Changes in sick leave one year before and after starting treatment: a naturalistic study of employed outpatients with common mental health disorders

Abstract

Background: This study explores sick leave changes 1-year pre- and post-treatment start for common mental health issues and their associations with self-reported symptoms, functioning, and health changes. Methods: Ninety-five employed patients, without previous disability benefits, underwent treatment at a public mental health outpatient clinic. Sick leave data was obtained from the Norwegian Labour and Welfare Administration. Symptoms, work/social functioning, and health quality were self-reported at treatment onset and completion. Results: Twelve months before starting treatment, only 6.3% were on sick leave, contrasting with 69.5% at treatment start. At post-treatment, 25% received work assessment allowance (WAA), 63% were off sick leave, and 12% were on sick leave. Sick leave days exhibited an inverted U-shape for non-WAA recipients. Those on sick leave post-treatment reported less improvement in symptoms and health, while the WAA group showed diminished work functioning enhancement. Discussion: Evaluating the effect mental health treatment has on sick leave is clearly affected by the timing of assessments. Treatment seems associated with improved sick leave outcomes compared with status at treatment start, but less so when compared with status one year before starting treatment. Also, a large group of patients went on to receive WAA, constituting a group in need of further longitudinal evaluations and interventions.