I enjoyed Chan & Sireling's article ^{Reference Chan and Sireling1} considerably, although I must write in response to the comments about obligatory declarations of mental health to employers.

Although there is little doubt that in most cases employers need to be aware of a bipolar affective condition in employees, this is not always appropriate. Indeed, best practice requires employers to require submission of pre-employment forms not to themselves but to an occupational health professional. Those with a bipolar condition should almost always be invited to a review with an occupational physician.

At that point, and that point only, is it appropriate for there to be discussion as to what is to be shared with the employer. At the very least such a consultation is likely to head in the direction of advice to an employer that the employee has a condition which may require adjustment under the Disability Discrimination Act. What an occupational physician tells an employer is, however, subject to their own professional judgement and indeed ultimately down to what the employee feels is appropriate.

Occupational medicine is a small specialty, although a valuable one, not least for psychiatric patients, for whom we can do a great deal.