Stability of return to work after a coordinated and tailored intervention for sickness absence compensation beneficiaries with mental health problems: results of a two-year follow-up study

Abstract

Purpose: Mental health problems (MHPs) are increasingly common as reasons for long-term sickness absence. However, the knowledge of how to promote a stable return to work (RTW) after sickness absence due to MHPs is limited. The purpose of this study was to assess the effects of a multidisciplinary, coordinated and tailored RTW-intervention in terms of stability of RTW, cumulative sickness absence and labour market status after 2 years among sickness absence compensation beneficiaries with MHPs. Methods: In a quasi-randomised, controlled trial, we followed recipients of the intervention (n = 88) and of conventional case management (n = 80) for 2 years to compare their risk of recurrent sickness absence and unemployment after RTW, their cumulative sickness absence and their labour market status after 2 years. Results: We found no statistically significant intervention effect in terms of the risk of recurrent sickness absence or unemployment. Intervention recipients had more cumulated sickness absence in year one (mean difference = 58 days; p < 0.01) and year two (mean difference = 36 days; p = 0.03), and fewer were self-supported at the end of follow-up (52% versus 69%; p = 0.02). Conclusion: The intervention showed no benefits in terms of improved stability of RTW, reduced sickness absence or improved labour market status after 2 years when compared to conventional case management.

Implications for Rehabilitation

• Evidence for effective return-to-work (RTW) interventions for people with mental health problems is limited, as most research to date has been done in the context of musculoskeletal disorders.

• A complex, multidisciplinary intervention, detached from the workplace, does not appear to improve the stability of RTW and may actually lead to more sickness absence days and less self-support when compared to conventional case management of sickness absence beneficiaries in Denmark.

• A stronger focus on cooperation with social insurance officers and employers may produce better results.

• Intervention
• mental health
• recurrent sickness absence
• return-to-work
• unemployment

Declaration of interest

The authors report no declarations of interest. The study was supported by grants from the Danish Prevention Fund (Forebyggelsesfonden, grant #07-2-2-020) and the Danish Working Environment Research Fund (Arbejdsmiljøforskningsfonden, grant #31-2008-09). Neither of the funding bodies was involved in the study design, the collection, analysis or interpretation of data, the writing of the paper or the decision to submit the paper for publication.