Understanding illness experiences of employees with common mental health disorders

Simpson, Glenn; Byrne, Paula; Gabbay, Mark; Rannard, Anne

doi:10.1093/occmed/kqv047

Cited by 13 publications

(8 citation statements)

References 11 publications

(9 reference statements)

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“…The process of rumination was reported to be centred on the unresolved work stressors leading to hospitalisation. This lived experience was consistent with a few other studies 4,37,39 reporting that the experience of work stress could lead to admission. The experience of ongoing rumination was also a result of the participants -having limited coping skills -left the issues too late and did not consult a health care worker for assistance at an earlier stage 39 .…”

Section: Ruminationsupporting

confidence: 90%

Experiences and perceptions of Return to Work (RTW) by clients with major depressive disorder in an extended sick leave period

Saonatse¹,

Witt²,

Niekerk³

2019

S. Afr. j. occup. ther.

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Introduction: Major Depressive Disorder (MDD) may cause difficulties that can influence employment. Although clients with MDD are typically expected to return to work (RTW) early, most are given the maximum duration of sick leave subsidised by their medical aid scheme, to recover. This study explored the lived perceptions and experiences of clients with MDD whilst on extended sick leave. Methods: The study used a descriptive phenomenological qualitative study design. Data were collected through informant interviews. An inductive content analysis was used to analyse the data. Findings: Eight participants were included in the study, of which 75% (n=6) were females and 25% (n=2) were males. One theme emerged from the data, namely 'waiting to RTW' with three categories (1) 'ruminating about RTW', (2) 'fears about RTW' and (3) 'social pressures to RTW'. Conclusion: The period of waiting to RTW after hospitalisation was found to be stressful due to perceived work issues and rumination about work politics that were perceived to contribute to the illness. However, social pressures also play a vital role as a facilitator to RTW. These findings have implications for vocational preparation by occupational therapists during this extended sick leave period. LITERATURE REVIEW Mental illnesses contribute to the global burden of disease and are reported to affect 10% of the global adult population 7, 8. Despite this, relatively few studies have been reported on this topic in developing countries such as South Africa 9,10. This indicates a gap in the knowledge about how mental illness is viewed in African countries and particularly how clients perceive and experience mental illness in relation to their state of employment mainly because the majority of literature described mental illness from Western perspectives. However, there are African concepts and understandings of mental

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Section: Ruminationsupporting

confidence: 90%

Experiences and perceptions of Return to Work (RTW) by clients with major depressive disorder in an extended sick leave period

Saonatse¹,

Witt²,

Niekerk³

2019

S. Afr. j. occup. ther.

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“…Whilst studies have investigated the experience of employees with mental illness (e.g. Simpson, Byrne, Gabbay and Rannard, 2015), very few have explored the experiences of managers faced with an employee mental health problem (Martin, Woods and Dawkins, 2015). Extant studies that have investigated managers' and business owners' perceptions of managing employees with mental illness, have been mainly concerned with the employment of an individual with a pre-existing mental health problem at the time of employment (e.g.…”

Section: Introductionmentioning

confidence: 99%

How managers experience situations involving employee mental ill-health

Martin

Woods

Dawkins

2018

IJWHM

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Mental health conditions such as depression are prevalent in working adults, costly to employers, and areas of social and legal liability for employers. Line managers are crucial in implementing organizational responses to employee mental ill-health but their perspectives are largely unrepresented in literature on workplace mental health promotion. This study aimed to explore situations in which line managers became aware of, and responded to, employees' emergent mental ill-health issues in order to guide theory and practice development. Design: Semi-structured interviews were conducted with 24 Australian managers who had supervised an employee with emerging mental health issues relating to depression or burnout. Interview transcripts were content analyzed to explore themes in managers' experiences. Findings: Managing an employee with an emerging mental health issue involves becoming aware of the issue, taking action to understand the situation and develop an action response, implementing the response and managing the ongoing situation. Each of these tasks had a range of positive and negative aspects to them e.g. managing the situation can be experienced as both a source of stress for the manager but also as an opportunity to develop greater management skills. Practical implications: Understanding line managers' experiences is critical to successful implementation of HR policies regarding employee health and wellbeing. HR strategies for dealing with employee mental health issues need to consider implementation support for managers, including promotion of guiding policies, training, emotional support and creating a psychosocial safety climate in their work units or teams.

