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Returning to Work after a Mental Health Crisis

Return to work: from early preparations to sustainable return

Reintegration into the workplace enables an employee to participate in working life again after suffering a mental health crisis. A return to work strategy that fits into the organisation's health management system, and trusting cooperation between the employee and the actors who are looking after them increase the probability of a sustainable return to the workplace.

What is RTW?

Return to work (RTW) is a complex process that enables an employee to go back to work after a longer period of sick leave. It brings together all the levels, structures, measures and individuals both inside and outside the organisation that are concerned with the employee's timely, sustainable return to work. An open dialogue between the different stakeholders is essential.

Why is this important?

In the most favourable case, a timely, sustainable RTW process can reduce long periods of incapacity for work and prevent health-related early retirement. For returning employees, the restoration and preservation of their work ability are important steps if they are to start participating in working life again. Against the background of demographic change and rising sick leave rates, it is a matter for the whole of society to help individuals get back to work. Everyone benefits from successful RTW measures.

What does the research say?

The key actors in an RTW process are the returning employee, their immediate superiors, their colleagues and the employee representatives within the organisation. The RTW process is supported by the engagement and networking of other partners, including RTW coaches, operational reintegration management officers, disability managers, occupational health physicians, the bodies that represent employees’ interests, and the treating physicians or therapists.

A dialogue between equals about the individual and work-related factors that contributed to the mental health crisis is the basis for a sustainable RTW:

  1. Early preparations for the employees' return reduce the uncertainties they face. Thought should be given to this while they are still receiving clinical treatment. It is also important to choose the right time to return to work as well. The employee is ready to go back when they and the experts who are looking after them jointly conclude that they are emotionally stable and confident enough to cope with resuming work.
  2. Combining individual self-care with the welfare services provided by the organisation contributes to the success of reintegration. Professional care strengthens the confidence of the returning employee, and the trust they have in both the RTW process and in themselves boost their ability to self-manage and their self-efficacy. Gradual RTW is a key element of operational reintegration management.
  3. An organisation-wide approach that prevents ill health and ensures attention to all employees’ working conditions will increase the likelihood of staff returning to work sustainably.

What action needs to be taken?

A successful RTW process takes account of work-related and individual stress factors, is informed by an understanding of how they interact, and coordinates the measures taken to address them. There are a number of promising approaches for sustainable RTW measures. For instance, it is important for actors outside the organisation to consider aspects of the situation that are specific to the employee’s job. Moreover, good results can be achieved by jointly negotiating an RTW strategy that engages the central stakeholders and incorporating it into the organisation's health management system.

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