Return-to-work-experts for inpatient treatment of patients with mental illnesses– a proof-of-concept-study (RETURN): the study protocol

Abstract

Background: Patients with mental illnesses often have massive difficulties returning to work after inpatient treatment at a psychiatric clinic and are often at risk of losing their jobs. The psychosocial support for this patient group at the interface of clinic/outpatient care is often insufficient. Methods/design: The RETURN-study prospectively assesses and surveys 200 patients with mental disorders in a cluster randomized intervention study, i.e. treatment teams and patients from intervention wards receive a returnto-work (RTW) intervention. Patients in control wards obtain treatment as usual (TAU). Pairs of comparable wards (similar patient population, similar staff density) have been identified and then randomized for control and intervention (n = 14 for each condition). On intervention wards return-to-work experts (RTW experts) who focus treatment on the workplace-related needs of patients with mental illnesses have been established. These RTW experts ensure the use of available resources within the framework of work-related discharge management and should lead to a more successful return to the workplace. The days at work in the year after release will be evaluated in a mixed methods approach as well as the return rate in the year after release, disability days in the year after return, relapse rate after 12 months, cost-benefit ratio of the intervention, analysis of the predictors / barriers for a successful return to the workplace (e.g. psychopathology, cognition, stigma, social-psychiatric support, company support, etc.), possibilities to implement the concept of RTW experts in standard psychiatric care (TAU-treatment as usual), the impact of the RTW experts' approach on the treatment process in standard psychiatric care.

Fit for Work and Life—an eight-week program for improvement of functionality and quality of life

“…In recent years, awareness of the interaction between work and mental health has increased greatly. However, the group of patients suffering from mental illnesses requiring hospitalization and their possible return to work has been neglected [ 52 ]. Fourth, the minimum participation (when the program is considered attended) of only three times is low.…”

Facilitators and Barriers of Return to Work in Working People with Serious Mental Illness: A Qualitative Study

“…Sometimes, barriers to RTW cause dissatisfaction in people with mental illness, mainly because of insufficient support or recurrence of the illness, especially in the context of work. 12,13 There is limited information about facilitators and barriers to RTW for designing interventions related to the RTW of WPSMI, especially in low-income countries. Among the limited studies conducted in this regard, some RTW interventions have not been successful.…”

“…Sometimes, barriers to RTW cause dissatisfaction in people with mental illness, mainly because of insufficient support or recurrence of the illness, especially in the context of work. 12 , 13 …”

Concept of the Munich/Augsburg Consortium Precision in Mental Health for the German Center of Mental Health

“…(2) The Munich Model is a disease management program that has been successfully implemented by TUM since 2006; it incorporates all evidence-based treatments and strategies related to relapse prevention in SZ and MDD, such as personal compliance profiles, psychoeducation, depot treatment, and others, and its success has been demonstrated (40). ( 3) The RETURN study focusses on how people with mental illness can best be supported when returning to their workplaces after being treated in a psychiatric hospital (41).…”