Interested to know others views on to what extent OH depts should go with regards to their clients

I have often offered the view that OH should not seek to take the place of primary care or be seen to be some form of alternative to seeing GPs etc. However - we all know that these lines get blurry from time to time. I am also quite keen on not over "medicalising" management issues and batting things straight back to management if I don’t think issues are clinical in origin.

However - I have a current situation that is starting to get very complicated and complaints have been made that I am not being supportive enough. You`ll have to excuse the word  I am going to use as its probabaly not that professional but will convey the facts. I have an employee who (to be honest) is basically quite "odd" in his attitudes and behaviour. He can be very volatile, emotionally labile, reacts very strongly to seemingly common place events, he appears to tell lies on a fairly regular basis without apparent reason(or he has very selective understanding of what he has said or done in front of witnesses.) Consequently he has a very chequered history with his managers. I am not aware that he has ever been taken to task formally re some of his more spectacular outbursts ( I see the beginning of this process resting with performanace management procedures, with OH getting involved if it is thought that there are any clinical/health issues) But  after this long history pf problems that havent been dealt with his managers are now making statements like  "he is obviously emotionally unstable and should be referred to OH for assessment".  I have seen  him on numerous occasions when he has presented as being fairly reasonable if a bit annoyed at being in my office, he has been very emotional, denies that he has any problems apart from the "b*****ds" he works with and that he cant see that he has done anything wrong. I have recommended stress risk assessments, I have used CBT techniques, I have sent him for psychothgerapetic support, I have arranged mediation, I have advised him to seek the advice of his GP, I have liaised with the GP, I have spent quite a lot of time with him trying to get to the bottom of whats going on and all with little success or understanding.

The current position is that he is currently subject to 3 disciplinaries, he has initiated 2 grievances and of course has gone sick with "work realted stress" My advice has been that resolution of the issues within this case would be best achieved initially by management rather than clinical intervention (with a recommendation of the management actions eg dealing promptly with the grievances/investigations)  and also said that without management intervention certificated absence is highly likely to continue in the longer term with no realistic potential for resolution of the problems. 

The consequence of this is that I am being presssurised - their point is that there is "obviously" something badly wrong with this individual and that OH needs to "do something " about it. My stance has been that the issues are apparently primarily about issues at work and they need sorting. I have also stated that I don’t believe its within the remit of OH to be trying to source a diagnosis to account for the issues. In my own private opinion I think there may be something wrong - however the remit for determining what it is would surely rest with a consultant psychiatrist/psychologist and not with OH?

Interested in how others handle situations like this