The effectiveness of return-to-work interventions that incorporate work-focused problem-solving skills for workers with sickness absences related to mental disorders: a systematic literature review

Objectives: This paper reviews the current state of the published peer-reviewed literature related to returnto- work (RTW) interventions that incorporate work-related problem-solving skills for workers with sickness absences related to mental disorders. It addresses the question: What is the evidence for the effectiveness of these RTW interventions? Design: Using a multiphase screening process, this systematic literature review was based on publically available peer-reviewed studies. Five electronic databases were searched: (1) Medline Current, (2) Medline Inprocess, (3) PsycINFO, (4) Econlit and (5) Web of Science. Setting: The focus was on RTW interventions for workers with medically certified sickness absences related to mental disorders. Participants: Workers with medically certified sickness absences related to mental disorders. Interventions: RTW intervention included work-focused problem-solving skills. Primary and secondary outcome measures: RTW rates and length of sickness absences. Results: There were 4709 unique citations identified. Of these, eight articles representing a total of six studies were included in the review. In terms of bias avoidance, two of the six studies were rated as excellent, two as good and two as weak. Five studies were from the Netherlands; one was from Norway. There was variability among the studies with regard to RTW findings. Two of three studies reported significant differences in RTW rates between the intervention and control groups. One of six studies observed a significant difference in sickness absence duration between intervention and control groups. Conclusions: There is limited evidence that combinations of interventions that include work-related problem-solving skills are effective in RTW outcomes. The evidence could be strengthened if future studies included more detailed examinations of intervention adherence and changes in problem-solving skills. Future studies should also examine the long-term effects of problem-solving skills on sickness absence recurrence and work productivity.