Narratives of sick leave, return to work and job mobility for people with common mental disorders in Sweden.

PURPOSE

The aim of this study was to analyze how different types of sick leave narratives were related to return to work (RTW), job mobility or continued sick leave for people sick-listed with common mental disorders. Special attention was paid to how the respondents described their contacts with employers and rehabilitation professionals.

METHODS

Eight persons sick-listed with common mental disorders were interviewed at two occasions (2005-2006 and 2008-2009) about their self-perceptions, their sick leave, and their contacts with their employers and rehabilitation professionals, first during their first months as sick-listed, and a follow-up after approximately 4 years.

RESULTS

Two types of narratives were identified: restitutive (with focus on recovery and RTW), and contingent (focusing on managing the present). A common theme was that mental problems were not recognized and talked about in the same way as physical problems. This had consequences for peoples' acceptance of their diagnoses and for the RTW processes. In restitutive narratives, RTW was essential for returning to life as it was, where support from managers and colleagues facilitated a successful return. In contingent narratives, the experience of sick leave was part of a broader story of change where work relations were of less importance.

CONCLUSIONS

A narrative understanding of rehabilitation involves sensitivity toward the stories people are caught up in, and what role professionals may play in them. Promotion of job mobility may be difficult to accept for persons with restitutive narratives, while persons caught up in contingent narratives may be more open-and benefit more-from such solutions.