Motivation for return to work and actual return to work among people on long-term sick leave due to pain syndrome or mental health conditions

Objectives To examine differences in patient activation and self-management support needs in a population of UK workers with long-term health conditions. Methods Demographic, health and activation information were taken from the data of participants with long-term conditions, collected via an online cross-sectional survey of workers. The 13-item British patient activation measure measured workers knowledge, skills and confidence towards self-managing. Results Three hundred and seven workers with mental health, musculoskeletal and other conditions completed the patient activation measure. Mental health conditions were most prevalent (36.8%). Workers were higher activated, however workers with mental health conditions were significantly less activated ( p = 0.006). Differences in activation by condition severity and age were revealed. Discussion This study provides insight to the activation of UK workers with long-term conditions. Whilst workers with mental health conditions need more training and education to self-manage, workers are variably activated indicating broader support needs. There is a gap for workplace self-management support. The patient activation measure is used in healthcare to improve people’s self-management and should be considered to be included in the workplace, and could form part of interventions to support workers self-management. More rigorous studies, including the patient activation measure, are needed to identify the best approaches to identifying workers self-management support needs.

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Vocational interventions to help adults with long-term health conditions or disabilities gain and maintain paid work: an overview of systematic reviews

BMJ Open ◽

10.1136/bmjopen-2021-049522 ◽

2021 ◽

Vol 11 (12) ◽

pp. e049522

Author(s):

William Mark Magnus Levack ◽

Joanna Kirstin Fadyl

Keyword(s):

Mental Health ◽

Systematic Reviews ◽

Health Conditions ◽

Paid Work ◽

High Quality ◽

Mental Health Conditions ◽

Moderate Quality ◽

Overview Of Systematic Reviews ◽

Quality Evidence

ObjectiveTo conduct an overview of systematic reviews to examine the effectiveness of vocational interventions to help adults with long-term health conditions or disability gain and maintain new paid work and to analyse the spread and quality of evidence in this area.MethodsWe pre-published our protocol in PROSPERO (CRD42019132448). We searched Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Proquest Dissertations and Theses database, NICE and Business Source Complete from inception to 21 August 2020. We included any systematic reviews of clinical trials on vocational interventions for adults with long-term health conditions or disability who were not in work or had recently gained work. We excluded reviews of vocational interventions for employed people on sick leave. Two researchers identified, critically appraised,using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2, and extracted data from included reviews. We used Grading of Recommendations Assessment, Development and Evaluation to evaluate strength of evidence underpinning overview findings.ResultsWe identified 26 reviews (5 high-quality and 21 critically low to moderate quality) that focused on vocational interventions for acquired brain injury, autism, intellectual disability, multiple sclerosis, mental health conditions, spinal cord injury and general disability populations. We identified moderate quality evidence that people with moderate to severe mental health conditions who participate in supported employment, particularly individual placement and support, are more likely to gain competitive employment compared with people who receive traditional vocational services (risk ratio 2.07; 95% CI 1.82 to 2.35; 27 studies, 6651 participants). We found only very low-quality to low-quality evidence on vocational intervention for people with any other health condition. We found little to no data on employer or employee satisfaction with work outcomes or the cost effectiveness of interventions.ConclusionGiven the importance placed on work opportunities for people with long-term health conditions or disability, there is urgent need for more high-quality research on vocational interventions for this population.Prospero registration numberCRD42019132448.

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Getting back to work: Experiences of the individual placement and support model from those with mental health conditions, an interpretative phenomenological analysis

Work ◽

10.3233/wor-213617 ◽

2021 ◽

pp. 1-11

Author(s):

Claire Raeside ◽

Jean McQueen

Keyword(s):

