This literature review examined nine studies from the USA, UK, Canada, Sweden and the Netherlands.  The review showed that the most frequently used accommodations were flexible scheduling, a decrease in working hours, adapting an employee’s job description/responsibilities and adapting training and supervision.  Physical amendments to the work environment were the least prevalent. To implement accommodations, such as aiding communication with the employer in the recruitment process or whilst in the job requires support from a job coach from a supported employment agency.  The review also found that accommodations were more likely to be implemented if employees had the help of a supported employment agency.

The review concludes that there is limited extant research but that this is a key research area as workplace accommodations can aid in producing sustainable employment.  Additionally, information relating to disability discrimination legislation needs to be more widely accessible to help employers choose reasonable accommodations.

This study examined 1029 employees who had a range of chronic illnesses: either musculoskeletal pain, arthritis and rheumatism, asthma, depression and anxiety, heart disease or diabetes.  Psychosocial factors that are linked with psychological and health related distress were examined amongst employees.  The results reported here have focused on depression and anxiety. 

Employees with depression and anxiety displayed higher scores on the general psychological and health distress measure.  Additionally, they displayed higher scores in work limitation in contrast to the other chronic illness groups. Employees who had asthma reported lower disclosure than all other illnesses except for depression and anxiety. Employees with depression and anxiety said they had more recurrent short periods of presenteeism than the other chronic illness groups apart from  those with arthritis and rheumatism.  Employees with depression and anxiety, arthritis and rheumatism and musculoskeletal pain showed less illness management at work than the other chronic illness groups.  When controlling for illness and the severity of the illness, work limitations most strongly predicted both measures of distress.

It was concluded that there is a need for employer and health care interventions that focus on work limitations and psychological health outcomes.  Employees suffering with chronic illnesses require both practical and emotional help from employers.

Evidence from HSE, EU-OSHA and IOSH was reviewed.  The review concluded that it’s important to take a proactive approach to helping employees with mental ill health return to work.  A flexible approach by employers should be taken, this might include a phased return to work.  Fit notes developed by GPs can also help employers understand adjustments that employees may need in their return to work. Additionally, social support from line managers can help in making the return to work effective.

The review suggests employers need to make a strategic commitment, e.g. signing the “Time for Change” pledge, implement relevant policies, assess and manage psychosocial risks and promote health and wellbeing. Providing training for managers, information for employees on mental ill health on the intranet and providing courses or counselling are a number of good practice suggestions.  Additionally, the role of the line manager should not be underestimated, having line managers who can change their management style to fit the preferences of the employee is crucial.

The relationships between employer support (line managers and occupational health), self-efficacy and self-management of chronic illness (e.g. musculoskeletal pain, arthritis, diabetes, depression and anxiety) at work were examined amongst 772 employees with one of six chronic illnesses. Self-efficacy in managing chronic illness at work, self-management behaviour at work and employer support (practical and emotional) were measured.

The findings showed that line manager support was directly related to employees’ self management of symptoms and medication at work.  These relationships were partially mediated by self-efficacy.  There was an indirect relationship between occupational health support and self-management of symptoms.  The results suggest that line mangers support employees directly and also by increasing self-efficacy whereas occupational health indirectly support employees as they help to establish work adjustments for employees which increase their self efficacy.

This was an exploratory qualitative study.  11 supervisors from large and medium sized organisations took part in semi-structured interviews.  Supervisors had employees who had returned to work after being off work because of common mental disorders. The study found there were 24 factors that were distinct to the worker, the work context or the return to work. A number of these factors are noted in research regarding mental disorders such as changes in the organisation and social isolation, however some factors were not relevant only to mental disorders but were relevant to the more general return to work process.  The 24 factors were categorised into 3 categories: elements specific to the worker, specific to the work context and the return to work.

Supervisors mentioned that interventions need to account for their perspectives as well as the limits that are placed on them within the workplace.  It was concluded that studies investigating return to work should concentrate evenly on both the individual returning to work and the workplace so that the process involves all the necessary stakeholders and is effectively executed.

This review examined the success of randomised controlled trial interventions to help employees with depressive disorders return to work. Specifically, it examined the impact of work-directed interventions (such as adapting work hours or work tasks) as well as clinical interventions (psychological, antidepressant medications and exercise).  23 studies with 5996 participants were included.

The review concluded that moderate quality evidence exists to show that by combining a clinical intervention with a work-directed intervention sick leave is reduced in the medium term, in comparison with solely a clinical intervention.  Moderate quality evidence also showed that improving primary care with additional structured telephone or online cognitive behavioural therapy decreased sickness absence in comparison with regular care.

