Sick note for work: how to get one for your mental health

If you are in crisis or feel unsafe, please call 999 or go to A&E. For urgent mental health support, call NHS 111 and select the mental health option. Samaritans (116 123, free, 24/7) and Shout (text 85258) are always available.

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To get a sick note for work for your mental health in the UK, you self-certify for the first seven days off and then, if you need longer, you ask a healthcare professional such as a GP for a fit note, which is the current name for what most people still call a sick note. Mental health counts here in exactly the same way as a physical health problem, so stress, anxiety and low mood are all reasonable reasons to be off work and to ask for a note if you need one.

That is the short version, and the rest of this piece walks through how the sick note actually works, how to get one when the reason is your mental health, what it does and does not decide, and where to go for the parts about pay and your job that a health guide like this one cannot answer. It helps to keep two questions separate from the start. One is medical, meaning how unwell you are and how long you need, which is a conversation with a healthcare professional. The other is about money and your rights at work, which is not a medical question at all and belongs with ACAS or Citizens Advice. If the stress has tipped into full exhaustion, how to recover from burnout is the companion guide and goes deeper on getting your energy back. Everything here is drawn from NHS guidance and UK mental health charities including Mind.

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What a sick note actually is

The document people call a sick note is officially a fit note, or a statement of fitness for work. The name changed to reflect that it is not just a yes or no on whether you can work, but a healthcare professional's assessment of whether your health is affecting your ability to work and what, if anything, might help you manage. It is not a punishment and it is not a judgement on you, it is a formal record that your health is getting in the way of work for a period.

A fit note says one of two things. Either you are "not fit for work", or you "may be fit for work" with support from your employer. The NHS explains that a healthcare professional chooses the second option when they think you could do some work, even if it is not your usual role, with the right support, such as reduced hours or different duties. If your employer cannot offer that support, the note is treated as though it says you are not fit for work. Mental health sits inside this framework just as physical health does.

Do you need a sick note for the first few days off?

No. For the first seven days off, including weekends and bank holidays, you do not need a fit note at all and you can self-certify, which means you tell your employer yourself that you were unwell. The NHS is clear that if you are off for seven days or less, your employer should not ask you for a note from a healthcare professional.

Self-certification usually means filling in a short form for your employer, or following whatever their normal process is, and you do not have to give a detailed medical account. You only need a fit note once you have been off for more than seven days in a row. That seven-day window matters, because it means a rough patch does not require you to get an appointment before you are allowed to rest, and you can take a few days without navigating the healthcare system first.

How do I get a sick note for mental health?

To get a fit note for your mental health, once you have been off for more than seven days you ask a healthcare professional who is supporting your care, most commonly your GP, and they assess whether your health is affecting your fitness for work. Since 2022 it is not only GPs who can issue one. The NHS lists the healthcare professionals who can provide a fit note as doctors, nurses, occupational therapists, pharmacists and physiotherapists, and if you are being treated in hospital you can ask a hospital doctor for one.

You do not have to be seen in person. The NHS says a healthcare professional will talk with you either face to face or by phone before deciding on the note, so an appointment for a mental health fit note can often be done over the telephone. When you book, it is worth saying briefly that the appointment is about your mental health and time off work, so the practice can allocate the right slot. In the appointment, be honest about how you are actually doing rather than playing it down, because the healthcare professional can only assess what you tell them. There is no charge for a fit note if you have been off sick for more than seven days.

One thing worth saying plainly, because a lot of people wait far too long, is that you do not need to be at breaking point to book that appointment. If your mental health has been affecting your sleep, your work or your relationships for a while, that is already a reasonable reason to talk to your GP, whether or not you end up needing time off at all.

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Can you get a sick note for stress, anxiety or depression?

Yes. Stress, anxiety and low mood are all recognised reasons to be off work, and a fit note can be issued for a mental health reason in the same way as for a physical one. The NHS is clear that being constantly under pressure at work can lead to burnout, a state of physical and emotional exhaustion, and Mind describes how sustained or unmanaged stress can affect your emotions, your body and your behaviour. Being signed off with your mental health is not a soft option or a grey area, it is a valid reason to be off when things have outstripped what you can carry.

