[Mental health problems among employees: service use and costs to the German healthcare system]. / Psychische Belastungen bei Erwerbstätigen: Leistungsinanspruchnahme und Kosten für das deutsche Gesundheitssystem.

BACKGROUND: Service use among employees with mental health problems and the associated costs for the health and social system have not yet been systematically analysed in studies or have only been recorded indirectly. The aim of this article is to report the service use in this target group, to estimate the costs for the health and social system and to identify possible influencing factors on the cost variance. METHODS: As part of a multicentre study, use and costs of health and social services were examined for a sample of 550 employees with mental health problems. Service use was recorded using the German version of the Client Sociodemographic Service Receipt Inventory (CSSRI). Costs were calculated for six months. A generalized linear regression model was used to examine influencing cost factors. RESULTS: At the start of the study, the average total costs for the past six months in the sample were €â€¯5227.12 per person (standard deviation €â€¯7704.21). The regression model indicates significant associations between increasing costs with increasing age and for people with depression, behavioural syndromes with physiological symptoms, and other diagnoses. DISCUSSION: The calculated costs were similar in comparison to clinical samples. It should be further examined in longitudinal studies whether this result changes through specific interventions.

[Implementation of psychotherapeutic consultation at work (PT-A): expectations, announcement, and use : Results of the friaa-study]. / Implementierung einer psychotherapeutischen Sprechstunde am Arbeitsplatz (PT-A): Erwartungen, Bekanntmachung und Nutzung : Ergebnisse der friaa-Studie.

INTRODUCTION: Psychotherapeutic consultation at work (PT-A) offers easily accessible, short-term support for employees experiencing psychological stress. The aim of the study was to evaluate aspects of the implementation regarding announcement, access, and use of the PT­A. METHODS: The study was conducted as part of a randomized controlled trial (RCT) called "Early Intervention in the Workplace". Forty-six company actors answered a questionnaire about how the companies announced the PT­A to their employees, the barriers in the announcement of the PT­A, and the beneficial factors of using the PT­A. The access routes of the 550 participating employees were used from the baseline data of the RCT. Seven company actors were qualitatively interviewed about their expectations of the PT­A and 22 participants of the RCT were interviewed about their experiences accessing and using the PT­A. RESULTS: The company actors hoped that the PT­A would have an impact on all levels of prevention. Most companies announced the PT­A centrally (e.g., flyers and intranet) as well as through individual recommendations (e.g., through the company's social counselling and occupational health professionals). Employees appreciated the opportunity to participate anonymously in the central announcement. Advantages of the supportive access were seen in the accessibility of employees without treatment experience, employees with high levels of suffering, and employees who have not yet recognized their own need for treatment. DISCUSSION: The results suggest that it is useful to announce the PT­A centrally to all employees but also to recommend it personally to affected employees. By using both methods, different PT­A target groups can be reached and the advantages of anonymous participation are retained.

[Psychotherapeutic consultation at work: associations between company size and psychosomatic health]. / Psychotherapeutische Sprechstunde am Arbeitsplatz: Zusammenhänge zwischen Unternehmensgröße und psychosomatischer Gesundheit.

BACKGROUND: The utilization of psychotherapeutic consultation at work (PT-A) has so far been investigated in large enterprises (LEs). These differ structurally from small(est) and medium-sized enterprises (SMEs). Differences in the user profiles of a PT­A with regard to psychosomatic health, work-related self-efficacy, and work ability depending on company size have hardly been investigated. This study also examined differences in the employees' perception of the psychosocial safety climate (PSC) in the company, which represents management's efforts to promote mental health. METHODS: As part of the Early Intervention in the Workplace intervention study called "friaa", employees from LEs and SMEs interested in a PT­A were surveyed throughout Germany from September 2021 to January 2023. Using t­ and χ2-tests, differences between employees in LEs (n = 439) and SMEs (n = 109) were examined with regard to the ICD-10 F diagnostic code ("International Statistical Classification of Diseases and Related Health Problems"; mental and behavioral disorders), depression (PHQ-9), anxiety (GAD-2), level of functioning (GAF), somatic symptom burden (SSS-8), health (VR-12), ability to work (WAI), self-efficacy (SOSES), and psychosocial safety climate (PSC-4). The association between these variables and especially the PSC­4 were investigated using correlation analysis. RESULTS: Both groups showed similar levels of stress. From the employees' perspective, psychosocial issues were addressed significantly more frequently in LEs than in SMEs with a medium effect size. The study provided initial indications that in LEs there were positive correlations of the PSC­4 with SOSES and WAI and negative ones with PHQ­9 and SSS­8. DISCUSSION: The comparable psychological strain on employees in LEs and SMEs points to the need for behavioral and structural preventive measures regardless of the company size. Mainly in SMEs, organizational communication of psychosocial health should be given greater priority.

