This post focuses on the unconscious biases that hinder an employee’s return to work after illness or injury. It s the fifth and final post in this series for line managers who have a team member returning to work after a serious health issue, and are wondering how they can best support their employee. 

Rather than focus on HR policies and employment law, what I am sharing here are the subtle and often unseen aspects which can help the employee’s return to work or derail it. Knowing about them will enhance your ability to relate empathically with your employee and support them, which is a key ingredient for a working relationship built on trust. This in turn can enhance employee engagement and loyalty. The previous posts are here, here, here and here.

As part of supporting employees returning to work after illness or injury, one of the topics I’ve written about has been how not to say the wrong thing. I’m continuing this theme but from the perspective of how the biases and assumptions we hold around health, illness and disability can impact how we treat people.

Let’s review some of the unconscious biases that hinder an employee’s return to work

These are the messages we are surrounded by every day, which we absorb and can impact what we believe, assume, think, feel, do and say.

The aim is to deepen our awareness so we can make mindful choices regarding what we say and do when supporting a colleague returning to work after a serious health issue. Last week I shared two prevalent biases.

  1. Having had a serious illness or acquired a disability means you can no longer work
  2. For an illness/symptom to be valid, it must be visible.

This week, I’m sharing three more and offering an exercise to discover the unconscious biases around health, illness and disability you may hold.

illness biases

Illness biases in our society. Drawn by B Babcock 2017.

As you read each bias, consider what could be the result if someone acted on them when supporting an employee returning to work after a serious health issue.

Unconscious Bias 3 – When you are ill, you must look ill. You cannot look or feel well.

This bias relates to the invisibility bias mentioned above and says, ‘You must be sneezing, blowing your nose, have a limb in a cast, stay in bed, be in a wheelchair, whatever. You can’t laugh or smile if you are depressed. You must give me a visible sign that you are really are ill. Only then will I believe you.’

Many illnesses, symptoms, and conditions are invisible like Chronic Fatigue Syndrome, Myalgic Encephalomyelitis (M.E.), Transverse Myelitis, and Multiple Sclerosis to name a few. And these conditions can fluctuate. There may be periods when the symptoms are very bad, and then they reduce or even disappear for a time. You can have a long-term condition punctuated by periods of wellness. And when you are in a bad patch, you can still look well.

Consider what it is like for the employee who has an invisible illness or disability who sees their employees roll their eyes when they leave work early because of symptoms, or the manager who asks more questions than of others who have been off sick.

Unconscious Bias 4 – You look well so you must have recovered or be recovering.

This bias says, ‘But if you are still ill, despite looking well, you must not be working hard enough at your recovery.’ Ach, that puts a ton of responsibility on a person and assumes a level of control that may not be possible.\

At work and elsewhere, this can lead to people giving the employee the quizzical look and possibly even saying something to others that the person looks well but is ‘supposed to be sick’. It can also lead to receiving a lot of advice regarding what you can do to recover.

When it comes to our bodies, we can directly control our breath, muscles and mind. We can influence other things, for example weight and body mass index through our diet and exercise. But there’s a lot going on in our bodies that we don’t see and cannot control.

Unconscious Bias 5 – Mental health issues aren’t real; people who have that are ‘soft’

The following example in the sport of cricket reminded me of this assumption. Jonathan Trott left England’s Ashes tour in 2014 because of a stress-related illness and took a leave of absence to focus on his health. ‘Michael Vaughan asserted that “both he and the public have been been ‘conned’ by Trott…”’ (Moss, 2014).

I don’t need to explain that further. The impact of being on the receiving end of that can be crushing. Having people say this about you can come across as if you do not know your own body and so are unable to evaluate your own experience.

Stigma around mental health issues unfortunately still exists in the workplace. Although there are initiatives encouraging Human Resources professionals to share their personal stories with mental health issues, ‘less than 10% of employees feel comfortable disclosing mental health problems…yet 78% of employers believe their staff are comfortable having mental health discussions at work’ (Gyton, 2017). There is an obvious disconnect.

What is it about mental health at work that isn’t working?

Perhaps it comes down to what Dr. Miller, policy advisor at the CIPD, said ‘A crucial missing link is often found in the relationship between line managers and their employees.’ An important link to this is the training line managers receive to manage and support staff with mental health problems. Dr. Miller said 22% of employers are investing in such training (Gyton, 2017).

There is the saying that people leave line mangers and not jobs. That line manager and employee relationship is so important. If you are a line manager supporting an employee with mental health or another health issue, one of the things you can do is develop your awareness of the assumptions you hold around health, illness and disability so you can make mindful choices going forward. This will help you to make any unconscious biases that can hinder an employee’s return to work after illness more conscious. Keep reading to find out how.

stigma of mental health at work

The stigma of mental health at work. Drawn by B Babcock 2017.

IMPORTANT TANGENT – MIND offers a course called Mental Health First Aid, which trains you in the signs of various mental health issues and appropriate ways of dealing with them. It’s very informative and helpful and I recommend it. Click here to learn more.

6 questions to discover your unconscious biases that may hinder an employee’s return to work after illness

These 6 questions will help uncover unconscious and biases you may hold around health, illness and disability. This will enable you to make mindful choices on how you support an employee returning to work after a serious health issue. You can also book a session with me and we can do this together. Sometimes having an objective person listen can give you new insights.

The questions ask you to reflect on what it is like for you when you, and those around you, are ill, disabled, and in good health. The questions are repetitive, but it is important to consider them in the different situations to uncover any unconscious biases. Take the holistic approach used here and consider what you think, feel and actually do. You don’t have to do this all in one go. It may be helpful to write your responses.

1. When you are ill and/or disabled

What is that like for you? What do you think, feel and do? Do you continue going into work, work from home, or stay in bed? Something else?

What is it like for the people around you? Your family, friends, colleagues, clients? How do they respond to you when you are ill? How do you respond in turn?

2. When you are in good health

What is that like for you? Again, what do you think, feel and do?

What is it like for the people around you? How do they treat you? How do you treat them?

3. When a family member, friend or colleague is ill and/or disabled

What is that like for you? What do you think, feel and do? Do you look after/deal with them the same way you look after yourself when you are ill? Or differently?

4. When a family member, friend, colleague, client is in good health

What is that like for you? What do you think, feel and do? How do you treat them?

5. For each of the above questions, review your responses. Ask yourself,

What must be true about me (and others) for me to think, feel and act the way I do?

What do I have to believe?

What am I assuming of myself and my capabilities? What am I assuming of others?

6. Read through your beliefs and assumptions because they point to the biases you may hold.

The biases can be helpful or unhelpful and that may depend on the situation. Consider a real life situation (your own or another person’s situation) and how the biases can lead to action on your part which is helpful or not to the situation. With these new realisations, you can choose to do something different when that is appropriate.

unconscious biases

Uncovering your unconscious biases? Drawn by B Babcock 2017.

What’s it like for you?

What biases around health, illness and disability have you come across at work or elsewhere? Which ones did you find unhelpful or helpful? Feel free to share here and ensure examples cannot identify companies or individuals.

If you have an employee returning to work after long-term sick leave and would like support to ensure a smooth transition, have a look at how we can work together and get in touch for a free no obligation consultation.

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© Copyright Barbara Babcock 2017


Moss, B., It takes strength to recognise your own mental ill-health, People Management, CIPD, 25-Mar-2014, Available

Gyton, G., Less than 10 per cent of employees feel comfortable disclosing mental health problems, People Management, CIPD, 20-Feb-2017, Available

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