Time off work for mental health: how to take a day or a few days

Read this first

You can take time off work for your mental health in the same way as for a physical illness: for the first seven calendar days you self-certify, which means telling your employer yourself with no note from a doctor, and you only need a fit note if you are off for more than seven days in a row. That covers the single day most people searching this are thinking about, and it covers a short break of a few days too. Mind puts it plainly, that taking time off for your mental health is just as valid as time off for physical health, and ACAS says employers must treat mental and physical health as equally important.

This piece stays on the short end of things, the day or the handful of days when you know you cannot face work and need to step back before it gets worse. It is not about being signed off for weeks, and if that is where you are, how to get a sick note for your mental health is the guide that walks through the fit note process properly. Here we cover how a short absence actually works, what to say to your employer, how to use the time so it does something, and how to tell when a day is not going to be enough. Everything is drawn from NHS, GOV.UK and ACAS guidance and from Mind, and none of it is legal advice.

A mental health day, in plain terms

As far as NHS, GOV.UK and ACAS guidance goes, a mental health day is not a separate thing with its own rules. If you are not well enough to work because of stress, anxiety or low mood, that is sickness absence, and it runs on the same rules as a stomach bug. ACAS's guidance on time off with stress says that if you need time off, you should follow your organisation's sickness policy if there is one, and GOV.UK's sick leave guidance describes one process for sickness absence, whatever the illness. The label you put on it matters less than the fact that you are unwell and the system already has a route for that.

A lot of people never take the day, because they tell themselves stress does not count or that they need to be in a much worse state before it is allowed. The NHS lists feeling overwhelmed, constantly worrying, difficulty concentrating and struggling to make decisions among the mental signs of stress, alongside physical ones like headaches, muscle tension and a faster heartbeat, and changes in behaviour like being irritable and snappy or sleeping too much or too little. If a few of those have moved in, you are not inventing a reason to be off. You are describing one.

Can you self-certify for stress or your mental health?

Yes. For the first seven calendar days of any sickness absence, including weekends and bank holidays, you self-certify, and ACAS is clear that you do not need to provide medical evidence in that window. Stress, anxiety and low mood are covered in exactly the same way as a physical illness.

Self-certifying just means telling your employer yourself that you are unwell. GOV.UK says that if you are off for seven days or less you do not need a fit note or other proof of sickness from a healthcare professional, though your employer can ask you to confirm the absence in whatever way you have agreed, such as a form or an email. Many workplaces have their own self-certification form. If yours does not, or if you are claiming Statutory Sick Pay, GOV.UK publishes a form called the SC2, an employee's statement of sickness, which you can use to self-certify a sick absence. You fill it in and hand it to your employer, not to a doctor.

The seven days are the useful part. A rough patch does not require a GP appointment before you are allowed to rest, and you can take a day, or a few, without touching the healthcare system at all. If you are still not well at the end of that week, a fit note comes in, and how long you can be signed off for stress covers that end of it.

Should I take a mental health day as sick leave or annual leave?

If you are unwell, sick leave is the mechanism, and if you are worn down but not unwell, annual leave is the other option. Which is right depends on how you actually are and on your workplace's policies, and the pay side of that choice is a question for ACAS or Citizens Advice rather than a health guide.

Mind's guidance on work and stress suggests using the holiday you are entitled to, and says that if things get too much, a few days off or a long weekend can help you feel refreshed. That is the annual leave route, and it suits the situation where you are tired and frayed and can see it coming. The sick leave route is for when you are not fit to work, today, whatever the calendar says. People often reach for annual leave because it feels less exposing, but if you are genuinely unwell the sickness route exists and is designed for exactly this. Whichever you choose, how sick pay works and anything about your rights are not medical questions, and ACAS (acas.org.uk), Citizens Advice (citizensadvice.org.uk) and GOV.UK are the right places to get those answered before you assume the worst.

What to say to your employer

Less than you think. You are telling them you are unwell and will not be in, in whatever way your sickness policy asks for, and you do not have to give a detailed medical account for a short absence. The message on the morning itself can be one line. The fuller conversation about what is going on can wait until you are ready, and for that ACAS says it can be a good idea to talk to your manager as early as possible about your situation, while Mind suggests arranging to speak to them privately and thinking about what you want to say in advance, even writing a few notes to bring with you.

