Stability of return to work after a coordinated and tailored intervention for sickness absence compensation beneficiaries with mental health problems: results of a two-year follow-up study.

Abstract

Mental health problems (MHPs) are increasingly common as reasons for long-term sickness absence. However, the knowledge of how to promote a stable return to work (RTW) after sickness absence due to MHPs is limited. The purpose of this study was to assess the effects of a multidisciplinary, coordinated and tailored RTW-intervention in terms of stability of RTW, cumulative sickness absence and labour market status after 2 years among sickness absence compensation beneficiaries with MHPs. In a quasi-randomised, controlled trial, we followed recipients of the intervention (n = 88) and of conventional case management (n = 80) for 2 years to compare their risk of recurrent sickness absence and unemployment after RTW, their cumulative sickness absence and their labour market status after 2 years. We found no statistically significant intervention effect in terms of the risk of recurrent sickness absence or unemployment. Intervention recipients had more cumulated sickness absence in year one (mean difference = 58 days; p < 0.01) and year two (mean difference = 36 days; p = 0.03), and fewer were self-supported at the end of follow-up (52% versus 69%; p = 0.02). The intervention showed no benefits in terms of improved stability of RTW, reduced sickness absence or improved labour market status after 2 years when compared to conventional case management. Evidence for effective return-to-work (RTW) interventions for people with mental health problems is limited, as most research to date has been done in the context of musculoskeletal disorders. A complex, multidisciplinary intervention, detached from the workplace, does not appear to improve the stability of RTW and may actually lead to more sickness absence days and less self-support when compared to conventional case management of sickness absence beneficiaries in Denmark. A stronger focus on cooperation with social insurance officers and employers may produce better results.