New Ways – Mental Health at Work

Managers’ knowledge about depression and anxiety and how they support employees with decreased work capacity due common mental disorders (CMD) is a missing piece of understanding in the field of mental health at work. In this project we investigate managers’ attitudes, knowledge, measures and strategies while supporting subordinates with CMD. In 2017 we sent a web-survey including such questions to 5556 managers. Several studies are published. In a qualitative study with eight focus groups in 2019, we also interviewed managers about their experience-based understanding of how work capacity is affected in employees with CMD. They also discussed their practices while supporting these employees. The first manuscript is published. The project ended in 2020, however more manuscripts will be submitted.

Researchers:
Agneta Blomberg
Monica Bertilsson, project manager
Gunnel Hensing

Managers are keypersons for employees with common mental disorders (CMD) and expected to support these employees. They have the opportunity to act at an early stage of an employees’ mental ill-health, and, early managerial measures might prevent employees from sick leave. However, the manager's room for action is largely determined by conditions at the organizational and work place levels. We are interested in the impact of such conditions on the managers’ measures for employees with CMD. In the autumn of 2021 we launched a web-based survey to 4400 Swedish managers in the private sector with a response rate of approximately 60-65%. Added to this we will explore in a qualitative study managers' experiences of how the organizational and workplace levels have promoted or made it difficult for managers to support these employees. Data-collection is on-going in 2022.

Researchers:

Monica Bertilsson, researcher, senior lecturer, Göteborgs universitet
Gunnel Hensing, professor, Göteborgs universitet
Agneta Blomberg, associate researcher, Göteborgs universitet

Partners:

Linda Corin, PhD, Institutet för stressmedicin, Västra Götalandsregionen
Lisa Björk, PhD, Institutet för stressmedicin, Västra Götalandsregionen
Carin Staland-Nyman, senior lecturer, Högskolan i Halmstad
Stephen Stansfeld, professor, Queen Mary University of London, Wolfson Institute of Preventive Medicine, England.
Christian Ståhl, professor, Linköpings universitet
Angeligue de Rijk, professor, Maastricht University, Maastricht, Netherlands
Ellinor Tengelin, senior lecturer, Högskolan Väst

Funding:

AFA försäkring (Dnr190130)

Work capacity is central in both sick leave and return to work processes. The purpose of this project is to investigate how managers perceive work capacity in employees with common mental disorders (CMD). The study is based on surveydata among managers in 2017 (n=3358, response rate 71%). The survey includes 1800 managers’ perceptions about work capacity in at least 2 700 subordinates who, according to the participating managers have had CMD. We will do descriptive analyses and investigate differences between groups of managers. The findings can facilitate cooperation and communication among involved parties in the rehabilitation process, as well as, facilitate the understanding that work capacity can be promoted in the work place despite symptoms or troubles. 

Dnr FK 2021/011187

Contact person: Monica Bertilsson

Partners:
Jenny Hultqvist, senior lecturer, Göteborgs universitet
Lisa Björk, PhD, Institutet för stressmedicin, Västra Götalandsregionen
Gunnel Hensing, professor, Göteborgs universitet

Funding: Försäkringskassan

This PhD project aims at evaluating the effects of interventions in the Swedish primary health care with the focus on identification and treatment of common mental disorders.

The project consists of two parts. The first part is a randomised controlled trial with the aim to evaluate the use of a screening tool (Work Stress Questionnaire ‘WSQ’) in the primary health care. The screening tool WSQ is developed to early identify persons with work-related stress. Sub-study 1 aims at evaluate whether physician’s use of the WSQ in the primary health care affects further health care use among the participants and if there are any differences in health care treatment among participants that received the intervention compared to controls.

In the second part of the PhD project, we evaluate the implementation of care managers in the primary health care, a care function with responsibility for support and regular contact with patients diagnosed with common mental disorders (CMD). The objective with this part of the project is to evaluate whether primary health care centers with a care manager have a more adequate antidepressant medication treatment and more completed psychotherapy treatments (sub-study 2), and shorter net sick leave time (sub-study 3) compared with primary health care centres without access to a care manager.

Researchers:
Cecilia Björkelund
Tove Hedenrud
Gunnel Hensing
Kristina Holmgren
Christine Sandheimer, project manager

The overall aim is to facilitate and improve the access to the correct mental health care. The researchers will gather evidence related to the perspectives of the professionals, patients and the public mental health debate. They want to develop a multi-applicable framework across European countries and stakeholders in order to achieve the adequate access to mental health care in terms of diagnose and treatment in women and men.

