30-month work participation trajectories of employees returning to work with common mental disorders

Abstract

Abstract Background Promoting a sustainable return to work (RTW) and work participation (WP) for employees with common mental disorders (CMDs) is a crucial challenge for mental healthcare, organisations, and society at large. To date, work-related factors have only very rarely been examined within RTW trajectory studies. The present study aims to examine 30-month WP trajectories and associated individual, health- and work-related factors of employees on sickness absence due to CMDs in Germany. Methods In a prospective cohort study with N = 259 participants, five measurements were conducted at baseline (during the last week of inpatient treatment), and 6, 12, 18 and 30 months later. WP was defined as the proportion of weeks being present at work between two measurement points (self-reported). WP trajectories over 30 months were estimated with Latent Class Growth Analysis (LCGA), and were described according to associated individual, health- and work-related factors. Results We extracted four trajectory classes: Class 1 ‘slowly increasing WP’ (19.6%) with a slow but constantly increasing WP over time, and finally reaching nearly 60% of WP; Class 2 ‘high maintaining WP’ (30.3%) with a maintaining high WP of over 80% after RTW until 30 months; Class 3 ‘highest maintaining WP’ (34.7%) with the highest maintaining WP throughout follow-up and reaching nearly 100% WP after RTW; and Class 4 ‘decreasing WP’ (15.4%) with a positive development of WP until 12 months, reaching of about 90% WP, but then decreasing below 60% WP until 30 months. Participants with persistent high WP (Classes 2 and 3, 65.0%) reported better individual-, health- and work-related characteristics at baseline, and more realized work accommodations during RTW. Conclusions For the majority of the employees, returning to work resulted in sustainable WP during the 30 months study period. However, about one third of the employees should be given more attention in their complete RTW process from treatment to workplace support. Key messages • Sustainable work participation after returning to work with common mental disorders is a long and complex journey. • Employees with a better individual, health- and work-related situation at baseline seem to be more likely to achieve a sustainable work participation.