...returned those who did not, and those for whom there was resolution or non resolution of their health problem. This study among public sector employees was cross-sectional. Data was collected using mailed questionnaires and analyses were performed for 1850 respondents. The results show significant difference between those who were back at work and those who were not, based on the cause they reported for their absence from work. Improved working conditions accompanying return to work may be a major determinant of health recovery and successful return to work, and ensure job retention.

El efecto del trabajo en el estado de salud mental de los individuos nos incita a cuestionar las condiciones que favorecen un retorno exitoso al trabajo. Los objetivos de este estudio son de describir las caracteristicas de los trabajadores que se han ausentado en razon de un problema de salud mental y efectuar comparaciones segun la situacion de retorno o no al trabajo y la resolucion o no de su problema de salud. Los datos de este estudio transversal han sido colectados mediante un cuestionario administrado a 1850 empleados del sector publico. Los resultados muestran una diferencia significativa entre los trabajadores que han retornado al trabajo y aquellos que no han regresado, apoyandose en la declaracion del motivo de su ausencia. La mejora de las condiciones de trabajo al momento del retorno es un determinante mayor de la restauracion del estado de salud, de un retorno exitoso al trabajo y de la continuacion del empleo.

**********

Over the last decades, workplaces have undergone a great deal of upheaval which has affected individuals' capacity to work and retain their jobs, and also their mental health. According to Vinet (2004), the spectacular rise in absences due to work-related mental health problems and the ensuing proportional rise in group insurance premiums attest to the extent and depth of this phenomenon. Work-related mental health problems are currently one of the leading causes of absence from work, and this phenomenon has grown markedly in recent years (Banham, 1992; Conti and Burton, 1994; Gabriel and Liimatainen, 2000; Karttunen, 1995; Vezina, 1996; Vezina and Bourbonnais, 2001; Nystuen, Hagen and Herrin, 2001). These health problems take diverse forms and diagnoses: adjustment disorders, situational depression, burnout, dependency problems, phobia, etc. (Gabriel and Liimatainen, 2000). According to Nieuwenhuijsen et al. (2003), the majority of workers who are absent due to a mental health problem surfer from transitory mental disorders that can be grouped into three categories: adjustment disorders (including burnout), mood disorders (including major depression), and anxiety disorders (Shiels, Gabbay and Ford, 2004; van der Klink et al., 2003).

Based on a report on mental health in the workplace by the International Labour Office (ILO) involving five industrialized countries--the United States, Great Britain, Germany, Finland and Poland--20% of the adult population is affected by a mental health problem (Gabriel and Liimatainen, 2000). Data from the European Survey on w0rking conditions, conducted in 2000, indicate that, after back pain, work-related stress is the second most common health problem across Europe (European Foundation for the Improvement of Living and Working Conditions, 2005). In industrialized countries, including Canada and Quebec, successive surveys have indicated that between one in five and one in four people in the general population show a high level of psychological distress (Institut de la statistique du Quebec, 2000). An analysis of data from health surveys conducted between 1987 and 1998 on the development of work disability due to mental health problems among Quebeckers clearly shows the increasing importance of this phenomenon (Vezina and Bourbonnais, 2001). Indeed, the proportion of workers who were absent as a result of a mental health problem almost doubled during this period, from 7.2% to 13.2%. In addition to being absent more often, workers were absent for longer periods of time. In fact, the analysis shows that the average number of disability days per person due to a health problem almost doubled between 1992 and 1998, from 3.49% to 7.83%.

A recent Health Canada report concludes that mental iii health in workplaces cost Canadian companies nearly 14% of their annual net profit, representing approximately $16 billion annually (Sroujian, 2003). For many wage loss insurance companies, mental health-related claims represent the most rapidly increasing category of disability costs. At Standard Life, from 1991 to 2003, the incidence of long-term disabilities related to mental health problems increased by 120% (Dube and Parent, 2004). In 2005, as in each of the previous 14 years, the main causes of disability indicated in new applications for benefits involved mental health problems, in particular depression and anxiety, which accounted for 47% of these applications (Conseil de gestion du regime d'assurance invalidite, 2005). The same is true in Quebec for the Commission de la sante et de la securite du travail (occupational health and safety commission, CSST) which saw its total compensation payments for employment injuries related to stress, burnout or other psychological factors, rise from $5.8 million in 1995 to $14.3 million in 2004 (CSST, 2006).

