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  • 1
    In: Psychiatrische Praxis, Georg Thieme Verlag KG
    Abstract: Ziel der Studie Erwerbstätige mit einer psychischen Erkrankung haben nach einer psychischen Krise oft massive Schwierigkeiten, ihre Arbeit wiederaufzunehmen. Im Mittelpunkt der Studie steht die Frage, wie Menschen den Übergang zwischen akutpsychiatrischer Klinik und Arbeitsplatz erleben. Methodik Der Studie liegt ein qualitatives Forschungsdesign (Grounded Theory) zugrunde. Zehn narrative Interviews mit erkrankten Arbeitnehmern sowie vier Gruppeninterviews mit professionellen „Rückkehr-Begleitern“ (Return-to-Work-Experten) wurden geführt. Ergebnisse Die vorliegende Analyse zeigt, dass das Zusammenspiel der beteiligten Akteure von enormer Bedeutung ist. Wesentlich ist, wie die Beteiligten den Rückkehrprozess deuten und welche Handlungsaufforderungen infolge dessen an die Beteiligten adressiert werden. Schlussfolgerungen Ein arbeitsplatzbezogenes Entlassmanagement sollte Unterstützungsangebote vorhalten, die an den Erwartungshaltungen der Beteiligten ansetzen und einen gemeinschaftlichen Deutungsprozess fördern bzw. in Gang setzen.
    Type of Medium: Online Resource
    ISSN: 0303-4259 , 1439-0876
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    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 124981-2
    SSG: 5,2
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  • 2
    In: BMC Psychiatry, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Patients with mental illnesses often have massive difficulties returning to work after inpatient treatment at a psychiatric clinic and are often at risk of losing their jobs. The psychosocial support for this patient group at the interface of clinic/outpatient care is often insufficient. Methods/design The RETURN-study prospectively assesses and surveys 200 patients with mental disorders in a cluster randomized intervention study, i.e. treatment teams and patients from intervention wards receive a return-to-work (RTW) intervention. Patients in control wards obtain treatment as usual (TAU). Pairs of comparable wards (similar patient population, similar staff density) have been identified and then randomized for control and intervention ( n  = 14 for each condition). On intervention wards return-to-work experts (RTW experts) who focus treatment on the workplace-related needs of patients with mental illnesses have been established. These RTW experts ensure the use of available resources within the framework of work-related discharge management and should lead to a more successful return to the workplace. The days at work in the year after release will be evaluated in a mixed methods approach as well as the return rate in the year after release, disability days in the year after return, relapse rate after 12 months, cost-benefit ratio of the intervention, analysis of the predictors / barriers for a successful return to the workplace (e.g. psychopathology, cognition, stigma, social-psychiatric support, company support, etc.), possibilities to implement the concept of RTW experts in standard psychiatric care (TAU - treatment as usual), the impact of the RTW experts’ approach on the treatment process in standard psychiatric care. Discussion This approach is already internationally established in the field of somatic rehabilitation and supported employment [Am J Psychiatry 171:1183–90, 2014; Lancet 370:1146–52, 2007; Cochrane Database Syst Rev, doi:10.1002/14651858.CD006237.pub3, 2014]; the innovative aspect of this project is to implement and evaluate it in standard psychiatric care in Germany. This project requires no new interventions to be developed and tested, as the techniques of the case manager/job coach is applied to the field of return to work. Trial registration The study was registered in Deutsches Register Klinische Studien searchable via its Meta-registry ( http://apps.who.int/trialsearch/ ), Trial registration number: DRKS00016037 , Date of registration: 21/12/2018, URL of trial registry record.
