Why early intervention fails 30/06/10

John Gilman and Phil Friend share their thoughts on early intervention and why it is not always successful

There cannot be an HR Director in the UK who has not had brought to their attention the fact that 'early intervention' can play an important role in returning employees to work in certain cases of sickness absence or disability. Similarly, legions of line managers have been made aware of the importance of managing absence and the processes that need to be adopted in order to do this.
Despite all these well-intentioned initiatives, however, in our work with employers and employees we still consistently come across situations where employees with disabilities are either wrongly languishing at home on long term absence or unhappy and less productive at work. So why is this?

Reasons can be complex, but fall broadly into a number of categories which often overlap. We have set out a few of them below:
Collaboration and support versus intervention: Mental health problems frequently feature in reasons for absence, both short and long term. Attitudes to people who have these conditions vary widely - from sympathy and understanding to outright cynicism or fear. In many cases, no one can be absolutely sure (including the employee) what the best route back to work will be. It may be a long journey with decisions taken on a daily basis. Unfortunately line managers are frequently poorly equipped to take responsibility for this and their attempts at 'early intervention' are clumsy and sometimes damaging (asking an employee with a mental health condition to visit the office to discuss their condition is often a bad idea and can make matters worse, sadly we know of many instances where it has happened).  Our advice?  Stop making line managers responsible for things they are incapable of dealing with effectively. Get the right people involved and wherever possible, make sure the employee feels they have some control of their own situation. And while that is happening, take time to establish what the line manager's attitude is to those with mental health conditions- this will be fundamental to making a return to work possible.

The effectiveness of 'policies' or 'guidelines' is not monitored properly:  Merely tracking a few metrics (for example the frequency and duration of sickness absence) doesn't always reveal what is really happening on a day-to-day basis. For example, earlier this year we carried out a research project for a client with 3,000 employees. The employer had invested huge sums in management time, training, policy drafting and assistive technology in order to ensure that they treated all employees fairly, consistently and legally. Yet one of our research findings was that over 72% of assistive technology users felt isolated, harassed and discriminated against - a significant exposure to subsequent long term absence and to litigation. But because they were still turning up for work the usual absence management 'triggers' were not activated.

The system can work against you: Whilst working for a financial services client, we discovered an employee who needed a specially adapted chair because of a back injury. He was still not back at work five months later because ‘Office Services only order new furniture every six months so we can get a bulk discount’.

Culture and management protocols play a major role in whether early intervention will work: Everyone knows that, we hear you say! When we talk about cultural barriers in getting people back to work people often have a stereotypical view of some monster employer where everyone works long hours, targets are ruthlessly pursued and the organisation 'doesn't carry passengers'. But in reality barriers can exist for a variety of reasons. For example, for another one of our clients, there was a problem with the performance appraisal system. It did not take into account situations where poor performance was directly related to IT shortcomings - so line managers were faced with a dilemma. Give the disabled person a higher rating in order to be fair to them (and make other employees resentful) or give them a lower rating (and make them feel unfairly treated). There were no clear guidelines as to which approach to take.

There are, of course, organisations where performance is critical and tough management attitudes are part of the culture. Long term absence and the development of mental health problems can be linked to issues related to a person's performance and this needs to be established if any form of return to work is likely. One thing we also know (but don't have empirical evidence to prove) is that someone is more likely to return to work if their manager likes them!

Working with dozens of employers, we have learnt much over the last 20 years about what works and what does not – so let us know if we can be of any help to you, your colleagues or your clients. We would also welcome any comments you have concerning this article so do feel free to drop us a line.

phil.friend@radar.org.uk
john@prioryhouse.eu
Phil Friend is Chair of the Royal Association for Disability Rights (RADAR) and John Gillman is one of their Board Directors.

Frank Fletcher 07855 946538 frank@onbeam.com
Phil Friend 07774 944246 phil@onbeam.com
John Gillman  07930 274349 john@onbeam.com
Karin Lloyd 02084 080478 karin@onbeam.com