I have someone who we lured to the team by offering 4 weeks off in the first 2 months of his employment so he could do a pre-planned trip. Didn't require any special approvals because it's just an SOP.
I have someone who regularly takes 2-3 days off every month, because he works in concentrated bursts of energy, then needs to decompress.
And of course, I have one person who NEVER takes time off, because they always have so much to do and are afraid to let a ball drop. This leads to overwhelm, and a ball drops anyhow. So I need to force them to take time off.
As with all things, it's not just the mechanism, but the environment that mechanism exists within. It needs to be deployed alongside strong accountability mechanisms - planning, goaling, 1:1s, team health assessments, and performance reviews - otherwise it can be abused, or it can be hard to say 'no' to a request, or it can be hard to know when people aren't taking time they need.
But if you've done that, it's an incredible tool.