Exploring the return-to-work process for workers partially returned to work and partially on long-term sick leave due to common mental disorders: a qualitative study

Abstract

The pattern we found suggests a critical intention-behaviour gap between solutions and intentions for a full return to work and its implementation at work. This implies that we should develop new interventions that focus on helping workers and their environment to bridge this gap.

Health problems of nursing workers in a public educational institution

“…For the return in the labor environment of workers with mental disorders, the development of strategies is necessary for the worker to be understood by the other team members, to count with the supervisors support for this return to be healthy, minimizing suffering (22) .…”

As interações entre os atores no retorno ao trabalho após afastamento por transtorno mental: uma metaetnografia

“…These experiences emerge as: weakness, for not being able to manage their workload 18,19,20 ; mistrust in themselves, as they do not endure the demands of the job well 18,21 ; discredit, as they do not deal well with their own expectations of being a successful employee 18,21 ; sensitivity as to the reactions of others regarding their return to work 21,22 ; oppression for feeling forced to satisfy the expectations of others 13,20,21 ; and finally the impression they are being judged by the others for their work capability 20,23 . These elements may cause even more concerns and distress about the process of return to work 20 , feeling of shame and guilt 21 , need for isolation 20 , creating or reinforcing the negative image of a worker with mental disorders 21,24 , and discredit as to the possibility of being wellreceived and looked after at the workplace 18 .…”

“…Also of note is the role of these practitioners in having the worker more aware of his/her problems, and the hardships they face at the workplace, thus their need to have a suitable amount of time to solve their problems before return to work 13,20,23,28 . To that end, they use cognitive approaches based on coping strategies, such as having a conflictavoidance behavior, establishing limits that are suitable to the condition, and, finally, the training of skills and competences that may be applied in the workplace, such as, for instance, the ability to ask for help 13,28 .…”

“…The management may play a negative role when, in their return to work process-related actions, they do not include elements such as warm welcome and understanding 18,25,30 , when their actions are permeated by prejudice and labeling of the worker who was on sick leave due to mental disorders 18,20,21 , when there is spurious questioning about the authenticity of the disease and integrity of the worker, generating an atmosphere of distrust 13,24,30 , when the management uses mechanisms, in particular the engagement of insurance companies, to force the early return of the worker, by sending frequent letters and making phone calls, by asking them to present the company medical reports more often, and finally when they abusively dispute the sick-leave period recommended by the physicians who provide care for the sick worker 23,24 . These aspects may lead the worker to lose faith in the management, bringing animosity and resentment into the return to work process 24 , in addition to a feeling of helplessness and neglect 21 , elements that may hamper the return to work.…”

“…However, we have decided to limit the scope of mental disorders to mood disorder diagnoses (ICD-10 codes F30 to F39), neurotic and stressrelated disorders (ICD-10 codes F40 to F43) 12 , as these are the most prevalent, and are typically associated to sick leaves that lead to return to work, rather than early retirement 13 .…”