title: Perspectives of unemployed workers with mental health problems: barriers to and solutions for return to work.
abstract: OBJECTIVE
  To evaluate the barriers to and solutions for return to work (RTW) from the perspective of unemployed workers who were sick-listed due to mental health problems.
  
  
  METHODS
  We conducted semi-structured interviews with 25 sick-listed unemployed workers with mental health problems. Qualitative data analysis was performed, using a process of identifying, coding, and categorising the patterns in data.
  
  
  RESULTS
  All workers experienced multiple problems in different domains of life related to their disease, personal circumstances (e.g., divorced, debts) and their environment (e.g., labour market problems, issues with the Social Security Agency). Workers differed in the way they perceived their RTW process and in the extent to which they were able to envision and implement the solutions for RTW, thus resulting in three types of workers' attitudes towards their own RTW process: (1) "frozen"; (2) "insightful though passive"; and (3) "action mode".
  
  
  CONCLUSIONS
  We conclude that the sick-listed unemployed workers with mental health problems have to deal with multiple problems, of which medical problems are only a part. These workers need help aimed at their coping methods according to one of the three types of workers' characteristics. Moreover, they need specific help organising and structuring their problems, getting their life back on track, and finding employment. Implications for Rehabilitation Unemployed workers with mental health problems face considerable challenges which impede their return to work. Evaluating the workers' attitude may provide useful information on their own return-to-work process. In many cases, workers indicate a need for coaching to help them with problem-solving, planning, gaining structure, getting their life back on track, and finding employment. Rehabilitation professionals should tailor RTW interventions to the needs of these workers, aimed at their specific problems and taking into account the workers' coping methods according to one of three types of workers' attitudes towards their own RTW process.
authors.affiliation: a Academic Medical Center, Coronel Institute of Occupational Health/Research Center for Insurance Medicine , University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Selwin S
authors.initials: SS
authors.lastname: Audhoe
authors.affiliation: a Academic Medical Center, Coronel Institute of Occupational Health/Research Center for Insurance Medicine , University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Karen
authors.initials: K
authors.lastname: Nieuwenhuijsen
authors.affiliation: a Academic Medical Center, Coronel Institute of Occupational Health/Research Center for Insurance Medicine , University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Jan L
authors.initials: JL
authors.lastname: Hoving
authors.affiliation: a Academic Medical Center, Coronel Institute of Occupational Health/Research Center for Insurance Medicine , University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Judith K
authors.initials: JK
authors.lastname: Sluiter
authors.affiliation: a Academic Medical Center, Coronel Institute of Occupational Health/Research Center for Insurance Medicine , University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: Monique H W
authors.initials: MHW
authors.lastname: Frings-Dresen
mesh_terms: D000328:Adult; D001290:Attitude; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation; D008603:Mental Health; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands; D036301:Qualitative Research; D062707:Return to Work / Q000523:psychology*; D018582:Sick Leave; D012943:Social Security; D014478:Unemployment / Q000523:psychology*
keywords: Unemployment; mental disorder; participation; return to work; sick leave