New dissertation on staying in work with mental health problems and return to work after sick leave
Welcome to Anna Frantz presentation of her thesis ”A problem-solving intervention among employees with mental health problems : effects, predictors and experiences”.
Time: 27 mars, kl. 9.00
Location: Rockefeller, Campus Solna
Supervisor: Elisabeth Björk Brämberg, Associate Professor, Institute of Environmental Medicine (IMM)
Opponent: Prof. Lene Aasdahl, Dept of Public Health and Nursing, Norwegian University of Science and Technology
Three questions to Anna Frantz
What is the thesis about?
Sick leave due to anxiety, depression, and stress-related mental disorders makes up a large part of all sick leave cases in Sweden. In this thesis, we investigated a problem-solving intervention in primary care, with workplace involvement in order to promote return to work. The participants also replied to a questionnaire about their health and the work environment. This was analyzed based on which factors were associated with sickness absence during 18 months.
In addition, interviews were conducted with employees who were at risk of sick leave due to mental illness, where they themselves described what helps and prevents them from being able to stay in work. Managers were also interviewed about their experiences of working with mental health in the workplace and the organizational conditions that affect this work.
Overall, the thesis aims to increase knowledge about whether a primary care-based, workplace-oriented intervention can support return to work and if so, for whom, and about the factors that are crucial for both employees and managers to succeed in dealing with mental illness in working life.
Can you tell us about some interesting results?
There was no difference between the intervention and usual care in terms of sickness absence days during 18 months follow-up. In both groups, the number of sick leave days decreased over time, especially during the first 6 months. This means that the prognosis for returning to work was generally good for most people. At the same time, there was a smaller group that was still on sick leave even at 18 months. Two factors that seemed to be associated with increased sickness absence during the follow-up period were low estimated work ability in relation to physical demands at work and high psychological demands (e.g. high pace, high effort, and conflicting demands). Being more certain of returning to one’s regular work within 3 months, on the other hand, was associated with lower rate of sickness absence.
In interviews with people who worked despite symptoms, promoting and hindering factors to working while having symptoms of mental health problems existed at several levels: individual, group, manager, and organization. A responsive manager who addressed problems and a good collegial climate at work were examples of support. At the same time, the physical work environment could constitute an obstacle. The managers, in turn, described a need for clear support from the organisation to prioritise work with mental health. Efforts to raise awareness among managers and employees were perceived as both positive and negative – positive because the issue was being highlighted, but at the same time adding the managerial burden when the benefit was unclear.
What further research is needed in the area?
It is still unclear whether the intervention tested has an effect on sick leave and return to work. Therefore, further studies are needed where the different components of intervention are evaluated to identify if and which ones can be effective.
Supporting people with mental health problems in the workplace is another important area. This applies both to people at risk of sick leave and who have returned to work to prevent relapse. Proportion of sickness absence cases related to mental disorders has increased in recent decades. Increased knowledge about preventing both initial sick leave and relapse is therefore important.