The effect of part-time sick leave for employees with mental disorders.
2012
Abstract Background:Part-time sick leave (PTSL) allows employees onfull-time sick leave (FTSL) to resume work at reduced hours. Whenthe partly absent employee’s health improves, working hours areincreased until the employee is able to work regular hours. Studieshave found that PTSL is an effective instrument for reducing sickleave durations for employees with musculoskeletal disorders andfor employees on sick leave in general. This is the first publishedjournal article to document how PTSL affects sick leave durationsfor employees with mental disorders.Aim: The aim is to estimate the effect of PTSL on the duration untilreturning to regular working hours for employees with mentaldisorders. We compare this effect to that of PTSL for employeeswith non-mental disorders (‘other disorders’).Methods: We use combined survey and register data about 226employees on long-term sick leave with mental disorders and 638employees with other disorders. These data contain informationabout type of disorder, PTSL and FTSL durations, and variousbackground characteristics. We use a mixed proportional hazardregression model that allows us to control for unobserveddifferences between employees on PTSL and those on FTSL.Results: Our analyses show that PTSL has no effect on the durationuntil returning to regular working hours for employees with mentaldisorders. Furthermore, looking at specific disorders such asdepression and stress-related conditions, we find no significanteffects of PTSL. In contrast, in line with previous research, we findthat PTSL significantly reduces the duration until returning toregular working hours for employees with other disorders. Theanalyses also illustrate the importance of controlling for unobserveddifferences between employees on PTSL and those on FTSL.Without this control, PTSL significantly reduces the duration untilreturning to regular working hours. When we control forunobserved characteristics, this effect decreases, and for employeeswith mental disorders the effect vanishes entirely.Discussion and Limitations:The lack of an effect of PTSL foremployees with mental disorders needs replication in other studies.If subsequent studies confirm our findings, one should notnecessarily conclude that PTSL is an ineffective intervention: PTSLmay play a role in combination with other workplace interventionsand in combination with person-centred interventions. The study islimited by self-reported data about disorders and a relatively smallnumber of employees with mental disorders.Conclusion and Implications:Our findings suggest that whilePTSL reduces sick leave durations for employees with otherdisorders, it does not affect sick leave durations for employees withmental disorders. These results may indicate that PTSL by itself isinsufficient for promoting the return to work of employees withmental disorders.Future Research: Future studies could benefit from larger data setswith disorder information based on medical assessments. In additionto quantitative effect studies, future studies could focus onqualitative workplace mechanisms that may counteract the potentialpositive effects of PTSL for employees on sick leave with mentaldisorders.Received 4 April 2011; accepted 27 October 2012
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