Interventions to improve return to work in depressed people

Nieuwenhuijsen, Karen; Verbeek, Jos; Neumeyer‐Gromen, Angela; Verhoeven, A. C.; Bültmann, Ute; Faber, Babs

doi:10.1002/14651858.cd006237.pub4

Cited by 121 publications

(183 citation statements)

References 187 publications

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“…Some of the studies named PST in the earlier meta-analyses have been grouped RTW-I in the present since they had a clear RTW-focus. In the earlier meta-analyses, there was no group reflecting the RTW-focus (Arends et al 2012; Nieuwenhuijsen et al 2014). As in previous studies, this meta-analysis showed generally small effects on sick leave, but there was a significant effect on sick leave when comparing all interventions to CAU.…”

Section: Discussionmentioning

confidence: 99%

“…The results of these meta-analyses are thus somewhat inconsistent, but as additional studies are published in a rapid pace further systematic reviews and meta-analyses are warranted to investigate the effect of psychological treatments on sick leave. In addition, two of the prior meta-analytic studies included solely depression (Nieuwenhuijsen et al 2014) or adjustment disorder (Arends et al 2012) respectively, and not the whole spectrum of CMDs, which could have reduced statistical power in previous studies. A third meta-analysis restricted outcomes to the proportion of employees who returned to work after the intervention and time until full RTW (Nigatu et al 2016), which might exclude studies with other relevant measures of sick leave and RTW.…”

Section: Introductionmentioning

confidence: 99%

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Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders

2018

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Sick leave due to common mental disorders (CMDs) increase rapidly and present a major societal challenge. The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the field. The aim of the present meta-analysis was to calculate the effect size of psychological interventions for CMDs on sick leave and psychiatric symptoms based on all published randomized controlled trials. Methodological quality, the risk of bias and publication bias were also assessed. The literature searches gave 2240 hits and 45 studies were included. The psychological interventions were more effective than care as usual on both reduced sick leave (g = 0.15) and symptoms (g = 0.21). There was no significant difference in effect between work focused interventions, problem-solving therapy, cognitive behavioural therapy or collaborative care. We conclude that psychological interventions are more effective than care as usual to reduce sick leave and symptoms but the effect sizes are small. More research is needed on psychological interventions that evaluate effects on sick leave. Consensual measures of sick leave should be established and quality of psychotherapy for patients on sick leave should be improved.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders

2018

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“…Rehabilitation services serve PMIs better when they are integrated with clinical services. 13 , 17 , 18 Thus, changes in rehabilitation must parallel corresponding changes in mental health care delivery. Some areas in which telerehabilitation may play a role are as follows: Telemedicine Telepsychotherapy Telepsychiatric social work and liaison Supervision of home-based rehabilitation Training and mentoring of grassroots workers by experts …”

Section: Role Of Telerehabilitationmentioning

confidence: 99%

Telerehabilitation in Psychiatry

Jayarajan

Sivakumar

Torous

et al. 2020

Indian Journal of Psychological Medicine

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The COVID-19 pandemic has interrupted the usual mechanisms of healthcare delivery and exacerbated symptoms of mental illnesses. Telemedicine has morphed from niche service to essential platform, with newly released guidelines that cover various aspects of tele-mental health delivery. Rehabilitation services, which incorporate a range of psychosocial interventions and liaison services, have been significantly impacted too. They are currently more institute-based than community-based in India. However, recent legislation has mandated that community-based rehabilitation options be available. While a large treatment gap for mental health issues has always existed, telemedicine provides an opportunity to scale services up to minimize this gap. Community-based rehabilitation can be delivered over various platforms, from text to phone to videoconferencing, and various devices. Telemedicine is cost-effective, and enables delivery of services where existing services are inadequate. The recent guidelines allow other healthcare workers to be involved in mental health service delivery. Hence, in addition to direct delivery of services, telerehabilitation can facilitate task-shifting, with mental health professionals mentoring and supervising existing human resources, such as ASHA workers, VRWs, DMHP programme staff, and others. Tele-rehabilitation also poses challenges - not all needs can be met; access and privacy can be a problem in resource-scarce settings; liaison with existing services is required; and organisations need to plan appropriately and re-allocate resources. Digital access to welfare benefits and interventions must be expanded without disadvantaging those without internet access. Yet, many rehabilitation interventions can be adapted to telemedicine platforms smoothly, and task-shifting can broaden access to care for persons with disability.

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“…Common mental disorders such as depression, anxiety and stress disorders are frequent causes of sick leave in high-income countries, including Denmark [ 1 2 3 4 ]. In Denmark, common mental disorders are the main reason for early retirement [ 2 5 ], and anxiety and depression alone account for annual production losses of 1.6 billion Euros (2010–2012 price levels) caused by absence from the labour market due to sick days, early retirement benefits and early death [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…People with common mental disorders who want to keep, return to or find a job often have a combination of social problems and health issues that call for integration of public services but are often met with fragmented and uncoordinated services [ 6 ]. Research has shown that adequate mental health care cannot stand alone when supporting people in returning to work [ 4 ]. Integration of health care and vocational services has shown to improve return to work for people with severe mental disorders [ 7 8 ].…”

Section: Introductionmentioning

confidence: 99%

Shared Decision Making in an Integrated Mental Health and Vocational Rehabilitation Intervention: Stakeholder Practices and Experiences

Pii¹,

Hybholt²,

Poulsen³

et al. 2020

International Journal of Integrated Care

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Introduction Common mental disorders such as depression, anxiety and stress disorders are frequent causes of sick leave in high-income countries, including Denmark [1-4]. In Denmark, common mental disorders are the main reason for early retirement [2, 5], and anxiety and depression alone account for annual production losses of 1.6 billion Euros (2010-2012 price levels) caused by absence from the labour market due to sick days, early retirement benefits and early death [2]. People with common mental disorders who want to keep, return to or find a job often have a combination of social problems and health issues that call for integration of public services but are often met with fragmented and uncoordinated services [6]. Research has shown that adequate mental health care cannot stand alone when supporting people in returning to work [4]. Integration of health care and vocational services has shown to improve return to work for people with severe mental disorders [7, 8]. Only little evidence exists regarding the effectiveness or feasibility of intersectoral integration efforts for persons with common mental disorders [1]. However, integrating mental health care and vocational rehabilitation has proven to be difficult [9-11]. Research has identified cooperation between multidisciplinary stakeholders across sectors as one of the main barriers [6, 12, 13]. A meta-synthesis of client experiences with return-to-work interventions showed that the lack of coordination between public services left clients confused and uncertain about how and when to return to work. It was suggested that return-to-work processes

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Interventions to improve return to work in depressed people

Abstract: Analysis 2.3. Comparison 2 Work-directed plus clinical versus clinical alone (long term), Outcome 3 Work functioning. Analysis 3.1. Comparison 3 Work-directed plus clinical versus work-directed (medium term), Outcome

Cited by 121 publications

References 187 publications

Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders

Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders

Telerehabilitation in Psychiatry

Shared Decision Making in an Integrated Mental Health and Vocational Rehabilitation Intervention: Stakeholder Practices and Experiences

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