Research aimed at reducing the risk of common mental disorders among a working-age population

At present, common mental disorders (depression, anxiety, adjustment disorders and stress-related ill-health) sick leave are the most common cause of sick leave with benefits in Sweden. Sick leave due to common mental disorders are longer and more often recurrent compared to other diagnosis.

Our research is aiming at the development, and evaluation of interventions that can be used to reduce the risk of sickness absence, or increase return to work among a working-age population. The interventions are provided at workplaces or within health care, e.g. primary care. In addition, we evaluate hos new routines, such as cooperation between employers, employee and the primary care can be gainfully developed and implemented.

Projects

  • A problem-solving intervention in the primary care – PROSA

  • A problem-solving intervention to enhance return to work among people on sick leave due to common mental disorders: Effects on short-term sick leave, psychosocial factors and balance in everyday life

  • Coordination of return-to-work among employees on sick leave due to CMDs – CORE

  • A problem-solving intervention involving employees at risk of developing common mental disorders and their managers – PRIME

A problem-solving intervention in the primary care – PROSA

Problem solving involving the workplace is an evidence-based intervention with promising effects on return-to-work among persons with common mental disorders. A key element is cooperation between the person on sick leave, his/her employer and health care professionals. The aim is to evaluate the effects of problem solving in the Swedish primary health care system in an employed population on sick leave due to common mental disorders. In addition, we will conduct a parallel process evaluation, a systematic identification of ethical aspects from the perspectives of different stakeholders concerning a work-focused problem-solving intervention and economic evaluation of a work-focused problem-solving intervention, compared to care as usual. Funded by Swedish Research Council for Health, Working Life and Welfare (Forte). 

Publication:

Björk Brämberg, E., et al. (2018). "Increasing return-to-work among people on sick leave due to common mental disorders: design of a cluster-randomized controlled trial of a problem-solving intervention versus care-as-usual conducted in the Swedish primary health care system (PROSA)." BMC public health 18(1): 889. https://pubmed.ncbi.nlm.nih.gov/30021545/

 

The aim of the project is to evaluate the effectiveness and the ethics of a problem-solving [EBB1] intervention (PROSA) in an employed population on sick-leave due to CMDs. The intervention is given by trained rehabilitation coordinators at primary care centers and includes employer involvement during the rehabilitation process. The research will investigate if the intervention is

1) more effective compared to care-a-usual in reducing the total number of days on sick-leave during the 18-month follow up and

2) in reducing short-term sick-leave and recurrent sick-leave periods after return-to-work

3) Facilitating and hindering factors and

4) Ethical considerations towards the intervention. Register data and individual semi-structured interviews will be collected/conducted and analysed.

As common mental disorders are one of the leading causes of sick leave in Sweden, we expect this research to contribute to important knowledge regarding the intervention, the rehabilitation process and if successful, to be implemented on a larger scale. Funded by Swedish Research Council for Health, Working Life and Welfare (Forte).  

 

Ida Karlsson

PhD student

A problem-solving intervention to enhance return to work among people on sick leave due to common mental disorders: Effects on short-term sick leave, psychosocial factors and balance in everyday life

This project is part of the PROSA project – and funded by AFA Insurance.

The project aims to:

(a) analyze the experiences of causes of sick leave due to common mental disorders (CMD) and barriers and facilitators in work and private life for return-to-work (RTW) from the perspective of employees and employers; and to evaluate the effect of a problem-solving intervention on:

(b) psychosocial factors at work and balance between work and private life for RTW, and

(c) short-term sick leave and recurrent short-term sick leave, after returning to work.

Data will be collected by (a) semi structured interviews, (b) questionnaires, and (c) text messages. A gender perspective, that considered internal, vertical, and horizontal gender segregation will be applied in the qualitative analysis. This can contribute to the development of an evidence-based intervention that is applicable in primary care and develop support structures for employers that recognizes both person and environment. Funded by AFA Insurance.

Lisa Holmlund (f.d Bergmark)

Postdoctoral researcher

Coordination of return-to-work among employees on sick leave due to CMDs – CORE

New health care interventions need to be based on science and best practice - and potential ethical issues need to be considered.

The purpose was to identify:

(a) facilitators of and barriers to the coordination of return-to-work (RTW) between the primary care services (PCC), the employee on sick leave due to common mental disorders (CMD), and the employers;

(b) ethical issues that arise in the coordination of RTW.

Semi-structured and focus group interviews with coordinators and physicians in PCC; employees on sick leave due to CMD; employers; occupational health professionals; and Swedish Social Insurance Agency officials (n=46) were analyzed thematically. The findings show facilitators and barriers across levels of systems and organizations, and risks of unequal access and support in coordination of RTW. They indicate a need of detailed packaging of coordination, formalization of coordinators’ qualifications and training, and considerations of organizational factors and ethical issues in coordination of RTW. Funded by AFA Insurance.  

 

Publications:

Björk Brämberg, E., et al. (2019). "Facilitators, barriers and ethical values related to the coordination of return-to-work among employees on sick leave due to common mental disorders: a protocol for a qualitative study (the CORE-project)." BMJ Open 9(9): e032463. https://pubmed.ncbi.nlm.nih.gov/31530623/

Björk Brämberg, E., et al. (2020). Möjliggörande och hindrande faktorer samt etiska aspekter vid samverkan med syfte att öka återgång i arbete bland personer med psykisk ohälsa. Slutrapport.  https://www.afaforsakring.se/forskning/projektkatalog/Projekt/39440/

Lisa Holmlund (f.d Bergmark)

Postdoctoral researcher

A problem-solving intervention involving employees at risk of developing common mental disorders and their managers - PRIME

We will test a workplace intervention targeting first line managers.

The aims are to

1) evaluate the problem solving intervention’s effect on sickness absence among employees at high-risk for future sickness absence due to common mental disorders;

2) evaluate whether and to what extent it was possible to adhere to the intervention’s protocol, the relationship between the intervention’s key elements and the effect outcome,  and to identify the facilitators and barriers to the intervention among supervisors and employees,

3) explore the supervisor’s organizational resources and the employee’s working/private life-balance and the impact on the effect outcome.

The study will be conducted as a randomized controlled trial in private sector companies. Funded by AFA Insurance.  The project starts during the autumn 2020 and runs until end of 2023.

Bozana Arapovic Johansson

Post Doc