Return-to-Work Strategies for Employees With Mental Health Conditions.

There's no question that employers can no longer ignore mental health issues. Compassion and support for employees aside, it is simply good business to protect the mental health and productivity of employees. This article describes existing challenges surrounding employees with mental disorders: the link between mental disorders, disability and an employee's ability to return to work; best practices for employers, employees and health care providers; and the role of the insurance company. Together, using proven strategies, everyone contributes to the optimal solution of helping employees with mental disorders return to work.

Workplace-based work disability prevention interventions for workers with common mental health conditions: a review of the literature.

INTRODUCTION: To summarize evidence on workplace-based work disability prevention (WDP) interventions in workers with common mental health conditions (CMHCs). Primary outcomes of interest were work absence duration and work functioning; secondary outcomes were quality of life, and economic costs. METHODS: We conducted a systematic literature search in 5 electronic databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science) for studies published from 2007 to 2009. Two reviewers screened for studies: (1) Targeting workers with CMHCs absent from, or struggling at, work; (2) evaluating workplace-based WDP interventions; (3) assessing our primary outcome(s); and (4) with controlled trials. Quality assessment (using 29 criteria) was performed by two reviewers. RESULTS: Our search yielded 671 abstracts: 8 eligible studies and of sufficient quality. We identified three main intervention elements: (a) Facilitation of access to clinical treatment; (b) Workplace-based high-intensity psychological intervention; and (c) Facilitation of navigation through the disability management system. Moderate evidence was found that facilitation of treatment improved work functioning, quality of life and economic outcomes, with limited evidence for work absence duration. Moderate evidence was found that psychological interventions, primarily cognitive-behavioral therapy, improved work functioning, quality of life, and economic outcomes. Moderate evidence indicated that facilitation of navigation through the disability management system improved work absence duration. CONCLUSIONS: Workplace-based interventions could improve work disability outcomes for workers with CMHCs. Facilitation of access to clinical treatment, and workplace-based high-intensity psychological intervention were most effective in improving work functioning and quality of life, and in reducing costs.

Linking goal progress to subjective well-being at work: the moderating role of goal-related self-efficacy and attainability.

Although goal progress is often hypothesized to be positively linked to well-being, existing research points to an inconsistent relationship and suggests that potential moderators need to be examined. This longitudinal study investigated whether 2 aspects of goal cognition-goal attainability and self-efficacy-influence the relationship between goal progress and well-being (viz., job satisfaction and emotional exhaustion) in a sample of 172 nurses. Work goal progress was not directly associated with well-being. Rather, the link between goal progress and well-being was moderated by goal cognition. Individuals who started off with unfavorable goal cognitions but who managed to achieve goal progress reported an increase in well-being, compared with those who had favorable goal cognitions and similar rates of progress. Progress appears to have compensated for low initial goal cognition in the prediction of well-being, and high initial goal cognition appears to have undermined this predictive relationship. Also, goal progress was associated with an increase in self-efficacy and goal attainability from Time 1 to Time 2. Results are discussed in relation to goal theories and the concept of self-correcting goal cycles.

Work conditions and employees' self-set goals: goal processes enhance prediction of psychological distress and well-being.

Although previous theory and research suggest that employee well-being should be predicted by work conditions (viz., Karasek and colleagues' job demands-control-social support [J-DCS] model), other factors are also likely to be important. In this study, the authors consider correlates of employee psychological distress and well-being using a goal-focused approach grounded in Ford's (1992) motivational systems theory. Specifically, work conditions and midlevel work goal processes (WGP) were examined in a questionnaire study of health care employees. Regarding predictions derived from the J-DCS model, the authors found full support for the iso-strain, partial support for the nonlinearity, and no support for the buffer hypothesis. Of importance, however, WGP (i.e., cognitions and emotions involved in the pursuit of self-set work goals) explained variance in job satisfaction, burnout, depression, and somatic complaints, over and above that of the J-DCS model. This suggests that investigation of WGP can enhance our understanding of employee psychological distress and well-being.

Can't live with you, can't live without you: negative family exchanges and adaptation in end-stage renal disease patients.

The present study examined associations between negative family exchanges (patient perceptions of family overprotection and negative expressiveness, and patient feelings of being a burden), and two indicators of adaptation to illness (mental health and negative affect) in patients with end-stage renal disease (ESRD). Data were collected using the perceptions of illness-related family exchanges questionnaire, the SF36 and the PANAS in a structured interview with 127 patients with ESRD in Greece. Findings indicate that patient perceptions of negative family exchanges are related to outcomes, even after controlling for demographic and clinical factors. It is important to consider caregivers in intervention programmes of ESRD patients.

Daily cognitive appraisals, daily affect, and long-term depressive symptoms: the role of self-esteem and self-concept clarity in the stress process.

The current study investigated how self-esteem and self-concept clarity are implicated in the stress process both in the short and long term. Initial and 2-year follow-up interviews were completed by 178 participants from stepfamily unions. In twice-daily structured diaries over 7 days, participants reported their main family stressor, cognitive appraisals (perceived stressor threat and stressor controllability), and negative affect. Results of multilevel modeling indicated that high self-esteem ameliorated the effect of daily negative cognitive appraisals on daily negative affect. Self-concept clarity also buffered the effect of low self-self-esteem on depressive symptoms 2 years later. Our findings point to the vulnerability of those having low self-esteem or low self-concept clarity in terms of both short- and long-term adaptation to stress. They indicate the need for the consideration of such individual differences in designing stress management interventions.