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Are you ever "ready" to return to work after being off sick due to your mental health?

I read a fascinating study today about the lack of recognition of difficulties in interpersonal relationships and the impact this has on people returning to work (Nilsen et al 2023).

When referring to "subjective health complaints", the paper defined these as:

"...characterised by symptoms with no clear biological markers, and where medical investigation offers few objective findings. The main groups of subjective health complaints – musculoskeletal and mental disorders – are the cause of the majority of both sick leave cases and sick leave days in Norway.

One of the gems for me was around the idea many of us hold that, if your absence is related to a "subjective health complaint", that a reduction in your symptoms would be required and adequate to signal that returning to work was timely and possible. However, the paper referred to recent studies that indicated that symptom reduction was only a minor positive indicator for a successful return to work and particularly with mental ill health, symptoms usually don't often reduce until after someone has returned to work.

Dog depressed work off-sick

Perhaps, given my interest in Cognitive Analytic Therapy, it shouldn't have surprised me to read this, as we don't focus on symptoms within the therapy. But as a Manager, I have almost certainly paid too much attention to whether someones symptoms had reduced before they returned to work.

So if we are focussing too much on the presence and eradication of symptoms, in order to support staff return to work, what are we perhaps missing instead?

The presence of good social relationships in work is actually a really strong indicator for successful returns and arguably, recovery from mental ill health in general. Being able to feel close with colleagues and engaged in meaningful activities are after all, positive steps that you can take to improve your mental health.

Of course you can't apply this hastily to all situations, some nuance is required, particularly if work itself is the cause of the ill health. But it seems that there is more of a subtle balance between the presence and number of symptoms and at which point returning to work is actually more helpful in someones recovery. These studies would argue that it is certainly not when the symptom count is at zero.

When staff feel that they are valued and that their colleagues are supportive, they are more likely to return to work with positive outcomes and sustained improvements in their health. How we proactively encourage and foster positive working social relationships in our offices can't be overstated.

Maybe asking "what can we do to help you manage coming back to work" is a better question than "are you feeling better and ready to come back to work?"


Are you interested to learn more about your own relational traits when it comes to your work and the relationships you have with your colleagues, team or boss?

If so, get in touch with us at and ask us about our new pilot for Professional Reformulation we are beginning in October 2023.


Nilsen, D.A., Nissen, O., Nordfjærn, T. et al. Who Returns to work? Exploring the Role of Interpersonal Problems in Occupational Rehabilitation. J Occup Rehabil (2023).

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