A clinic appointment at 2pm on a Tuesday costs most employed people half a day. There is the appointment, plus the journey both ways, plus the conversation with a manager about where you are going, plus the sense that everyone now knows something. Multiply that by an assessment and three follow-ups and it is a fortnight of annual leave — one of the main reasons people who need psychiatric care put it off.
Video changes that arithmetic, and it raises a set of questions about work that are worth thinking through before your first appointment rather than afterwards.
The arithmetic of an appointment
A first psychiatric assessment typically takes about an hour and follow-ups around twenty minutes. Without travel, the hour is just an hour. That makes several patterns possible that a clinic appointment does not:
- an early or late slot either side of your working day;
- a follow-up in a lunch break, since twenty minutes fits;
- an appointment from home on a day you were already working remotely;
- a single hour of leave for an assessment rather than a half-day.
Happy Clinic runs appointments 11am to 7pm Monday to Friday, which covers the end of a standard working day but not the beginning. Availability depends on the clinician, so ask about later slots when you book rather than assuming. Current times and prices are on the fees page, and how it works sets out the sequence from booking to treatment plan.
The follow-ups are where this matters most. A titration schedule that would collapse under four half-days of leave survives four twenty-minute calls.
Taking the call from work premises
This is the part people get wrong, so it is worth being blunt. A meeting room at your workplace is almost never private enough for a psychiatric assessment.
Consider what you will be saying out loud: your symptoms, your drinking, your family history, thoughts of self-harm. Now consider the realities of an office — glass-walled meeting rooms, booking screens showing your name, colleagues who knock, thin partitions, and the fact that someone will ask what the meeting was.
There is also the device. A work laptop may be monitored, and its camera or microphone may be blocked by IT policy anyway. A work phone is the employer’s, not yours.
If you must be at work when the appointment happens, the least bad options are a parked car with the engine off, or a genuinely private room with a door that locks, on your own device, with headphones. The guide on keeping your video consultation private goes through the practicalities. If neither is possible, move the appointment. A consultation where you hold things back is worth less than a rescheduled one.
What you do and do not have to tell your employer
In outline, and this is general information rather than legal advice:
You do not have to disclose a mental health condition to your employer. There is no general duty to tell them a diagnosis, and you do not have to explain the clinical detail of an appointment.
You do have to follow your employer’s absence and time-off procedures. If you need time out of the working day, you are subject to the same rules as any other appointment. Many people simply say “a medical appointment”, which is accurate and sufficient.
Disclosure is the trigger for adjustments. That is the trade-off. An employer cannot adjust for something it does not know about, so someone at work has to know enough for the duty to arise — though that can be the effects (“I struggle to concentrate in open-plan spaces”) rather than the label. Recruitment is different again: health questions before a job offer are restricted, with narrow exceptions.
Reasonable adjustments under the Equality Act 2010
GOV.UK states that employers must make reasonable adjustments so that workers with disabilities, or physical or mental health conditions, are not substantially disadvantaged when doing their jobs, and says this applies to all workers including trainees, apprentices and contract workers.
Whether a condition counts as a disability is a legal test, not a diagnosis. GOV.UK sets out the definition of disability under the Equality Act 2010: a physical or mental impairment with a substantial and long-term negative effect on your ability to do normal daily activities, where substantial means more than minor or trivial and long-term means 12 months or more. Fluctuating and recurring conditions are covered, which matters for depression and anxiety that come and go.
The examples GOV.UK gives are ordinary rather than dramatic — an assigned desk instead of hot-desking for someone with social anxiety, altered hours, a phased return, changes to duties, working from home. Adjustments relevant to treatment specifically include time for appointments, and flexibility while a new medication is settling. Note that GOV.UK is explicit that Access to Work “will not pay for reasonable adjustments”: those are the employer’s legal obligation, not a grant.
Sick leave, fit notes and what a private psychiatrist can do
GOV.UK’s guidance on taking sick leave says that for absences of seven days or fewer you do not need to give your employer a fit note; beyond seven calendar days in a row, including weekends, a fit note is required. Fit notes can be issued by GPs, hospital doctors, registered nurses, occupational therapists, pharmacists and physiotherapists, after an assessment of your fitness for work.
A fit note is not a binary certificate. The guidance for employers and line managers describes a “may be fit for work” option with tick boxes for a phased return, altered hours, amended duties and workplace adaptations including working from home, plus a comments box for more detail. That is often more useful than being signed off entirely.
Be clear about one limit. Happy Clinic does not write medico-legal or benefits reports. What a private assessment produces is a clinical summary sent to you, and to your GP with your consent — which gives your GP the specialist information they need.
Access to Work
Access to Work is a government grant scheme. It covers practical support such as specialist equipment, support workers, travel costs and workplace modifications, and it has a mental health support strand delivering tailored work plans and one-to-one sessions with mental health professionals through providers including Able Futures and Maximus. GOV.UK states that a grant will not affect other benefits and does not have to be paid back.
On eligibility, GOV.UK says you must have a physical or mental health condition or disability that means you need support to do your job or get to and from work, be 16 or over, be in paid work or about to start or return to paid work within 12 weeks, and live and work in England, Scotland or Wales. Two details are easy to miss: you do not need a diagnosis to apply, and the mental health support strand can only be claimed once.
Occupational health is not your psychiatrist
These two get confused, and the difference matters.
| Occupational health | Private psychiatric care | |
|---|---|---|
| Who instructs it | Usually your employer | You |
| Main question | Are you fit for this role, and what adjustments help | What is wrong, and how is it treated |
| Who gets a report | Your employer, with your consent to release it | You, and your GP with your consent |
| Treatment | Generally does not treat or prescribe | Diagnosis, treatment plan, prescribing, review |
| Cost to you | None | Paid privately |
| Confidentiality | Clinical detail is confidential, but the report goes to the employer | Ordinary medical confidentiality |
The fit note guidance encourages employers to refer to occupational health in complex cases. That referral is worth accepting — but it is an assessment of your work, not of your illness, and it does not replace the diagnostic and treatment role described in what is telepsychiatry.
Shift workers and night workers
Shift work makes the timing problem harder and the clinical picture more complicated at the same time.
Rotating shifts mean a fixed weekly slot rarely works, so book each follow-up individually against your rota. Bring the rota to the appointment: a psychiatrist adjusting medication needs to know when you are actually awake, because dosing advice built around a nine-to-five day can be wrong for someone finishing at 7am.
Sleep deserves its own conversation. Night work disrupts sleep for reasons that have nothing to do with mental illness, and untangling shift-related sleep loss from depression or anxiety is genuinely difficult — worth flagging early. Happy Clinic treats insomnia linked to mood or anxiety, and the range of what it covers is listed under conditions.
Finally, safety. Some medications affect alertness, particularly at the start. If you drive, operate machinery or work nights, say so before anything is prescribed.
If work has become unbearable and you are in crisis, this is not the right route. If a life is at risk, call 999 or go to A&E. For urgent mental health help call NHS 111 and, in England, choose the mental health option. Samaritans are on 116 123, free, 24 hours a day. Otherwise, appointments can be booked on the booking page without a GP referral.
This article is general information, not personal medical advice. If you are worried about your mental health, speak to a doctor. In a crisis call 999 or NHS 111.
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