OP, I’ve had experience of this from two sides; my husband had a severe mental health crisis that saw him out of work for three months, then back for three months, then out for six weeks initially, and then hospitalized for six months before a phased return over three months. I’m also the HR manager of a large organisation where we regularly see people on extended leave due to mental health issues.
With my husband, he works in a very stressful industry and, like your husband, is very senior. Complete workaholic- doing ridiculous hours. He burnt out completely. We were terrified about what would happen to his job but his work were fantastic. They paid him throughout, supported him through a phased return, we’re understanding when he went off again, and then gave him paid time off for further appointments. It was such a huge relief.
However, I would have liked if he had resigned once he was in a better headspace. He’s been back at work for four years now and all is going well, but it’s still a very stressful job. He’s now better equipped to deal with it, thanks to all of the therapy.
In terms of my own job, and I can only speak for my company, we are very tolerant of people in genuine crisis. Once they’re engaging with us, occupational health, and their own doctors, our priority is doing everything we can to help them get well (eg, pay them in full, give them space). We have rarely gone down the capability route but it’s usually the employee who comes to the conclusion that they’re unable to continue. I would say that 90% of people who have been out for three months plus come back.
That said, we’re a very big organisation so not always comparable to smaller companies.
It’s a very tough time for you.
My advice would be to look at what your plan B is as a family and give your husband breathing space where he can decide for himself that working like this isn’t helpful by him and resigning would be beneficial for him. I know with mine, the stress of feeling he’d let me and our family down if he resigned caused even more stress. We agreed what alternatives we would look at (living on my income but seriously cutting back, downsizing for a smaller mortgage, him moving into a less senior role and taking a pay cut). I understand that’s not easy.
While I can’t say what his company will do, my advice to him would be to stay on top of things like fit notes, occupational health appointments etc.
As a couple, you do need to look at alternatives to your husband going back, or ideas for if his employers dismiss on capability.
Best of luck, it’s a shitty situation for you both.