Many workers are likely to be faced with a mental health problem that is serious enough to cause absence from work. Mental health problems are not trivial illnesses. They can have particularly incapacitating effects resulting in long periods of disability, are persistent, and involve a high risk of relapse (Conti and Burton, 1994; Druss, Schlesinger and Allen, 2001). Studies have shown that the duration of a work disability as a result of depression appears to be two and a half times longer than that caused by other illnesses (Gabriel and Liimatainen, 2000). Moreover, a lack of support measures during the occupational reintegration process can lead to the construction of permanent work disability and thus to marginalization and social exclusion. Despite the extent of work absences and the concern raised by this phenomenon, studies on the occupational reintegration process of workers who have been absent due to a mental health problem remain fragmented.

Most of the studies reviewed in the field of mental health rehabilitation focus on people with serious mental illness such as schizophrenia, whose life trajectory has been mainly marked by difficulties with occupational integration rather than with occupational reintegration. In the field of occupational health, studies on rehabilitation essentially focus on workers who have been victims of accidents or occupational diseases. Although these mental health and occupational health studies do not apply specifically to the population examined here, they nevertheless highlight some findings on the interventions to be favoured in this field and, as such, shed an interesting light on this study. In fact, the more recent conceptual frameworks developed in the field of rehabilitation state the need to take environmental factors into account in the analysis of the rehabilitation process (Badley, 1995; Fougeyrollas, 1995; Franche et al., 2005; Baril et al., 2003; Loisel et al., 2005; Durand et al., 2003). According to Loisel et al. (2001), the effectiveness of an occupational reintegration program depends, in particular, on a well-documented analysis of return-to-work opportunities and obstacles which exist at various levels in the workplace, that is, from the employee' s individual work situation to the overall organization of the workplace.

Some studies have specifically examined the occupational reintegration of workers who held a job and were absent due to a mental health problem, but few of these have focused on the work environment (Briand et al., 2007). Research studies on this subject are mainly oriented towards cognitive-behavioural interventions centred on the individual, which involve problem solving and stress management, and hardly consider the work environment and concerted action among partners (Nystuen and Hagen, 2003; van der Klink et al., 2003). However, the need to take work-related variables into account in the analysis of the occupational reintegration process is all the more crucial since an increasing number of studies have demonstrated that there is a link between psychosocial constraints deriving from work and the development of mental health problems as measured by psychological distress or absenteeism. In fact, several epidemiological studies, some of which are based on longitudinal research designs, have documented the effect of work constraints on the prevalence and incidence of mental health problems (Karasek and Theorell, 1990; Niedhammer et al., 1998; van der Doef and Maes, 1999; Stansfeld et al., 1999; Brisson, Larocque and Bourbonnais, 2001; Siegrist and Marmot, 2004; Rugulies et al., 2006; Bourbonnais et al., 2006a).

In recent years, workplaces have undergone a great deal of upheaval which has had an impact on work organization, in particular through work intensification and increasing job insecurity, and an effect on the mental health and capacity to work of individuals. Based on this perspective, the role played by work in the occurrence of mental health problems prompts us to question its impact on the conditions which favour a successful return to work. In brief, it is reasonable to think that if working conditions can lead to mental health problems and withdrawal...

NOTE: All illustrations and photos have been removed from this article.



More articles from Relations Industrielles/Industrial Relations
Labour law/Droit du travail.(Recent Publications/Publications recentes..., September 22, 2007
Human resources management and organizations/Gestion des ressources hu..., September 22, 2007
Sociology of work/Sociologie du travail.(Recent Publications / Publica..., September 22, 2007
Labour economics, employment and social security/Economique du travail..., September 22, 2007
Equity at work/Equite au travail.(Recent Publications/Publications rec..., September 22, 2007

Looking for additional articles?
Search our database of over 3 million articles.

Looking for more in-depth information on this industry?
Search our complete database of Industry & Market reports by text, subject, publication name or publication date.

About Goliath
Whether you're looking for sales prospects, competitive information, company analysis or best practices in managing your organization, Goliath can help you meet your business needs.

Our extensive business information databases empower business professionals with both the breadth and depth of credible, authoritative information they need to support their business goals. Whether it be strategic planning, sales prospecting, company research or defining management best practices - Goliath is your leading source for accurate information.