Background: Sickness absence due to mental health problems (MHPs) is increasing in several European countries. However, little is known about return to work (RTW) for employees with MHPs. This prospective study aimed to identify predictors for RTW in employees sick-listed with MHPs. Methods: Employees were recruited when applying for sickness benefit due to MHPs from the Municipality of Copenhagen (n = 644). Information about age, gender, occupation, self-reported RTW expectancy, self-reported reason for absence and prior absence with MHPs was retrieved from application forms for sickness benefit. Each participant was followed-up in the National Register for Social Transfer Payments for a maximum period of 52 weeks to estimate time to RTW. Hazard ratios for RTW with 95% confidence intervals were calculated using Cox proportional regression analyses. Results: Employees sick-listed with self-reported stress/burnout returned to work faster than those with self-reported depression (HR = 0.76), and other MHPs (HR = 0.56). A positive RTW expectancy of the sick-listed person (HR = 1.27) and no prior absence with MHPs (HR = 1.29) were associated with a shorter time to RTW. Conclusion: Sickness absence due to self-reported stress/burnout, a positive RTW expectancy and no prior absence with MHPs predicted a shorter time to RTW among Danish employees sick listed with MHPs. Findings could help social insurance officers and other rehabilitation professionals to identify groups at high risk for prolonged absence.

/pdf/predictors-of-return-to-work-in-employees-sick-listed-with-3gc3b0u0ws.pdf

Predictors of return to work in employees sick-listed with mental health problems: findings from a longitudinal study

Background There is international concern about the levels of sickness and disability benefits, with mental disorders known to account for a large proportion of claims. Aims To examine trends in sickness and disability benefits awarded for mental disorders in the UK. Method The researchers analysed UK Government data from 1995 to 2014. Results Mental disorders have become the most common cause of receiving benefits, with the number of claimants rising by 103% from 1995 to 1.1 million in 2014. Claimants with other conditions fell by 35%. In 2014, 47% of claims were attributed to a mental disorder. The number of long-term claimants (claiming over 5 years) with mental disorders increased by 87% from 2000 to 2011. Two-thirds of mental disorder claimants were classified as having a depressive or anxiety disorder. Conclusions Common mental disorders may involve greater morbidity and social costs than usually recognised. Availability of suitable employment, as well as individual support, may be necessary to reduce benefit levels.

/pdf/claims-for-sickness-and-disability-benefits-owing-to-mental-4uboy3a2kh.pdf

Claims for sickness and disability benefits owing to mental disorders in the UK: trends from 1995 to 2014

Long-term sickness absence and incapacity benefits (disability pension) rates have increased across industrialised countries. Effective measures are needed to support return to work. The recommendations of this guidance were informed by the most appropriate available evidence of effectiveness and cost-effectiveness. Public health evidence was provided by research using a variety of study designs that attempted to determine the outcome of a particular intervention by evaluating status before and after the intervention had been effected, and was not limited to randomised control trials. Where the evidence base was depleted or underdeveloped, expert witnesses were called to give their opinion on the best available evidence and emerging interventions. The process enabled challenge and contestability from stakeholder groups at different points as the guidance was developed. Forty-five heterogeneous studies were included in the review of interventions to reduce long-term sickness absence and transitions from short-term to long-term absence (mainly covering the former and also mainly examining musculoskeletal conditions). The analysis of evidence was restricted to descriptive synthesis. Three general themes emerged from an analysis of the studies that were more likely to report positive results: early interventions; multidisciplinary approaches; and interventions with a workplace component. Two further reviews were undertaken, one on interventions to reduce the re-occurrence of sickness absence, which identified seven studies on lower back pain, and concluded that early intervention and direct workplace input are important factors. The final evidence review focused on six studies of interventions for those in receipt of incapacity benefit. The evidence was that work-focused interviews coupled with access to tailored support are effective and cost-effective interventions. Practitioners should consider the impact of interventions and management options on work ability for patients of working age. Work ability should be considered a key outcome for future intervention studies.

