Your Occupational Health Physician believes that it would benefit both you and your organisation for you to attend an Occupational Mental Health Assessment and would like to make a referral for you to Centric Mental Health for this purpose.
OCCUPATIONAL MENTAL HEALTH ASSESSMENT AND REPORT
This stand-alone psychological assessment service aims to provide an understanding of your current mental health needs and identify any appropriate support in relation to these needs. It will provide additional clinical information for Occupational Health Professionals which they may use to advise employees and employers around how to support your well-being and facilitate your decision making and engagement with your work.
Through this assessment process you will have an opportunity to gain a deeper understanding of your current mental well-being through completion of a clinical interview and assessment with a Centric Mental Health Psychologist. Following this, you will be invited for a one-to-one feedback session where you can review a draft of the report and will be provided with tailored suggestions to improve well-being based around your own strengths and additional resources and/or services.
Following this assessment an Occupational Mental Health report will be made available to your Occupational Health Physician to help them understand how to best support you in terms of your psychological well-being and engagement with work.
YOUR INFORMATION AND YOUR DATA PROTECTION RIGHTS
In accordance with the General Data Protection Regulation (GDPR), outlined below is information regarding the collection and use of your personal data and your rights concerning this activity. Any information shared will be used for the sole purpose of making this referral and undertaking an assessment as detailed below.
What data is collected?
Your personal data (e.g. name, your role, any personal data provided by your Occupational Health Physician) and special categories of personal data (mental health related data).
What will happen to my personal data?
Data collected for the purposes of making this referral will stored in a confidential secure system and will be reviewed by the Occupational Health Team in Centric Mental Health for the purpose of informing acceptance this referral, set up appointments and issue of report. This data will be collated and will be shared between Cognate Health and Centric Mental Health for the purposes of providing an occupational mental health referral, assessment, and report.
Your GP will be advised of your attendance at this assessment. If you do not wish for this to take place, please advise your Centric Mental Health clinician. If you or your Occupational Health Physician would like that your report be shared with your GP please make your clinician aware at your feedback meeting.
Duration and Storage Access
The report generated based on the Occupational Mental Health assessment will be issued to the Occupational Health Physician who has made the initial referral. The full report is released to your referring Occupational Health Physician only. If you wish to access the report for your own records, you will be invited to submit a written request to Centric Mental Health and the report will be issued to you within 30 days from the receipt of your request.
Centric Mental Health will store this data for eight years, in accordance GDPR policy requirements (please also see our Privacy Policy https://mentalhealth.ie/privacy-policy).
PERMISSION FOR RELEASE AND RECEPTION OF INFORMATION
By signing this document, I acknowledge that I am providing permission for Centric Mental Health, its staff and contracted clinicians to release information to and receive information from the above named entity and provide this permission willingly and knowingly.
I understand that I can revoke this permission at any time via verbal or written request to Centric Mental Health which will be noted in the box in the section below.
I understand that if I choose to rescind my consent, that I am not obligated to provide any specific reason to Centric Mental Health as to why I have taken this step.
Centric Mental Health will advise your referring Occupational Physician of your decision to withdraw consent. It may be that your decision to withdraw from this assessment process jeopardises your own employment contract and we would suggest that you review your own legal contract with your employer to understand your obligations in this regard. As a third party we responsible for providing this stand-alone Occupational Mental Health service and are in no way party to or involved in your direct contract with your employer.