Return to work among employees on long term sickness absence due to common mental disorders

Transcription

1 Return to work among employees on long term sickness absence due to common mental disorders Maj Britt Dahl Nielsen, Malene Amby, Ute Bültmann & Reiner Rugulies

2 PIWA - Psychological wellbeing and work The National Research Centre for the Working Environment

3 Program Sickness absence and return to work in a Danish context About the PhD study Results from the baseline questionnaire Characteristics of participants Depressive symptoms Social support from co-workers and supervisor

4 Common Mental Disorders Self-reported clinical mental health problems (depression/anxiety) Reduced functioning and wellbeing (stress/burnout)

5 Issues regarding common mental health problems Unclear diagnosis Uncertain prognosis Limited of knowledge on treatment Stigma Employees on long term sickness absence due to common mental disorder less often return to the old employer compared to other diagnosis (Høgelund,2003)

6 Purpose of the PhD. project To understand and explain what factors hinders or facilitates return to work Including aspects of. Changes in health Changes in work role functioning Environmental factors Personal factors

7 The Danish flexicurity model Flexibility for the employers in Denmark: Employers can easily hire and dismiss people Social Security for the employees: Employees can receive different kinds of social benefits if they get fired or otherwise is unable to work The state bear the financial burden of social benefits

8 Sickness benefit compensation 1st.Day of absence 15th.day of absence The employer is obliged to give sickness compensation The employer can apply for reimbursement from the municipality

9 Municipalities has legal obligations to secure RTW 1) Municipality receives the application for reimbursement 2) Municipality sends an evaluation form to the employee 3) Municipality receives the evaluation form the employee 4) A social worker conduct a personal interview with the employee At latest after 4 weeks of absence Returned by the employee after 8 days At latest after 8 weeks of absence

10 Trust.and lack of diagnoses The employer has the right to obtain a sickness notification from the general practitioner after 5 days of absence or a declaration of absence from the employee The social workers in the municipality can receive advice from medical doctors

11 Study design 1) A longitudinal survey with 6 month follow-up 2) Qualitative interviews with 20 women

12 Inclusion and exclusion Inclusion Employee On sickness benefit compensation Off sick for at least 4-12 weeks Self-reported CMD at least part of the reason for absence Exclusion Alcohol or substance abuse Personality disorders Manio-depression Self-employed

13 Data collection (1) From June January 2008 we identified all employees on long term sickness absence due to self-reported CMD Data was collected via evaluation forms and applications for reimbursement We gathered information on age, gender, occupation, expected date for RTW

14 Data-collection (2) Employees in the Greater Copenhagen Area All employees on long term sickness absence 250 cases per week Employees on sickness absence due to CMD N=731 Participants N=301

15 Characteristics of participants and employees on sickness absence due to CMD in the Greater Copenhagen Area Employees on long term sickness absence due to CMD (N=731) 70 % female Mean age 41 Participants : (N=301) 79 % female Mean age 40 (21-62)

16 Themes - baseline questionnaire Mental health problems Self-rated health Work-role-functioning Perceptions of causes about the disease Social support Expectation and wishes of RTW Job accommodation Treatment

17 Employment status at baseline 83 % of respondents were employed full time 90 % of respondents were off-sick full time 10 % already quit their job 10 % were dismissed from their job

18 Vocational education % None below 3 years years More than 4 years

19 Workplace ,5 % ,5 Public Private Other

20 Self-reported reasons for being on sickness absence % Stress Depression Burnout Anxiety Fatigue Other

21 Perceptions of contributing factors related to sickness absenteeism 83 % reported work related factors 37 % reported private conditions

22 Depressive symptoms DSM-IV % ,5 41,4 3,3 No depression Major depression Danish population (major depression)

23 Treatment 68 % had consulted either a psychologist or a psychiatrist within the last 3 months 42 % was offered counselling by their work place 35 % took some kind of antidepressant medication

24 Social support from employer and coworkers 69 % felt that co-workers wanted them to RTW 58 % felt the supervisor wanted them to RTW 13 % felt that the supervisor pressured them to RTW 27 % were afraid of loosing their job if not returning soon 56 % wished to return to their old employer

25 work in progress 2008 February March April May The follow-up questionnaire The qualitative in-depth interviews

26 Thank you Contact information Maj Britt Dahl Nielsen National Research Centre for the Working Environment, Denmark Homepage PIWA research group: A copy of this presentation can be found at