    Type of Medium: Online Resource
    ISSN: 1471-244X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2050438-X
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  • 3
    In: European Psychiatry, Royal College of Psychiatrists, Vol. 66, No. 1 ( 2023)
    Abstract: Only two-thirds of patients admitted to psychiatric wards return to their previous jobs. Return-to-work interventions in Germany are investigated for their effectiveness, but information regarding cost-effectiveness is lacking. This study investigates the cost-utility of a return-to-work intervention for patients with mental disorders compared to treatment as usual (TAU). Methods We used data from a cluster-randomised controlled trial including 166 patients from 28 inpatient psychiatric wards providing data at 6- and 12-month follow-ups. Health and social care service use was measured with the Client Sociodemographic and Service Receipt Inventory. Quality of life was measured with the EQ-5D-3L questionnaire. Cost-utility analysis was performed by calculating additional costs per one additional QALY (Quality-Adjusted Life Years) gained by receiving the support of return-to-work experts, in comparison to TAU. Results No significant cost or QALY difference between the intervention and control groups has been detected. The return-to-work intervention cannot be identified as cost-effective in comparison to TAU. Conclusions The employment of return-to-work experts could not reach the threshold of providing good value for money. TAU, therefore, seems to be sufficient support for the target group.
    Type of Medium: Online Resource
    ISSN: 0924-9338 , 1778-3585
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    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2023
    detail.hit.zdb_id: 2005377-0
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  • 4
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Current Opinion in Psychiatry Vol. 35, No. 4 ( 2022-07), p. 293-301
    In: Current Opinion in Psychiatry, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 4 ( 2022-07), p. 293-301
    Abstract: Mental illnesses are among the most common diseases worldwide. Cases of inability to work caused by mental illness are frequent and the related economic burden is immense. A successful reintegration into their work environment of those patients who were on sick leave due to a mental illness is an important prognostic factor for the further course of the disease and helps reducing financial consequences. It was the aim of the present review to give an overview of the status quo of return-to-work interventions in the international literature. Recent findings Main themes of interventions addressing return to work of persons with mental illnesses are the provision of psychotherapeutic support with or without combining these approaches with work directed interventions. Personal contact of employees, mental healthcare staff and supervisors may be helpful with regard to facilitating return to work. Summary Current return to work interventions are mostly elaborate, extensive and expensive without convincing results regarding work related outcome parameters. A variety of reasons might be responsible for this finding, including heterogeneity of outcomes, a poor definition of return-to-work-interventions and the complexity of the issue (involving multiple stakeholders).
    Type of Medium: Online Resource
    ISSN: 0951-7367 , 1473-6578
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2026976-6
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  • 5
    In: Das Gesundheitswesen, Georg Thieme Verlag KG, Vol. 85, No. 04 ( 2023-04), p. 298-304
    Abstract: Hintergrund Psychische Erkrankungen sind inzwischen die zweithäufigste Ursache für Krankschreibungen und die häufigste Ursache für krankheitsbedingte Verrentungen. Um Jobverluste zu vermeiden sind besondere Interventionen zur Rückkehr an den Arbeitsplatz erforderlich. Ein erfolgreicher Rückkehrprozess kann eine erneute Krankschreibung sowie Erwerbsunfähigkeit verhindern. Zudem kann eine gelingende Rückkehr in den Berufsalltag positiv auf den Genesungsprozess zurückwirken. Internationale Erfahrungen zeigen, dass Return-to-Work-Programme eine wirksame Handlungsoption sind, um Patienten nach längerer Erkrankung nachhaltig wieder ins Arbeitsleben zurückzuführen. Return-to-Work-Programme bilden hinreichende Unterstützungsangebote, um mangelnde Ressourcen (z. B. fehlende Wertschätzung) und Belastungen (z. B. zu hohes Arbeitsvolumen) zu bewältigen. Methode Für die Studie RETURN wurde ein Return-to-Work Konzept für stationär-psychiatrisch behandelte Patienten entwickelt. Ergebnisse Die Intervention besteht aus dem Einsatz von Return-to-Work- Experten, die auf Basis eines Handbuches arbeiten. In klar definierten Modulen werden mit den Patienten während des stationären Aufenthaltes u. a. sozialrechtliche Grundlagen und Einzelheiten des Rückkehrprozesses besprochen sowie schwierige Situationen (z. B. Umgang mit der Offenlegung der Diagnose, Rückkehrgespräch) vorbereitet. Nach Entlassung erfolgt die Weiterbetreuung v. a. im Hinblick auf Erfahrungen am ersten Arbeitstag, Begleitung zu Gesprächen des BEM (Betriebliches Eingliederungsmanagement) und Unterstützung bei etwaigen Schwierigkeiten. Schlussfolgerung Die Ergebnisse der noch laufenden Studie werden zeigen, ob der gewählte methodische Ansatz zu einer Verbesserung der Rückkehr an den Arbeitsplatz führt.
