions to the person returning to work may include:

“How do you feel about going back to work?”

“Are you worried about something when you return?”

“Do you want me to tell the other employees about something?”

“As a supervisor, how can I best help you return?”
When the employee returns to the workplace after sick leave, welcome the employee and show that you are happy to have them back.

“Welcome back to work! It's great to have you back.”
Support the work according to the needs of both the work and the employee.

“We have already planned arrangements related to your work now that you are returning to work. Have you had a chance to think about this? How do the planned work tasks, workload and work organization affect you at the moment?”
Let the employee know that you are available.

Work arrangements refer to adapting the work according to the employee’s work ability. The employer and the employee may, for example, agree on working time arrangements, the tailoring of work tasks, changes in the work space or the support provided by another employee. The purpose of work arrangements is to support work ability and enable the continuation of work despite health-related restrictions.
When a mental health disorder affects work ability, ways to modify the work may include:
- reduction of working time
- a change in the employee’s job description or a reduced number of tasks
  
  division of work into smaller units with the help of a supervisor or a co-worker
- a partner's support or support person, an individual through which to communicate with the larger group
- a private room where you can close the door
- the possibility to practice social situations, such as attending a meeting, even if there are symptoms of tension or anxiety, for example
- extra breaks and the possibility to use relaxation methods
- the possibility to contact the support person during the day
- listening to music from headphones
- remote work
- creative solutions, such as the presence of a pet at the workplace.

View of an expert by experience: In work life with depression

I've had depression since I was in high school. By the age of 44, I have had experienced three periods of severe depression, during which I have been out of work life. However, a person is not the same as their diagnosis. I have earned two university degrees and have been in work life for twenty years. I have worked as a social worker, spokesperson and project planner and I have received a lot of positive feedback on my work.

Depression can remain hidden in the workplace. I believe that my depression has often not been noticed at all because I have done my job well. I have been an enthusiastic, committed and productive employee. I have been a colleague and a subordinate who always has a lot of ideas and some new project going on. I have also experienced joy and a deep sense of meaningfulness at work, which have given me a lot of energy in everyday life. However, depression has been a real experience at the same time.

Long-term depression is a persistent mild feeling of being dispirited. For me, it has been associated with chronic fatigue and a tendency to worry. The onset of severe depression has meant that the facade of coping and work ability have crumbled. Severe depression has been a free fall in the darkness. It has been a deep feeling of hopelessness and emptiness filled with the pain of the mind.

I believe that work can sometimes be one of the factors that trigger and prolong depression. For example, a poor atmosphere at work is a really consuming experience if it continues for a long time. The worst strain in my career has been inappropriate behaviour, which has eroded confidence in myself and others for a long time. The world of temporary employment relationships also brings its own challenges to coping. Recurring uncertainty about the continuation of work has occasionally led me to overdo it, as I have tried to show my added value to the employer over and over again.

Depression has taught me a lot both about myself and about work life. I have had to face the demands I set for myself and have learned internal flexibility. I have come to appreciate my own sensitivity, although for some, it is a sign of weakness. I have decided to speak openly about my experiences of depression because I want to eliminate the shameful stigma of mental health problems in work life.

Recurrent depression is not an obstacle to participation in work life. It is essential that the resource and stress factors of the work are balanced. Healthy work structures and practices are important for everyone and especially so for employees struggling with depression. In my experience, a low hierarchy, an open culture of discussion and opportunities to influence one's work are also the best ways to support mental health.

Minna Salonen Social Psychologist (Master of Social Sciences), expert by experience

6. How to support employees with symptoms or illness?

Supporting employees with symptoms or illness

View of an expert by experience: In work life with depression

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6. How to support employees with symptoms or illness?

Supporting employees with symptoms or illness

Job burnout

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View of an expert by experience: In work life with depression