Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience.

BACKGROUND: Seeking help for severe depressive symptoms remains a major obstacle for particular groups within the general population. Value-related attitudes might contribute to this treatment gap, particularly in rural regions with a low density of psychiatric-psychotherapeutic services. We aimed to investigate narratives of socialization, value systems, and barriers of help-seeking to better understand social milieus at increased risk for underuse of psychiatric-psychotherapeutic services in a rural area in East Germany. This could complement the explanatory power of classical socio-demographic determinants and provide guidance for possible interventions. METHOD: Based on results of an analysis of a population-based German cohort study (SHIP-TREND-1), 20 individual semi-structured interviews were conducted with participants who met criteria for having been moderately or severely depressed at least once in their life. Qualitative analyses of interview data were guided by grounded theory methodology. RESULTS: Participants with severe symptoms of depression were more frequent among non-responders of this study. We identified key aspects that influence help-seeking for mental health problems and seem to be characteristic for rural regions: family doctors serve as initial contact points for mental health problems and are considered as alternatives for mental health professionals; norms of traditional masculinity such as being more rational than emotional, needing to endure hardships, embodying strength, and being independent were frequently mentioned as inhibiting help-seeking by middle-aged men; anticipated adverse side-effects of therapy such as worsening of symptoms; a frequently expressed desire for less pathologically perceived treatment options. CONCLUSIONS: Our results suggest that barriers regarding help-seeking in rural regions are multifaceted and seem to be influenced by traditional norms of masculinity. We believe it is critical to strengthen existing and already utilized services such as family doctors and to implement and evaluate tailored interventions targeting the needs of the rural milieu.

[Return to Work and Stay at Work - The Question of Successful Operational Integration Management]. / Return to Work und Stay at Work ­ Die Frage nach einem gelingenden betrieblichen Eingliederungsmanagement.

OBJECTIVE: The study focuses on the question of how the design of operational integration management (OIM) can be optimized, especially in small and medium-sized enterprises (SMEs), and how previous experience with operational integration management can be used to develop preventive measures to ensure employability. METHODS: The study follows a multi-perspective qualitative research design. It focused on the survey of 40 retrospective interviews with employees who have undergone different variants of the OIM. In addition, company and inter-company actors were examined through expert surveys. The evaluation of the interviews followed the heuristics of case reconstruction and the research strategy of Grounded Theory. RESULTS: Various influencing factors for the design of a operational integration management can be identified - the biographically anchored attitudes of employers and employees, the corporate culture as well as (company-specific) structural factors - which can become successful conditions and inhibitors of OIM processes in SMEs. Dilemmas that can hinder OIM processes are also evident. OIM processes can also have effects that go beyond the OIM objectives in a narrower sense. CONCLUSION: The reintegration and retention of the employability of employees can be successful above all if there is a trust-based corporate culture of mindfulness, appreciation and openness. This depends in particular on the attitudes of all those involved. But even in such a corporate culture, dilemmas and conflict potential have an influence on the success of the OIM process. Each company also needs internal and/or external actors with sufficient knowledge and skills to carry out an OIM.

[Research on Participation in Working Life: On the Transfer from Theory into Practice]. / Forschung zu Leistungen zur Teilhabe am Arbeitsleben: Zum Wissenstransfer zwischen Theorie und Praxis.

OBJECTIVE: This study focuses on the theory-practice transfer in the field of research on participation in working life (LTA). The aim was to determine what expectations are prevalent on the part of service providers, how they access scientific knowledge, how the transfer into practice takes place and what research gaps exist. At the same time, representatives of the German Statutory Pension Insurance were asked about internal structures for identifying research topics and evaluating research results as well as for knowledge transfer. The aim of the article is to address the relationship between research and practice in the field of LTA and to create a sensitivity for this topic. METHODS: The results of this study are based on a written survey of 28 Vocational Training Institutes (BFW) of the Federal Association of Vocational Rehabilitation Centres (BV BFW) and on three expert interviews with representatives of pension insurance companies (federal and regional). The response rate of the BFW survey was approximately 54% (N=15). For the evaluation of data primarily qualitative content analysis was applied, which included a step by step coding of the data. RESULTS: The results of the survey indicate a pronounced need for translation processes and a culture of cooperation between research and practice. At the same time, a tension between the preservation of the autonomy of research and an increasing transfer orientation became evident. In addition, a wide range of approaches for structuring possible transfer activities could be identified. CONCLUSION: In the area of research on services for participation in working life, the development of a strategy for research transfer represents a future task. It is necessary to explore new communication structures and participatory research formats in which research groups and sponsors as well as practitioners can jointly carry out research in this field.