Psychosomatic consultation in the workplace: opportunities and limitations of the services offered--results of a qualitative study.

Christine Preiser,Andrea Wittich,Eva Rothermund,Monika A Rieger,Harald Gündel

doi:10.1007/s00420-015-1098-y

Abstract

PurposeIn Germany, innovative concepts of anchoring psychotherapeutic consultations within an occupational setting emerge in models like the “psychosomatic consultation in the workplace” (PCIW). Characteristic quality is the close cooperation between company-based occupational health physicians (OPs) and external psychotherapeutic consultants. Little is currently known about the attitudes of OPs and other stakeholders in companies in terms of possible contributions of these offers to their tasks within the field of mental health and work.MethodsData were collected via individual interviews with different stakeholders (n = 8) and two OP focus groups (each n = 5) with and without experience with PCIW. Data were analysed with content analysis.ResultsCommon mental disorders (CMD) were perceived as occurring increasingly but still being stigmatized. PCIW allows employees quick access to a neutral psychotherapist and thus might help to avoid chronification of CMD. For companies, this may mean that longer periods of absenteeism (and presenteeism) can be avoided. The interviewees also feel that the ongoing collaboration with a psychotherapeutic specialist may sensitize OPs to recognize mental disorders earlier and provide basic treatment. PCIW was stated as an early, easy and fast first access to psychotherapy. The effort of PCIW is limited if structural changes in the workplace are necessary to reduce mental stressors. Also, if financed by the company, PCIW should have clear time limits and cannot aim to replace health insurance benefits.ConclusionsTaking above-mentioned limitations into account, PCIW appears to be a promising tool to bridge the gap between OP-conducted company-based health promotion and early secondary care.

Highlights

Mental illnesses are being cited more and more frequently as a reason for sick leave: in 2014, 17 % of sick leave days in Germany were due to common mental disorders (CMD), i.e. mainly depression and anxiety according to the DAK Health Report (Hildebrandt et al 2014)
This article focuses on the perspectives on mental illness at the workplace and—against this background—the opportunities and limitations, criticism and assessments pertaining to the service psychosomatic consultation in the workplace
It is conceivable that the psychosomatic medical consultant offering the psychosomatic consultation in the workplace” (PCIW) or the occupational health physicians (OPs) will be involved in the targeted return to work process, as already suggested by international models of collaborative care (Martin et al 2012; Goorden et al 2014; Arends et al 2014). Close cooperation between those operating within the workplace—especially company-based OPs and other professionals—and external physicians and psychologists can overcome the hitherto rather strict division between care offered in the working environment and standard care

Summary

Introduction

Mental illnesses are being cited more and more frequently as a reason for sick leave: in 2014, 17 % of sick leave days in Germany were due to common mental disorders (CMD), i.e. mainly depression and anxiety according to the DAK Health Report (Hildebrandt et al 2014). Evidence from OECD reports that draws on national data, OECD data and other international scientific data suggests that about 15 % of the working-age population experiences CMD or mild psychological impairment. Mental disorders are known to reduce actual employment prospects, productivity and wages, but are a strong predictor for. International estimates suggest the treatment gap, i.e. the percentage of individuals who require care but do not get it, is around 60 % regarding depression and anxiety disorders, to name two examples (OECD 2014)

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