The fit note covers a specific period that the healthcare professional decides on, and if you are still unwell when it runs out you can go back and ask for it to be extended. Equally, you are not locked in for the whole period. The NHS says you should return to work as soon as you feel able, with your employer's agreement, and that can be before the end date on your fit note if you have recovered sooner or your employer can make adjustments to help. You do not need to see a healthcare professional again just to go back.

Quick, practical support has a place alongside all of this. Wobble's therapists work to the Wobble response framework, a structured framework built for short, practical, single-response support, and Wobble's Clinical Lead is James Penney, an NCPS Accredited Psychotherapeutic Counsellor. The idea is not to replace a proper course of therapy where that is what you need, it is to give you one clear, doable step when you are in the thick of it. When Wobble was tested with real people, 96% said they felt better after a single video, which is the kind of small concrete first move that is manageable even on a bad week. If the pressure is rooted in the job itself, maximum time off for stress in the UK covers how long you can be signed off and how the note extends.

The part a sick note cannot answer: pay and your job

The question sitting behind "sick note for work" is often really about money and job security, and this is where a health guide has to hand you over. How much sick pay you are entitled to and for how long, whether your job is protected, and what adjustments your employer should consider, are not medical questions, and a healthcare professional does not decide them.

For anything about sick pay, your rights while you are off, returning to work, or adjustments to your role, ACAS (acas.org.uk) and Citizens Advice (citizensadvice.org.uk) are the right places to go, and GOV.UK sets out the statutory position on sick pay. It is worth getting that information early rather than guessing, because knowing where you actually stand tends to take a layer of stress off in itself.

When to see your GP

Book a GP appointment if your mental health has been low or strained most days for a few weeks or more, if it is affecting your work, sleep or relationships, if it feels like it is getting worse rather than better, if you are leaning on alcohol or other substances to cope, or if you have tried looking after yourself and nothing is shifting. A GP can talk through your options, check whether anything else is contributing, and issue a fit note if you are not well enough to work. You do not have to justify being there.

In England you can also refer yourself to NHS Talking Therapies at nhs.uk/talk without going through your GP, though waits vary widely, and in Scotland, Wales and Northern Ireland the GP route is the standard one. Seek urgent help if you are having thoughts of suicide or self-harm or feel you cannot keep yourself safe. NHS 111 has a 24/7 mental health option, Samaritans (116 123) are free to call day or night, and Shout (text 85258) is there if calling feels like too much.

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Quick summary

A sick note for work is now called a fit note, and for a mental health reason it works the same way as for a physical one. For the first seven days off, including weekends and bank holidays, you self-certify and need no note at all. Beyond seven days you ask a healthcare professional, usually your GP, who can assess you in person or by phone and issue a fit note saying you are "not fit for work" or "may be fit for work", covering a period they judge and extendable if you are still unwell. Stress, anxiety and low mood are all valid reasons, the note is free after seven days, and you can return before the end date once you feel able. The medical side sits with a healthcare professional, but the questions about pay, your rights and your job belong with ACAS, Citizens Advice and GOV.UK, and it is worth getting that information early. If your mental health is affecting your daily life, your GP and NHS Talking Therapies are the proper next step.

For how long you can be signed off, see maximum time off for stress in the UK. For the recovery side, see how to recover from burnout.

Sources and further reading

• NHS: Getting a fit note (nhs.uk)
• NHS: When do I need a fit note? (nhs.uk)
• NHS: Can I go back to work before the end date on my fit note? (nhs.uk)
• NHS: Returning to work after mental health issues (nhs.uk)
• NHS: Get help with stress, Every Mind Matters (nhs.uk/every-mind-matters)
• NHS Talking Therapies self-referral (England): nhs.uk/talk
• Mind: Stress (mind.org.uk)
• ACAS: Time off work for mental health and sick pay (acas.org.uk)
• Citizens Advice (citizensadvice.org.uk)
• Samaritans: 116 123 (samaritans.org)
• Shout: text 85258 (giveusashout.org)

This article is for information only and does not replace advice from a qualified medical professional. If your mental health is affecting your daily life, please speak to your GP or contact NHS 111. If you are in crisis, please call 999 or go to A&E.