If you are off for more than a day or two, ACAS suggests the employer and worker agree how often they will keep in touch so that it is not overwhelming, which is worth raising yourself so the contact is on terms you can manage. ACAS is also plain that employers should take a mental health absence seriously, in the same way as a physical one, and if yours does not, that is a workplace matter for ACAS rather than something to carry on your own.

How to actually use the day

A mental health day that you spend refreshing your inbox and rehearsing what people are saying about you is not a day off. The point is to take the pressure off your nervous system, and the NHS stress guidance gives a short list of things that help with that: talking to friends, family or a trusted colleague about how you feel, getting some exercise, using breathing exercises, planning ahead for the stressful things you know are coming, and not trying to do everything at once. It also lists what not to lean on, which is alcohol, cigarettes, gambling or drugs to cope, and isolating yourself.

So a decent shape for the day is to sleep if you can, move a bit, eat something, tell one person the truth about how you are, and then, from a slightly steadier place, look at what is actually making work feel impossible. The NHS Every Mind Matters stress page suggests breaking big tasks into smaller parts and planning ahead with a list, which sounds mundane and is, and is also usually what turns a vague dread into two or three things you can face on Monday.

Quick, practical support has a place here too. 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 to give you one clear, doable step when you are in the thick of it, not a course of therapy you have to commit to. When Wobble was tested with real people, 96% said they felt better after a single video, which is the kind of small concrete move that fits inside a day off.

When a day off is not enough

A day off is a pressure valve, not a treatment, and it is worth being honest with yourself about which one you need. The NHS says to see a GP if you are struggling to cope with stress or if the things you are trying yourself are not helping, and neither of those means you have to be at breaking point. If the dread is back the moment you think about the next week, if you have taken a few of these days already, or if your sleep, concentration or mood have been off for a while, the day was telling you something bigger.

At that point the mechanism changes. Beyond seven days in a row you need a fit note from a healthcare professional, most commonly your GP, which can say you are not fit for work or that you may be fit for work with support from your employer. Stress leave from work is the piece on deciding to take that step, and how to get a sick note for your mental health covers the process. If you want to stay in work but need support to do it, Access to Work, the GOV.UK scheme, includes mental health support for people in England, Scotland and Wales, which can mean a tailored plan to help you get or stay in work and one-to-one sessions with a mental health professional, and you apply through the providers named on GOV.UK. Northern Ireland runs a separate scheme through nidirect.

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, if you are leaning on alcohol or other substances to cope, or if self-help is not shifting anything. A GP can talk through your options and, if you are not well enough to work beyond the first week, issue a fit note. In England you can also refer yourself to NHS Talking Therapies at nhs.uk/talk without going through your GP, as long as you are registered with a GP surgery, and there is no charge, though waits vary widely. 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.

Quick summary

Time off work for your mental health works the same way as time off for a physical illness. For the first seven calendar days you self-certify, which means telling your employer yourself with no medical evidence, using their form or the SC2 if you are claiming Statutory Sick Pay, and you only need a fit note if you are off for more than seven days in a row. If you are unwell, sick leave is the route, and if you are worn down but not unwell, annual leave is the other option, with pay and rights questions going to ACAS, Citizens Advice and GOV.UK. Tell your employer the short version on the day, use the time to take the pressure off rather than refresh your inbox, and if a day is not enough, that is information: your GP, NHS Talking Therapies and Access to Work are the next steps.

For the fit note process, see how to get a sick note for your mental health. For how long you can be off, see maximum time off for stress in the UK.

Sources and further reading

• GOV.UK: Taking sick leave (gov.uk/taking-sick-leave)
• GOV.UK: Statutory Sick Pay, employee's statement of sickness (SC2) (gov.uk)
• GOV.UK: Access to Work (gov.uk/access-to-work)
• ACAS: When an employee is off sick (acas.org.uk/sick-leave)
• ACAS: Time off with stress (acas.org.uk)
• ACAS: Looking after your mental health at work (acas.org.uk)
• NHS: Stress (nhs.uk/mental-health)
• NHS: Every Mind Matters, stress (nhs.uk/every-mind-matters)
• NHS Talking Therapies self-referral (England): nhs.uk/talk
• Mind: Getting support at work (mind.org.uk)
• Mind: Work and stress (mind.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.

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.