Factors Related to the Recurrence of Sickness Absence Due to Common Mental Health Disorders: A Systematic Review.

PURPOSE: Employees who experience sickness absence (SA) due to common mental disorders (CMD) are at increased risk of recurrent sickness absence (RSA). This systematic literature review examines the factors at different levels in the work and non-work context that increase or decrease the likelihood of RSA due to CMD. The resulting knowledge enables more accurate identification of employees at risk of RSA. METHODS: We conducted a search in June 2023 using the following databases: PubMed, PsycInfo, Web of Science, Cumulative Index to Nursing & Allied Health Literature (Cinahl), Embase and Business Source Ultimate (BSU). Inclusion criteria were as follows: (self-)employees, CMD, related factors, RSA. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Individual, Group, Leader, Organisation and Overarching/social context (IGLOO) model were used to cluster the found factors and these factors were graded by evidence grading. RESULTS: Nineteen quantitative and one qualitative studies of mainly high and some moderate quality were included in this review. A total of 78 factors were found. These factors were grouped according to the IGLOO levels and merged in 17 key factors. After evidence grading, we found that mainly low socioeconomic status (SES) and the type of previous SA (short-term SA and SA due to CMD) are predictors of an increased risk of RSA. CONCLUSIONS: Having a low SES and previous experience of SA (short term, or due to CMD) are factors that predict the chance of RSA, implying the need for prolonged support from occupational health professionals after the employee has returned to work.

Development of the core of an ICF-based instrument for the assessment of work capacity and guidance in return to work of employees on sick leave: a multidisciplinary modified Delphi study.

BACKGROUND: Several occupational health disciplines are involved in return to work guidance, implying that good interdisciplinary collaboration is important. A shared conceptual framework and a common language for the assessment of work capacity and guidance in return to work is expected to be at the benefit of appropriate and sustainable employability of sick employees. The International Classification of Functioning, Disability and Health (ICF) can be considered a shared conceptual framework and is also promising in terms of a common language. The purpose of the current study is to reach multidisciplinary consensus among occupational health professionals on the content of an ICF-based instrument for the assessment of work capacity and guidance in return to work. METHODS: To obtain multidisciplinary consensus we conducted a modified Delphi study among twelve occupational health experts, including four occupational physicians, four insurance physicians and four labour experts. The study included two e-mail rounds and two virtual meetings. In the consecutive rounds the experts assessed ICF items as well as a list of non-ICF-based work-related environmental factors on their relevance for the assessment of the work capacity and guidance in return to work together with their interpretability. RESULTS: The four consecutive Delphi rounds resulted in 20 items that are minimally needed for the assessment of the work capacity and return to work possibilities of employees on sick leave. The final list included six items on personal functioning, seven items on social functioning and seven items on physical functioning. CONCLUSIONS: This set of items forms the core of an ICF-based instrument, which is expected to facilitate interdisciplinary and intradisciplinary communication because of the use of a shared conceptual framework. As such, it should be of help in the guidance in return to work of employees on sick leave and contribute to appropriate and sustainable employability.

Strengthening supervisor support for employees with common mental health problems: developing a workplace intervention using intervention mapping.

BACKGROUND: This study presents the development of a workplace intervention to strengthen supervisor's support for employees with common mental health problems (CMHP). CMHP have been increasing over the last years, resulting into negative work outcomes, such as absenteeism or reduced work performance. To date, organisational interventions have been promising in preventing these negative work outcomes, however it is yet unknown in what way the role of workplace stakeholders, in particular supervisors, can be strengthened. This study contributes to the literature of interventions on an organizational level which uses a preventative approach by promoting stay at work among employees with CMHP through supervisor support. METHODS: we applied the intervention mapping (IM) approach, by actively involving workplace stakeholders (employees with CMHP, supervisors and occupational health professionals) through the development process and the use of Integrated model of behaviour prediction for employers. All six steps of IM are followed and thematic analysis was used to analyse interviews and focus groups. RESULTS: Based on a comprehensive needs assessment, the intervention resulted in an online guideline, with five step-wise themes on how to support employees with CMHP to stay at work (SAW). The guideline addressed the most important and changeable actions using the Integrated model of behaviour prediction. The guideline presents how to signal and address problems in the workplace and find solutions by stimulating autonomy of employees, explore job accommodations and ask for occupational support. In addition, basic conditions on how to create mentally healthy workplaces were presented. Coaching sessions by occupational health professionals, that include practical strategies using the best available evidence, were identified by the stakeholders. CONCLUSIONS: This SAW-Supervisor Guideline-intervention responds to the need of supervisors to be supported in their role, responsibility and ways to support employees with mental health issues, through a behaviour-oriented, preventative approach. Intervention mapping provided a systematic process to identify, structure and prioritize factors of supervisor support, resulting in a novel workplace intervention. The active involvement of workplace stakeholders throughout the process resulted into a well-received intervention. The theoretical framework provided practical ways to induce supportive behaviour of supervisors, bridging theory with practice.