/pdf/nice-guidance-on-long-term-sickness-and-incapacity-4zu7i45hqi.pdf

NICE guidance on long-term sickness and incapacity

Much of the economic and other historiography of post-war Britain is shaped by the perceived failure of Britain to consistently match the growth rates of GDP experienced in other rich countries. These declinist narratives are commonly coupled to tendentious and ideologically driven analyses of economic, social and political developments. This article seeks to displace this declinist narrative by one focussing upon de-industrialization and its consequences. The argument is that de-industrialization, beginning in the 1950s, brought about such a range of profound changes, that it provides the best underpinning narrative for understanding late twentieth-century Britain. After suggesting why ‘growth’ and ‘decline’ are not the best terms for understanding this period, the article sets out the case for seeing the employment changes brought about by de-industrialization as crucial to many changes in economic welfare. De-industrialization not only increased wage inequalities and job insecurity, but also re-shaped the social security system and the pattern of public employment. In addition, de-industrialization has seriously compromised the aim of neo-liberalism to free the labour market from the influence of government.

/pdf/de-industrialization-not-decline-a-new-meta-narrative-for-3n9flj225r.pdf

De-industrialization Not Decline: A New Meta-narrative for Post-war British History

Rising premature mortality in the UK’s persistently deprived areas: Only a Scottish phenomenon?

Background Getting incapacity benefit (IB) claimants into work has become a focus for policy makers. Strategies to help this group depend on an understanding of the reasons for claiming benefit at a local level where variations from a national strategy may be needed. Methods Data supplied by the Department for Work and Pensions (DWP) was analysed to establish reasons for claiming benefit in Scotland and Glasgow between 2000 and 2007. Results There has been a continuing rise in mental health diagnosis and a corresponding fall in musculoskeletal diagnosis during this period. More people were claiming because of mental health problems in Glasgow than in Scotland. Also those with a poor employment history (creditsonly claimants) are more likely to claim IB because of a mental health problem. This study has shown a breakdown into 25 categories those claiming IB because of a mental health problem. Conclusion DWP data can be used to provide important insights into the trends in reasons for claiming IB, in particular those claiming because of mental health problems. This study also highlighted the growing importance of problems caused by alcohol and drug-abuse claimants, a subset of the mental health category. DWP data should be used at a local as well as a national level to guide and evaluate interventions to help this vulnerable group.

Mental health as a reason for claiming incapacity benefit--a comparison of national and local trends

This article provides an in-depth study of Incapacity Benefit (IB) claims in a major city and of the factors behind their changing level. It relates to the regime prior to the introduction of the Employment and Support Allowance (ESA) in 2008. Glasgow has had one of the highest levels of IB in Britain with a peak of almost one fifth of the working age population on IB or Severe Disablement Allowance (SDA). However, over the past decade the number of IB claimants in Glasgow, as in other high claiming areas, has fallen at a faster rate than elsewhere, and Glasgow now has twice the national proportion of working-age people on IB/SDA rather than its peak of three times. The rise in IB in Glasgow can be attributed primarily to deindustrialisation; between 1971 and 1991, over 100,000 manufacturing jobs were lost in the city. Policy response was belated. Lack of local statistics on IB led to a lengthy delay in official recognition of the scale of the issue, and targeted programmes to divert or return IB claimant...

/pdf/falling-incapacity-benefit-claims-in-a-former-industrial-2ryqv3uaib.pdf

Falling Incapacity Benefit claims in a former industrial city: policy impacts or labour market improvement?

Background Incapacity Benefit (IB) is the key contributory benefit for people who are incapable of work because of illness or disability. Methods The aims were to establish the utility of routinely collected data for local evaluation and to provide a descriptive epidemiology of the IB

/pdf/establishing-the-potential-for-using-routine-data-on-2qar4p4bjx.pdf

Establishing the potential for using routine data on Incapacity Benefit to assess the local impact of policy initiatives.

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Mental health as a reason for claiming incapacity benefit--a comparison of national and local trends

Falling Incapacity Benefit claims in a former industrial city: policy impacts or labour market improvement?

Establishing the potential for using routine data on Incapacity Benefit to assess the local impact of policy initiatives.