Supporting return to work after psychiatric hospitalization-A cluster randomized study (RETURN-study).

Area of Science:

• Psychiatry
• Occupational Health
• Rehabilitation Medicine

Background:

• Job loss due to mental illness episodes leads to negative personal consequences and prolonged inability to work.
• Existing return-to-work (RTW) programs often target common mental disorders with costly interventions lacking proven efficacy.
• There is a need for accessible RTW interventions for individuals with severe mental illnesses requiring inpatient treatment.

Purpose of the Study:

• To evaluate an easily implementable RTW intervention for inpatients with severe mental illnesses.
• To assess the effectiveness of case manager support in facilitating return to work.

Main Methods:

• A multi-center, cluster-randomized controlled trial involving 268 inpatients in acute psychiatric wards.
• Intervention group: received support from case managers (RTW experts).
• Control group: received treatment as usual.

Main Results:

• Patients in the intervention group returned to work more often at 6 and 12 months, with significantly more days at work at 6 months.
• Intervention patients demonstrated earlier return to workplace compared to the control group (p=0.040).
• The main outcome (days at work at 12 months) did not reach statistical significance (p=0.14).

Conclusions:

• The RETURN intervention highlights the potential of case management for facilitating return to work in patients with severe mental illness.
• Further qualitative analyses are recommended to understand intervention limitations and areas for improvement.
• The study suggests that targeted case management can aid in reintegration after sick leave for this population.