Specific return-to-work interventions may be effective for work-related mental health disorders

1. In this systematic review and meta-analysis, multi-domain and health-focused return-to-work (RTW) interventions were positively associated with RTW rates and quality of life in those with work-related mental health conditions.

2. However, RTW interventions were not associated with improvements in certain outcomes such as absenteeism, stress, or depressive symptoms.

Evidence Rating Level: 1 (Excellent)

Mental health conditions contribute to decreased productivity and constitute a significant proportion of disability claims, especially those originating in the workplace. Though return-to-work (RTW) interventions are common for mental health disorders requiring an extended sick leave, there is a lack of evidence for their use in mental health conditions with a workplace origin. As a result, the objective of the present study was to evaluate the effectiveness of RTW interventions on RTW rates, quality of life, and mental well-being in those with work-related mental health conditions.

Of 26,153 identified records, 28 (n=19 randomized controlled trials, n=9 quasi-experimental trials) studies were included from various databases from 2000-2020. Studies were included if they investigated the effects of RTW interventions on work-related mental health conditions in adults. Studies were excluded if they did not include descriptions of the intervention or did not report on RTW outcomes. The review was performed using PRISMA guidelines. The Critical Appraisal Skills Program (CASP) and the Joanna Briggs Institute (JBI) checklist were used to assess study quality. The primary outcomes were the proportion of patients returning to work, absenteeism rates, stress, depression, and quality of life.

The results demonstrated that health-focused and multi-domain interventions were positively associated with RTW rates and quality of life. However, there was no significant improvement in certain outcomes, such as absenteeism, stress, or depressive symptoms. Despite these results, the study was limited by the inclusion of primarily European studies, which may limit its generalizability. Nonetheless, the present study suggested that tailored interventions may enhance rates of RTW in those with work-related mental health conditions.

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