Abstract
Mental health problems are a major public health and work-life issue. We examined in a quasi-experimental design whether occupational health psychologist (OHP) appointment reduces subsequent sickness absence (SA) due to mental disorders among younger Finnish employees.The present study was conducted among 18–39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We examined differences in SA days due to mental disorders (ICD-10, F-diagnosed sickness allowances) between those treated (at least one OHP appointment for work ability support) and the comparison group (no OHP appointment) during a one-year follow-up. The full sample (n = 2286, 84% women) consisted of employees with SA due to a diagnosed mental disorder during 2008–2017. To account for the systematic differences between the treatment and comparison groups, the included participants were matched according to age, sex, occupational class, education, previous SA, occupational health primary care visits and psychotropic medication. The weighted matched sample included 1351 participants. In the weighted matched sample, the mean of SA days due to mental disorders was 11.4 (95% CI, 6.4–16.5) for those treated (n = 238) and 20.2 (95% CI, 17.0–23.4) for the comparison group (p < 0.01) during the follow-up year. The corresponding figures in the full sample were (11.1, 6.7–15.4) days for those treated (n = 288) and (18.9, 16.7–21.1) days for the comparison group (p < 0.01). This quasi-experimental study suggests that seeing an OHP to support work ability reduces SA due to mental disorders.
Highlights
Frequent use of occupational health services is related to mental health problems(Reho et al, 2019) and frequent use is associated with increased sickness absence (SA) rates due to mental disorders(Harkko et al, 2020) as well as disability retirement.(Reho et al, 2020) early intervention and support for work ability in the occupational health care may be useful preventing mental health problems arising or worsening, reducing the use of occupational health services and preventing work disability.(Sanderson and Andrews, 2006) In the Finnish occupational health care system, work ability support for the personnel may be offered, for instance, by providing appointments with occupational health psychologists (OHP)
We aimed to examine whether OHP appointment for work ability sup port can reduce SA due to mental disorders among 18–39-year-old Finnish employees with an existing mental disorder using register data
A recent Swedish study showed that a brief participative problem-solving intervention provided by the occupational health services prevented SA among those employees with common mental disorders or symptoms of stress.(van de Keus Poll et al, 2020) A Dutch early stage intervention targeted at employees with both high risk of SA and mild to severe depressive symptoms showed beneficial in reducing depressive symp toms and SA.(Lexis et al, 2011) A Finnish cognitive behaviour inter vention lasting for four months as an early stage programme for employee mental wellbeing showed effective in improving various mental health measures among municipal employees.(Ojala et al, 2018) These kinds of programmes are highly encouraging and support inter vention at early stage when only mild symptoms are evident
Summary
Mental health problems are a major public health and work-life issue.(Whiteford et al, 2013) Young adults are more likely to experi ence mental disorders than any other age group and for instance, the median age of onset for mood disorders is 30 years.(Kessler et al, 2005; Jones, 2013) In addition, work-related stress is highly common already among young employees,(Mauno et al, 2013) and in general every third European employee feels stressed during workdays.(Leka and Jain, 2010) Over time, prolonged stress and mild mental health problems may lead to more severe disorder, increased use of health care services and sickness absence (SA) from work.(Birnbaum et al, 2010) Reducing and preventing SA is highly important target as SA poses a considerable economic burden to individuals, employers and the society.(OECD/Eu ropean Union, 2018)In Finland, law mandates every employer to provide preventive occupational health services to their employees. Instead of treat ing illnesses, the focus is on early intervention on work-related health risks, and prevention of work disability. Frequent use of occupational health services is related to mental health problems(Reho et al, 2019) and frequent use is associated with increased SA rates due to mental disorders(Harkko et al, 2020) as well as disability retirement.(Reho et al, 2020) early intervention and support for work ability in the occupational health care may be useful preventing mental health problems arising or worsening, reducing the use of occupational health services and preventing work disability.(Sanderson and Andrews, 2006) In the Finnish occupational health care system, work ability support for the personnel may be offered, for instance, by providing appointments with OHP. Most employees likely benefit already from one or two visits and more serious mental health problems such as anxiety or depression may be revealed, in which case the number of psychologist visits can be increased, and other treatments such as psychotropic medication and psychotherapy may be needed.(Depression, 2017; Joosen et al, 2015)
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