Journal of Occupational Rehabilitation

, Volume 23, Issue 4, pp 621–630 | Cite as

Effectiveness of a Coordinated and Tailored Return-to-Work Intervention for Sickness Absence Beneficiaries with Mental Health Problems

  • Marie H. T. Martin
  • Maj Britt D. Nielsen
  • Ida E. H. Madsen
  • Signe M. A. Petersen
  • Theis Lange
  • Reiner Rugulies


Purpose Sickness absence and exclusion from the labour market due to mental health problems (MHPs) is a growing concern in many countries. Knowledge about effective return-to-work (RTW) intervention models is still limited, but a multidisciplinary, coordinated and tailored approach has shown promising results in the context of musculoskeletal disorders. The purpose of this study was to assess the effectiveness of this approach as implemented among sickness absence beneficiaries with MHPs. Methods In a quasi-randomised, controlled trial, we assessed the intervention’s effect in terms of time to RTW and labour market status after 1 year. We used two different analytical strategies to compare time to RTW between participants receiving the intervention (n = 88) and those receiving conventional case management (n = 80): (1) a traditional multivariable regression analysis controlling for measured confounding, and (2) an instrumental variable (IV) analysis controlling for unmeasured confounding. Results The two analytical approaches provided similar results in terms of a longer time to RTW among recipients of the intervention (HR = 0.50; 95 % CI 0.34–0.75), although the estimate provided by the IV-analysis was non-significant (HR = 0.70; 95 % CI 0.23–2.12). After 1 year, more recipients of the intervention than of conventional case management were receiving sickness absence benefits (p = 0.031). Conclusion The intervention delayed RTW compared to conventional case management, after accounting for measured confounding. The delayed RTW may be due to either implementation or program failure, or both. It may also reflect the complexity of retaining employees with mental health problems in the workplace.


Return to work Sickness absence Mental health Intervention effectiveness 



The study was supported by grants from the Danish Prevention Fund (Forebyggelsesfonden, grant #07-2-2-020) and the Danish Working Environment Research Fund (Arbejdsmiljøforskningsfonden, grant #31-2008-09). The study was approved and registered by the Danish Data Protection Agency (Registration number: 2008-54-0438).


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Marie H. T. Martin
    • 1
    • 2
  • Maj Britt D. Nielsen
    • 1
  • Ida E. H. Madsen
    • 1
  • Signe M. A. Petersen
    • 1
  • Theis Lange
    • 4
  • Reiner Rugulies
    • 1
    • 2
    • 3
  1. 1.National Research Centre for the Working EnvironmentCopenhagenDenmark
  2. 2.Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
  3. 3.Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
  4. 4.Department of BiostatisticsUniversity of CopenhagenCopenhagenDenmark

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