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“…l The systematic review included four economic evaluations: two workplace-focused interventions were found to be cost saving from the perspective of the employer 60,71 and two studies showed no economic benefit compared with CAU. 21,80 l A review of qualitative studies 58,69,78,86 that focused on the RTW process found that, from the employee perspective, the following considerations were prominent: (1) concerns about reduced working capacities, (2) difficulty setting limits in demanding work situations, (3) a sense of responsibility and a fear of being a burden to an employer, (4) recognition of exhaustion and ( 5) the need to control cognitions and behaviour such as perfectionism. An interesting finding was that most workers were able to describe solutions; however, few workers expressed an intention to implement or utilise the solutions in the workplace, with the exception being structural adaptations of work demands.…”

Section: Resultsmentioning

confidence: 99%

A case management occupational health model to facilitate earlier return to work of NHS staff with common mental health disorders: a feasibility study

Parsons

Juszczyk

Gilworth

et al. 2021

Health Technol Assess

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Background The NHS is the biggest employer in the UK. Depression and anxiety are common reasons for sickness absence among staff. Evidence suggests that an intervention based on a case management model using a biopsychosocial approach could be cost-effective and lead to earlier return to work for staff with common mental health disorders. Objective The objective was to assess the feasibility and acceptability of conducting a trial of the clinical effectiveness and cost-effectiveness of an early occupational health referral and case management intervention to facilitate the return to work of NHS staff on sick leave with any common mental health disorder (e.g. depression or anxiety). Design A multicentre mixed-methods feasibility study with embedded process evaluation and economic analyses. The study comprised an updated systematic review, survey of care as usual, and development of an intervention in consultation with key stakeholders. Although this was not a randomised controlled trial, the study design comprised two arms where participants received either the intervention or care as usual. Participants Participants were NHS staff on sick leave for 7 or more consecutive days but less than 90 consecutive days, with a common mental health disorder. Intervention The intervention involved early referral to occupational health combined with standardised work-focused case management. Control/comparator Participants in the control arm received care as usual. Primary outcome The primary outcome was the feasibility and acceptability of the intervention, study processes (including methods of recruiting participants) and data collection tools to measure return to work, episodes of sickness absence, workability (a worker’s functional ability to perform their job), occupational functioning, symptomatology and cost-effectiveness proposed for use in a main trial. Results Forty articles and two guidelines were included in an updated systematic review. A total of 49 of the 126 (39%) occupational health providers who were approached participated in a national survey of care as usual. Selected multidisciplinary stakeholders contributed to the development of the work-focused case management intervention (including a training workshop). Six NHS trusts (occupational health departments) agreed to take part in the study, although one trust withdrew prior to participant recruitment, citing staff shortages. At mixed intervention sites, participants were sequentially allocated to each arm, where possible. Approximately 1938 (3.9%) NHS staff from the participating sites were on sick leave with a common mental health disorder during the study period. Forty-two sick-listed NHS staff were screened for eligibility on receipt of occupational health management referrals. Twenty-four (57%) participants were consented: 11 (46%) received the case management intervention and 13 (54%) received care as usual. Follow-up data were collected from 11 out of 24 (46%) participants at 3 months and 10 out of 24 (42%) participants at 6 months. The case management intervention and case manager training were found to be acceptable and inexpensive to deliver. Possible contamination issues are likely in a future trial if participants are individually randomised at mixed intervention sites. Harms No adverse events were reported. Limitations The method of identification and recruitment of eligible sick-listed staff was ineffective in practice because uptake of referral to occupational health was low, but a new targeted method has been devised. Conclusion All study questions were addressed. Difficulties raising organisational awareness of the study coupled with a lack of change in occupational health referral practices by line managers affected the identification and recruitment of participants. Strategies to overcome these barriers in a main trial were identified. The case management intervention was fit for purpose and acceptable to deliver in the NHS. Trial registration Current Controlled Trials ISRCTN14621901. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 12. See the NIHR Journals Library website for further project information.

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Understanding illness experiences of employees with common mental health disorders

Cited by 13 publications

References 11 publications

Experiences and perceptions of Return to Work (RTW) by clients with major depressive disorder in an extended sick leave period

Experiences and perceptions of Return to Work (RTW) by clients with major depressive disorder in an extended sick leave period

How managers experience situations involving employee mental ill-health

A case management occupational health model to facilitate earlier return to work of NHS staff with common mental health disorders: a feasibility study

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