Dilemmes des médecins traitants lors du retour au travail de personnes aux prises avec un trouble mental courant : illustration par des vignettes cliniques

Boileau-Falardeau, Fabienne; Turcotte, Jean-Robert; Lafleur, Paul-André; Corbière, Marc

doi:10.7202/1073530ar

Cited by 3 publications

(7 citation statements)

References 29 publications

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“…33 Other factors that may explain these suboptimal practices include the lack of time available during consultations and physicians' fee-for-service remuneration models, which can limit physicians' level of engagement in the management of their patients' mental health-related sick leave. 13,15,34 Second, we found that access to mental health-related sick leave services varied in function of the level of involvement of different stakeholders and professionals. As mentioned by Corbière et al, 30 even if all stakeholders share the interest of achieving safe and sustainable return to work, the collaboration between them is difficult because each stakeholders' role are not well defined and understood by everyone.…”

Section: The Match Between the Person's Needs And Their Ability To Ac...mentioning

confidence: 90%

“…For example, this has been raised in a recent Swedish study, aimed at documenting organizational factors influencing return‐to‐work coordination processes, which found that lack of collaboration, long waiting times and inadequate drawing of RTW plans by primary care physicians were perceived as main barriers to better RTW coordination 33 . Other factors that may explain these suboptimal practices include the lack of time available during consultations and physicians' fee‐for‐service remuneration models, which can limit physicians' level of engagement in the management of their patients' mental health‐related sick leave 13,15,34 …”

Section: Discussionmentioning

confidence: 99%

“…Additionally, while family medicine groups offer nursing and social work services, access to psychology and occupational therapy is restricted, often requiring specific private insurance coverage or personal financial resources. Previous studies also documented that family physicians too often work in silos and lack the knowledge to effectively manage patients' RTW process and lack time to help patients navigate the system 13,15,18–20 . In this context, patients' rights to universal quality healthcare are undermined as well as their opportunities for recovery and healthy and safe RTW 21 .…”

Section: Introductionmentioning

confidence: 99%

“…These services are provided by family medicine groups composed of family physicians and different healthcare professionals 14 but also include general healthcare, rehabilitation and social services provided in the community and private clinics. When required, family physicians are the main prescribers of sick leave and have a central role in the management of the patient's recovery and RTW trajectory 13,15 . Following a recovery‐oriented practice model, they should engage in shared decision‐making with patients, ensuring informed access to preferred and appropriate services 16 .…”

Section: Introductionmentioning

confidence: 99%

“…When required, family physicians are the main prescribers of sick leave and have a central role in the management of the patient's recovery and RTW trajectory. 13 , 15 Following a recovery‐oriented practice model, they should engage in shared decision‐making with patients, ensuring informed access to preferred and appropriate services. 16 However, in the province of Quebec, access to a regular family physician is limited and over 20% of the population remains unregistered.…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting patients' journey with primary healthcare services during mental health‐related sick leave

