From sickness absence to sustainable return to work among employees with common mental disorders in Germany

Mental health conditions are increasing worldwide and have a significant impact on the working population. In Germany, common mental disorders such as depression and anxiety are responsible for the longest periods of sick leave, yet research on return to work (RTW), particularly the phase after returning, remains limited.

This thesis of Alexandra Sikora examined the RTW process among German employees with common mental disorders, from the onset of sick leave through to the actual return to work and the subsequent phase. Key findings include: 

• The vast majority of employees returned to work, with a gradual RTW being the standard procedure for 80% of participants who had undergone psychiatric treatment. 
• Work ability improved steadily during the RTW process, with the need for support depending on the level of work ability. 
• Four trajectories of work participation emerged, with 65% of returning employees maintaining high or very high work participation over time. 
• Receiving one or more workplace adjustments during the RTW process can contribute to long-term recovery and work ability.

The results emphasize the long-term nature of RTW and the need for ongoing support and resource development even after the initial return. The IGLOo framework is proposed to systematically address all levels of support (individual, group, leadership, organizational, and contextual). Indicators such as successfully completing RTW, maintaining high work participation, restoring good work ability, preventing early exit from work, and ensuring access to appropriate workplace adjustments appear crucial for sustainable RTW. This thesis highlights the critical role of work-related factors and tailored, continuous support for sustainable RTW.

Find the full thesis here: From sickness absence to sustainable return to work among employees with common mental disorders in Germany