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Current research on return to work (RTW) for employees with common mental disorders suffers from two limitations. First, research mostly focuses on the influence of resources during the absence period ignoring the resources which may facilitate sustainable RTW, i.e. employees continuing to work and thrive at work post-return. Second, research tends to view the work and non-work domains separately and fails to consider the interaction of resources at the individual, group, leader and organisational levels, once back at work. In the present position paper, we present an integrated framework and a preliminary definition of sustainable RTW. Based on current occupational health psychology theory and existing research on RTW, we develop ten propositions for the resources in and outside work, which may promote sustainable RTW. In addition to the individual, group, leader, and organisational levels, we also argue for the importance of the overarching context, i.e. the societal context and the culture and legislation that may promote sustainable RTW. Our framework raises new questions that need to be addressed to enhance our understanding of how key stakeholders can support employees with common mental health disorders staying and thriving at work.

This is an Open Access Article. It is published by Taylor & Francis under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (CC BY-NC-ND). Full details of this licence are available at: http://creativecommons.org/licenses/by-nc-nd/4.0/ ; Current research on return to work (RTW) for employees with common mental disorders suffers from two limitations. First, research mostly focuses on the influence of resources during the absence period ignoring the resources which may facilitate sustainable RTW, i.e. employees continuing to work and thrive at work post-return. Second, research tends to view the work and non-work domains separately and fails to consider the interaction of resources at the individual, group, leader and organisational levels, once back at work. In the present position paper, we present an integrated framework and a preliminary definition of sustainable RTW. Based on current occupational health psychology theory and existing research on RTW, we develop ten propositions for the resources in and outside work, which may promote sustainable RTW. In addition to the individual, group, leader, and organisational levels, we also argue for the importance of the overarching context, i.e. the societal context and the culture and legislation that may promote sustainable RTW. Our framework raises new questions that need to be addressed to enhance our understanding of how key stakeholders can support employees with common mental health disorders staying and thriving at work.

Background: Common mental disorders affect about one-third of the European working-age population and are one of the leading causes of sick leave in Sweden and other OECD countries. Besides the individual suffering, the costs for society are high. This paper describes the design of a study to evaluate a work-related, problem-solving intervention provided at primary health care centers for employees on sick leave due to common mental disorders. Methods: The study has a two-armed cluster randomized design in which the participating rehabilitation coordinators are randomized into delivering the intervention or providing care-as-usual. Employees on sick leave due to common mental disorders will be recruited by an independent research assistant. The intervention aims to improve the employees return-to-work process by identifying problems perceived as hindering return-to-work and finding solutions. The rehabilitation coordinator facilitates a participatory approach, in which the employee and the employer together identify obstacles and solutions in relation to the work situation. The primary outcome is total number of sick leave days during the 18-month follow-up after inclusion. A long-term follow-up at 36 months is planned. Secondary outcomes are short-term sick leave (min. 2 weeks and max. 12 weeks), psychological symptoms, work ability, presenteeism and health related quality of life assessed at baseline, 6 and 12-month follow-up. Intervention fidelity, reach, dose delivered and dose received will be examined in a process evaluation. An economic evaluation will put health-related quality of life and sick leave in relation to costs from the perspectives of society and health care services. A parallel ethical evaluation will focus on the interventions consequences for patient autonomy, privacy, equality, fairness and professional ethos and integrity. Discussion: The study is a pragmatic trial which will include analyses of the interventions effectiveness, and a process evaluation in primary health care settings. Methodological strengths and challenges are discussed, such as the risk of selection bias, contamination and detection bias. If the intervention shows promising results for return-to-work, the prospects are good for implementing the intervention in routine primary health care. ; Funding Agencies|Swedish Research Council for Health, Working Life and Welfare [2016-07415, 2018-01252]

Purpose: To identify health-, personal- and work-related factors predictive of return to work (RTW) in employees sick-listed due to common mental health problems, such as, stress, depression, burnout, and anxiety. Methods: We distributed a baseline questionnaire to employees applying for sickness absence benefits at a large Danish welfare Department (n = 721). A total of 298 employees returned the questionnaire containing information on possible predictors of RTW. We followed up all baseline responders for a maximum of one year in a national registry of social transfer payments, including sickness absence benefits. Results: At baseline, about 9% of respondents had quit their job, 10% were dismissed and the remaining 82% were still working for the same employer. The mean time to RTW, measured from the first day of absence, was 25 weeks (median = 21) and at the end of follow-up (52 weeks) 85% had returned to work. In the fitted Cox model we found that fulfilling the DSM-IV criteria for depression predicted a longer time to RTW (HR: 0.61, CI: 0.45-0.84), whereas a better self-rated health predicted a shorter time to RTW (HR: 1.18, CI: 1.03-1.34). Employees working in the municipal (HR: 0.62, CI: 0.41-0.94) and private sector (HR: 0.65, CI: 0.44-0.96) returned to work slower compared to employees working in the governmental sector. Gender, education, cohabitation, size of workplace, low-back and upper-neck pain and employment at baseline did not predict RTW. Conclusion: Our results indicate that time to RTW is determined by both health- and work-related factors.

Objective This paper summarizes the main findings and recommendations of an advisory report on health and prolonging working life, which was requested by the Dutch Minister of Social Affairs and Employment. Methods The advisory report was compiled by a multidisciplinary committee of ten scientists appointed by the Health Council of The Netherlands. The committee's aims were to (i) describe the health of the ageing population, (ii) describe how prolonging working life influences health, (iii) describe determinants, besides health, for prolonging working lives, and (iv) review the literature on interventions aimed at retaining or improving employability of older workers. Results The report was presented to the Minister on 26 June 2018. As the likelihood of health problems increases with age, prolonging working life may be difficult. In general, life expectancy increases and gains in life years and health seem mainly attributable to people aged >75 years. Work is good for mental health. However, it may be beneficial for mental health to stop working around the retirement age. Besides health, financial factors, lifestyle, motivation to work, and working conditions play a role in prolonging working life. A systematic review of the evidence indicated that interventions such as worksite health promotion or career development workshops can support older workers in this matter. Conclusions The Health Council advised the Dutch Government to focus on worksite health promotion and career development interventions as well as the improvement of their implementation. This requires a tailored approach as there is a large diversity in health among older workers and particularly between low- and high-educated people. With this in mind, it was further recommended to explore whether flexible pension schemes might better suit this diversity.