Psychological and physical factors aiding return to work of long-term absent

A new study examines the psychological and physical aspects that can ease the transition back to work for people who are long-term absent. The study shows the importance of security, support and self-esteem, but also of physical factors such as economic security and good healthcare. A support system has to be individually adapted in order to be effective. The practical relevance of the study has increased due to new rules for sick leave instigated by the current government.

Background

Sweden experienced a large increase in absenteeism from 1997 to 2003, which has largely been due to a rise in long-term absenteeism. An increase in the number of days in an average case of absence prompted politicians, employers and other actors to find new ways of rehabilitation. A number of measures and changes have been made in recent years by both the current and previous governments, but the probability of returning to work after a long-term absence from the labour market is still low.

The employer has responsibility for employees’ rehabilitation in Sweden. The trend over the last decade of increased outsourcing and businesses focusing on their core activities is difficult to combine with the Swedish rehabilitation model, with negative consequences for employees. A new study (in Swedish) follows 19 individuals who use a different model, called an ‘employer ring’ (arbetsgivarring) – a network of employers and other organisations that helps employees to overcome different adjustment processes. This applies to situations where an employee requires vocational rehabilitation. Through the network, employees can switch between different workplaces and assignments in order to adapt to a new situation. This is advantageous for both the employee and the employer.

Overview and results of study

The second part of the longitudinal study – entitled ‘Ways back’ – followed 20 individuals who started using an employer ring in 2004. The first part described their employment history and perceived barriers on the way back to the labour market. The second part of the study, initiated in 2006, focused on assessing which psychological and physical considerations ease the transition back to the labour market.

Of the 19 individuals (one declined participation) who took part in the second part of the study, nine were no longer on long-term sick leave and had wholly or partially returned to their own employer, to a new employer/workplace or to studies. Although it was not possible to create a reference group, the authors still state that this is better than the national average. The study shows that three psychological factors were important for those on long-term sick leave: security, support and self-esteem. Although they are mentioned as separate entities, the authors state that these factors interact and that all three are equally important. For example, it is difficult for a person to build up self-esteem if they do not feel safe in a new working environment.

Importance of safety and support systems

The analysis shows that safety reflects a feeling that somebody cares about you and that somebody wants you to do well. The participants were in contact with a large number of organisations – such as the Swedish Social Insurance Agency (Försäkringskassan), different employers within the network and Starck & Partner, a partner within the employer ring which specialised in rehabilitation and organising employer rings. This procedure is positive if the employer and different agencies work together for the employees’ interests, but it can also be negative if no one takes responsibility for them. The analysis showed that the support system should provide a balance between encouraging an employee to take responsibility and releasing the employee from responsibility. A support system can both help and break an employee; therefore, consideration has to be taken of individual differences, qualifications and the present situation.

Significance of physical factors

Feelings of security, support and self-esteem were characteristic for those who had returned to the labour market. Although the study focused on psychological aspects, some physical aspects were mentioned during the interviews. A return to the labour market is also dependent on physical factors such as healthcare, economic security, possibilities for re-schooling, guidance and employment services. According to the authors, there was a clear interaction between the psychological and physical factors and an individual’s ability to return to the labour market.

Commentary

This study is relevant in Sweden today because of the new rules, whereby a person who is absent from the labour market is interviewed after 180 days to see if he or she can find a job at another workplace (SE1001029I). The model that is examined here allows an employee to switch workplaces, which is what the new regulation wants to achieve.

Organising employer rings could be an important model in the future, because it is beneficial to both employers and employees. It is also better adapted to the demands and conditions in today’s labour market, as companies focus on core competences and new rules for absentees. This study provides practical knowledge about psychological and physical factors that are important for the return to work of persons who are long-term absent to a former or new employer, and it is therefore highly relevant.

Reference

Mellner, C., Astvik, W. and Aronsson, G., Vägar tillbaka - En uppföljningsstudie av psykologiska och praktiska förutsättningar för återgång i arbete efter långtidssjukskrivning med stöd av en arbetsgivarring, University of Gothenburg, 2009.

Mats Kullander and Claes Bäckman, Oxford Research