Implementing Employer Involvement for Patients with Stress-Related Disorders in Swedish Primary Care – A Process Evaluation - Abstract
Purpose: Employer involvement in primary health care rehabilitation has been suggested as a promising avenue to curb increasing sick-leave rates due to common mental disorders. The aim of this study is to examine organizational prerequisites for employer involvement in the primary mental health care setting. Methods: In 2017, an intervention was launched at eleven primary health care units to assist rehabilitation coordinators and general practitioners with involving employers early on in the return-to-work process for patients with stress-related disorders. Eleven pre-intervention and ten post-intervention interviews with general practitioners, managers and rehabilitation coordinators were thematically analysed using the Consolidated Framework for Implementation Research (CFIR). The centres that succeeded with implementation were compared to the centres that failed implementation. Results: Employer contact was more easily established at centres where general practitioners were genuinely dedicated to issues related to insurance medicine, and where the coordinator had a clear and distinctive role in relation to other staff members. At the successful centres, the cooperation between general practitioners and rehabilitation coordinators was structured and the intervention’s core component – that is, employer involvement – could be added to pre-existing workflows. Conclusion: Primary care stakeholders aiming to involve employers should establish solid routines and structures for insurance medicine with clear roles for the involved professional groups and should stabilize the staff situation before this step is launched.