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Return to work after a long mental health sick-leave

Return to work after a long mental health sick-leave. Experiences and results from a development-project Jouni Puumalainen , researcher, Rehabilitation Foundation 26.09.2011 Meeting the psycho-social challenges of return-to-work. Background.

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Return to work after a long mental health sick-leave

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  1. Return to work after a long mental health sick-leave Experiences and results from a development-project JouniPuumalainen, researcher, Rehabilitation Foundation 26.09.2011 Meeting the psycho-social challenges of return-to-work

  2. Background In the end of 2010 there were 259 000 persons receiving disability pension in Finland During 2010 approximately 25 000 new disability pensioners For third of the new pensioners the main diagnose was mental health disorder Main road to disability pension is sick-leave (usually after 300 sick-leave days) 25 % of the sickness allowance days are due to mental disorders - second largest diagnose-group after musculoskeletal diseases (32 %) (Statistical yearbook of Social Insurance Institution 2009) Alaviite

  3. Aim of the development-project • Depression is the most usual single diagnose among those who are on a sick-leave because of mental disorders • For that reason, the target-group of the project was persons, who were on a long sick-leave because of depression (mean duration of the sick-leave was 17 months) • The aim of the project was to develop new methods to support the return to work • The project proceeded as a co-operation between workplace, employee, occupational health care and rehabilitation counselor (from Rehabilitation Foundation). Also psychiatric clinics or pension institutions were involved, when needed.

  4. 1) Personal support Personal guidance by rehabilitation counselor Not concentrating on problems but on abilities Rehabilitation counselor took part in the negotiation with employee, employer and occupational health (the role was some sort of a “neutral attorney or advocate”) Individual support: meeting the customer in rehabilitation institution, but also in work place, café, public library etc… Natural surroundings Alaviite

  5. 2) Group-work Participants chosen by occupational health care and rehabilitation counselor Group discussions, functional methods, versatile program Group-work had an element of fellow support, which was very important to the participants (they gave support to other participants) Not a therapy-group, return to work was all the time in the main focus Two types of groups: 1) Work concentrated group for those also ready to return to work and 2) Work ability group for those, who yet needed support to develop their work ability also functional ability Alaviite

  6. Return to work Project had an evaluation: questionnaire at the beginning and a follow-up questionnaire. Altogether project had 38 customers, aged 24-58. Also interviews of customers, occupational health, employers and project worker (rehabilitation counselor) were made for the evaluation In the follow-up 68 % were at work or were heading for work (work trial or work assessment), others were yet on a sick-leave or had had a disability pension. Most of them who returned to work, returned through work trial or work assessment, for example for 4 months work was some how modified: shorter work days, less demanding tasks etc… During the return to work, the employee could receive the group support or the support of the rehabilitation counselor. Also the employer could receive the counselors support, if needed. Alaviite

  7. Symptoms of depression In the project the symptoms of depression were measured by “Deps-riddle”, which is developed in Finland for the use of primary health care to sort out depressive patients. “Deps-riddle” is based on many previous scales and what is new and suitable for primary health care, the scale is short: only 10 items. But in use it has shown to be rather accurate. Scale ranges 0-30 points. At the beginning of the project “Deps-riddle” mean for participants was 17,56, which means rather difficult depression. In the follow-up the mean was 11,85, which means rather mild depression. The decrease of the symptoms happened only with those who returned to work. So, is work a remedy or vice versa: only those whose symptoms decrease are able to return to work? Alaviite

  8. Opinions and experiences of the employees “Today I am more merciful to myself” “I realized that the recovering takes time, but I don’t any more have to be hyper energetic worker seeking for perfectness” “Nowadays I cope with my self and I can see also my weaknesses and accept them” “My self-esteem increased, when belonging to some group and could discuss with my fellows and get good advice” “It was an amazing experience, how totally strange professionals and others can care about me. Someone really cares!” Alaviite

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