Sickness certification for mental health problems: an analysis of a general practice consultation database.

BACKGROUND Although mental illness remains the leading cause of both sickness absence and incapacity benefit in most high-income countries, little is known about how frequently patients with mental ill-health receive sickness certificates and what conditions are most commonly certified for. This study aims to use general practice consultation data to determine the rate of sickness certification for common mental health problems. METHODS Analysis of a general practice consultation database rates of certification are presented for people consulting with a mental health problem, along with the proportion of these consultations in which a certificate was issued. RESULTS The highest rates of certification among those consulting with mental health problems occurred for depression, stress-related problems and bereavement. Almost two-thirds of the consultations for bereavement resulted in a sickness certificate being issued. At least one in three mental health consultations resulted in a sickness certificate being issued. CONCLUSIONS Consultation for mental health problems in primary care frequently results in the issuing of a sickness certificate. Further study is urgently needed to provide adequate support systems to enable patients to return to work whenever possible.