to say don't go and get signed off with stress

[writingonthewall]

I see this all the time on MN

OP: there's been a death in the family, I'm doing fine but need time off work to organise the funeral/comfort DH. work will only give me 3 days compassionate leave, after that I have to take holiday or unpaid leave

everyone else: go to your GP and get signed off with stress.

before I get flamed, I am a GP and I fully understand that bereavement hits different people in different ways. I sometimes do sign people off work after a bereavement - if you can't stand up for crying, then you can't work. And whilst there is no hierarchy of grief, as a general rule losing a child is very very traumatic whilst losing a parent is something that you do expect to happen at some point. So no problems with signing certificates for genuine mental health problems post bereavement.

What I do object to is this "get signed off with stress" when you aren't ill.

Do people not realise that, firstly, you are asking the GP to commit fraud. Secondly general practice is buckling. We are under resourced (all practices in one area I know are about to lose 20-25% of their funding) and even if we had the money, there are no GPs to recruit. And it's going to get worse if the new juniors contract doesn't get sorted out.

Every appointment taken up with a medicalisation of normal life, is an appointment that someone who is ill can't have and a potential delay in the diagnosis of someone else's cancer or other serious condition.

so please. see your GP if you are ill - physically or mentally. But think before you do and don't involve us in your battles with your employer and your general normal life events. Being sad after a bereavement is normal. The treatment is to talk about the person you have lost, cry a bit, and take care of yourself. It isn't to rush to the doctor for a medical cure.

I am with you OP

a family member once complained bitterly to me that her GP had been unsympathetic and not signed her off 'for stress' during a family members last few weeks of life

She had been sent to get a sick note by her boss, who otherwise would not authorise the leave, and to her great credit was truthful with the GP explaining that she was upset and needed some time off to act as a carer, but had no illness symptoms, etc

the GP refused to sign her off and explained it wasn't an appropriate use of the system -and so has become the bad guy in the situation
the fact was, the person that should have sorted things for her was her boss, who could have authorised compassionate leave directly, which her contract allows for and the situation warranted - it would have been an HR issue and needed no GP involvement

and instead my relative wasted her time, the GPs appointment and damaged the rapport, trust and good relationship she had previously had with her GP, meaning she is less likely to seek help from him for medical issues in the future

Her boss meanwhile, oozed sympathy and said all the right things, while not actually acting in her interests or organising the leave she was requesting

Lalala I'd argue in that case your employer should need to give you some paid time off. I don't think you should get a sick note when you're not sick because they won't. Does thay make sense?

It does stealth, but it's not going to happen with some businesses. So I suppose there's also the long term effect to think of.

Option 1 - Get signed off by GP
Option 2 - Take unpaid leave, get into a financial mire causing stress and worry. Possibly end up being legitimately signed off by the GP.
Option 3 - Go back to work too soon. End up in a state. Probably end up being legitimately signed off by the GP.

Maybe sometimes the GP signing off before the extra issues happen may be more cost effective than not doing so?

Obviously like every situation there will be some people taking the piss, but for those who genuinely can't afford to take unpaid time off (either financially or because the company would just get rid of them) I do think that perhaps being signed off by the GP for a couple of weeks could prevent longer term issues.

YANBU OP.

I don't know how you can stay civil when people are obviously wasting your time. No wonder med students don't want to be GPs any more. (I would get the rage I think.)

I also hate it when people (on here) say "go see you GP" for all kinds of life problems eg relationship issues, normal stress, and/or feeling sad/tired.

A mental breakdown/mental illness is one thing. (A GP can probably do sthing for that.) But how exactly is a GP to know (in 5 min flat) if someone is just normally sad/tired, wanting a few more days off to rest/sort out the funeral arrangements ... or ill? (Cos who wouldn't like a few more days or a weeks off time off after a bereavement if it was a possibility?)

So I fear we will not have a free NHS for much longer, if people continue to use it so often, and to feel so entitled. Ditto jobs and benefits if we all demand for our jobs to be kept open long-term, and then take the mickey with having loads of time off.

The more of anything which becomes possible, (eg extended maternity/bereavement/sick leave), the more people will expect and demand it? So we will be told, "just ask, you are entitled", "everyone else does it/gets it", "you are a mug not to ask" etc.

But who will police this extra time off/say "no"? (Cos it must be hard for private employers? And in the public sector, just adds to the deficit?)

We are gradually losing the art of stoically carrying on through sickness and tragedy. And as most women now work, I feel we have lost the comfort of having someone "at home" to "care" for us. (Eg Have a meal ready/time to chat/run errands for us?) Not very PC to mention this, and I do feel bad to even think it, as I believe in gender equality. But it's something we have lost with fewer homemakers. (Of either sex.) And when things go wrong, we really struggle just to cover the basics due to lack of time? (Which is not to glorify the past which was shitty in other ways.)

It would be lovely if no-one had to go to work who didn't really feel like it and/or take time off whenever we needed to. But that's just not feasible.

So we will have to manage with the current bereavement rules/what employers can offer us in terms of any extra time off. (Or else quit the job then?) Cos we can't expect the right to time off when feeling sad, or cos we have too much on our plate?