Mental Health ◽

Interpretative Phenomenological Analysis ◽

Social Inclusion ◽

Phenomenological Analysis ◽

Health Conditions ◽

Individual Placement And Support ◽

Mental Health Conditions ◽

Paid Employment ◽

Individual Placement

BACKGROUND: Evidence continues to build on the value of Individual Placement and Support (IPS), enabling those with long-term mental health conditions to find mainstream employment. Many of these individuals would like to work; however, unemployment for this population remains high. IPS research thus far has targeted the effectiveness of the model, with less emphasis on how individuals perceive and experience IPS and the return to work. OBJECTIVE: This study explores the barriers, enablers, meaning and personal experience of being supported to find work through IPS, for individuals with long-term mental health conditions. Findings based on lived experiences of nine participants from two Scottish centres running IPS, should be useful to enhance and develop services. METHODS: This study involves qualitative data collection, using semi-structured interviews and Interpretative Phenomenological Analysis (IPA). RESULTS: Transcript analysis revealed three master themes: 1) “Working is good for me”: positive aspects to working; 2) “Rome wasn’t built in a day”: time-unlimited supported journey and 3) “My inner critic”: negative aspects to working. Participants praised IPS for the on-going practical and emotional support in overcoming self-identified occupational barriers. CONCLUSION: Paid employment was greatly associated with financial freedom, social inclusion, increased self-esteem and alleviation of depressive symptoms. Participants described the person-centred, time-unlimited approach taken by the employment specialists (ESs) or occupational therapists (OTs), as the main enabler to maintaining paid employment. Barriers, such as anxiety and work-related stress were identified, however, participants felt supported to overcome some of these negative symptoms.

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Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

BMC Health Services Research ◽

10.1186/1472-6963-12-189 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 8

Author(s):

Gillard Steve ◽

◽

Adams Katie ◽

Edwards Christine ◽

Lucock Mike ◽

...

Keyword(s):

Mental Health ◽

Mixed Method ◽

Self Care ◽

Health Conditions ◽

Mixed Method Study ◽

Community Based ◽

Mental Health Conditions ◽

Health Initiatives

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“Dis-able bodied” or “dis-able minded”: stakeholders’ return-to-work experiences compared between physical and mental health conditions

Disability and Rehabilitation ◽

10.3109/09638288.2016.1172675 ◽

2016 ◽

Vol 39 (10) ◽

pp. 969-977 ◽

Cited By ~ 2

Author(s):

Emmie Vossen ◽

Nicolette Van Gestel ◽

Beatrice I. J. M. Van der Heijden ◽

Etiënne A. J. A. Rouwette

Keyword(s):

Mental Health ◽

Return To Work ◽

Health Conditions ◽

Work Experiences ◽

Physical And Mental Health ◽

Mental Health Conditions

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Do return to work interventions for workers with disabilities and health conditions achieve employment outcomes and are they cost effective? A systematic narrative review

Employee Relations ◽

10.1108/er-01-2017-0023 ◽

2018 ◽

Vol 40 (6) ◽

pp. 999-1014 ◽

Cited By ~ 3

Author(s):

Pauline Dibben ◽

Geoffrey Wood ◽

Rachel O’Hara

Keyword(s):

Mental Health ◽

Cost Effectiveness ◽

Return To Work ◽

Cost Effective ◽

Employment Outcomes ◽

Health Conditions ◽

Content Type ◽

Musculoskeletal Conditions ◽

Mental Health Conditions ◽

Lower Back

Purpose The purpose of this paper is to evaluate existing evidence on whether return to work interventions achieve employment outcomes and are cost effective in order to better inform those needing accommodations at work, as well as their line managers and trade union representatives, occupational health specialists and HR managers. Design/methodology/approach The paper uses a systematic narrative review to evaluate the evidence on the employment outcomes and cost effectiveness of return to work initiatives. Findings Evidence on interventions for musculoskeletal conditions such as lower back pain indicates that certain forms of intervention such as vocational rehabilitation and workplace-based rehabilitation facilitate outcomes such as employment, reduced sick leave and effective return to work. However, there is very little evidence on whether these interventions are cost effective. More generally there are glaring gaps in evidence on cardio-respiratory (heart and breathing) and mental health conditions with regard to both employment outcomes and the cost of interventions. Research limitations/implications This systematic review has critical and timely implications for both knowledge development and practice. While highlighting methodological limitations in the existing research base, it also presents avenues for further research on return work strategies and the factors inhibiting and facilitating their adoption and effective operation. Originality/value Although there is much existent literature on the return to work process, far less attention has been paid to the employment outcomes and cost effectiveness of interventions. This paper highlights the interventions for musculoskeletal conditions such as lower back conditions that may result in positive employment outcomes, with implications for practice. However, it also highlights gaps in evidence on the employment outcomes and cost effectiveness of interventions for cardio-respiratory (heart and breathing) and mental health conditions.

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