Guideline-based care 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 a study.

The report, published in the March issue of the American College of Occupational and Environmental Medicine's Journal of Occupational and Environmental Medicine, also found that the guideline-based approach may be especially appropriate for the large group of workers with relatively minor "stress-related" symptoms.

Researches from VU University Medical Center in the Netherlands 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.

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According to the study, there were no significant differences in treatment outcomes -- in both groups, total missed work time averaged about 150 days. However, researchers said that 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, the researchers concluded that guideline-based was cost-effective because it led to equal treatment outcomes at lower cost. About half of the 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.

Dr. David J. Bruinvels, lead researcher on the study, said that mental health problems such as depression or anxiety are a major cause of lost work time and decreased productivity. Before going on sick leave, workers usually must visit primary care doctors or occupational physicians. Bruinvels said that providing these physicians with research-proven treatment guidelines might allow treatment to start sooner, thus reducing the impact on productivity.

April 2, 2009

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