Psychologist warned about the danger of psychiatric examination at work
If an employer really has the right to initiate the referral of an employee for a psychiatric examination, this can be called a rather dangerous mechanism in terms of social consequences. This opinion was expressed by Maria Todorova, a family and child psychologist and neuropsychologist, in an interview with Izvestia on January 12.
"In fact, a situation is being created in which any person, relatively speaking, can be declared mentally dysfunctional based on external signs interpreted by a third party. Even with the formal availability of medical regulations, the line between concern for safety and interference in the personal sphere is extremely thin here. Since a person can, simply put, be "driven," she expressed her opinion.
In practice, the decision to send for an examination will most likely be made as part of a mandatory medical examination by a general practitioner, that is, a therapist. The problem is that mental disorders, unlike somatic diseases, do not have a simple and unambiguous list of external symptoms that could be mechanically fixed.
Increased anxiety, isolation, emotional instability, fatigue, and sleep disorders can be both signs of a permanent disorder and a reaction of a mentally healthy person to stress, overload, or an unfavorable working atmosphere. In this situation, the risk of subjective assessments increases, and hence stigmatization, when an employee's behavior becomes uncomfortable for someone.
As for the examination procedure itself, it is crucial that it remains strictly medical and does not depend on the will of the employer. According to the logic of current legislation, psychiatric examination should be conducted by a state psychiatrist in accordance with the established procedure, and not in an arbitrarily chosen commercial clinic. Expenses in this case, as a rule, relate either to the compulsory health insurance system or to the obligations of the employer within the framework of labor protection.
A separate and extremely sensitive issue is medical confidentiality. The employer should not have access to the diagnosis or details of the employee's mental state; only information about professional aptitude or time constraints for specific types of work is acceptable. This may apply to driving a car, for example, or other transport, the expert believes.
"The most vulnerable point remains the difference between a temporary condition and a clinical disorder. An acute reaction to stress, professional burnout, and family bereavement are normal reactions of the psyche to abnormal circumstances. They are not a mental illness and do not require psychiatric records. Only a psychiatrist can determine this line, not a doctor at a medical examination, and even more so not an employer," Todorova said.
It is at the stage of the examination that the specialist must distinguish a temporary, reversible condition, possibly a depressive episode, from a stable disorder that can really affect occupational safety.
The risk of replacing social and organizational problems with a medical diagnosis is quite high here. Instead of reducing the workload, reviewing working conditions, or working with the corporate environment, it is easier to "write off" all a person's problems as an illness.
The psychologist noted that there is a mandatory annual psychiatric examination for a number of individual professions, including kindergarten teachers, teachers, drivers, and so on. The question is to what extent this innovation will encourage employers to send people for an examination in addition to the annual inspections, and to what extent these referrals will be compulsory.
In May, Daria Salnikova, a clinical psychologist, described the symptoms of chronic fatigue. One of its symptoms is insomnia. For example, a person sleeps for 12 hours for three or four days in a row and cannot get enough sleep.
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