This systematic literature search reviewed 8 studies. The review found that amongst employees with common mental health conditions, there were 3 frequent aspects of interventions, these were: enabling employees to get clinical treatment outside work, workplace psychological interventions (e.g. CBT) and helping employees with the disability management system.   These positively impacted on some if not all of these commonly used measures of return to work consequences: work absence duration, work functioning outcomes, quality of life and economic outcomes.  This review suggests that increased communication between health care providers and workplaces will increase the positive effects of interventions especially as workers with Common Mental Health Conditions may be hesitant to get treatment.

It was concluded that enabling employees to get clinical treatment outside work and workplace based high-intensity psychological interventions had the most positive impact on work function, quality of life and decreasing costs.

This quasi-experimental study examined two individual-level psychotherapy interventions amongst 168 individuals with common mental disorders who were on sick leave.  One intervention was Cognitive Behavioural Therapy (CBT) and the other was work-focused Cognitive Behavioural Therapy (W-CBT), this intervention was similar to CBT but additionally included a module that concentrated on work and return to work.  The length of time till return to work, mental health problems and costs to the employer were measured.

Those in the W-CBT group returned to work significantly earlier than those in the CBT group, 65 days earlier, and had a partial return to work 12 days earlier.  It is proposed that this difference results in a 20% cost saving for employers. Both groups displayed significant decreases in mental health problems.  The findings suggest that it may be valuable to both employees and employers to combine work-related elements with CBT.

220 employees with Common Mental Disorder symptoms and who had been off work between 4 and 26 weeks were randomised to the intervention (ECO) or care as usual (CAU) group and follow up was 12 months later.  Those in the ECO group had a significantly shorter number of days before they first returned to work than the CAU group. At 9 months follow up a higher number of employees in the ECO group compared to the CAU group accomplished remission.

The ECO (E-health module embedded in Collaborative Occupational health care) is a blended web-based intervention which consists of two elements: an eHealth module (Return@Work) and a decision aid which the Occupational Physician received through email which assisted the physicians in the guidance they gave to employees.  The Return@Work eHealth Module has 5 modules. The programme was modified for each employee depending on their symptoms so the sessions varied from 6 to 17 sessions. 

158 Dutch employees who had been off work because of a Common Mental Disorder (e.g. depression, anxiety disorder and adjustment disorder) for at least two weeks who had partially or fully returned to work were randomised into an intervention (SHARP) or care as usual (CAU) group.  Outcomes were measured at 3, 6 and 12 months.  The length of time to recurrent sickness absence was significantly greater in the SHARP group than the CAU group.

The intervention was SHARP-at work – Stimulating Healthy participation And Relapse Prevention compared to CAU (Care As Usual). The intervention is a five step problem-solving process. It was implemented by Occupational Physicians within the first 2 weeks of employees returning to work. Intervention consultations lasted 30 minutes and it was suggested 2 to 5 consultations were given within the first three months of returning to work. 

This was a systematic review, 9, 173 articles were found but interestingly only one was eligible which was a non-randomised controlled clinical trial and cluster based evaluation study.  In this study the intervention was a health promotion intervention implemented amongst 9, 743 employees who were on sick leave.  Anxiety and depression disorder were measured using M.I.N.I (Mini-International Neuropsychiatric Interview) and HAD (Hospital Anxiety and Depression Scale). The results suggest that the intervention had a positive impact on the majority of patients with depressive disorders.  Results showed a significant trend towards greater chances of recovery or remission a year after the intervention was instigated.  However, the results tended to be better amongst male employees and the intervention was not successful amongst employees who had greater spontaneous remission.

It was concluded that due to the lack of eligible studies and the positive findings from this one study more evidence based programmes to target depression in the workplace should be produced.  Programmes should especially concentrate on groups of higher risk employees, such as young women and those aged 40 and under.

This review found 17 eligible studies.  The review aimed to examine the impact of workplace physical activity interventions on mental health outcomes. Interventions were physical activity such as aerobic dance, weight-training exercise, strength or resistance training and yoga exercise.  One high quality study that examined an exercise intervention programme with behaviour change found a significant decrease in stress scores and depression scores.  Another two high quality randomised control trials suggest that yoga resulted in significant decreases in anxiety. 

Conclusions from the results are that physical activity and yoga have the potential to decrease depressive symptoms and anxiety. The benefits of physical activity interventions on stress are less clear. 

In this review occupational digital mental health interventions were examined to assess their effectiveness in improving employee psychological well-being and work effectiveness. 5 databases were searched for relevant studies published from January 2000 to May 2016. 21 randomised controlled trial studies were included in the review which included 5260 participants.  The results showed there was a significant effect of occupational digital mental health interventions on psychological well-being and work effectiveness and the findings suggest that occupational digital mental health interventions are as effective as more traditional non digital occupational interventions and other digital interventions provided outside the workplace at improving mental health outcomes.  Interventions that are associated with higher engagement and adherence tended to be those that offered guidance, lasted a shorter time (6 to 7 weeks), used additional methods for delivering the intervention and engaging users (e.g. email and text messages) and used persuasive technology (e.g. self-monitoring and tailoring).