Sustainable return to work for workers with mental health and musculoskeletal conditions

Abasiama Etuknwa, Kevin Daniels, Rachel Nayani, Constanze Eib

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Common mental health and musculoskeletal disorders (CMDs and MSDs) are two of the most significant causes of non-participation in employment amongst working age adults. Background: This case study fills an important gap in the scientific literature on reintegration back to work after sickness absence due to CMDs and MSDs. It particularly examines the return to work (RTW) experiences of sick-listed employees to understand the facilitators and barriers of sustainable RTW. Methods: Using a realist evaluation approach within a qualitative inquiry, perceptions of employees were explored to provide in-depth understanding of what, how and under what circumstances sustainable RTW can be enabled for employees absent on a short- or long-term basis. Repeat face-to-face semi-structured interviews were conducted with 22 participants (15 women and 7 men, aged 30–50 years and sick-listed with MSDs and CMDs) who were recruited using purposive sampling. Data was thematically analysed. Results: A total of 2 main codes and 5 subcodes were developed and grouped into three theoretical abstractions. As a result of validating the context, mechanism, and outcome configurations with accounts of participants, all three initial theories explaining the most prominent mechanisms that either facilitates or impedes a sustainable RTW for people with CMDs and MSDs were justified. Conclusions: Our findings reveal the active role of line managers on the RTW outcomes of returning employees. However, line-manager’s competence and ability to effectively support and implement appropriate RTW strategies suited to employees’ hinges on working in alignment with key stakeholders and returning employees.
Original languageEnglish
Article number1057
JournalInternational Journal of Environmental Research and Public Health
Issue number2
Early online date6 Jan 2023
Publication statusPublished - Jan 2023


  • flexible working
  • line manager
  • rehabilitation
  • return to work
  • sickness absence
  • management
  • working conditions-job quality

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