Skip to main content

Advertisement

SpringerLink
Log in

Does Part-Time Sick Leave Help Individuals with Mental Disorders Recover Lost Work Capacity?

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose This paper aims to answer the question whether combining sick leave with some hours of work can help employees diagnosed with a mental disorder (MD) increase their probability of returning to work. Given the available data, this paper analyzes the impact of part-time sick leave (PTSL) on the probability of fully recovering lost work capacity for employees diagnosed with an MD. Methods The effects of PTSL on the probability of fully recovering lost work capacity are estimated by a discrete choice one-factor model using data on a nationally representative sample extracted from the register of the National Agency of Social Insurance in Sweden and supplemented with information from questionnaires. All individuals in the sample were 20–64 years old and started a sickness spell of at least 15 days between 1 and 16 February 2001. We selected all employed individuals diagnosed with an MD, with a final sample of 629 individuals. Results The results show that PTSL is associated with a low likelihood of full recovery, yet the timing of the assignment is important. PTSL’s effect is relatively low (0.015) when it is assigned in the beginning of the spell but relatively high (0.387), and statistically significant, when assigned after 60 days of full-time sick leave (FTSL). This suggests efficiency improvements from assigning employees with an MD diagnosis, when possible, to PTSL. Conclusions The employment gains will be enhanced if employees with an MD diagnosis are encouraged to return to work part-time after 60 days or more of FTSL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Because employers have the responsibility to cover the first two weeks of employee sick leave, the social insurance register contains spells of at least 15 days.

  2. Following Aakvik et al. [24], we normalize the factor loading for the selection equation to one.

  3. This integral is solved using the Gauss-Hermite quadrature with five points and nodes. As a sensitivity test we also estimated the model with 10 points and nodes but found only small changes in the third decimal of the treatment parameters.

  4. The estimates for the selection equation (reported in Table 7), the outcome equation for FTSL employees and the outcome equation for PTSL employees for Samples 1–3 (reported in Table 8a–c) have reasonable signs, but very few are statistically significant for the FTSL employees, and none are statistically significant for PTSL employees.

References

  1. The global burden of disease: 2004 update. World Health Organization. 2004.

  2. Mental disorders as a major challenge in prevention of work disability: experiences in Finland, Germany, the Netherlands and Sweden. The Social Insurance Institution (KELA). Finland. Social Security and Health Reports 66. 2006.

  3. Sjukskrivning—orsaker, konsekvenser och praxis: En systematisk litteraturöversikt. SBU. Statens beredning för medicinsk utvärdering (The Swedish council on technology assessment in health care), Swedish. 2003.

  4. Andrén D, Palmer E. Deltidssjukskrivning (Part-time sick leave). Unpublished document. Riksförsäkringsverket (Swedish Social Insurance Board), Swedish. 2004.

  5. Andrén D, Andrén T. Starting sick leave on part-time as a treatment method? Örebro University. Swedish Business School (2009). Working Papers 2009:10.

  6. Andrén D, Andrén T. Part-Time Sick Leave as a Treatment Method? Göteborg University, Department of Economics. 2008. Working Paper in Economics 320.

  7. Andrén D, Svensson M. Part-time sick leave as a treatment method for individuals with musculoskeletal disorders. J Occup Rehabil. 2012;22(3):418–26.

    Article  PubMed  Google Scholar 

  8. The ICD-10 classification of mental and behavioural disorders. World Health Organization. 1992.

  9. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 2000.

    Google Scholar 

  10. Hensing G, Wahlstrom R. Sickness absence and psychiatric disorders. Scand J Public Health. 2004;32:152–80.

    Article  Google Scholar 

  11. Timbie JW, Horvitz-Lennon M, Frank RG, Normand S-LT. A meta-analysis of labor supply effects of interventions for major depressive disorder. Psychiatr Serv. 2006;57:212–8.

    Article  PubMed  Google Scholar 

  12. Nieuwenhuijsen K, Bültmann U, Neumeyer-Gromen A, Verhoeven AC, Verbeek JH, van der Feltz-Cornelis CM. Interventions to improve occupational health in depressed people. Cochrane Database Syst Rev. 2008. doi:10.1002/14651858.CD006237.pub2.

  13. Llena-Nozal A. The effect of work status and working conditions on mental health in four OECD countries. Natl Inst Econ Rev. 2009;209:72–87.

