Systematic review of SAW-RTW Interventions for Common Mental Disorders
Jennifer Christian MD
SAW/RTW interventions that reduce work disability for workers with mental health problems has been viewed by many as uncharted territory. A new systematic review and meta-analysis of the evidence concerning interventions for that population reveals that significant progress in understanding what works is now available. Full text article is attached.
Here are the excerpts I found most relevant, and pasted below my signature is a table that summarizes the current evidence concerning specific types of intervention. Bottom line: Communication with the workplace is the MAIN THING that we know works!
From Methodology: “The studies selected for review were peer-reviewed, randomized or controlled studies assessing employment-related outcomes of interventions aimed at sick-listed workers with anxiety disorders, depressive disorders, adjustment disorders, stress-related disorders, personality disorders and/or somatoform disorders. Employment-related outcomes were defined broadly as (1) time until RTW; (2) proportion of participants achieving RTW, (3) number of sick leave days, and (4) self-reported work-readiness.” A total of 42 articles were eventually selected for review, covering almost 39,000 workers. 10 were high control randomized controlled trials (RCTs). 31 were fair quality RCTs. The 8 remaining were controlled studies of fair to poor quality.
From Discussion: Overall, the result revealed a significant, but relatively small, positive effects of the included interventions – similar to the effect size reported in a systematic review of CBT-interventions to facilitate RTW among sick-listed workers with common mental disorders. …[E]ffect sizes of this magnitude still carry considerable economic value.
From Abstract: “Conclusions: The results reveal strong evidence for interventions including contact to the work place and multicomponent interventions and moderate evidence for interventions including graded RTW. In addition, the results provide strong evidence for interventions targeting stress compared with interventions targeting other mental disorders. The findings point to important implications for policy and design of future interventions.
Jennifer Christian, MD, MPH
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