Abstract
The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.
Highlights
The global burden of mental disorders is substantial [1,2]
There is moderate evidence that multimodal rehabilitation increases the possibility of return to work, whereas counseling, exercise, and return-to-work programs do not have any significant effect on return to work rates at one year after the start of rehabilitation
Personal control, occupational competence, and background factors such as age and socioeconomic status did not predict return to work. These results indicate that the length of rehabilitation period does matter in a dose response manner and that eight weeks of therapy may be insufficient for most participants, which is consistent with Supportive Environment Theory (SET)
Summary
The global burden of mental disorders is substantial [1,2]. In Sweden, the contribution of psychiatric disorders to workplace absenteeism has increased markedly since 2007, and constitutes the majority of long-term illnesses for both men and women [3]. There is moderate evidence that multimodal rehabilitation increases the possibility of return to work, whereas counseling, exercise, and return-to-work programs do not have any significant effect on return to work rates at one year after the start of rehabilitation. This is supported by an extensive review [6]
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