Cooperation of return-to-work professionals: the challenges of multi-actor work disability management

Abstract

Purpose: This article explores which concrete factors hinder or facilitate the cooperation of return-to-work (RTW) professionals in a complex system of multiple stakeholders.

Method: The empirical material consists of in-depth interviews with 24 RTW professionals from various organizations involved in work disability management in Finland. The interviews were analyzed using thematic content analysis.

Results: The study revealed several kinds of challenges in the cooperation of the professionals. These were related to two partly interrelated themes: communication and distribution of responsibility. The most difficult problems were connected to the cooperation between public employment offices and other stakeholders. However, the study distinguished notable regional differences depending primarily on the scale of the local network. The main areas of improvement proposed by the interviewees were related to better networking of case managers and expansion of expertise.

Conclusions: The article argues for the importance of systematic networking and stresses the role of public employment services in the multi-actor management of work disabilities. The article contributes to existing work disability case management models by suggesting the employment administration system as an important component in addition to health care, workplace and insurance systems. The study also highlights the need for expansion of expertise in the field.

Implications for Rehabilitation

• Cooperation between RTW professionals in public employment offices and other organizations involved in work disability management was considered inadequate.

• In order to improve the cooperation of RTW professionals, the stakeholders need to create more systematic ways of communication and networking with professionals in other organizations.

• There is a need to expand the expertise in work disability management and rehabilitation, partly by increasing the role of other professionals than physicians.

Keywords:

• Cooperation
• return to work
• unemployment
• vocational rehabilitation
• work disability

Acknowledgements

We would like to thank all the professionals who agreed to be interviewed. We would also like to thank Raija Gould, Susan Kuivalainen and Jukka Kivekäs for their comments on earlier versions of the paper. Finally, we gratefully acknowledge the helpful suggestions of the two anonymous reviewers.

Ethical standards

All procedures performed in the study involving human participants were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Disclosure statement

The authors report no conflicts of interest.

Notes

1 Kela manages a big part of social security in Finland, for example family benefits, health insurance, rehabilitation for certain groups, basic unemployment security, housing benefits, financial aid for students and basic pensions.

2 Labor force service centers are targeted for a relatively small group of long-term unemployed who need individual support and special social services. The centers are organized together with municipalities, public employment offices and Kela. The majority of the unemployed persons are clients in public employment offices.