IGLOO: a framework for return to work among workers with mental health problems

It is important for society and for organizations to support workers returning to work following mental health-related absence. Recent evidence points to an increase in mental health problems among the general population, with approximately 38.2% of the EU population suffering from a mental disorder each year (European Commission 2008, 2016). Of those who take a period of sick leave, 55% of workers make unsuccessful attempts to return to work (RTW), and 68% of those who do return have less responsibility and are paid less than before (Matrix Insight 2013). A number of challenges have been reported by workers following a period of long-term sickness absence; however current research has been somewhat limited by a focus on the initial return and a siloed approach where work and non-work contexts are considered separately.

In this book chapter, we apply the IGLOO (individual, group, leader, organizational and overarching contextual factors that may support sustainable RTW) model (Nielsen et al. 2018). In doing so, we focus on the sickness absence before return to work and consider the factors that could support return to work following long-term sickness absence. We provide an overview of the resources that may facilitate return to work among workers who are on sick leave with mental health problems. Based on the IGLOO framework, we identify and discuss resources, i.e., factors that facilitate return to work at five levels: the individual (e.g., beliefs about being able to manage a successful return to work, health behaviors), the group (work groups, friends, and family), the leader (line managers and healthcare provides who take the lead in supporting workers return), the organizational (Human Resource policies and external organizations such a charities), and the overarching context (social security systems). We discuss these resources that pertain to the work context but also the non-work context and highlight the importance of understanding how resources apply at different levels. We argue that there is a need to understand how societal factors, such as legislation, culture, and national policies, impact return to work outcomes. We propose a holistic approach that focuses on integrating the resources in and outside work and is needed to facilitate successful and sustainable return to work for workers with mental health problems.