If your mental health condition makes it hard to work, psychiatrists can write a doctor’s note for job-protected leave under the Family and Medical Leave Act.
You don’t always need a psychiatrist’s note. It depends on your workplace policies, your benefits, and how much time off you’re requesting.
Your employer can’t legally retaliate against you for taking protected mental health leave, and you have the right to keep details of your diagnosis private.
Research shows that more people, especially young people, are taking time away from work for mental health reasons.
Under the Family and Medical Leave Act (FMLA), medical doctors — including psychiatric providers— can write you a doctor’s note for work. If you live with a mental health condition that’s making it hard to meet your day-to-day responsibilities, you may be eligible for up to 12 weeks of unpaid leave without losing your job.
Mental health is a valid reason to need time away. You have rights, and you deserve to take care of yourself. A psychiatric provider can support you in this process.
When you might need a psychiatrist’s note for work
If you’re facing mental health difficulties, you may have the option of taking time off work. Mental health conditions are covered in the FMLA, which allows eligible employees of certain companies to take a leave of absence from work (up to 12 weeks) without jeopardizing their job.
Under the FMLA, you can take intermittent time away (for example, you could take a day off per week to attend treatment). You can also take the 12 weeks off continuously. It’s important to note that FMLA is generally not paid time off.
Whether you need a psychiatrist to write you a note for time off depends on factors like:
Your benefits
Organizational policies
How much time you need off
The relationship you have with your supervisor
Mental health symptoms that are impacting your daily functions
Current mental health treatment that you are receiving, including medications or therapy
For example, if you have paid sick time accrued, and your workplace doesn’t require you to submit a doctor’s note to take this time, you can use this time for mental health reasons without needing a psychiatrist’s note.
Some organizations offer mental health days to be used at your discretion. It’s best to ask your supervisor or human resources (HR) department about the policies specific to your organization. Some organizations may not require a psychiatrist’s note for going on leave.
But if organizational policies are strict, or if you need more time off than your regular time off benefits would allow, you’ll need a note from a psychiatrist. This can allow you to take time off under the FMLA.
Any diagnosed mental health condition is legally protected under both the American Disabilities Act (ADA) and the FMLA. This includes conditions like:
It also covers neurodevelopmental conditions like attention-deficit hyperactivity disorder (ADHD) and autism.
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How to ask your psychiatrist for time off work
Explore these steps you’ll need to take to get a psychiatrist’s note to take time off work.
Ask your human resources department what you need. It’s best to first speak with your HR department to find out what exactly you’ll need to take a mental health leave and if you’re eligible. You may not need a psychiatrist’s note at all. If you do, HR can let you know what exact information the note will need to include.
Find a psychiatric provider. You’ll need to find a psychiatrist if you aren’t already working with one. If you’re in therapy, you can ask your therapist for a referral. Your general practitioner can also provide you with a referral. Once you start working with a psychiatric provider, you can talk to them about what you’re feeling. They can help you decide whether taking time away from work would be helpful or not.
Get an assessment. Your psychiatric provider will talk to you about the symptoms you’re experiencing and why you need a leave from work. They’ll likely ask you questions about how your symptoms are impacting your ability to function and how a leave would help. If you’re also going to attend treatment with them, doing medication management, they might also make a diagnosis. But a diagnosis isn’t necessary to take time away from work. Remember that it’s up to the psychiatric provider and their clinical judgement whether or not a note will be given.
If your psychiatrist believes time off work will help, they will write the note. The psychiatrist will document everything and provide you with the note, following your employer’s instructions. There’s no specific form they need to fill out. According to the FMLA, the note must include:
When the mental health condition began and how long it’s expected to last
A statement that you’re unable to work and detailing for how long
A description and appropriate medical facts about the condition you live with. They may share your diagnosis, but aren’t required to.
The psychiatrist’s information, including name, contact information, and medical license
Bring the note to your employer. Once you have the note, you should bring it directly to your HR department. You may also be able to authorize the psychiatrist to give the note directly to your employer. Your employer must respond to your request within five business days.
