Academic journal article Nordic Journal of Working Life Studies

Employer Strategies for Preventing Mental Health Related Work Disability: A Scoping Review 1

Academic journal article Nordic Journal of Working Life Studies

Employer Strategies for Preventing Mental Health Related Work Disability: A Scoping Review 1

Article excerpt

Background and relevance of the problem

Nordic working life research has a long tradition for critical studies on work disability prevention that provides a consistent knowledge base on the central role of employers in developing and maintaining a healthy workforce (Hvid 2011; Kamp & Nielsen 2013). Importantly, employers have responsibility to structure preventive initiatives, and their efforts to organize and manage human resources in working environments influence employee sickness absence understood as temporary or periodic inability to work (Geisen & Harder 2011; Loisel & Anema 2013). One of the major challenges for employers striving to prevent work disability is the magnitude of common mental disorders (CMDs) such as anxiety, depression, and stress-related illness (Andersen 2012; Corbiere 2009; McDowell & Fossey 2015). From a cross-national perspective, musculoskeletal disorders no longer comprise the largest diagnostic group. Instead, CMDs are increasing among the working-age population, with depression and stress-related illness rising as the dominant public health problem among the Nordic countries (Prins 2013). The economic and social costs associated with high levels of CMD make a clear 'business case' for work disability prevention as a renewable area for employers to boost preventive legitimacy and approaches. Many employers do strive to establish a comprehensive preventive approach, while struggling to understand the complex ways in which CMDs are embedded within productivity, work organization, and social relations at work (MacEachen 2006). Facilitating new employer opportunities to prevent CMDrelated work disability has therefore been subject to much scientific and political debate, including a wide spectrum of research fields (Gallie 2011; Pomaki 2012; WHO 2006).

Employer activation in work disability policy

Several Nordic research studies have debated the employer role in work disability policies, and to what extent employers should be responsible to accommodate workers. Dealing with employer responsibility in organizing return to work (RTW), however, is a complex issue for several reasons. Employers do not receive a great deal of training in managing the process of RTW (Ekberg 2016; Stochkendahl 2015). Employers need capacity building in workplace strategies and how to coordinate separate activities to make them work together (Kärrholm 2007; Tjulin 2010). Contemporary sickness benefit policies and legal requirements do not always adequately prompt employers to engage in RTW, and often little guidance is given on specific requirements for work accommodation and follow-up outside the workplace (Clayton 2011; Seing 2015a). In contrast, recent administrative reforms seem to have been introducing continuous change in work activation and sickness benefit schemes with added responsibility for RTW coordination put on local welfare services (Aust 2015; Seing 2012). This makes it difficult to integrate inclusive working life with work activation policies (Andreassen & Spjelkavik 2013). While recent reforms are debateable and manifested differently across the Nordic countries, the reforms have proven less likely to facilitate and maintain a strong workplace approach, and rather created a 'missing link' to employers in post injury/illness prevention (Clayton 2011; Ståhl 2009). Importanly, Nordic welfare states risk to miss critical employer resources that could serve a more systematic approach to bridge preventive activities and renew the role of employer as a stakeholder in social policy (Midtsundstad 2008). Interestingly, differences in work disability outcomes seem to be highly correlated with differences in applied workplace interventions across countries. The main implication of such research findings is that a policy change is needed to encourage more attention to employer efforts and workplace initiatives, through collaborative action at the workplace level (Anema 2009).

The value of integrated prevention approaches

Many practical and economic reasons exist to why the workplace may be the ideal setting for establishing and implementing initiatives to prevent CMD-related work disability. …

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