Effect of an intervention to enhance guideline adherence of occupational physicians on return-to-work self-efficacy in workers sick-listed with common mental disorders

Abstract

BackgroundSince a higher level of self-efficacy in common mental disorders is associated with earlier return-to-work (RTW), it is important to know if work related self-efficacy can be increased by occupational health care. The primary aim of this study was to evaluate whether an intervention to enhance guideline adherence of occupational physicians lead to an increase in RTW self-efficacy in workers three months later. The secondary aim was to evaluate whether the intervention modified the association between RTW self-efficacy and return-to-work three months later.MethodsA total of 66 occupational physicians participated in the study. They were randomized into two groups; the intervention group received a training, the control group did not. The training aimed to enhance adherence to a mental health guideline that contained strategies that are supposed to enhance RTW self-efficacy. In 128 sick-listed workers guided by these occupational physicians, RTW self-efficacy, RTW, and personal, health-related and work-related variables were measured at baseline and three months later. Generalized linear mixed models analysis and linear mixed models analysis were used for the evaluations.ResultsIn workers whose occupational physicians had received the training RTW self-efficacy increased significantly more than in workers whose occupational physicians had participated in the control group (t = −2.626, p ≤ .05). Higher baseline RTW self-efficacy scores were significantly more often associated with full RTW than with no RTW three months later (OR 2.20, 95 % CI 1.18–4.07), but the intervention did not affect this association.ConclusionsThis study showed that a training to enhance guideline adherence of occupational physicians leads to increased RTW self-efficacy in workers sick-listed with common mental disorders during the first months of sickness absence in a real-life occupational health care setting. This insight is helpful for optimizing the recovery and RTW process, and for understanding the role of RTW self-efficacy in this process.Trial registrationISRCTN86605310

Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues: position paper and future directions

“…If people with MI/MHI make insufficient effort to find or keep employment as a result of self-stigma, this increases their risk of unemployment. Whereas cognition is increasingly gaining attention in work rehabilitation research, such as research on return-to-work perceptions and return-to-work self-efficacy [44][45][46], studies on the long-term effects of self-stigma, anticipated discrimination and especially on the "Why Try" effect on unemployment are scarce and warrant more attention [47]. Moreover, considering the high prevalence of the "Why Try" effect, more intervention studies on how to overcome self-stigma and improve work-related self-efficacy are urgently needed.…”

“…Mental disorders are even more prevalent in young people: in OECD countries, approximately one in four 15 to 24 year-olds have a mental disorder, which puts them at a higher risk of dropping out of school and having poorer chances of finding stable employment [1]. A recent epidemiological study investigating the influence of different chronic health problems on loss of employment in workers aged [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] showed that workers with selfreported psychological health problems had the highest risk of unemployment. Moreover, compared to workers with other chronic health conditions, they also had a higher risk of other adverse occupational outcomes, such as taking early retirement and exiting the work force via disability benefits and sick leave [6][7][8].…”

Reducing the time until psychotherapy initiation reduces sick leave duration in participants diagnosed with anxiety and mood disorders

“…For example, studies carried out with workers with a diagnosed mental disorder found that a delay of more than 3 weeks in the medical consultation after going on sick leave was one of the main factors predicting a long sick leave of between 3 and 6 months (Brouwers et al, 2009). In addition, different studies have shown that when there is an initial consultation with the work physician (not a mental health specialist) in the first 2 (Caballero-Martínez et al, 2014;Van Beurden et al, 2015) to 6 weeks (Nieuwenhuijsen, Verbeek, de Boer, Blonk, & van Dijk, 2005) of the sick leave, there is a reduction in the number of workers on long-term sick leave for common mental disorders. Other studies have found that the return to work occurs sooner when there has been follow-up by the work physician (previously trained by a psychiatrist), compared to care as usual Therefore, the studies mentioned above suggest that the time until initiating the evaluation and treatment by a healthcare professional of a patient on sick leave for a common mental health disorder is an important factor in the duration of the sick leave.…”

Effectiveness of a return-to-work program for workers without an employment contract, sick-listed due to common mental disorders

“…Common mental health problems are mild-to-moderate depressive, anxiety, and stress-related complaints, which have also been described as common mental disorders (CMD) (1). The large impact of CMD on society has led to a growing attention in recent literature for the development and evaluation of interventions that aim to promote returnto-work (RTW) of workers on sick leave due to a CMD (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Many of these studies focused on sick-listed employees, ie, workers with an employment contract.…”