Giving a psychiatrist’s note to your employer
Even after you’ve received a psychiatrist note, you might still have questions about how and when you should give that note to your employer — and what happens afterward.
How much to share about your condition
The FMLA doesn’t require you or your psychiatrist to share your exact diagnosis to qualify for a leave of absence. Different people have different comfort levels when it comes to sharing the specifics of their condition. Living with a mental health condition isn’t anything to feel ashamed about. But you, and only you, reserve the right to choose who you tell.
Your psychiatric provider will need to provide medical facts about the condition you live with, as well as state that you live with a serious health condition that prevents you from being able to work.
Is my psychiatrist’s note covered under privacy laws/HIPAA?
Under the FMLA, your psychiatric provider can share information about your condition even though you haven’t signed a medical release form. This is different from HIPAA. But psychiatric providers will still strive to protect your confidentiality as much as possible. They only need to share enough information about your health to relate back to your work.
However, further contact between your employer and psychiatric provider is protected under HIPAA. So your employer may not ask your provider more questions about your mental health after they’ve received the note.
If you have any questions about your privacy, ask your provider.
What will happen after I give my employer the note?
Once you give the note to your employer, they have two options: accept it and grant your leave or determine that it’s incomplete or invalid. If they say it’s incomplete, they need to provide to you, in writing, what additional information they require. They’re also able to require a second or third opinion, but only if they have reason to doubt that your first psychiatrist’s note is invalid.
Your employer can also request recertifications of your ability to work. They can only ask for this once every 30 days at most, after your original certification has ended. So, for example, if your psychiatrist wrote in your note that you’d need 2 months away from work, but you end up needing more, your employer can ask for a recertification every 30 days after the original 2 months.
Can I be fired for missing work for mental health?
Legally, you can’t be fired for taking a mental health leave under the FMLA. Your employer must return you to the same or an identical job when you come back. They’re not able to punish or retaliate against you in any way.
It’s worth noting that many people feel unfairly retaliated against for taking a mental health leave. If you think your rights have been violated, contact the U.S. Department of Labor’s Wage and Hour Division (WHD) or find an office near you. You have rights.
If your mental health condition is impacting your ability to make decisions, focus, engage with others, and accomplish daily tasks, some time off from work may be helpful. This time off may be paired with other mental health treatments, like medications or therapy.
Halee Fullerton, PMHNP-BC
Clinical reviewer
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Taking time away from work for mental health is a protected right. A psychiatrist can help you get that leave when you need it. Understanding your workplace policies, what information is required, and how the process works can make the experience less stressful.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
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Saya Des Marais
Saya graduated with her Master in Social Work (MSW) with a concentration in mental health from the University of Southern California in 2010. She formerly worked as a therapist and motivational interviewing trainer in community clinics, public schools, mental health startups, and more.
Her writing has been featured in FORTUNE, GoodRX, PsychCentral, and dozens of mental health apps and therapy websites. Through both her clinical work and her personal OCD diagnosis, she’s learned the importance of making empathetic and accurate mental health content available online.
She lives in Portland, Oregon but you can find her almost just as often in Mexico or in her birthplace, Tokyo.
Halee Fullerton, PMHNP-BC
Halee is a psychiatric nurse practitioner with experience treating children, adolescents, and adults. She has worked in outpatient community health with children/adolescents as well as inpatient substance use disorder treatment. She currently sees patients via outpatient telehealth. Before becoming a psychiatric nurse practitioner, she worked in emergency rooms, medical-surgical units, long-term care facilities (including Alzheimer/dementia units) and the intensive care unit.
She chose a career in mental health because she wanted to help people and to contribute to breaking down stigma around mental health. She is especially passionate about working with people who are navigating substance use disorders, depressive disorders, and anxiety/trauma-related disorders. She has three labradoodles that she adores.
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