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Bipolar disorder and safety-critical work — DOccMed MCQ

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HardMental Health and WorkBipolar disorder and safety-critical workDOccMed

A rail signalling technician with bipolar disorder reports reduced sleep, increased spending and irritability after stopping medication. His partner has contacted the GP, and he is due to work alone overnight on live signalling equipment. What is the most appropriate advice regarding fitness for work?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Advise urgent clinical review and temporary restriction from lone safety-critical work

Possible hypomanic relapse can impair judgement, sleep and risk perception. Lone safety-critical work on live signalling equipment should be restricted until urgent clinical assessment and stabilisation. The advice is task-specific and temporary, not a judgement that he cannot work in rail. Self-confidence during hypomania is not a reliable measure of fitness.

Reference: FOM Fitness for Work guidance; NICE Bipolar disorder guidance