Guideline-Based Care Is Effective for Workers with Mental Health Problems

Guideline-based care provided by occupational physicians is an effective and economical treatment approach for employees with common mental health problems, according to research reported in the March Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

The guideline-based approach may be especially appropriate for the large group of workers with relatively minor "stress-related" symptoms, according to the new research by Dr. David J. Bruinvels and colleagues of VU University Medical Center, Amsterdam.

The researchers compared two approaches to care in 240 Dutch police officers on sick leave because of mental health problems. One group of officers received standard care, consisting of referral to a psychologist for evaluation and treatment.

The other group received guideline-based care, provided by occupational physicians. Based on research-proven methods, this approach emphasized a gradual return to work, along with help in dealing with stress on the job and building problem-solving skills.

There were no significant differences in treatment outcomes—in both groups, total missed work time averaged about 150 days. However, guideline-based care seemed to reduce missed work time for officers with administrative duties, compared to "street" officers. Guideline-based care also had advantages for officers with relatively mild, stress-related symptoms; most of the officers in the study fell into this category.

Even though it did not reduce missed work time, guideline-based was cost-effective because it led to equal treatment outcomes at lower cost, the researchers write. About half of officers in the guideline-based care group were eventually sent to see a psychologist, compared to nearly all of those in the standard-care group.

Mental health problems such as depression or anxiety are a major cause of missed work time and productivity loss. Before going on sick leave, workers usually must visit primary care doctors or occupational physicians. Providing these physicians with research-proven treatment guidelines might allow treatment to start sooner, thus reducing the impact on productivity.

The new results support the effectiveness and cost-effectiveness of guideline-based care provided by occupational physicians. This approach may be especially useful in teaching more effective strategies for dealing with stress to the large group of workers with mild mental health problems. "The study contributes to the further development of effective evidence-based guidelines and collaborative occupational health care for workers with common mental disorders," Dr. Bruinvels and colleagues conclude.

About ACOEM

ACOEM, an international society of 5,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.