Spotting a high-risk employee before the situation escalates is one of the biggest challenges for HR and occupational health teams. When this happens too late, the consequences show up as prolonged sick leave, higher absenteeism and teams that lose operational capacity.
Detecting high-risk employees early requires combining initial triage with continuous reassessment during therapy, setting clear thresholds, adapting the support channel and sustaining care for at least six months to consolidate a real functional recovery.
The good news is that the data is encouraging: with the right detection and sustained therapeutic support, high-risk employees can recover their social and occupational functioning within a matter of months. Understanding how to identify them, and what pace of recovery is reasonable to expect, helps HR plan resources better, sustain support for as long as needed, and reduce the impact on absenteeism and presenteeism.
Why does it matter to detect high-risk employees early?
A high-risk employee is someone showing significant impairment in their social and occupational functioning, severe anxiety or depressive symptoms, or both at once. It’s often the same profile that, weeks earlier, starts showing signs of burnout at work without anyone noticing in time. Although it usually represents a small share of the workforce, it accounts for a disproportionate share of sick leave, turnover and clinical cost.
The problem is that early detection alone is not enough. A recent analysis of digital mental health programmes revealed that initial triage identifies only half of the cases that are ultimately classified as high-risk. The other half is detected later, during the therapeutic process itself, thanks to the therapist’s ongoing reassessment.
This has a direct implication for HR: relying solely on an entry questionnaire gives an incomplete picture. Continuous monitoring is needed throughout the whole support journey, not just at the start.
Steps to detect and support high-risk employees
There’s no single formula, but there is a structured process that helps identify risk accurately and sustain recovery over time. Here are the steps that make the difference.
Step 1: Set up standardised triage assessment
Use clinically validated instruments, such as the PHQ-9 for depression, the GAD-7 for anxiety and the SOFAS for social and occupational functioning, at the very first point of contact any employee has with the wellbeing programme.
These questionnaires allow risk levels to be classified objectively from day one, rather than relying on subjective impressions or on the employee explicitly asking for help.
Step 2: Don’t stop at the triage result
The data shows that relying exclusively on the initial assessment leaves out a significant proportion of severe cases. Many employees who appear stable when entering the programme develop, or reveal, meaningful functional impairment weeks later.
That’s why periodic reassessment by the assigned psychologist is just as important as the initial triage itself.
Step 3: Combine self-reported data with clinical assessment
The questionnaires employees fill in themselves (PHQ-9, GAD-7) capture how the person feels. The scales rated by the therapist, such as the SOFAS, capture how they actually function day to day.
The two sources don’t always align, and that gap is valuable: combining them noticeably improves the accuracy of high-risk classification.
Step 4: Define clear high-risk thresholds for your organisation
Agreeing with your mental health provider on the specific scores that trigger a priority-care protocol (for example, a SOFAS score of 50 or below, or a GAD-7/PHQ-9 score of 15 or above) helps keep the response consistent, rather than depending on individual judgement case by case. This matters especially for profiles with high risk exposure, such as middle managers and their mental health, where deterioration signals can more easily go unnoticed.
Step 5: Set realistic expectations about recovery timelines
Functional improvement isn’t immediate. Available data shows a typical progression: moderate gains during the first month, more visible progress between month one and month three, and a clear consolidation of recovery between the third and sixth month.
Communicating these timeframes to managers helps avoid premature judgements, such as assuming an employee “isn’t improving” when they’re actually in the expected phase of the process.
Step 6: Prioritise resources where the impact is greatest
A well-calibrated triage system allows the most intensive support — such as 1:1 video therapy — to be directed to those with greater functional impairment, while other profiles can benefit from lighter modalities, such as chat-based support.
Step 7: Track functioning, not just symptoms
Measuring only the reduction in anxiety or depressive symptoms gives a partial picture. The real indicator that an employee is regaining their ability to work and relate to others is the improvement in their social and occupational functioning over time.
Step 8: Sustain support beyond the first few months
Recovery tends to consolidate between the third and sixth month. Withdrawing support before that point, or closing follow-up as soon as the most visible symptoms disappear, can cut short a recovery that isn’t yet stable.
Key insights at a glance
| Detection point | What the data shows | What HR should do |
|---|---|---|
| Initial triage | Identifies roughly half of high-risk cases | Activate a priority-care protocol from first contact |
| Reassessment during therapy | Detects the other half of cases not visible at triage | Maintain continuous monitoring, not just a one-off check |
| Months 1 to 3 of support | Initial, progressive improvement in functioning | Expect gradual, not immediate, progress |
| Months 3 to 6 of support | Consolidation of functional recovery | Sustain support until stabilisation is confirmed |
Why ifeel is the partner you need to manage high-risk employees
Managing the mental health of a global workforce is a major business challenge, and high-risk employees are precisely the ones who put an organisation’s ability to respond to the test. Wellbeing programmes only truly work when they combine accurate detection with sustained therapeutic support over time.
At ifeel, we help companies build exactly that combination: a clinically validated triage system, a team of psychologists who continuously reassess each person’s progress, and follow-up focused on real functioning, not just the disappearance of symptoms. We have a network of more than 600 mental health professionals and an approach backed by our own clinical research, enabling HR teams to make decisions based on real data rather than intuition.
For organisations that want to detect their high-risk employees early and support their recovery in a sustained way, having a specialised clinical partner is what makes the difference between prolonged sick leave and a successful return to work. Get in touch with our team to find out more.
Leadership lens 🔍
High-risk employees aren’t always detected the first time round: half only emerge during the therapeutic process itself, not at the initial assessment. For leadership, this means an effective mental health programme can’t be limited to an entry questionnaire — it needs continuous follow-up and realistic expectations about recovery timelines, which typically consolidate between the third and sixth month; investing in that sustained support is what turns early detection into real recovery and fewer prolonged absences for the business.
