Summary

Mental health problems in the workplace are currently one of the main causes of work absence, a phenomenon that has seen a marked increase in the last two decades. Research work in the occupational rehabilitation and mental health field has highlighted the importance of a collaborative process involving the stakeholders in the return-to-work process. However, while a handful of studies have focused on the work reintegration of workers who held jobs but had been absent from them for mental health reasons, very few of these studies have specifically explored the design and implementation of return-to-work programs. 

This report concerns the design, implementation, and evaluation of an integrated practices program for supporting a return to work following an absence for a mental health problem. The research project was carried out in response to a joint employee/employer request made by a health and social services establishment in Québec, Canada, for intervention regarding the problem of mental health-related work absences among its personnel and their return to work. To carry out the project, the research team utilized a multi-faceted employee/employer approach and worked with a research steering committee representing all the stakeholders. The steering committee’s terms of reference were to assist in arriving at a consensus definition of the problem and of the means to be implemented to support both the return to work of workers who had been absent for mental health problems and their job retention. The committee was also responsible for developing a process based on consistent practices among the various workplace stakeholders and for reaching agreement on strategies conducive to the active involvement of all the organization’s personnel in this issue. Its work led to the conceptualization of a program theory and the development of an operational model.

The method used to develop the program for supporting a return to work following an absence for mental health reasons had several components: a structured information-collection process that involved the analysis of absence data and of interviews with stakeholders engaged in the return-to-work process in order to determine their current practices; consultation of organizational documents on the return-to-work process; a review of the scientific literature on the topic; and an examination of current practices in workplaces concerned by this problem. This information laid the groundwork for conceptualizing the program theory in the form of a theoretical model, a logic model, and an operational model. With the steering committee’s collaboration, the research team developed a process for assisting in and supporting the recovery and return to work of employees who were absent from work for mental health reasons. This process was aimed at identifying the clinical, personal, and organizational factors that had contributed to their stopping work. For most of the employees, the search for solutions to help them return to work and retain their jobs was a positive experience. The importance placed on welcoming back the returning employees and on supporting them in their work, implementing reassurance practices during their sick leave, and allowing them to make changes in their work would also appear to be a determining factor in a successful return to work.

This study further revealed that the success of such a program can be ensured only if the following essential conditions are in place: a climate of trust characterized by respect, effective communication, and collaboration among the various internal and external stakeholders involved in the return to work. Lastly, it should be noted that interventions carried out with absent workers may also have an impact on other workers exposed to the same risk factors. Ultimately, the individual approach used in such a process could become an organizational process involving the other exposed workers. This research report details the various steps in the study and the main results and findings.