A review of the literature
Work Research Centre
Stress Impact Project - Chapter 4
Vocational rehabilitation and work resumption
The aim of this chapter is to review the literature on vocational rehabilitation and work resumption as it applies to workers who experience stress related illnesses in the workplace. The main focus was on identifying literature which related to workplace responses to absenteeism due to stress related disorders.
There is increasing evidence which suggests that today more than ever before, employees are working in an atmosphere of anxiety and stress. A fundamental and dynamic shift is taking place in the world of work. Many have called this change the third revolution or ‘tidal wave’. Most experts have agreed, however, that the situation is a transformation from an industrial economy to an information or knowledge based economy. Structural changes (downsizing, mergers, acquisitions and restructuring), changing social and working contexts and the introduction of new technology are all implicated in the stress process. The negative impact of stress can be observed in the wide range of conditions that are associated with it. Stress has been associated not only with a variety of psychological conditions including anxiety and depression, but also with a number of important physical conditions including heart attack, ulcers and stroke. It is also considered to be a contributing factor to low back pain and repetitive stress injuries.
The World Health Organization (2001) predicts that by 2020, mental illness will be the second leading cause of disability worldwide, after heart disease. The International Labour Organization ((ILO), 2000) says mental illness affects more human lives and gives rise to a greater waste of human resources than all other forms of disability. Mental disorders are one of the three leading causes of disability. In the EU, for example, mental health disorders are a major reason for granting disability pensions. Five of the 10 leading causes of disability worldwide are mental health problems – major depression, schizophrenia, bipolar disorders, alcohol use and obsessive-compulsive disorders – and account for 25-35% of all disability (Cameron, 2000). Employers are greatly affected by their employees’ mental health, and employers affect – positively or negatively – their employees’ mental health. The incidence of stress within European society is on the increase and accounts for over 30% of all absence from work (Paoli, 1997). Evidence for this is emerging from a number of sources including surveys, longitudinal studies and absence statistics (e.g. Van der Hek and Plomp, 1997; Jones et al, 1998). Estimations of the Health and Safety Executive (1998) are that between 30 – 60% of all Sickness Absence in the UK is related to a mental or emotional disturbance (i.e. stress, burnout). In The Netherlands long-term sickness absence due to ‘mental disorders’ has increased from 17 % in 1974 to 32 % in 1992 (Allegro & Veerman, 1998). This figure has increased over the past decade. Evidence from the literature suggests that Workers on long-term absence as a result of stress are less likely to return to work than those with physical injuries or illnesses (Watson Wyatt, 2000). Watson Wyatt (1998), in their annual survey of integrated disability management programmes, found that incidents of disability are increasingly related to slowly developing, chronic conditions and work-induced stress. In this survey, musculoskeletal problems such as carpal tunnel syndrome and repetitive motion complaints (50 percent) exceeded injuries (44 percent) as the most common condition triggering an occupational disability expense. The
survey also found that mental health-related disabilities are on the rise. Forty-five and 58 percent of employers, respectively, expressed growing concern...