I sometimes think a citizens income would be helpful, as maybe more of us could afford to quit. Or to take unpaid leave if the employer agrees, for whatever reason.

Taking unpaid leave (or hols) would be fairer than using sick leave, cos how are GPs able to judge who is "ill" .. or who is just struggling, like a lot of others who manage to carry on?

Of course, it's lovely to have any extra leave (paid or not paid) if you are an employee, but as a consumer, imagine if schools, shops and services closed on odd days, merely due to lack of staff? Or if all the GPs in your health centre were off sick on the same day you needed to see one? (Having signed each other off?)

Last time I went to my local surgery, the female GP looked a lot worse than I did. So I felt sorry for her and would have offered to sign her off. (I felt bad for even being there, as maybe she had been up all night with someone who was dying and I only had a bad case of eczema.)

I think a large driver of this is the misconceptions- not around bereavement or grief - but the nonsense mandated by HR departments (as seen in schools, too, where kids are not allowed to take time off unwell and parents have to get a medical certificate to prove it every time in some cases) - I think there should be a greater trust in self certification and every company should have a robust policy for bereavement and stress and any other reasons for time off that allows full flexibility and allows employee to self certify without raised eyebrows, tutting, emails from HR, coworkers bitching, and whatever else. I wonder what increasing mandatory self certification times would do to ease some of the pressure on GPs? there'd be a small perceptible impact I'm sure.

I was signed off by my GP when my Dad died. I had no other option as my bitch of a manager made my life hell - when he was taken to hospital she said I had to give her notice before I had time off, when I phoned her to tell her he'd died she said she she presumed I'd be in the next day as it would do me good. I wasn't allowed to take annual or unpaid leave but couldn't do my job (I had a stressful customer facing job at the time). She didn't offer to move me to another department (she could easily have swapped people around) so I didn't know what else to do apart from speak to my GP who offered to sign me off there and then.

One other thing is that sometimes other types of leave - such as taking annual or unpaid leave aren't available to you - especially in the type of work I've mainly done in schools and pre-schools which are term time based so, understandably in a way, taking leave outside the school hols is rarely possible.
Fortunately, for all our well-being, sick leave remains an option for those that need it, if a GP agrees that is in your best interests.

"I had one colleaugue take months off when her husband was diagnosed with cancer ( not terminal), another took months off to care for her partners dad when he became sick, another took months off when her daughter was assaulted by a violent partner. These people all took months of sick leave signed off by their GP with stress. I don't doubt they are stressed and that they need time off for a family crisis but where do you draw the line as to what is sick leave and what should be taken as unpaid leave? "

These situations merit leave subsidised by the NI system IMO, similar to maternity and parental leave.

A very common scenario is when a manager tries to manage an employees performance and the employee gets upset, so they get signed off with stress for weeks on end by the GP. I understand the GP is in a very difficult situation as the patients advocate, it is very difficult for them to deny a patient's wishes.

Often another tip of iceberg situation.

Almond - this is quite correct. And it's probably most appropriate, with someone presenting with "stress" to say "I'm signing you off for a week - come see me again, then." and to take the tie to ask about their emotional state and how they're coping with the practicalities (waiting in all day for someone to pick up a specialised bed that's not been needed for the past 4 days = not great, even for the most stoical of people.)

*whattodowiththepoo

UGH op is right, some people won't ever just suck it up and deal with it.
Life can suck, deal with it. Or you don't deserve life full of love and happiness.*

A lot of posts on this thread is an example of why there is such an issue with mental health and suicide in this country but this post is particularly disgusting.

I lost someone very close to me over two years ago, it was very sudden and traumatic. The trauma over events that followed the death were worse than the death. My one regret at the time is that I didn't go to the doctor and get signed off sick. I went back to work too soon and couldn't hold it together. One of the reasons I didn't go to my gp and ask for help was that I didn't want to appear weak and I was very aware of attitudes like this.

I 'sucked it up' but I've ever dealt with it in an appropriate way and I nearly expect a mental breakdown over it in the future.
As for not deserving a life full of happiness, my life will never be full of happiness anyway as I will carry it around until the day I die. I've learned to accept that.

If anyone is reading this thread and feeling the way I did two years ago I would urge them to ignore some of the nonsense spouted here and go to their Doctor. If that doctor is not sympathetic, though most will be, find one who is. There is no shame in asking for help, in fact it's the sensible and brave thing to do.

Agreed Fools - I would ask for compassionate leave. I blame Friday night tiredness and wine for blurry thinking.Like I say, I have supportive employers. If I didn't, sick leave might be the only option for some. It may not be right but there are just as many arse hole employers as there are lead-swinging employees.

I don't think the OP is arguing that anyone should just 'suck up' loosing a parent. The point is that usually the kind of leave required will be compassionate leave, not sick leave.

Compassionate leave should not require a note from a GP.

Rdoo
I 'sucked it up' but I've ever dealt with it in an appropriate way and I nearly expect a mental breakdown over it in the future.
As for not deserving a life full of happiness, my life will never be full of happiness anyway as I will carry it around until the day I die. I've learned to accept that.

