The document discusses examining an employee's mental fitness for work. It introduces Elizabeth, an employee who has been struggling with her work. It then discusses how fitness for work assessments are often requested after incidents that impact work performance or safety. The document also examines what factors are considered in a fitness for work assessment, including job demands and an employee's physical and mental capacities. It raises questions about who should conduct the assessment and what the assessment should determine.

1. Examining mental fitness for
work: Unfit or safe for duty?
Frank O’Connor
1

2. Meet Elizabeth
o A few years of experience
o Hasn’t been handling ordinary
work very well
o That’s every day here – our
work won’t wait
o She needs comforting when
things go badly for customers
o Bursts into tears but Doc says
she’s just stressed and tired
o Sometimes she needs hours
before she’s ready to work
o She says she’s all right
Is she safe to work?
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p2 of 19.

3. Most often requested
o After employment has been
offered
o As a condition of a transfer
or promotion
o After an incident involving
reduced work performance
or lapse of safety
o After or during an illness
o Following an injury
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p3 of 19.

4. There may have been a change
… to conditions in either or
both of workplace and the
employee’s health
o The change may be expected
to be temporary or enduring
o Reassessment may be needed
if conditions change further
o Satisfactory performance:
working safely and consistently
to the standard expected
without undue impact on others
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p4 of 19.

5. Falling mental capacity matters
o In high-stakes workplaces,
even with well-formed
safety practices, a loss of
mental capacity increases
risk and is often concealed
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p5 of 19.

6. Changing working conditions?
Significant change in
o Work processes or tools
o Place or layout of work
o Techniques and skills
o Demands made of worker
o Transfer to another location
o Changes at present location
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p6 of 19.

7. Changed employee personal
health conditions?
o … which may be made
worse by the work
o … which limit, reduce or
prevent satisfactory job
performance
o … make it unsafe to do the
job without undue risk to
self
others
public
Weakness while
recovering after injury
Light duties at work while
getting over serious illness
Tendinitis that limits reach
and carrying capacity
Loss of ability to recall
names and numbers
Ear infection affecting
balance in a scaffolder
Deficient colour vision in
an electrician
Extra physical exertion on
an existing heart disorder
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p7 of 19.

8. What’s “Mentally Fit for Work”?
If capacity for work is free
from interference from
o Alcohol or drugs (legal or ?)
o Insufficient rest and sleep
o Distractions in state of mind
= Mentally fit for work
Is safe this simple?
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p8 of 19.

9. Mental Safety at Work?
o Even where the stakes
aren’t so obviously high,
people still have to work
safely, whatever else is
going on in their lives
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p9 of 19.

10. “Fitness For Work” Assessment?
o when an employer wants to
be sure an employee can
safely and reliably perform
a specific job or task under
specified working
conditions, without undue
hazard to self or others
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p10 of 19.

11. Assess what?
Work details
o Job outputs and inputs
o Working conditions
o Demands made on worker
Job descriptions often not enough
Worker details
o Experience and training
o Performance record
o Concerns noted
Supervisor reports often poor
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p11 of 19.

12. How is the assessment done?
The assessor may
consider capacities:
o Physical or mental abilities
o Past and present conditions
o Sensory acuity
o Level of skill
o Functional limitations
Often assumes a “medical” issue
Physically FFW ≠ mentally FFW
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p12 of 19.

13. Questions of fitness for work
A suitable assessor?
GP for aggressive outbursts?
Psychologist for skin allergy?
Assessor matched to purpose?
Qualified in whose view?
A differential diagnosis?
Some job analysis?
A GP may do neither
An occupational health
physician may do both
How does good enough look?
Who gets to decide?
What’s the problem
anyway?
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p13 of 19.

14. What is my concern?
o Describe your concern
Is the person able to
understand?
o Describe why you are
concerned
Is the person willing to
cooperate?
What will you say?
o What do you need to
know?
No more, no less
Balance safety with privacy
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p14 of 19.

15. What might a mental safety
inspection look like?
What does it find?
o Limited reporting
“Fit for the work” or
“Unfit for the work” or
“Fit, subject to work
modifications” (specified)
o Limited validity
Period before reassessment
Reasons for reassessment
Conditions in or excluded
Sources used/consulted
What does it not find?
Fault or liability
Prognosis in detail
Treatment
…
o May not find (or need)
Causes or precursors
Diagnosis
…
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p15 of 19.

16. Decision Support Process
Notice change
o Review with others
o Plan when we’ll check
Assess concern
o What does ‘risky’ look like?
o One of those conversations?
Respond to improve
o Give and get help
o A rest? A change? A break?
o Action planning
o Monitor – how does it look?
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p16 of 19.

17. Unable or Unwilling to Cooperate?
Does the person
o want to change the situation?
o have the skills and knowledge
to address the issue?
o have the energy or motivation
to address the problem?
What problem does the
behaviour cause for the
organisation or for the
employee?
o Is this clear to the employee?
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p17 of 19.

18. Why does concealment happen?
Why don’t people ask for
help?
o Self-disclosure has
advantages and risks
o Disclosure may be narrow
or broad – it depends
People seek help for
others much more
readily than for
themselves
How does a safety culture
practice affect the state
of minds on the job?
o What goes wrong most
often?
o Which laws apply?
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O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p19 of 19.