    Article  Google Scholar 

  14. Skaner Y, Nilsson GH, Arrelov B, et al. Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden. BMJ Open. 2011;1:e000303.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Socialstyrelsen. Försäkringsmedicinskt beslutsstöd—vägledning för sjukskrivning [Decision making support in insurance medicine—guidelines in sickness certification]. 2007.

  16. Skånér Y, Nilsson GH, Arrelöv B, et al. Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden. BMJ Open. 2011;1:e000303. doi:10.1136/bmjopen-2011-000303.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Ljungquist T, Arrelöv B, Lindholm C, et al. Physicians who experience sickness certification as a work environmental problem: where do they work and what specific problems do they have? A nationwide survey in Sweden. BMJ Open. 2012;2:e000704. doi:10.1136/bmjopen-2011-000704.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Englund L, Svärdsudd K. Sick-listing habits among general practitioners in a Swedish county. Scand J Prim Health Care. 2000;18(2):81–6.

    Article  CAS  PubMed  Google Scholar 

  19. Hickie IB. Primary care psychiatry is not specialist psychiatry in general practice. Med J Aust. 1999;170:171–3.

    CAS  PubMed  Google Scholar 

  20. Peterson S, Eriksson M, Tibblin G. Practice variation in Swedish primary care. Scand J Prim Health Care. 1997;15:68–75.

    Article  CAS  PubMed  Google Scholar 

  21. Arrelöv BE, Borgquist L, Svärdsudd KF. Influence of local structural factors on physicians’ sick-listing practice: a population-based study. Eur J Public Health. 2005;15(5):470–4.

    Article  PubMed  Google Scholar 

  22. Hensing G, Timpka T, Alexanderson K. Dilemmas in the daily work of social insurance officers. Int J Soc Welf. 1997;6:301–9.

    Google Scholar 

  23. Ydreborg B, Ekberg K, Nilsson K. Swedish Social Insurance Officers’ experiences of difficulties in assessing applications for disability pensions—an interview study. BMC Public Health. 2007;7:128.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Aakvik A, Heckman JJ, Vytlacil EJ. Estimating treatment effects for discrete outcomes when responses to treatment vary: an application to Norwegian vocational rehabilitation programs. J Econ. 2005;125(1–2):15–51.

    Article  Google Scholar 

  25. Heckman JJ. Dummy endogenous variables in a simultaneous equation system. Econometrica. 1978;46(4):931–59.

    Article  Google Scholar 

  26. Heckman JJ. Sample selection bias as a specification error. Econometrica. 1979;47(1):153–61.

    Article  Google Scholar 

Download references

Acknowledgments

I thank the editor and two anonymous referees for helpful and relevant comments and suggestions. I gratefully acknowledge financial support from the Swedish Council for Working Life and Social Research (FAS 2005-0376). The funding source is a Swedish government research agency that initiates and supports basic and applied research with a view to improving our knowledge about working life, public health and welfare. The funding source had no influence in the design, analysis or in the preparation of the manuscript.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Örebro University School of Business, 701 82, Örebro, Sweden

    Daniela Andrén

Authors
  1. Daniela Andrén
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniela Andrén.

Appendix

Appendix

See Tables 3, 4, 5, 6, 7 and 8.

Table 3 Descriptive statisticsa for all individuals in Sample 1, by the type of sick leave (part/full-time) at the beginning of the sick leave spell
Full size table
Table 4 Descriptive Statistics for all individuals in Sample 1 who started their sick leave on full-time (Sample 2), by the type of sick leave at the end of the sick leave spell (part/full-time)
Full size table
Table 5 Descriptive Statistics for all long-term sick employees who started their sick leave on full-time (Sample 3), by the type of sick leave (Part/full-time)
Full size table
Table 6 Full recovery at cut-off points by the type combination of degree of sick leave in the beginning and at the end of spell (Sample 1)
Full size table
Table 7 Probit estimates (β) and standard errors (SE) of the selection into treatment
Full size table
Table 8 Probit estimates (β) and standard errors (SE) of the outcome equations
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Andrén, D. Does Part-Time Sick Leave Help Individuals with Mental Disorders Recover Lost Work Capacity?. J Occup Rehabil 24, 344–360 (2014). https://doi.org/10.1007/s10926-013-9467-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-013-9467-4

Keywords

Search

Navigation