Mental health in the workplace: the role of the family doctor

Work-related mental health problems are now the leading cause of long-term disability in Canada, ahead of chronic physical illness (Mental Health Commission of Canada, 2023). Yet many workers wait months before seeking help, either because they minimize what they're experiencing, or because they don't know that their doctor or specialized nurse practitioner can actually intervene in this type of situation.

The role of the healthcare professional does not end with the prescription of an antidepressant or a work stoppage. They often play a central role in assessing the situation, directing people to the appropriate resources and providing support throughout the recovery process.

What the doctor or IPS can do

Medical consultation for a work-related mental health problem begins with a comprehensive clinical assessment. The physician or PHI seeks to understand the nature and severity of symptoms, their duration, their impact on functioning and their link to the work context. This assessment leads to a diagnosis, whether of burn-out, adjustment disorder, depression or anxiety disorder.

The health professional may prescribe a work stoppage when the person's condition warrants it. In Quebec, the medical certificate of incapacity for work is the document that triggers salary insurance or CNESST benefits, depending on the context. This document specifies the duration of the work stoppage and, if applicable, any functional limitations.

The doctor can also prescribe medication if indicated, initiate or refer for psychotherapy, and coordinate with other professionals such as social workers, psychologists or occupational physicians as needed.

Stopping work: when and how

Time off work is not a universal solution, but is often necessary in cases of severe burn-out, major depression or adjustment disorder with depressed mood. Its duration depends on the severity of the condition, the nature of the work and the conditions to which the person will return. A break that is too short and does not allow for real recovery may delay recovery and increase the risk of relapse.

A gradual return to work, with reduced hours and adapted tasks at first, is recommended in most mental health cases. This gradual return allows tolerance to be tested and risk factors to be identified and addressed before a return to full-time work. The doctor or IPS plays a coordinating role in this process, liaising with the employer and insurer where necessary.

Resources available in Québec

In addition to medical follow-up, several resources are available to Quebec workers in difficulty. Employee assistance programs, where they exist within the company, offer rapid access to free psychological counselling sessions. CLSCs offer social work services and referrals to community resources. Professional associations, for those in regulated professions, often have support programs for their members.

The CNESST intervenes when the mental health problem is recognized as being linked to an occupational injury, which implies a specific assessment process. In this context, the attending physician is involved in the documentation and follow-up of the case.

Frequently asked questions about mental health in the workplace

Can an employer contest a work stoppage for mental health reasons?
The employer can request an independent medical assessment, but cannot refuse a doctor's prescription for time off work. Protection against dismissal due to illness is governed by law in Quebec. A doctor or specialized lawyer can inform you of your rights.

Can consulting for a mental health problem at work harm my career?
Medical confidentiality applies. The employer has no access to the diagnosis, only to information on the work incapacity and its duration. Early consultation reduces the risk of aggravation and prolongation of the stoppage, which is beneficial in the long term.

Is it possible to obtain a work stoppage by teleconsultation?
Yes, in most cases. The doctor or IPS can assess the situation by teleconsultation and issue an electronic certificate of incapacity to work.

When to consult a healthcare professional

If your mental state is affecting your ability to work, if you've been feeling exhausted for several weeks, or if you fear you won't be able to continue without help, you should seek medical advice without waiting for the situation to deteriorate further.

A physician or specialized nurse practitioner can assess your situation, help you with administrative procedures and direct you to the appropriate resources. A face-to-face or online consultation teleconsultation at one of our Omicron Clinic in Quebec gives you quick access.

Mental health: assessment and follow-up | Clinique Omicron