Special report: Best practice in rehabilitation - research
Early intervention, flexible return-to-work procedures and developing an agreed rehabilitation plan are key to getting stressed out employees back to work more quickly, new research claimed this week.
The study entitled "Best practice in rehabilitating employees following absence due to work-related stress", carried out by the Institute for Employment Studies, will form the basis of new guidance from the Health and Safety Executive later this year on managing work-related stress.
The research report revealed how stress is a "major contributor" to absence in the UK. It said stress was the second most common work-related illness and that over 560,000 people were affected. Around 6.5 million working days are lost in Britain each year due to stress, depression or anxiety.
As a result, stress is one of the main areas of work for the Health and Safety Executive in order for it to meet a Government target of a reduction in days lost due to work-related injury and ill-health of 30% by 2010. The report states that "although prevention of stress is often seen as the main priority, it is essential that preventative approaches are accompanied by, rather than seen as an alternative to, rehabilitation."
The research
The study examined rehabilitation "best practice" at a range of organisations from across England, Scotland and Wales, including large businesses, public authorities, as well as small and medium sized firms. Criteria for what constituted best practice followed a review of existing evidence from academics and practitioners of different rehabilitation methods.
The report provides a general account of the organisational practice, and a summary of any existing research evidence concerning its effectiveness, where available. Specific examples are provided of how this practice is used within the organisations involved, and any evidence concerning its effectiveness within the organisations. As such the report can provide a wide range of organisations with useful information of a range of techniques to support the rehabilitation of employees suffering from work-related stress.
The main findings of the research revealed that early contact with absent workers, a flexible approach to their return and developing a joint rehabilitation plan with the employee concerned were critical to ensure a smooth return to work.
The research concluded that when an employee "goes off" with work-related stress they should be contacted within the first week of absence, preferably on day one. The purpose of this initial contact should be to offer general support and communicate the organisation's concern. "It should not be to discuss interventions and treatments," said the report.
It added that early health assessment was important and that quality health care was critical. One of the main issues for organisations was diagnosis or assessment. Often, a medical certificate is received for 'stress' or 'work-related stress', said the report, but that this provided "little or no information as to the cause of the problem, the nature of the problem, the likely duration, and appropriate interventions."
A flexible return to work is also important. The report claimed that "it is generally recognised that workers who have been absent from work through illness will achieve their former functional level more quickly if they are allowed to return on a gradual basis."
It encouraged a gradual return over a four to six week period or longer and that the timing of the return and well as the working conditions should be well considered.
Developing an agreed rehabilitation plan was a "central theme" said the study, and that to work effectively such a plan must be "agreed by all stakeholders, but particularly the employee." The plan should be developed and initiated at the appropriate time for the employee, with regular reviews built in and both employee and line manager must be committed to the plan and to a successful return, said the report.
Taking it forward
The Health and Safety Executive commissioned this study, along with another - also published this week entitled "Beacons of Excellence in Stress Prevention" - to help it develop further guidance and management standards for work-related stress.
Reacting to the studies, Professor Colin Mackay, principal psychologist in HSE's Human Factors Unit, said: "These research projects have provided us with some excellent case studies in both stress prevention and rehabilitation of employees following stress-related absence.
"Our feedback from employers dealing with stress is that while they are largely confident that they are able to identify the main sources of stress within their organisations, they find it difficult to know what interventions to put in place to manage them. The new guidance will be a valuable resource for both managers and health and safety professionals."
The HSE announced in June the launch of a pilot project for the development of stress management standards. Twenty four organisations representing both public and private sectors across the UK are involved in the formal pilot study, which is expected to run until Autumn 2003.
New guidance from the HSE, which will be launched in October, will cover each of the "stressor" areas identified in its publication "Tackling work-related stress - a managers' guide to improving and maintaining employee health and well-being". These are "demands, control, support, role, relationships and change."
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