Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)

Hamann, Johannes; Lang, Anne; Riedl, Lina; Blank, Daniela; Kohl, Monika; Brucks, Adele; Goretzko, David; Bühner, Markus; Waldmann, Tamara; Kilian, Reinhold; Falkai, P.; Hasan, Alkomiet; Keck, Martin E.; Landgrebe, Michael; Heres, Stephan; Brieger, Peter

doi:10.1192/j.eurpsy.2022.2357

Cited by 5 publications

(4 citation statements)

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“…Fourteen wards (clusters) were randomised to either the intervention group or the control group. Further details of the design of the RETURN project are published elsewhere [26], and results have recently been published [27].…”

Section: Methodsmentioning

confidence: 99%

The cost-utility of a return-to-work intervention in comparison to routine care for patients with mental disorders in Germany: Results from the RETURN project

et al. 2023

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Background Only two-thirds of patients admitted to psychiatric wards return to their previous jobs. Return-to-work interventions in Germany are investigated for their effectiveness, but information regarding cost-effectiveness is lacking. This study investigates the cost-utility of a return-to-work intervention for patients with mental disorders compared to treatment as usual (TAU). Methods We used data from a cluster-randomised controlled trial including 166 patients from 28 inpatient psychiatric wards providing data at 6- and 12-month follow-ups. Health and social care service use was measured with the Client Sociodemographic and Service Receipt Inventory. Quality of life was measured with the EQ-5D-3L questionnaire. Cost-utility analysis was performed by calculating additional costs per one additional QALY (Quality-Adjusted Life Years) gained by receiving the support of return-to-work experts, in comparison to TAU. Results No significant cost or QALY difference between the intervention and control groups has been detected. The return-to-work intervention cannot be identified as cost-effective in comparison to TAU. Conclusions The employment of return-to-work experts could not reach the threshold of providing good value for money. TAU, therefore, seems to be sufficient support for the target group.

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Section: Methodsmentioning

confidence: 99%

The cost-utility of a return-to-work intervention in comparison to routine care for patients with mental disorders in Germany: Results from the RETURN project

et al. 2023

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“…The promotion of pre-vocational training or supported employment appears to have a lot of potential in this context [26] . A recent study implied that greater RTW success was achieved when using targeted RTW interventions and already starting them while the patients are still on sick leave or at a psychiatric clinic [27] . A study has just started at Hannover Medical School using an RTW program designed for patients on sick-leave due to MHDs.…”

Section: Implications For Research and Practicementioning

confidence: 99%

Returning-to-work after mental health-associated sick leave: A qualitative interview study exploring the experiences of general practitioners in Germany

Geipel

Hamann

2023

Preprint

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Background and Aim: Psychiatric disorders are increasingly commonly globally. Especially when these disorders affect working people, this places a financial burden on society due to long-term sick leave, the incapacity to work and the inability to earn and pay taxes. General practitioners (GPs) are often the first health professionals to be consulted by those suffering from mental health disorders. This study investigated the experiences of GPs regarding their patients with mental health disorders and identified factors that are important for a successful return to work. Methods: This qualitative study used semi-structured interviews to explore the opinions of GPs (n = 12) working in Munich, Germany, or its metropolitan area. The interviews were audio-recorded, transcribed, and analyzed using the reflexive thematic analysis method as described by Virginia Braun and Victoria Clarke. Results: GPs think of themselves as important parts of the rehabilitation process of patients with mental health disorders. In their daily routine, they face many obstacles to ensure the best treatment and outcome for their patients. They also suffer from poor collaboration with other stakeholders, such as psychiatric hospitals, therapists or employers. They indicated that the mental health disorder of each patient is unique, including the barriers to and possibilities of a successful return to work. Additionally, the workplace appears to play a crucial role in the success rate of re-entry into work. It can exacerbate the mental health disorders or aid in their treatment. Fear, shame and stigmatization of the patients are personal factors responsible for prolonged sick leave. Conclusion: We conclude that GPs believe that they can have a major impact on the rehabilitation of patients with mental health disorders. As such, special focus should be placed on supporting them in this context..

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“…At present, most of the studies on the RTW of patients with schizophrenia are mainly focused on intervention measures (Hamann et al, 2023; Harris et al, 2017), and some studies have explored the barriers and facilitators to RTW of patients with other mental disorders (Joosen et al, 2022). However, there is a lack of a qualitative description of the experience of RTW in patients with schizophrenia over time after treatment, including what happens before and during the process of RTW (Young et al, 2005), this suggests that more attention needs to be paid to the different experiences of patients with schizophrenia in different periods of time during their RTW process after treatment.…”

Section: Introductionmentioning

confidence: 99%

Experiences of returning to work in patients with schizophrenia after treatment: A longitudinal qualitative study

Song,

Zhang,

Qin

et al. 2024

Int J Soc Psychiatry

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Background: Returning to work (RTW) has always been regarded as one of the important indicators to evaluate the therapeutic effect of patients with schizophrenia. The existing studies on RTW in patients with schizophrenia are mostly focused on intervention measures, and the qualitative research on RTW is very limited. The purpose of this study was to evaluate the experience of the RTW after treatment in patients with schizophrenia. Method: A longitudinal qualitative study was conducted involving 24 patients with schizophrenia in China. The interviews were held at three time-points during their RTW process, (1) when patients had improved and were close to discharge, (2) within 1 month post-discharge, and (3) 6 months post-discharge. The interview recordings were transcribed by the research team, and transcripts were independently analyzed by two independent coders using reflexive thematic analysis. Results: A total of 24 patients with schizophrenia participated in 72 personal interviews. The thematic framework based on the experience of patients with schizophrenia reveals a three-phases of the process of RTW: improved, being at a loss, and job crisis. The study identified one theme of the first phase: the expectation and optimism. Two themes in the second phase: (1) psychological distress of upcoming work; (2) expectation of assistance pre-work. And four themes in the third phase: (1) tremendous pressure of RTW; (2) lack of medical and social support; (3) social status and interpersonal relationships change; and (4) high level of financial pressure. Conclusion: The experience of RTW is a dynamic process with great challenges in each phase, patients with schizophrenia have been deeply affected by what they have experienced. There is an urgent need to ensure that existing community and social support is integrated into daily care to support patients with schizophrenia to RTW successful. The findings of this study also suggest relevant departments and employers should be aware of the barriers to RTW for patients with schizophrenia, and take certain measures to change the current situation.

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Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)

Abstract: This peer-reviewed article has been accepted for publication but not yet copyedited or typeset, and so may be subject to change during the production process. The article is considered published and may be cited using its DOI.

Cited by 5 publications

References 26 publications

The cost-utility of a return-to-work intervention in comparison to routine care for patients with mental disorders in Germany: Results from the RETURN project

The cost-utility of a return-to-work intervention in comparison to routine care for patients with mental disorders in Germany: Results from the RETURN project

Returning-to-work after mental health-associated sick leave: A qualitative interview study exploring the experiences of general practitioners in Germany

Experiences of returning to work in patients with schizophrenia after treatment: A longitudinal qualitative study

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