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

Abstract Background If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work...

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Main Authors: Johannes Hamann, Anne Lang, Lina Riedl, Daniela Blank, Monika Kohl, Adele Brucks, David Goretzko, Markus Bühner, Tamara Waldmann, Reinhold Kilian, Peter Falkai, Alkomiet Hasan, Martin E. Keck, Michael Landgrebe, Stephan Heres, Peter Brieger
Format: Article
Language:English
Published: Cambridge University Press 2023-01-01
Series:European Psychiatry
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S0924933822023574/type/journal_article
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author Johannes Hamann
Anne Lang
Lina Riedl
Daniela Blank
Monika Kohl
Adele Brucks
David Goretzko
Markus Bühner
Tamara Waldmann
Reinhold Kilian
Peter Falkai
Alkomiet Hasan
Martin E. Keck
Michael Landgrebe
Stephan Heres
Peter Brieger
author_facet Johannes Hamann
Anne Lang
Lina Riedl
Daniela Blank
Monika Kohl
Adele Brucks
David Goretzko
Markus Bühner
Tamara Waldmann
Reinhold Kilian
Peter Falkai
Alkomiet Hasan
Martin E. Keck
Michael Landgrebe
Stephan Heres
Peter Brieger
author_sort Johannes Hamann
collection DOAJ
description Abstract Background If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on “common mental disorders” and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment. Methods The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued. Results A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant (p = 0.14). Intervention patients returned to their workplace earlier than patients in the control group (p = 0.040). Conclusions The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement.
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spelling doaj.art-fd3963f1c0ac46e2920131ec8fb932342023-03-09T12:33:49ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-01-016610.1192/j.eurpsy.2022.2357Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)Johannes Hamann0https://orcid.org/0000-0002-3861-6017Anne Lang1https://orcid.org/0000-0002-4441-8279Lina Riedl2https://orcid.org/0000-0002-0658-5332Daniela Blank3Monika Kohl4Adele Brucks5David Goretzko6Markus Bühner7https://orcid.org/0000-0002-0597-8708Tamara Waldmann8https://orcid.org/0000-0002-8084-2827Reinhold Kilian9https://orcid.org/0000-0002-4401-5787Peter Falkai10Alkomiet Hasan11Martin E. Keck12https://orcid.org/0000-0001-5111-9333Michael Landgrebe13Stephan Heres14Peter Brieger15Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, München, Germany Bezirksklinikum Mainkofen, Deggendorf, GermanyKbo-Isar-Amper-Klinikum, Haar, GermanyDepartment of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, München, GermanyKbo-Isar-Amper-Klinikum, Haar, GermanyDepartment of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, München, GermanyDepartment of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, München, GermanyPsychological Methods and Assessment, Ludwig-Maximilians-Universität München, München, GermanyPsychological Methods and Assessment, Ludwig-Maximilians-Universität München, München, GermanyKlinik für Psychiatrie II am BKH Günzburg, Sektion Gesundheitsökonomie und Versorgungsforschung, Günzburg, GermanyKlinik für Psychiatrie II am BKH Günzburg, Sektion Gesundheitsökonomie und Versorgungsforschung, Günzburg, GermanyDepartment of Psychiatry and Psychotherapy, Klinikum der Ludwig-Maximilians-Universität München, München, GermanyMedical Faculty, Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, GermanyDepartment of Psychiatry, Psychotherapy and Psychosomatics, Klinik Seewis, Seewis, SwitzerlandDepartment of Psychiatry and Psychotherapy, kbo Lech-Mangfall-Hospital, Agatharied, GermanyKbo-Isar-Amper-Klinikum, Haar, GermanyKbo-Isar-Amper-Klinikum, Haar, GermanyAbstract Background If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on “common mental disorders” and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment. Methods The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued. Results A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant (p = 0.14). Intervention patients returned to their workplace earlier than patients in the control group (p = 0.040). Conclusions The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement. https://www.cambridge.org/core/product/identifier/S0924933822023574/type/journal_articleMental healthrehabilitationreturn to work
spellingShingle Johannes Hamann
Anne Lang
Lina Riedl
Daniela Blank
Monika Kohl
Adele Brucks
David Goretzko
Markus Bühner
Tamara Waldmann
Reinhold Kilian
Peter Falkai
Alkomiet Hasan
Martin E. Keck
Michael Landgrebe
Stephan Heres
Peter Brieger
Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)
European Psychiatry
Mental health
rehabilitation
return to work
title Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)
title_full Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)
title_fullStr Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)
title_full_unstemmed Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)
title_short Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)
title_sort supporting return to work after psychiatric hospitalization a cluster randomized study return study
topic Mental health
rehabilitation
return to work
url https://www.cambridge.org/core/product/identifier/S0924933822023574/type/journal_article
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