Somewhere in most Japanese companies’ work rules is a clause that reads roughly like this: if an employee on leave cannot return to work by the end of the leave period, their employment ends automatically.

Most HR staff read straight past it. Yet that one sentence drives more of what goes wrong with mental health leave than anything in the return-to-work procedure.

In Japan, this kind of leave isn’t a legal entitlement. It exists because the company’s rules create it, and those rules set the clock. Everyone involved knows how much time is left, the employee most of all. As the deadline gets close, people push to come back before they’re ready, doctors get asked for certificates, and HR feels pressure to accept them. The return ends up following the calendar instead of the person’s recovery.

The Problem: Returns That don’t Last

Most companies handle the start of the leave reasonably well. The return is where things go wrong. A Ministry of Health, Labor and Welfare research group found that nearly half of employees who took leave for depression went off again within five years, and most of those did so within the first two. A second leave also tends to last longer than the first.

Why Returns Fail

The return happens too early.
Treating doctors want their patients back to normal life, and with a deadline approaching, many will write a certificate saying the person can return. That certificate answers one question: is this person stable enough for daily life? It doesn’t answer whether they can manage this job, this commute and this workload. That’s a different judgment, and it belongs to the industrial physician and the company.

The cause is still there.
If the employee comes back to the same difficult client, the same backlog and the same targets, the return plan is a formality. The conditions that led to the leave haven’t changed.

The manager changes.
The April personnel transfers bring in a new manager who was never told there was a return plan. Overtime creeps back and nobody notices, because nobody is watching for it.

What HR Can Do at Each Stage

Before Leave: help managers notice and refer
Most managers see the warning signs. Emails sent later and later at night, reports getting shorter, missed meetings, overtime rising while results fall. What they lack is a sense of what to do next. Their role is to notice and refer, to the industrial physician, to HR or to a counseling service, never to diagnose.

Give them a sentence they can actually use. Something like: you’ve seemed stretched lately, and I’d like you to have a chat with the industrial physician, just to check in. Managers who have the words ready are far more likely to say them.

The stress check, which becomes mandatory for small workplaces too from April 2028, can flag problems early. Only if someone acts on the results, though.

At the Start of Leave
The first week sets the tone. Explain the leave rules, how long the leave period can run, and the sickness allowance available from health insurance, since salary usually stops. Name one person, usually in HR, as the single point of contact. Have the team handle the work handover, and make sure nobody contacts the employee about work. A well-meant text from the manager about a client account is exactly the wrong thing in week one.

During Leave
Keep contact regular, light and from one person. About once a month is usual. Ask how things are going and whether anything is needed from the company. Don’t ask when they’ll be back.

Medical information should come through the industrial physician, with the employee’s consent, boiled down to what the workplace needs to know. HR doesn’t need the diagnosis history, only whether a return is getting closer. Recovery isn’t a straight line, so one good or bad month means little on its own.

Deciding Whether Someone is Ready
Treat a return-to-work certificate as meaning the person is eligible to return from that date. It doesn’t mean they start that morning. The company makes the final decision, after the industrial physician has met the employee and given a written opinion.

A few simple tools help. A daily life record, kept for a few weeks, shows whether someone is getting up at a regular time and getting through the day. Trial commuting, part of the ministry’s return-to-work guidance, tests the journey and the office before the formal return. Rework programs, run by clinics that specialize in helping people back to work after depression, have a strong record of preventing second leaves, yet very few HR teams ever suggest one.

The First Two Years
Follow-up doesn’t need to be constant, but it does need to last. Fixed review points work well: a short meeting with HR, and where possible the industrial physician, at one, three, six and twelve months, then a lighter check in the second year. Each one covers the same ground, whether the limits on hours are still holding and whether the workload has drifted back up. Put the dates in the calendar on the day the employee returns, so they happen even when everything seems fine.

When the manager changes, the return plan has to be handed over. Build that into the transfer process, because it won’t happen by itself.

Questions to Answer Before Approving a Return

• Has the industrial physician met the employee and given a written opinion, beyond just seeing the certificate?
• Has the employee kept a stable daily routine for at least a few weeks?
• What exactly is different about the workload that led to the leave?
• What are the limits on hours, overtime and travel, and when will they be reviewed?
• Who checks in, how often, and for how long?
• If the manager changes, who hands over the plan?

If the answers are vague, the return probably isn’t ready. The leave ends the day the employee comes back. The risk doesn’t.