Promoting Factors to Stay at Work Among Employees With Common Mental Health Problems: A Multiple-Stakeholder Concept Mapping Study.

Most individuals affected by common mental health problems are employed and actually working. To promote stay at work by workplace interventions, it is crucial to understand the factors perceived by various workplace stakeholders, and its relative importance. This concept mapping study therefore explores perspectives of employees with common mental health problems (n = 18), supervisors (n = 17), and occupational health professionals (n = 14). Per stakeholder group, participants were interviewed to generate statements. Next, each participant sorted these statements on relatedness and importance. For each group, a concept map was created, using cluster analysis. Finally, focus group discussions were held to refine the maps. The three concept maps resulted in several clustered ideas that stakeholders had in common, grouped by thematic analysis into the following meta-clusters: (A) Employee's experience of autonomy in work (employee's responsibility, freedom to exert control, meaningful work), (B) Supervisor support (being proactive, connected, and involved), (C) Ways to match employee's capacities to work (job accommodations), (D) Safe social climate in workplace (transparent organizational culture, collective responsibility in teams, collegial support), and (E) professional and organizational support, including collaboration with occupational health professionals. Promoting stay at work is a dynamic process that requires joined efforts by workplace stakeholders, in which more attention is needed to the interpersonal dynamics between employer and employee. Above all, a safe and trustful work environment, in which employee's autonomy, capacities, and needs are addressed by the supervisor, forms a fundamental base to stay at work.

Towards a better understanding of work participation among employees with common mental health problems: a systematic realist review.

OBJECTIVES: Common mental health problems (CMHP) represent a major health issue and burden to employees and employers. Under certain conditions work contributes to wellbeing and participation of employees with CMHP. Promoting work participation is important, however the specific conditions in which work participation occurs is complex and largely unclear. This calls for a novel, realistic approach to unravel the complex relationship between outcomes, context and underlying mechanisms of work participation. METHODS: In the present realist review, peer-reviewed studies conducted between 1995 and 2020 were systematically reviewed on the outcome measures `stay at work` (SAW) and `work performance` (WP). The database search from seven databases identified 2235 records, of which 61 studies met the selection criteria and methodological rigor. RESULTS: The synthesis demonstrates how work participation is promoted by the following mechanisms and contextual factors: (i) organizational climate and leadership, (ii) social support, (iii) perceived job characteristics, (iv) coping styles, (v) health symptoms and severity, (vi) personal characteristics, and (vii) features of interventions. An explanatory framework, based on the Capability-for-Work model, presents a new set of capabilities leading to SAW and WP. CONCLUSIONS: This systematic realist review revealed mechanisms and contextual factors that promote both SAW and WP among employees with CMHP. These show how the organizational climate, social support in the work context, job characteristics and certain capabilities enable employees with CMHP to participate at work. Our contributions and practical implications are discussed, providing valuable insights for employers, professionals and researchers in the development of evidence-based interventions.

Understanding work participation among employees with common mental disorders: What works, for whom, under what circumstances and how? A systematic realist review protocol.

BACKGROUND: Work participation among employees with common mental disorders (CMDs) is an increasingly important, yet highly complex phenomenon. Given the call for preventing instead of reacting to negative work outcomes, there is a need to understand how employees with CMDs can continue working. OBJECTIVES: 1) to provide insights in applying a realist approach to the literature review process and 2) to present a way to develop an explanatory framework on work participation, the related causal mechanisms and the interaction with the work context. METHODS: A systematic realist literature review, using stay at work (SAW) and work performance (WP) as outcomes of work participation. This protocol paper explains the rationale, tools and procedures developed and used for identification, selection, appraisal and synthesis of included studies. RESULTS: The review process entailed six steps to develop so called 'middle range program theories'. Each step followed a systematic, iterative procedure using context-mechanism-outcome (CMO) configurations. CONCLUSIONS: Conducting a realist review adds on the understanding to promote work participation, by examining the heterogeneity and complexity of intervention- and observational studies. This paper facilitates other researchers within the field of occupational health by demonstrating ways to develop a framework on work participation using realist synthesis.

Combining work and family in the Netherlands: blessing or burden for one's mental health?

In this article we study which characteristics of combining work and family put people at risk for mental illness. Two alternative perspectives on the impact of multiple social roles on mental health are tested: the role accumulation perspective and the role strain perspective. Both perspectives are studied with data from a cross-sectional national survey held among a large, representative sample of Dutch people (N=1008). Multivariate analyses provided support for both perspectives. Having more social roles was related to better mental health. We also found a positive mental health effect of having a full-time job in combination with having children. However, having a partner who contributes less to household duties or having a job with low decision latitude or lower skill discretion was related to mental illness. So, certain aspects of social roles may also threaten people's mental health. Overall, our findings do not support the idea that combining work and family is necessarily a burden and harmful for people's mental health. Whether multiple social roles are a blessing or burden for people's mental health seems to depend on the characteristics of the social roles.