Mental Health in the Workplace: Navigating Incapacity Dismissals When Depression and Anxiety Take Hold

Mental health challenges are no longer the exception in South African workplaces—they're becoming the norm. With depression affecting millions of employees and workplace stress reaching unprecedented levels, HR practitioners and business owners increasingly face the complex challenge of managing employees whose mental health conditions impact their work performance. The question isn't whether you'll encounter these situations, but how prepared you'll be when they arise.

Essential Medical Report Questions for Mental Health Conditions

When dealing with mental health-related incapacity, your medical report must go beyond standard illness assessments. Based on Schedule 8 of the Labour Relations Act and the latest case law, here are the critical questions your medical practitioner should address:

Cognitive and Conative Capacity Assessment

• Does the mental illness impact the employee's cognitive ability (capacity to understand and process information)?

• Is the employee's conative ability affected (capacity to make decisions and exercise self-control)?

Specific Mental Health Impact Questions

How does the mental illness affect the employee's ability to:

• Concentrate and focus on tasks for the required periods? 

• Handle workplace stress and pressure appropriately? 

• Interact professionally with colleagues, clients, and supervisors? 

• Follow complex instructions and complete multi-step assignments? 

• Maintain professional boundaries and workplace behaviour? 

• Manage emotional responses in challenging situations?

Nature and Diagnosis Specifics

• How was the diagnosis reached, and by whom?

• Are there co-occurring mental health conditions?

• Is there a documented relationship between workplace factors and the mental health condition?

• Has workplace stress, trauma, or specific incidents contributed to or exacerbated the condition?

Fluctuation and Triggers

• Are there periods when symptoms are more or less severe?

• What workplace factors might trigger or exacerbate symptoms (deadlines, conflicts, performance reviews, specific tasks)?

• Are there environmental modifications that could reduce psychological triggers?

• How predictable are symptomatic episodes?

• Does the employee have insight into their condition and its effects?

Treatment Response and Medication Effects

• How is the employee responding to current psychiatric treatment?

• Do psychotropic medications affect alertness, concentration, decision-making, or performance?

• Are there side effects that impact work capacity (drowsiness, cognitive dulling, mood swings)?

• Is the treatment regimen stable or likely to change?

• How long has the current treatment been in place, and what is the expected duration?

Risk Assessment for Mental Health

• Are there safety-sensitive aspects of the job that could be compromised?

• How does workplace stress or pressure specifically affect the condition?

• What early warning signs should supervisors be aware of?

• Are there behavioural indicators that suggest the employee is struggling?

Recovery and Accommodation Specifics

• What specific workplace accommodations would support the employee's mental health recovery?

• Would flexible scheduling, reduced workload, or modified duties significantly help?

• Is there potential for improvement with proper workplace accommodation?

• What ongoing support might be required (regular check-ins, adjusted deadlines, quiet workspace)?

• Could temporary adjustments lead to full recovery and normal work capacity?

Functional Capacity in Work Context

• Can the employee safely operate machinery, drive vehicles, or handle safety-critical tasks?

• Is the employee's judgement sufficiently intact for their specific role responsibilities?

• How does the condition affect attendance reliability and consistency?

• Can the employee maintain confidentiality and handle sensitive information appropriately?

Accommodation Obligations for Mental Health

The CT Wilcocks v Ugu District Municipality (D 2158/2018) [2022] ZALCCT 12 case reinforces that dismissal remains a last resort. For mental health conditions, accommodation considerations should include:

• Environmental modifications: Quiet workspaces, reduced stimuli, flexible seating arrangements

• Schedule adjustments: Flexible start times, regular breaks, reduced hours during treatment intensification

• Task modifications: Temporary removal of high-stress responsibilities, adjusted deadlines, simplified procedures

• Support structures: Regular supervision, peer support systems, access to employee assistance programs

Confidentiality and Consent Considerations

Given the persistent stigma around mental illness, ensure your medical report request:

• Confirms the employee's explicit, informed consent for disclosure

• Requests only information directly relevant to work capacity

• Clarifies how the information will be stored, shared, and protected

Supporting Documentation

• Provide detailed job descriptions emphasizing psychological demands

• Include information about workplace stressors and environmental factors

• Share any incident reports or performance concerns that prompted the assessment

Mental health-related incapacity dismissals require a sophisticated understanding of both psychiatric conditions and legal obligations. The stakes are high—not just for avoiding unfair dismissal claims, but for creating workplaces that support employee well-being while protecting business interests.

By asking the right questions, respecting the unique aspects of mental illness, and following the guidance established in recent case law, employers can navigate these complex situations with confidence and compassion.

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