The Effects of the Dutch national guideline on the management of employees with mental health problems by occupational physicians.

Mental health problems often lead to prolonged sick leave. In the Netherlands, mental health problems are responsible for approximately one third of all employees disabled for over a year.

Many share the view that better treatment and early intervention could prevent long lasting disability. Early 2000, the Dutch Association of Occupational Physicians (NVAB) has published an authorized guideline concerning the management of employees with mental health problems by occupational physicians.




In a randomized controlled trial (RCT), the effects of the guideline on sick leave and work disability of employees with mental health problems will be assessed.
Subjects in the intervention group will be treated by occupational physicians, who are trained in the use of the guideline (n=100).

The control group (n=100) will receive usual care, with minimal involvement of the occupational physician and frequent referral to a psychologist. In addition, all employees with mental health problems who not participated in the RCT will be included in a cohort study. Subjects will be recruited from two Dutch police departments.




Between January 2002 and January 2005 489 policemen were absent of work because of mental health problems. Of these, 231 (47%) enrolled in the RCT. Final results of the study, including the results of the RCT, will be available in 2006.

Treatment according to the Dutch National Guideline on the Management of Employees with Mental Health Problems by Occupational Physicians will cause less work disability than treatment according to usual care, with minimal involvement of the occupational physician and frequent referral to a psychologist.

N/A

Treatment according to the Dutch national guideline on the management of employees with mental health problems by occupational physicians.

This guideline focuses on four aspects of the management of mental health problems.

First, the occupational physician acknowledges the interaction between the disabled employee and his surroundings (work, personal and care).

Second, a simplified classification of mental health problems is introduced, with only four categories.

Third, the occupational physician acts as case manager, who intervenes when recovery stagnates.

Finally, the occupational physician may also act as care manager by counseling employees with work related problems.