Perspectives of unemployed workers with mental health problems: barriers to and solutions for return to work

Figures & data

Table 1. Overview of the workers’ perceived barriers to returning to work (n = 25).

Barriers to returning to work
1. Current perceived decreased ability to work due to mental and physical health status (including mental health problems and/or traumatic experiences)
• Mild mental complaints up to severe mental health problems, e.g., major depressive symptoms, fatigue, reduced concentration, stress, disrupted sleep
• Physical complaints, e.g., musculoskeletal complaints, visual impairment, Lyme disease, gynaecological problems and intestinal problems
• Psychosocial problems and/or traumatic experiences, e.g., personal problems such as divorce and family care problems, financial problems, negative work experiences, death of loved ones, relatives or acquaintances
2. Labour market problems
• Lack of available jobs
• Reduced chance of getting a job because of extended sick leave or lack of work experience
• Lack of career prospects due to unavailability of jobs
• Finding an employer who is willing to employ workers with impairments or disabilities
3. Inadequate (medical) treatment
• Long waiting lists for psychiatric treatment
• Lack of intensive psychiatric/psychological help
• Health insurance only covering up to five psychological treatment sessions
• Treatment through curative care is not focused on return to work
4. Issues related to the Social Security Agency
• Poor communication
• No personal contact with a professional representative of the Social Security Agency
• Perceived bureaucracy
• Requirement to possess computer skills and have internet access to make contact
• Inadequate support (e.g., no help with job search or writing a letter of application, training programme does not address the need) or rules that do not fit their situation
• Unclear procedures and lack of information when sick-listed
5. Personal characteristics and beliefs
• Low education
• Older age
• Lack of required training
• Difficulties working with an employer
• Strong need to maintain current balance
• Non-indigenous ethnic origin
• Wearing a headscarf
6. Personal circumstances
• Financial problems
• Not able to follow education, visit the gym, buy a computer or pay a ticket for public transport to get to the workplace
• Lack of childcare facilities
• Rapid return to work discouraged by the general practitioner or family

Table 2. Overview of the workers’ perceived solutions for returning to work (n = 25).

Solutions for returning to work
1. Appropriate treatment
• Treatment by medical doctor, psychologist, psychotherapist or social care worker
• Hypnosis
• Cognitive behavioural therapy
• Medication
2. Recovery from complaints/gradually returning to work
• Recovery from complaints (e.g., getting more sleep and regaining control)
• Gradual return to work
• Gradual return to work in combination with intensifying social life
• Regaining rhythm and structure (e.g., due to gradual return to work or internship)
3. Type of work and preconditions
• Adapted work activities or workplace
• Work that suits the worker
• Work that is fun and exciting
• Availability of work
• Preconditions such as transport to the workplace or access to a car
4. Beliefs and being active
• Want to work as soon as possible (e.g., to get a normal daily rhythm, to come out of isolation, to be among people again)
• Stayed positive, did not sit back passively
• Volunteer work
• Being active (e.g., visiting the gym, riding a bike, walking in the countryside or with a group with the same problems and doing jobs at home)
• Rest and structure needed
5. Support/communication with the Social Security Agency
• Better communication with and help and support from the Social Security Agency
• Personal contact in an early stage of sick leave and more frequent contact to address the worker’s questions and problems
• Help of a coach with
• Guidance during and a plan for the return to work
• Searching for the right job
• Mediation
• Writing job application letters
6. Adequate coaching and training
• Help and coaching/guidance from
• Agencies
• Vocational rehabilitation agencies
• Budget coaches
• The family
• Including
• Training for other job skills
• Guidance to another job
• Social support at home