Managing a delayed return to work: Response to Keith Bushnell's article

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Moving Minds, a psychological management and rehabilitation service, responds to Keith Bushnell's recent article on mental health and workplace absence.

There have been attempts to address this problem. One recent attempt was The Department for Work and Pensions (DWP), which sponsored an intervention for benefit claimants who had been out of work for more than six months.

The project "Pathways to Work" provided contact in the form of six work focused interviews (WFI) with "early skilled intervention by personal advisers" and financial incentives.

After 18 months the numbers who were still benefit claimants had dropped from 40 out of 50 to 39 out of 50, an unimpressive improvement.(Evidence on the effect of Pathways to Work on existing claimants; Bewley et al, DWP, Research report No 488, para 3.3.2 and fig 3.3).

Despite this failed pilot study the project was rolled out nationwide.

There are two possible reasons why this intervention failed. One is that it took place too long after the onset of the sick leave and secondly it was the wrong sort of intervention.

Leaving the past behind, it is more important to suggest ways in which interventions might work.

When should interventions take place?

As we have seen from the published DWP data (Box 1). there is no reason why this should not start six or eight weeks after the onset of an illness. Waiting for six months to elapse could be seen as akin to negligence, bearing in mind the evidence-base.

There is, however, a reluctance by the current health management organisation, to which all income protection clients are attached, to provide this.

In these circumstances providers of income protection policies will have to undertake this task themselves and tailor their policies to reflect this time imperative, in order to prevent subsequent expensive claims.

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