Self-Efficacy Beliefs of Employees with Mental Disorders or Musculoskeletal Diseases after Sickness-Related Absence: Validation of the German Version of the Return-to-Work Self-Efficacy Scale.

Return-to-work self-efficacy (RTW-SE) is an important predictor of the duration until employees return to work after a sickness-related absence. The aim of the present validation study was to investigate the psychometric properties of the German RTW-SE scale. Data were obtained from three independent samples of employees who were in outpatient care due to mental disorders or musculoskeletal diseases (n1 = 301, n2 = 103, n3 = 104). Confirmatory factor analyses showed an inadequate fit for a one-factor solution and an acceptable fit for a two-factor model that distinguished by item-wording direction. To test whether the two factors represent substantively different dimensions of the construct or rather a statistical item-wording effect, two subscales were formed based on item-wording direction. As the subscales were not differentially associated with external measures, the one-factor solution may be considered appropriate. The scale showed good to excellent internal consistency values over time and across samples, had low retest reliability indices, and indicated construct validity based on moderate to high associations with cognitive and disease-related variables. The results further demonstrated the scale's sensitivity to change. The RTW-SE baseline score predicted physical performance and pain-related psychological impairment after orthopedic rehabilitation. In multiple regression analysis, RTW-SE remained a significant predictor of pain-related psychological impairment but not physical performance, partially demonstrating the predictive validity of the scale. The German version of the RTW-SE scale demonstrated satisfactory results regarding its validity and reliability.

Early intervention, treatment and rehabilitation of employees with common mental disorders by using psychotherapeutic consultation at work: study protocol of a randomised controlled multicentre trial (friaa project).

BACKGROUND: Common mental disorders are one of the leading causes for sickness absence and early retirement due to reduced health. Furthermore, a treatment gap for common mental disorders has been described worldwide. Within this study, psychotherapeutic consultation at work defined as a tailored, module-based and work-related psychotherapeutic intervention will be applied to improve mental health care. METHODS: This study comprises a randomised controlled multicentre trial with 1:1 allocation to an intervention and control group. In total, 520 employees with common mental disorders shall be recruited from companies being located around five study centres in Germany. Besides care as usual, the intervention group will receive up to 17 sessions of psychotherapy. The first session will include basics diagnostics and medical indication of treatment and the second session will include work-related diagnostics. Then, participants of the intervention group may receive work-related psychotherapeutic consultation for up to ten sessions. Further psychotherapeutic consultation during return to work for up to five sessions will be offered where appropriate. The control group will receive care as usual and the first intervention session of basic diagnostics and medical indication of treatment. After enrolment to the study, participants will be followed up after nine (first follow-up) and fifteen (second follow-up) months. Self-reported days of sickness absence within the last 6 months at the second follow-up will be used as the primary outcome and self-efficacy at the second follow-up as the secondary outcome. Furthermore, a cost-benefit assessment related to costs of common mental disorders for social insurances and companies will be performed. DISCUSSION: Psychotherapeutic consultation at work represents a low threshold care model aiming to overcome treatment gaps for employees with common mental disorders. If successfully implemented and evaluated, it might serve as a role model to the care of employees with common mental disorders and might be adopted in standard care in cooperation with sickness and pension insurances in Germany. TRIAL REGISTRATION: The friaa project was registered at the German Clinical Trial Register (DRKS) at 01.03.2021 (DRKS00023049): https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023049 .