Labourot,

Pinette,

Giguère

et al. 2024

Health Expectations

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ContextBest practice guidelines for the recovery and return to work (RTW) of people with mental disorders recommend access to the services of an interdisciplinary team combining pharmacological, psychological and work rehabilitation interventions. In the Canadian context, primary healthcare services are responsible for providing these services for people with common mental disorders, such as depressive or anxiety disorders. However, not everyone has easy access to these recommended primary healthcare services, and previous studies suggest that multiple personal, practice‐related and organizational factors can influence the patient's journey. Moreover, previous studies documented that family physicians often work in silos and lack the knowledge and time needed to effectively manage by themselves patients' occupational health. Thus, the care and service trajectories of these patients are often suboptimal and can have important consequences on the person's recovery and RTW.Objective and Population StudiedOur study aimed to gain a better understanding of the patient journeys and the factors influencing their access to and experience with primary healthcare services while they were on sick leave due to a common mental disorder.MethodsA descriptive qualitative research design was used to understand and describe these factors. Conventional content analysis was used to analyze the verbatim.ResultsFive themes describe the main factors that influenced the patient's journey of the 14 participants of this study: (1) the fragmented interventions provided by family physicians; (2) patients' autonomy in managing their own care; (3) the attitude and case management provided by the insurer, (4) the employer's openness and understanding and (5) the match between the person's needs and their access to psychosocial and rehabilitation services.ConclusionsOur findings highlight important gaps in the collaborative practices surrounding the management of mental health‐related sick leave, the coordination of primary healthcare services and the access to work rehabilitation services. Occupational therapists and other professionals can support family physicians in managing sick leaves, strengthen interprofessional and intersectoral collaboration and ensure that patients receive needed services in a timelier manner no matter their insurance coverage or financial needs.Patients of Public ContributionThis study aimed at looking into the perspective of people who have lived or are currently experiencing a sick leave related to a mental health disorder to highlight the factors which they feel hindered their recovery and RTW. Additionally, two patient partners were involved in this study and are now engaged in the dissemination of the research results and the pursuit of our team research programme to improve services delivered to this population.

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Section: The Match Between the Person's Needs And Their Ability To Ac...mentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Factors affecting patients' journey with primary healthcare services during mental health‐related sick leave

Labourot,

Pinette,

Giguère

et al. 2024

Health Expectations

View full text Add to dashboard Cite

show abstract

Recognition During the Return-to-Work Process in Workers with Common Mental Disorders

2022

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Acceptability and exploratory effects of an occupational therapy intervention to improve recovery and return to work of workers with mental health disorders in primary care: a mixed methods study protocol

Labourot,

Hong,

Briand

et al. 2024

Front. Psychiatry

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BackgroundPeople with common mental disorders (CMD) are prone to experience work disabilities, which can lead to sick leave. To support their recovery and return to work, evidence recommends providing a combination of primary care services including psychological and work rehabilitation interventions. Furthermore, interventions to coordinate return to work are required to ensure timely access to services and concerted action among stakeholders. Occupational therapists are qualified to provide these interventions and to facilitate sick leave management. However, current medical practices, lack of collaboration among stakeholders, and lack of occupational therapists working within family medicine groups create highly variable care pathways and delays in access to appropriate services.AimThis study aims to evaluate the acceptability and explore the effects of an occupational therapist-led program integrated within family medicine groups designed to improve the management of CMD-related sick leave and promote patients' recovery and sustainable return to work in the Canadian province of Québec.MethodsThis study will consist of a mixed methods multiple case study design. It will also use a participatory research approach, actively engaging family medicine group team members and patient partners throughout the study. The occupational therapy program will include three components: 1) consultation for prevention of sick leave and support for return-to-work decisions, 2) coordination of recovery and return-to-work services, and 3) provision of recovery and work rehabilitation services adapted to each patient’s needs. Questionnaires, interviews, and focus groups will be used to collect data on the eight dimensions of the acceptability model described by Sekhon et al. and to measure pre- and post-outcomes to assess the effects of the occupational therapy program. Data will be analyzed using the Framework Method and repeated measures statistical analysis.DiscussionWe expect that the provision of this innovative occupational therapy program will improve patients’ outcomes and the service trajectory of people with CMD. This study will document how to enhance interprofessional collaboration within family medicine groups and to ensure equitable access to work rehabilitation services for all patients, thereby improving recovery and healthy sustainable return-to-work.

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Dilemmes des médecins traitants lors du retour au travail de personnes aux prises avec un trouble mental courant : illustration par des vignettes cliniques

Cited by 3 publications

References 29 publications

Factors affecting patients' journey with primary healthcare services during mental health‐related sick leave

Factors affecting patients' journey with primary healthcare services during mental health‐related sick leave

Recognition During the Return-to-Work Process in Workers with Common Mental Disorders

Acceptability and exploratory effects of an occupational therapy intervention to improve recovery and return to work of workers with mental health disorders in primary care: a mixed methods study protocol

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