Workplace mental health assessment (Occupational mental health assessment (fitness for work))
An assessment, usually by an occupational health professional, of how your mental health affects your work — to advise on fitness for work, adjustments and support, with your consent over any report.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It assesses how your mental health and work affect each other, and advises on fitness for work, adjustments and support.
- It is supportive, not a test to catch you out — the aim is helping you stay in or return to work well.
- What you share is confidential; a report is normally only sent to your employer with your consent, and you can usually see it first and ask for changes.
- The occupational health professional advises only — your employer makes the work decisions, and your diagnosis and treatment stay with your own clinicians.
- If work stress ever tips into thoughts of suicide or self-harm: if you are at immediate risk call 999 or go to A&E anywhere in the UK; otherwise call Samaritans on 116 123, or in England, Scotland or Wales call 111 and choose the mental health option — in Northern Ireland call Lifeline on 0808 808 8000 — or text SHOUT to 85258.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your psychiatrist will give you advice for your situation.
Practical advice on staying in or returning to work safely
If you are acutely unwell or in crisis, you need clinical care first, not a work-focused assessment.
You take part in the conversation and can ask questions. You should be told about consent and confidentiality before you start.
Clear, impartial, practical advice with realistic timescales
You take part in the conversation and can ask questions. You should be told about consent and confidentiality...
In Great Britain you can usually ask to see the report before it is sent to your employer and request factual...
Your employer considers the advice and discusses next steps with you, such as adjustments or a phased return.
Agreed adjustments and support are put in place; sometimes a follow-up OH review checks how things are going.
What is a workplace mental health assessment?
A workplace mental health assessment looks at how your mental health and your job affect each other. It is usually carried out by an occupational health (OH) professional — an OH nurse or doctor, sometimes a psychiatrist or psychologist — often after a referral from your employer because of sickness absence, a difficulty at work, or to plan a return to work.
Its purpose is practical and supportive: to advise on whether and how you can do your job safely, what adjustments might help (for example changes to hours, duties or environment), and what support or treatment might be useful. It is about helping you stay in or return to work well, not catching you out.
An important feature is independence and consent. The OH professional gives impartial advice; they are not simply there to do what your employer wants. What you tell them about your health is confidential, and an OH report is normally only shared with your employer with your consent — and in Great Britain you usually have the right to see the report first and ask for changes before it is sent. The report contains advice about work, not all your medical details.
It also has limits: the OH professional advises, but decisions about your job — and about adjustments — are ultimately your employer's, within the law. Diagnosis and treatment of any mental health condition usually stay with your GP, an NHS talking therapies service (in England this is called NHS Talking Therapies and often lets you refer yourself; Scotland, Wales and Northern Ireland have their own psychological therapy services with different names and referral routes) or a specialist.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Management referral
Requested by your employer, with your knowledge, to get advice on your health in relation to work, fitness for duties, and adjustments. The most common type.
Self-referral
Where you can ask to see occupational health yourself, if your workplace offers this, for confidential advice and support.
Return-to-work assessment
Focused on planning a safe, sustainable return after sickness absence, often including phased return and adjustments.
Fitness-for-work / capability assessment
Advises on whether you can do your role, with or without adjustments, sometimes where capability or ill-health retirement is being considered.
Preparing for your test
- Find out who has referred you and why, and what questions the assessment is meant to answer.
- Understand that the occupational health professional is independent and there to give impartial advice, not just to follow your employer's wishes.
- Think about how your work affects your health and how your health affects your work, including what would help.
- Bring a list of medicines and details of any treatment or support you are receiving.
- Note any adjustments that have helped before, or that you think might help now.
- Remember you can usually ask to see any report before it goes to your employer and request changes if something is inaccurate.
- You can ask about confidentiality and consent at the start, and what will and will not be shared.
What happens
The OH professional explains who referred you, the purpose of the assessment, what will happen to any report, and the limits of confidentiality. They then ask about your health, how it affects your work and daily life, your job and its demands, and what support or adjustments might help. With significant mental health difficulties, they may ask about mood, sleep, stress, and safety.
The assessment is usually a conversation lasting around 45–60 minutes, in person, by phone or by video. It is advisory and supportive, not an interrogation, and you can ask questions throughout. With your consent, the OH professional may, where helpful, ask your permission to contact your GP or specialist for further information.
Afterwards, the OH professional usually writes a report for your employer. This contains practical advice — for example whether you are fit for work, any recommended adjustments, a likely timescale, and whether the Equality Act may be relevant — rather than your full medical details. In Great Britain you normally have the right to see this report before it is sent and to ask for factual corrections.
The OH professional advises; your employer then decides what to do, within their legal duties. Any treatment you need continues through your own clinicians.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- If you are acutely unwell or in crisis, you need clinical care first, not a work-focused assessment.
- An OH assessment is not a substitute for diagnosis or treatment of a mental health condition, which stays with your own clinicians.
