Effect, economic and process evaluation of a mental health return to work intervention: study design

Abstract

Abstract Background In Germany, the sickness absence duration for mental disorders lasts on average more than twice as long as for all other diseases. Interventions that link medical-therapeutic approaches with organisation-directed methods to improve a sustainable return to work (RTW) have hardly been evaluated. The aim is to present the study design, which evaluates the (cost-)effectiveness and feasibility of an 18-month intensified RTW aftercare delivered by German psychiatric outpatient clinics to employees with mental disorders. Methods A two-arm multicentre randomised controlled study is carried out. Sick-listed employees with mental disorders are recruited within psychiatric hospitals (n = 506). Besides care as usual, the intervention group receives a multimodal treatment consisting of individual RTW-support, RTW-aftercare groups, and web-based aftercare. At five time points over a 24-month observation period, quantitative effectiveness and health economic evaluation data from a societal perspective will be obtained. Intervention fidelity, reach, context, satisfaction and dose delivered will be examined in a multi-method process evaluation. A qualitative evaluation using pre-and post-interviews from a sub-sample (n = 30) will complement the effectiveness and process evaluation findings. Results Recruitment is currently ongoing. The intervention is expected to improve the employeés achievement of a sustainable RTW, defined as the 12-month remain and participation at work without having sickness absence periods of > 6 weeks (after RTW). It is hypothesized that the intervention is preferable in terms of costs compared to care as usual. The interviews allow for a better understanding of subjective experiences with the intervention. Discussion This study evaluates the (cost-)effectiveness and implementation process of an intensified RTW aftercare. If successfully implemented and evaluated, it might be adopted as standard care for employees with mental disorders in Germany. Key messages