Stress and Mental Ill-health in the Workplace: Evaluation of an Intervention for the Prevention of Sick Leave

Karolinska Institute

Status: Completed

Conditions: Common Mental Disorders and/or Stress Related Symptoms

Treatments: Behavioral: Problem-solving based intervention; Behavioral: Treatment as usual

Study type: Interventional

Funder types: Other

Identifiers

NCT02563743

2014-0742

4-2544/2014

Details and patient eligibility

About

Purpose

Common mental disorders (CMD:s) are the leading cause of sick-leave spells in Sweden, resulting in suffering for the individual and financial costs for the employer as well as for society at large. Studies on interventions that address stress and mental ill-health and that focus on sick leave and return to work (RTW) show little or no effect of commonly used methods such as medication or psychological approaches. Furthermore, these interventions often focus on the individual's symptoms without considering their work situation. The occupational health services (OHS) has knowledge of the employee's work environment and can offer treatment facilitating the employee's RTW and improving the employee's work ability while taking into account both the individual and the work situation. The intervention in the current study will be performed at the OHS.

The study aim is two-fold: first, an intervention that addresses both individual and workplace related aspects among employees with work-related CMD:s and/or stress related symptoms will be evaluated. In particular, the treatment's cost-effectiveness and impact on sick leave and mental health will be studied. Secondly, the concerned OHS staff's adherence to the intended treatment and associations with the outcome of the intervention will be assessed.

Enrollment: 100 patients

Sex: All

Ages: 18 to 63 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The employee suffers from stress related symptoms or work-related common mental disorders.
• The employee is either not on sick leave or is on sick leave for a maximum of 3 consecutive months (full or part time).
• The employee understands both written and spoken Swedish.
• The employees nearest supervisor should be aware of the employees visit(s) at the OHS (to avoid differential selection into the experimental and the control condition)

Exclusion criteria

• Bullying
• Pregnancy
• Post traumatic stress-disorder
• Severe mental disorders (e.g. psychosis)
• Any co-morbidity that may substantially affect the employee's ability to work and/or quality of life.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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100 participants in 2 patient groups

Problem-solving based intervention

Experimental group

Description:

Problem-solving based intervention with a participative approach. During the intervention a systematic assessment of the match between the employee and the work environment is considered. The intervention applies a participatory approach where the supervisor and the employee are guided by the OHS consultant and encouraged to actively take part in problem solving concerning the work situation. The intervention consists of three meetings, one between the OHS consultant and a representative for the employer (usually the nearest supervisor), one between the consultant and the employee and then a third meeting where all three parties participate.

Treatment:

Behavioral: Problem-solving based intervention

Treatment as usual

Active Comparator group

Description:

The control intervention consists of the usual interventions given at the participating OHS. These interventions are also work-directed and usually also include participation of both the employee and the supervisor. However, structured problem solving methods and the systematic consideration of the match between the employee and the job situation are not applied. The content of the control condition will vary between different occupational health service units.

Treatment:

Behavioral: Treatment as usual