Promoting work participation of non-permanent workers with psychological problems: An evidence-based approach to occupational health care

Unemployed and temporary agency workers and workers with expired fixed-term contracts are a particularly vulnerable group, at risk for sickness absence and prolonged work disability due to psychological problems. These workers who are without an employment contract, are also known as non-permanent workers. This thesis is focused on how work participation of sick-listed non-permanent workers with psychological problems can be promoted by investigating prognostic factors, perspectives of workers about return-to-work (RTW), and by evaluating interventions that can influence work participation. Results indicated that workers’ self-appraisal of health, age and working status were strong prognostic factors for future work participation. Qualitative findings showed workers are dealing with multiple problems in different domains of life, and identified three types of workers’ attitude towards their own RTW process that can influence work participation. Another study showed that a guidance document was feasible for sickness absence counseling of non-permanent workers with minor psychological problems and useful for the insurance physician. A systematic literature review revealed that effective RTW interventions for these workers are scarce, thereby underlining the need to develop effective RTW interventions for non-permanent workers. The 6-month follow-up of a controlled trial of a newly developed RTW intervention called "Brainwork", showed no marked difference on the duration of sick leave between the intervention and control group. It is recommended that occupational health professionals are aware of the prognostic factors for work participation and the three types of workers’ attitude towards their own RTW process of non-permanent workers with psychological problems.