- It is not the route to resolve a workplace dispute by itself; HR, your union or Acas may be needed.
- It cannot make decisions about your job; it only advises.
Delay or rearrange if…
- You are acutely unwell or in crisis — seek clinical help first (999 or A&E if at immediate risk anywhere in the UK; otherwise call Samaritans on 116 123, or in England, Scotland or Wales call 111 and choose the mental health option; in Northern Ireland call Lifeline on 0808 808 8000).
- You do not understand why you have been referred or what will be shared; clarify consent and purpose first.
- Key information from your GP or specialist is needed but not yet available.
- You feel too unwell to take part fairly; a short delay may give a more accurate picture.
Alternatives to discuss
- Your GP and your local NHS talking therapies service for assessment and treatment (in England this is NHS Talking Therapies, which usually allows self-referral; Scotland, Wales and Northern Ireland have their own services and referral routes)
- A specialist (psychiatrist or psychologist) where more detailed assessment is needed
- Workplace support such as an Employee Assistance Programme
- HR, trade union or Acas advice for workplace issues and rights
- Self-help and support organisations such as Mind for information and support
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Practical advice on staying in or returning to work safely
- Recommendations for adjustments that can make work manageable
- An independent, impartial view that considers both you and the job
- Help your employer understand what support you need, with your consent
- Signposting to treatment and support, such as an NHS talking therapies service or an EAP
- A clearer, planned route back to work after absence
Risks & complications
- Talking about mental health and work can feel stressful or exposing
- Worry about what your employer will be told (though a report needs your consent and you can usually see it first)
- The advice may not be what you, or your employer, hoped for
- Feeling the assessment did not fully capture your situation; you can comment on the report
- Concern about how adjustments will be received at work
- Uncertainty about your job if capability or ill-health retirement is being considered
- Rarely, an assessment that is rushed or not properly independent can give advice that does not reflect your situation; you can question it and seek advice from your union, HR or sources such as Acas.
The key safeguards are independence, consent and accuracy. Occupational health advice should be impartial, the report should normally only go to your employer with your consent, and in Great Britain you usually have the right to see it first and ask for factual corrections. The main pitfalls are confusion about confidentiality, feeling pressured, or a report that contains more detail than needed. Remember the OH professional advises only — they do not decide your job, and your diagnosis and treatment remain with your own clinicians.
Published figures to discuss
There are no meaningful 'success rates' for an occupational health assessment; its value is in clear, impartial, accurate advice and a workable plan. Outcomes depend on the individual situation, the workplace and whether adjustments are put in place. Returning to work and staying well vary widely between people, so honest, individual advice matters more than any figure.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Confidentiality misunderstanding | Common medico-occupational pitfall | The patient should know who requested the report, what will be shared and what consent means. | Guide sourcesClinical context |
| Fitness-for-work uncertainty | Common | Capacity for work is task-specific and may depend on adjustments, hours, travel, risk and support. | HSE — work-related stress and mental healthhse.gov.ukSource-linked context |
| Workplace factors missed | Recognised | Bullying, workload, trauma exposure, shift work and discrimination can maintain symptoms. | Guide sourcesClinical context |
| Risk to self, patients, public or colleagues | Clinically important in some roles | Safety-critical work needs explicit risk assessment and clear recommendations. | HSE — work-related stress and mental healthhse.gov.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery. 'Afterwards' is about the report and advice, the conversation with your employer, and putting any agreed adjustments and support in place.
- Feeling a little drained or anxious after discussing health and work
- Waiting a short time for the report and your employer's response
- Some back-and-forth while adjustments are agreed and arranged
- Mixed feelings if the advice differs from what you expected
Aftercare
- Read the report carefully and raise any factual errors before it is sent, where you have that right.
- Discuss the recommended adjustments and support with your employer.
- Keep up any treatment or support through your GP, an NHS talking therapies service or a specialist.
- Use workplace support such as an Employee Assistance Programme if available.
- Note what helps and what does not, so adjustments can be reviewed.
- Seek advice from your union, HR or Acas if you are unsure about your rights at work.
- Look after your wellbeing, as the process and returning to work can be stressful.
- Clarity on the referral reason and the questions being answered
- A chance to see and comment on the report (where you have that right)
- Recommended adjustments noted, to discuss with your employer
- Ongoing treatment and support in place with your own clinicians
- Workplace support (such as an EAP) details to hand
- Sources of advice known: union, HR, Acas
⚠ Get urgent help if…
- Mood dropping significantly, or feeling hopeless, around the assessment or return to work
- Any thoughts of suicide or self-harm — if at immediate risk call 999 or go to A&E anywhere in the UK; for support call Samaritans on 116 123, or in England, Scotland or Wales call 111 and choose the mental health option (in Northern Ireland call Lifeline on 0808 808 8000), or text SHOUT to 85258
- Feeling pressured to return before you are ready, or unsafe at work
- A report being shared without your consent, or containing inaccurate information
- An assessment that does not feel impartial or independent
- Work stress worsening your mental health despite raising it
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your psychiatrist gives you.