    Type of Medium: Online Resource
    ISSN: 0941-3790 , 1439-4421
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    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 1101426-X
    SSG: 20,1
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  • 6
    Online Resource
    Online Resource
    American Psychiatric Association Publishing ; 2020
    In:  Psychiatric Services Vol. 71, No. 8 ( 2020-08-01), p. 855-857
    In: Psychiatric Services, American Psychiatric Association Publishing, Vol. 71, No. 8 ( 2020-08-01), p. 855-857
    Type of Medium: Online Resource
    ISSN: 1075-2730 , 1557-9700
    Language: English
    Publisher: American Psychiatric Association Publishing
    Publication Date: 2020
    detail.hit.zdb_id: 2022142-3
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  • 7
    In: International Journal of Social Psychiatry, SAGE Publications, Vol. 69, No. 4 ( 2023-06), p. 949-956
    Abstract: In recent years it could be shown that psychosocial working conditions and mental health of employees are closely correlated. One well-established instrument to measure psychosocial stress at work is the COPSOQ (Copenhagen Psychosocial Questionnaire, German Standard Version). It is an 84 item self-rating instrument addressing several domains of psychosocial working conditions and is generally used for risk assessments in companies. Aims: To examine associations between COPSOQ ratings with clinical features and symptoms of employees who currently suffer from an episode of a mental illness requiring inpatient treatment. Method: For 265 inpatients with mental disorders who participated in a cluster randomized trial (RETURN-study) COPSOQ-data were available as part of the baseline data acquisition. These data were compared with the German COPSOQ validation sample of the Freiburg research center for occupational sciences (FFAW; approximately 250,000 participants). For subdomains of the COPSOQ that showed major and significant differences between the two samples regression analyses were done to predict COPSOQ scores within the RETURN-sample. Results: Psychiatric inpatients did not assess their working conditions significantly different compared to the population based FFAW sample. However, with regard to the effects of working conditions (general health, burnout, presenteeism, and intention to leave the job) there were major differences between the two samples with the clinical sample expressing more negative views. In the RETURN sample these were predicted by a greater expression of depressive symptoms. Conclusions: The linkage between work and mental wellbeing is complex. Mental illness is not necessarily a result of poor working conditions, while good working conditions may not in every case prevent symptoms of bad health, even if such associations exist.
    Type of Medium: Online Resource
    ISSN: 0020-7640 , 1741-2854
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2066492-8
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  • 8
    Online Resource
    Online Resource
    Elsevier BV ; 2021
    In:  Journal of Psychiatric Research Vol. 137 ( 2021-05), p. 173-177
    In: Journal of Psychiatric Research, Elsevier BV, Vol. 137 ( 2021-05), p. 173-177
    Type of Medium: Online Resource
    ISSN: 0022-3956
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 1500641-4
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  • 9
    In: European Psychiatry, Royal College of Psychiatrists, Vol. 66, No. 1 ( 2023)
    Abstract: If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on “common mental disorders” and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment. Methods The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued. Results A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant ( p  = 0.14). Intervention patients returned to their workplace earlier than patients in the control group ( p  = 0.040). Conclusions The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement.
    Type of Medium: Online Resource
    ISSN: 0924-9338 , 1778-3585
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    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2023
    detail.hit.zdb_id: 2005377-0
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