The project has three objectives. The first focuses on collecting data related to a health perspective, patients' perspectives and the general debate on mental health. The second aim is to develop a framework that is applicable to achieve adequate access to proper care in terms of diagnosis and treatment and the third purpose is to provide tools and methods that can increase the effectiveness and efficiency of mental health care treatments.

The Mentally project targets professionals working within primary and specialized mental health care, ex-patients and possible patients of mental health care and their social network, the general public, academics, policy makers and journalists.

The MentALLY project

Researchers:
Malin Axelsson
Gunnel Hensing, project manager
Viktor Schønning
Simon Øverland

The purpose of this project was to develop and test a method for improved communication between doctor, patient and the patient's manager about mental ill health and work. Based on new research on work capacity in persons with mental ill health, we developed the Capacity Note – a form which deals with the patient's work situation, how the impaired health affects the capacity to work and what adjustments can be made in the workplace. With the help of the Capacity Note, the patient discusses his situation first with his doctor and then with his manager. An important basis of the project was to strengthen the patient's active participation in the sick leave process. The Capacity Note was used for a period in regular clinical work in primary care and was then evaluated qualitatively and quantitatively to answer how the participants perceived the Capacity Note, if the method was feasible and if it had an effect on the patients' sick leave. The project was completed in May 2022.

Researchers:
Annika Jakobsson
Lena Nordeman
Paula Nordling, project manager
Ingmarie Skoglund
Stephen Stansfeld
Simon Øverland

More information

• Dissertation: Physicians' practices in sickness certification for common mental disorders - assessment of work capacity and communication with the patient's workplace

• Factors associated with general practitioners' contacts with sick-listed patients' employers: A Swedish nationwide questionnaire study

• Assessing work capacity - reviewing the what and how of physicians' clinical practice.

This project investigates if better work-related health and job satisfaction can be achieved by a different approach to the healthcare they provide called Person-centred care (PCC). PCC is an approach to care based on a partnership between patients/relatives and healthcare professionals. PCC has shown to have beneficial effects for patients’ health. The aim of the project is to evaluate if the implementation of person-centred care affects the work experience among healthcare professionals working in hospital wards. This project contains two ways of analysing this effect. The first part contains a questionnaire that is given to the healthcare professionals at three times (baseline, 6-month and 12-month follow-up). The other approach to the effect of the implementation of PCC is by analysing the data on sickness absence and turnover rates at unit level in hospitals across Västra Götaland, analyse this data over time, and compare the results with wards that have not implemented PCC. This project will provide further evidence how this change modifies work-related health, job satisfaction, sickness absence and intention to quit in a hospital setting.

Researchers:
Monica Bertilsson
Inger Ekman
Andreas Fors
Gunnel Hensing
Cornelia van Diepen, project manager

A knowledge gap that is highlighted in several scientific reviews is why some people with depression and anxiety can continue to work, while others with similar work tasks and severity in depression and anxiety end up in sick leave. In the first phase of C2WI project, an index (Capacity to Work Index) has been developed so we can investigate this question. C2WI is based on previous qualitative studies exploring work capacity, studies conducted within the New Ways research group. The index will be the core of a web-based survey which will be distributed to a wide selection of employees in regions, municipalities and private companies in Sweden, to gain increased knowledge about work capacity among individuals with depression and anxiety at population level.

The ADAPT project - What factors promote work participation for individuals with common mental disorders (CMD)?

Researchers:
Monica Bertilsson
Agneta Blomberg
Gunnel Hensing, project manager
Carin Staland Nyman
Christian Ståhl

In Sweden, many men with common mental disorders as depression and anxiety disorder do not seek care. The aim of this PhD project is to investigate why. The studies are based on survey data from general population samples in Sweden. Barriers can occur on multiple stages on the pathway to care: not perceiving a need, not seeking care, and perceiving the care as insufficient when seeking it. Therefore, the first study investigates differences based on gender, education, and country of birth in the likelihood to face these barriers. The second study investigates if men who faced these barriers have worse mental health outcomes than men who did not. The third and fourth study investigates men’s attitudes to sickness absence for depression, and the relation between men’s mental health literacy and mental healthcare-seeking.

Researchers:
Bo Burström
Gunnel Hensing
Jesper Löve
Sara Blom, project manager

Work Instability Scale - Common Mental Disorders (WIS-CMD) is a research project whit aiming to develop an instrument that can be used in clinical settings and workplaces to detect early signs of declining work ability in employees at work with depression and anxiety.

Researchers:
Monica Bertilsson
Louise Danielsson, project manager
Gunnel Hensing
Kristina Holmgren

Ways-of-life, stress and mental health in the primary care context – WHISH-PRIM

Ways-of-life, stress and mental health in the primary care context – WHISH-PRIM

TIDAS – Health, sick leave and return to work