Supporting return to work after psychiatric hospitalization-A cluster randomized study (RETURN-study).
Mental health
rehabilitation
return to work
Journal
European psychiatry : the journal of the Association of European Psychiatrists
ISSN: 1778-3585
Titre abrégé: Eur Psychiatry
Pays: England
ID NLM: 9111820
Informations de publication
Date de publication:
09 01 2023
09 01 2023
Historique:
pubmed:
10
1
2023
medline:
19
1
2023
entrez:
9
1
2023
Statut:
epublish
Résumé
If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on "common mental disorders" and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment. The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued. A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant ( The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement.
Sections du résumé
BACKGROUND
If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on "common mental disorders" and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment.
METHODS
The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued.
RESULTS
A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant (
CONCLUSIONS
The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement.
Identifiants
pubmed: 36621009
doi: 10.1192/j.eurpsy.2022.2357
pii: S0924933822023574
pmc: PMC9879869
doi:
Types de publication
Randomized Controlled Trial
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e9Références
Cochrane Database Syst Rev. 2020 Oct 13;10:CD006237
pubmed: 33052607
Gesundheitswesen. 2021 Dec 17;:
pubmed: 34921361
BMJ. 2008 Sep 29;337:a1655
pubmed: 18824488
Soc Psychiatry Psychiatr Epidemiol. 2021 Sep;56(9):1657-1667
pubmed: 33860804
Eur Neuropsychopharmacol. 2011 Sep;21(9):655-79
pubmed: 21896369
Cochrane Database Syst Rev. 2012 Dec 12;12:CD006389
pubmed: 23235630
Scand J Work Environ Health. 2022 Jul 1;48(5):361-371
pubmed: 35373306
Epidemiol Psychiatr Sci. 2020 Nov 05;29:e178
pubmed: 33148366
Br J Psychiatry. 2003 Jun;182:467-8
pubmed: 12777333
J Health Econ. 2011 Mar;30(2):277-92
pubmed: 21247647
Curr Opin Psychiatry. 2022 Jul 1;35(4):293-301
pubmed: 35674707
Psychiatr Prax. 2018 Sep;45(6):299-306
pubmed: 28561216
Int J Methods Psychiatr Res. 2014 Sep;23(3):304-19
pubmed: 24729411
Schizophr Bull. 1997;23(2):317-28
pubmed: 9165640
Psychiatr Serv. 2020 Aug 1;71(8):755
pubmed: 32741338
Front Psychiatry. 2020 Jun 03;11:512
pubmed: 32581884
BMC Psychiatry. 2020 Apr 19;20(1):177
pubmed: 32306925
Work. 2021;68(3):551-561
pubmed: 33612503
Front Psychiatry. 2021 Jan 18;11:616223
pubmed: 33584377
Psychol Med. 2020 Jan;50(1):20-28
pubmed: 30606273
Int J Epidemiol. 2014 Apr;43(2):476-93
pubmed: 24648481
Health Technol Assess. 2021 Feb;25(12):1-94
pubmed: 33641712
Psychiatr Prax. 2018 May;45(4):197-205
pubmed: 28499318