Understanding illness experiences of employees with common mental health disorders.

BACKGROUND

Common mental health disorders (CMHDs) are a leading cause of sickness absence. To address this, a Fit for Work Service (FFWS) was introduced in Greater Manchester, UK, in 2010, offering case-managed and multidisciplinary interventions to early-stage sickness absentees experiencing physical health conditions and/or associated psychosocial problems, to enable a speedy return to work.

AIMS

To explore the illness experiences of employees who contacted or were referred to the Greater Manchester FFWS (GM-FFWS).

METHODS

A qualitative in-depth study, using narrative interviews with GM-FFWS service users who experienced mental ill-health. Interviews were recorded, transcribed and analysed for key themes.

RESULTS

There were 21 interviews available for analysis. Multiple disruptive life events overwhelmed employees' capacity to cope, triggering mental ill-health. For some individuals, the onset of mental ill-health was unexpected and had profound psychological effects on participants' sense of self and personal identity. In certain cases, previous bouts of emotional distress contributed to an underlying psychology of low self-esteem. Mobilizing resources was often a significant factor in supporting recovery. The illness experience led to a process of self-re-evaluation among some participants.

CONCLUSIONS

Disruptive events at work have the potential to threaten an individual's sense of self. Employee's experiences of CMHDs can only be fully understood if there is awareness of how these experiences emerge from a person's biography and subsequently inform their responses to contemporary life events. The design of future clinical and non-clinical workplace interventions should take account of these biographical aspects of the illness experience.