The Uneven Foci of Work Disability Research Across Cause-based and Comprehensive Social Security Systems

MacEachen, Ellen; Varatharajan, Sharanya; Du, Bronson; Bartel, Emma; Ekberg, Kerstin

doi:10.1177/0020731418809857

Cited by 10 publications

(9 citation statements)

References 30 publications

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“…This study took place in four municipalities in the Capital Region of Denmark, a country with a comprehensive system providing social security 10 and healthcare free of charge. 11 Compensation for lost work capacity, called sick leave benefit, is governed by municipal jobcentres and is reimbursed to the employer or directly to the person on sick leave if the citizen is unemployed.…”

Section: Study Setting and Contextmentioning

confidence: 99%

Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with depression or anxiety: results from a three-arm, parallel randomised trial

Hoff¹,

Poulsen

Fisker³

et al. 2021

Occup Environ Med

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ObjectiveThe aim of this study was to investigate an integrated mental healthcare and vocational rehabilitation intervention to improve and hasten the process of return-to-work of people on sick leave with anxiety and depression.MethodsIn this three-arm, randomised trial, participants were assigned to (1) integrated intervention (INT), (2) improved mental healthcare (MHC) or (3) service as usual (SAU). The primary outcome was time to return-to-work measured at 12-month follow-up. The secondary outcomes were time to return-to-work measured at 6-month follow-up; levels of anxiety, depression, stress symptoms, and social and occupational functioning at 6 months; and return-to-work measured as proportion in work at 12 months.Results631 individuals were randomised. INT yielded a higher proportion in work compared with both MHC (56.2% vs 43.7%, p=0.012) and SAU (56.2% vs 45%, p=0.029) at 12-month follow-up. We found no differences in return-to-work in terms of sick leave duration at either 6-month or 12-month follow-up, with the latter being the primary outcome. No differences in anxiety, depression or functioning between INT, MHC and SAU were identified, but INT and MHC showed lower scores on Cohen’s Perceived Stress Scale compared with SAU at 12-month follow-up.ConclusionsAlthough INT did not hasten the process of return-to-work, it yielded better outcome with regard to proportion in work compared with MHC and SAU. The findings suggest that INT compared with SAU is associated with a few, minor health benefits. Overall, INT yielded slightly better vocational and health outcomes, but the clinical significance of the health advantage is questionable.Trial registration numberNCT02872051.

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Section: Study Setting and Contextmentioning

confidence: 99%

Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with depression or anxiety: results from a three-arm, parallel randomised trial

Hoff¹,

Poulsen

Fisker³

et al. 2021

Occup Environ Med

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“…Uneven foci of work disability policy research across cause-based and comprehensive social security systems were identified in a recent scoping review by MacEachen et al (2018). Articles on cause-based systems dwelled on system fairness and policies of proof of entitlement, while those on comprehensive systems focused more on system design complexities relating to worker inclusion and scope of medical certificates.…”

Section: Overarching Resources: Work and Non-work Related Legislation And Social Welfare Policymentioning

confidence: 99%

“…Overall, a clear difference in the nature of problems examined in the different systems was observed. For research to better inform policy making, the authors call for cross-pollination of research topics across the systems and more international comparison studies that are attuned to these policy differences (MacEachen et al 2018).…”

Section: Overarching Resources: Work and Non-work Related Legislation And Social Welfare Policymentioning

confidence: 99%

IGLOO: A Framework for Return to Work Among Workers with Mental Health Problems

Nielsen¹,

Yarker²,

Munir³

et al. 2020

Handbook of Disability, Work and Health

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“…For research to better inform policy making, the authors call for cross-pollination of research topics across the systems and more international comparison studies that are attuned to these policy differences (MacEachen et al 2018).…”

Section: Overarching Resources: Work and Non-work Related Legislation...mentioning

confidence: 99%

IGLOO: A Framework for Return to Work Among Workers with Mental Health Problems

Nielsen¹,

Yarker²,

Munir³

et al. 2020

Handbook of Disability, Work and Health

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It is important for society and for organizations to support workers returning to work following mental health-related absence. Recent evidence points to an increase in mental health problems among the general population, with approximately 38.2% of the EU population suffering from a mental disorder each year (European Commission 2008.Of those who take a period of sick leave, 55% of workers make unsuccessful attempts to return to work (RTW) and 68% of those who do return have less responsibility and are paid less than before (Matrix Insight 2013). A number of challenges have been reported by workers following a period of long-term sickness absence, however current research has been somewhat limited by a focus on the initial return and a siloed approach where work and nonwork contexts are considered separately.In this book chapter, we apply the IGLOO (individual, group, leader, organizational and overarching contextual factors that may support sustainable RTW) model (Nielsen et al. 2018). In doing so, we focus on the sickness absence before return to work and consider the factors that could support return to work following long-term sickness absence. We provide an overview of the resources that may facilitate return to work among workers who are on sick leave with mental health problems. Based on the IGLOO framework we identify and discuss resources, i.e. factors that facilitate return to work at five levels: The individual (e.g. beliefs about being able to manage a successful return to work, health behaviours), the group (work groups, friends and family), the leader (line managers and healthcare provides who take the lead in supporting workers return), the organisational (Human Resource policies and external organisations such a charities) and the overarching context (social security systems).We discuss these resources that pertain to the work context but also the non-work context and highlight the importance of understanding how resources apply at different levels. We argue that there is a need to understand how societal factors, such as legislation, culture and national policies, impact return to work outcomes. We propose a holistic approach, that focuses on integrating the resources in and outside work, is needed to facilitate successful and sustainable return to work for workers with mental health problems.

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The Uneven Foci of Work Disability Research Across Cause-based and Comprehensive Social Security Systems

Cited by 10 publications

References 30 publications

Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with depression or anxiety: results from a three-arm, parallel randomised trial

Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with depression or anxiety: results from a three-arm, parallel randomised trial

IGLOO: A Framework for Return to Work Among Workers with Mental Health Problems

IGLOO: A Framework for Return to Work Among Workers with Mental Health Problems

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