Results & realistic expectations
A good assessment results in clear, practical, impartial advice: whether you are fit for work, what adjustments would help, a realistic timescale, and what support might be useful. It should help both you and your employer find a workable, healthy way forward.
The report gives advice, not decisions. Your employer decides what to do within their legal duties, and the OH professional does not diagnose or treat your mental health condition — that stays with your own clinicians. The aim is a fair, supported plan, not a verdict on you.
Advice reflects your situation at the time of the assessment and may need updating as your health or your work changes. A follow-up OH review is common to check how adjustments are working. If circumstances change, or the plan is not working, a further assessment can be arranged.
Related tests, treatments or support
A workplace assessment works best alongside your own mental health care — for example treatment from your GP, an NHS talking therapies service or a specialist — and any workplace support such as an Employee Assistance Programme. It may also sit alongside HR processes and, where relevant, the protections of the Equality Act 2010.
Follow-up & long-term care
After the report, your employer should discuss the recommendations with you and agree next steps. A follow-up occupational health review is often arranged to check progress with a return to work or adjustments. Keep your own clinical follow-up going in parallel, and seek advice if you are unsure about your rights.
- Keep up treatment and support with your own clinicians
- Review adjustments with your employer to check they are working
- Use workplace support such as an EAP where available
- Raise concerns early if work is affecting your health
- Arrange a follow-up OH review if your situation changes
Repeat, follow-on and what comes next
- Advice may need updating as your health or your work changes.
- A follow-up review is common to check how adjustments are working.
- If a plan is not working, a further assessment can be arranged.
- You can comment on a report and ask for factual corrections before it is sent (in Great Britain).
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear, impartial, practical advice with realistic timescales
- Transparency about consent and what is shared with your employer
- A chance to see and correct the report before it goes (where you have that right)
- A follow-up review to check adjustments are working
- Signposting to your own clinical care and to workplace and rights support
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the assessment is by an OH nurse, OH physician, or a psychiatrist/psychologist
- The length and complexity of the assessment
- Whether reports from your GP or specialist need to be obtained
- Format: in person, by phone or by video
- Whether follow-up reviews are included
- The detail and type of report required
- Who carries out the assessment and their qualifications
- What the report will cover and who will receive it
- Confirmation of your consent rights and chance to see the report first
- Whether follow-up reviews are included
- What happens, and what it costs, if further information or reports are needed
- How confidentiality is handled and what is and is not shared
On the NHS? Workplace mental health assessments are usually arranged and funded by your employer through occupational health rather than the NHS; your own NHS treatment and support, such as your GP and your local NHS psychological therapy service, continue separately and free. These talking therapy services are called NHS Talking Therapies in England, where you can often refer yourself, but the service names, who can use them and how you get referred are different in Scotland, Wales and Northern Ireland.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining who will see the report, or sending it without your consent
- Not telling you that you can usually see and comment on the report first
- Confusion about the limits of confidentiality between you, OH and your employer
- A report containing more clinical detail than needed for work advice
- Feeling pressured to agree to something you do not understand
Marketing red flags
- An OH service implying it can decide your job, rather than advise
- Reports shared with employers without proper consent
- Suggesting OH replaces your own diagnosis and treatment
- Vague answers about independence, confidentiality or consent
- Pressure to return to work regardless of how you are
Choosing a specialist safely
- Check the psychiatrist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good psychiatrist will welcome every one of these.
- Why have I been referred, and what questions will the assessment answer?
- What will be in the report, who will see it, and can I see it first?
- What are the limits of confidentiality and how is my consent handled?
- What adjustments might help me, and how will they be reviewed?
- How does this fit with my own treatment and my GP?
- Where can I get advice about my rights at work if I need it?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the psychiatrist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will my employer be told everything I say?
Is occupational health on my side or my employer's?
Can occupational health decide whether I keep my job?
Do I have to attend?
Will they diagnose or treat me?
Who pays for it?
Find a verified psychiatrist for workplace mental health assessment
Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.
No verified consultants list this procedure yet — browse the full directory.
How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Society of Occupational Medicine — return-to-work guidance Acas — supporting mental health at work HSE — work-related stress and mental health GOV.UK — Fit for Work guidance for employers Mind — mental health at work nidirect — urgent and emergency care services (NI) nidirect — GP out-of-hours service (NI) NHS England — 111 mental-health crisis support NHS inform — urgent mental health help (Scotland) NHS 111 Wales — mental health and wellbeing nidirect — mental health emergency / Lifeline (NI) NHS — find NHS Talking Therapies (England) NHS inform — psychological therapies (Scotland) NHS 111 Wales — counselling nidirect — mental health care professionals (NI)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Return-to-work assessment · Stress and burnout management · Treatment for anxiety disorders · Depression assessment and treatment · Cognitive behavioural therapy (CBT) referral