Don't accept it and don't suck it up, be strong.
If you can't just be strong on your own getting help to be strong is also being strong, do what you have to do but don't be afraid to suffer and work hard to be happy.
Everyone deserves to be happy but not everything you deserve will be gift wrapped and delivered to you

There are lots of posts from here from people saying they went ot the go as otherwise leave (paid or otherwise in some cases, paid in some cases) wouldn't have been granted. Fine I suppose but by that logic you can't expect gps or the health system to like it. They are being expected the pick up the pieces of someone else's (your organisation) failing. They will complain and quite rightly.
I'm still thinking about the preventative argument. Again, if you have supportive employers they will set up conditions for you to work or not in such a way that it doesn't make you slip into mental illness. If not, your GP will race in like the cavalry and force the issue. They won't like it but I agree there is no choice.

I agree with you OP. It should not just be 'get a sick note'. I'm nearly 50 and I'm lucky never to have had a sicknote, though I wasn't best pleased when my gp told me to self cert for a week after a miscarriage. It doesn't mean you can't take leave or unpaid leave. I wish more GPs were a bit more discriminating. At worked there are a couple of professional sick-takers and I simply cannot believe the sicknotes GPs will give them. Some are way too liberal with sicknotes and some way too mean. No excuse for some of the managers' comments. Simply poor management skills.

kittybiscuits everyone is supposed to self cert for the first week of an illness-miscarriage or cancer. The only exception would be if the doctor thought there was absolutely no way you would be back to work after a week (which some people would be with a miscarriage, some, not all), and they wished to save themselves a follow up appt in a week, as it wasn't clinically necessary, then they could sign you off for as long as they thought you'd be ill.

So, asking you to self cert was correct. Not being unsympathetic to your miscarriage at all. You should self cert unless you will be off longer than a week.

Yes I know about self cert. What he said was 'self cert for a week then keep your chin up and get yourself back to work'.

Depends on your job. I speak to teachers all the time who have lost a child or a spouse and there is NO compassion leave in their schools (usually academies) or 3 days leave. 3 days isn't enough if you've lost your husband and you are caring for your children through this and you need to arrange a funeral etc.

I advise them to get signed off because you cannot go and stand in front of a bunch of teenagers 3 days after the death of someone so close to you and pretend everything is alright. 3 days, if you get that, is not enough to organise a funeral, let alone grieve. You simply cannot do all that and teach, plan, mark and assess. I've heard of teachers being threatened with capability a few weeks after the death of a spouse or parent.

So until the law recognises a right to bereavement leave then yabu

Fannyglum aS per my OP it is entirely likely that someone would be medically unfit to teach three days after the death of their spouse. I would have no hesitation in signing them off and made his clear in the OP.

what about a teacher who wanted to be signed off sick to have time to deal with the practicalities of their parents estate after an expected death, but was functioning fine? That's the sort of request that is inappropriate.

Maybe. But then a teacher physically wouldn't have any time to do that if they were teaching. It isn't right, but the way teaching is at the moment they wouldn't have the time to do it as well as teaching.

I agree with you in principle, but the way the world of work is set up means that people feel they have no choice.

I completely sympathise, but that doesn't help the person who can't get an appointment with me because they are taken up with my requests for sick notes for people who aren't ill. It's for the teacher to negotiate with the head and should be nothing to do with the NHS.

"It's for the teacher to negotiate with the head and should be nothing to do with the NHS."

And if the head (or any other boss) says no? What then?
Are relatives supposed to chuck their dead into rivers because they can't get time off to arrange a funeral?
Have a bit of compassion.

I was given a week's compassionate leave when my father died, and took a further two weeks annual leave to support my mother. It would not have occurred to me to take it as sick leave. I was sad, not sick.

Some parts of the public sector are tightening up on sick leave now - although in most places you can get 6 months on full pay (followed by 6 months on half pay), there are fairly strict procedures now in place to manage people out who take lots of sick leave. And being cynical, it's amazing how many people manage to come back to work just before their half pay starts. I have a friend who works as CEO for a large company. He said they won't employ anyone who has a record for having taken off large chunks of time with stress...

I just think you should be more generous spirited and understanding on this issue writing
You've just raised "what about a teacher who wanted to be signed off sick to have time to deal with the practicalities of their parents estate ..."
As we've all said everyone grieves differently, some people like to throw themselves into considerations of practical arrangements, and there is a lot to be done, which can certainly also lead to more stress for many.

As a PP said I feel there is a challenge here for you to give further consideration to the overlapping areas of bereavement, grief, stress, and mental health.
Also signing people off for a week with stress in these kind of circumstances - following a close personal bereavement - is hardly a biggie in the scheme of things. I don't fully understand why you are finding it to be so?
Yes, it would be better if employers were better on this - granting more adequate compassionate leave. And a national entitlement to bereavement leave seems an excellent proposal.

But meanwhile I think we have to accept that mental health, just like physical health, is affected by the stresses and strains of our lives, one of the greatest of which is bereavement.