Employment and mental health

Wondering about work? New tool helps patients and their doctors talk about employment and mental health

16 May 2013

For many people experiencing a mental health condition, the decision to return to employment can be a difficult one.

The Employment and Mental Health Option Grid (EmOG) has been published to help individuals and their clinicians have evidence-informed conversations about the benefits and risks of returning to employment.

Option Grids are decision support tools used internationally to help patients and health providers digest technical details together in relation to the evidence for different treatment options.

The EmOG is the first Option Grid to be developed in New Zealand and was led by the Wise Group in partnership with Te Pou, and health professionals, patient representatives and academics from New Zealand and around the world.

Dr Lik Loh, who helped developed the tool, said he anticipated using it frequently at his clinic.

“Many of my patients have mental illness and addictions, and we often find it hard to start the discussions about going back to work, even though I have seen how doing the right sort of work can be good for health. These kinds of conversations also tend to increase the anxiety levels of my patients. I believe the Grid will help us have these conversations more often, and will add value to my consultations,” said Dr Loh.

The Grid uses the research evidence to compare the options of 'continuing to stay off paid work’ versus ‘taking steps to return to work with the help of an employment specialist’ in relation to a number of patient frequently asked questions.

Wise Group strategic policy advisor Helen Lockett said the long term aim of the Grid is to help foster a culture in health services where returning to or remaining in good employment is embedded and valued as an important part of treatment.

“There is rigorous evidence to show the benefits of returning to and staying in employment for people with mental health conditions as well as evidence on how to achieve this,” said Ms Lockett.

“For people who have been out of employment for over a year providing more healthcare treatment alone is unlikely to support return to work. What is effective is clinical management that is employment-focused integrated with one-to-one employment support. It is hoped that the Employment and Mental Health Option Grid will support GPs and other health professionals to hold these employment-focused conversations with patients and support timely referral to employment support services.

“However, unlike other evidence-based treatments, employment support services are not routinely available in secondary and primary mental health services in New Zealand. Until they are, health professionals can refer patients to local employment services which have demonstrated alignment with the evidence-base and have a track record of good outcomes,” said Ms Lockett.

Te Pou is currently conducting focused implementation of the Option Grid in clinical environments in New Zealand where there is integrated employment support available.

There are now 17 Option Grids published as part of an international collaborative. The process to develop an Option Grid takes between six to nine months. Once finalised the Grid is freely available online for anyone to download and use. An evidence document showing all the references which have been used to write it supports each Option Grid. Authors are acknowledged but no one has ownership of the Grid. Find out more at www.optiongrid.org.

View the Option Grid online at http://www.optiongrid.org/resources/employmentandmentalhealth_grid.pdf.

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