Paper: Workplace-based interventions for return to work or work functioning outcomes among workers with common mental health conditions: A Systematic Literature Review

Author(s) and Affiliation(s):
Georgia Pomaki, Occupational Health and Safety Agency for Healthcare (OHSAH) in BC
Renée-Louise Franche, Occupational Health and Safety Agency for Healthcare (OHSAH) in BC, University of British Columbia, Simon Fraser University, Institute for Work & Health, University of Toronto
Noushin Khushrushahi, Occupational Health and Safety Agency for Healthcare (OHSAH) in BC
Thomas Lampinen, Occupational Health and Safety Agency for Healthcare (OHSAH) in BC
Phil Mah, Occupational Health and Safety Agency for Healthcare (OHSAH) in BC
Eleanor Murray, Occupational Health and Safety Agency for Healthcare (OHSAH) in BC
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Room: St. Patrick Room, 3rd Floor
Objectives:

The present study is a systematic literature review that examined the effectiveness of workplace-based interventions in improving return-to-work (RTW) outcomes or work functioning (WF) in workers with mental health conditions (MHCs) who are on sick leave. Workplace-based interventions are initiatives that employers or insurers can undertake or strongly facilitate. MHCs include mood, anxiety and adjustment disorders as primary or secondary diagnoses.

Methods:

We searched 6 electronic databases and hand-searched articles for reviews, qualitative studies and quantitative intervention studies published in English, French, Dutch and German between 2004 and 2009. We also searched websites of established international institutions for related guidelines and reports. Two reviewers screened abstracts (and when necessary, full-text articles) applying pre-established inclusion/exclusion criteria. Quality assessment and data extraction were performed in separate stages, each by two independent reviewers. Disagreements were resolved by consensus and involved a third reviewer as needed. We categorized evidence as high quality, medium quality or low quality; synthesized evidence to reach conclusions; and organized conclusions into three main themes: individual-, disability management practice-, and organizational-level interventions.

Results:

Our search yielded 1483 abstracts from reviews and 673 abstracts from primary studies. Following eligibility screening and quality assessment, we retained a total of 7 reviews, 9 quantitative studies, 6 qualitative studies, 4 guidelines, and 4 reports in our evidence synthesis. Disability management practice level interventions were most commonly examined, with little attention paid to organizational-level interventions. Effective interventions include: (a) structured and planned, close communication between worker, employer, care providers and other disability management stakeholders; (b) facilitated access to evidence-based treatments; and (c) systematic and coordinated (often guideline-based) RTW practice.

Conclusions:

Our review supports the effectiveness of workplace-based interventions for worker with MHCs who are on sick leave. Specifically, interventions that promote structured RTW practice or communication among those involved in RTW practices were found to be effective. Individual-level interventions based on cognitive behavioural therapy principles that were delivered by the employer or insurer were also effective in reducing sickness absence. There is a need to examine the effectiveness of organizational-level interventions that aim at raising awareness of MHCs or supporting the workplace as a way to improve RTW or WF outcomes.