Employees Receiving Inpatient Treatment for Common Mental Disorders in Germany: Factors Associated with Time to First and Full Return to Work

Abstract

Purpose In Germany, return to work (RTW) after inpatient treatment for common mental disorders (CMDs) is a complex process at the intersection of the mental healthcare system and the workplace. This study examined (1) the time to first and full RTW and (2) associated factors among employees receiving inpatient treatment for CMDs. Methods In this prospective cohort study, employees receiving inpatient psychiatric or medical rehabilitation treatment for CMDs were interviewed by phone during their last week before discharge. Follow-up interviews were conducted after 6, 12, and 18 months. Health-, personal, and work-related factors were used from baseline measurement. Parametric survival analysis was conducted to identify factors associated with time to first and full RTW. Results A total of N = 269 participants who stayed at a psychiatric clinic or a medical rehabilitation facility were included. Almost all participants (n = 252, 94%) from both treatment settings reported a first RTW and a full RTW. The time to first and full RTW was shortest among participants from medical rehabilitation (both median 6 days) and longer among participants from psychiatric treatment (median 17 days to first RTW and 73 days to full RTW). While only health-related and personal factors were associated with time to first RTW, leadership quality and needed individual RTW support were associated with time to full RTW. Conclusions More attention to work accommodation needs for RTW in clinical practice and coordinated actions towards RTW in collaboration with key RTW stakeholders in the workplace may support a timely RTW.Clinical Registration Number DRKS00010903, retrospectively registered.

Are psychosocial work factors and work-home interference associated with time to first full return-to-work after sick leave due to common mental disorders?

“…Here, 82% had returned to their ordinary working hours during a 12-month follow-up (Keus van de Poll et al 2020 ). A German study of patients receiving in-patient care for CMDs found that 93.7% returned to work after 18 months of follow-up (Sikora et al 2022 ). In a Danish study of employees on sick leave with CMDs enrolled from PCCs, using an outcome of full-time work at 12 months, 67% returned to full-time work after 1 year (Netterstrøm et al 2015 ).…”

“…However, in a recent scoping review, de Vries et al ( 2018 ) found the evidence for many factors influencing RTW, including psychological job demands, to be insufficient. Similarly, the evidence for the association between low social job support in the workplace and RTW is inconclusive (Flach et al 2012 ; Netterstrøm et al 2015 ; Sikora et al 2022 ). A good balance in everyday life is perceived as essential for a ‘successful’ RTW, while interference between demands at work and in private life has been identified as a barrier (Hees et al 2012 ; Joosen et al 2021 ; Nybergh et al 2020 ).…”

“…To date, there is limited evidence of an association between WHI and HWI and time to RTW. Only recently, Sikora et al ( 2022 ) found that employees receiving in-patient treatment for their CMDs and reporting work-home interference as associated with a longer time to first and full RTW.…”

Evaluating a multimodal, clinical and work-directed intervention (RTW-PIA) to support sustainable return to work among employees with mental disorders: study protocol of a multicentre, randomised controlled trial

“…The SIBAR has a 7-point response scale, with the answer options: immediately , one month , three months , six months , nine months , one year or later , and not at all anymore . As has been done before [ 90 ], the single SIBAR-item responses will be dichotomised into a’positive RTW expectation (≤ 3 months)’ and’negative RTW expectation (> 3 months)’.…”

The cost-utility of a return-to-work intervention in comparison to routine care for patients with mental disorders in Germany: Results from the RETURN project

“…Another reason could lie in expectations towards return-to-work. Sikora et al [3] could show that a positive expectation towards return-to-work in patients with a common mental disorder (CMD) was associated with a quicker return to the job.…”