Resolving long-term absence: the need for a correct diagnosis

It sounds painfully obvious: you can only resolve a long-term health issue with a correct diagnosis. Yet we’ve found that in almost half of the long-term absence cases we take on, the reported condition was far from being the full story. Only once these were properly understood could the issues be resolved.

There’s nothing usual about the way health issues are either diagnosed or self-diagnosed. We look at the symptoms, find the most likely cause and then treat it. Mostly, this works. Conditions such as a torn muscle, broken bone or even a chronic chest illness aren’t a challenge to diagnose and are generally straightforward to fix. But for long-term health issues, especially when involving mental health, things are more complicated.

When people are referred to us by their employer (or the employer’s insurance company) we’ve found a significant gap between what was diagnosed and what is going on. An analysis of case referrals to MorganAsh shows that, in 47% of cases, the original reported condition was not the full story – and in 11% of cases, treatments were changed once there was a proper understanding of the actual issues.

This is a huge disconnect. But why? Too often, all the underlying causes of health issues aren’t fully understood before treatments (such as counselling and physiotherapy) are recommended. This is particularly true of cases that involve mental health issues in the workplace, which themselves are almost always the result of a combination of factors.

There is a real need for those who suffer from something which keeps them off work for extended periods to talk to someone who can properly understand their whole situation. Someone who can assess it holistically; thoroughly.

It takes time and expertise to understand all of a person’s well-being issues – regardless of their causes. That person needs to not be limited by employment law or commercial considerations. The approach should be to use the accepted biopsychosocial approach (where a person’s medical condition isn’t just because of biological factors, but also psychological and social factors) and combine this with an understanding of any workplace issues.

We find that seldom are long-term absence issues driven by a single, easy-to-identify thing. A physical condition can lead to anxiety. An ill fit in the workplace can result in depression, which then manifests as physical symptoms. We’re not clear-cut entities. Our personal and family lives affect our work lives, whether we like it or not – and vice versa.

Without any criticism intended, many of those who suffer from long-term absence slip through the net. This can be due to too quick a diagnosis, or not enough digging for underlying issues, a desire for a quick fix – whatever.

While there is certainly a place for online support, and apps to help with mental health, they assume that employees can self-diagnose their condition. The next line of defence assumes that HR people and mental health first-aiders can recommend treatments from EAPs – which is problematic at the least, as this pretty much skips the diagnosis stage. Even when there is a diagnosis, there may not have been enough time to delve into what’s really the problem.

If almost half of cases don’t have the full diagnosis, it’s no wonder that absence becomes long term.

Read our full report

We have a full report available of our findings. If any of these comments resonate with you and you would like to find out more, please download the full report.