title: Improving Access to Mental Health Care by Delivering Psychotherapeutic Care in the Workplace: A Cross-Sectional Exploratory Trial.
abstract: OBJECTIVE
  Common mental disorders like mood and anxiety disorders and somatoform disorders have high costs, yet under-treatment is still frequent. Many people with common mental disorders are employed, so the workplace is potentially a suitable context in which to provide early treatment. Our study investigates whether a change of setting (workplace versus standard care) improves access to treatment for common mental disorders.
  
  
  METHODS
  Conditional latent profile analysis was applied to identify user profiles for work ability (WAI), clinical symptoms like depression (patient health questionnaire depression, PHQ-9), health-related quality of life (QoL, SF-12), and work-related stress (Maslach Burnout Inventory, irritation scale). Patients were recruited consecutively, via psychotherapeutic consultation in the workplace (n = 174) or psychotherapeutic consultation in outpatient care (n = 193).
  
  
  RESULTS
  We identified four user profiles in our model: 'severe' (n = 99), 'moderate I-low QoL' (n = 88), 'moderate II-low work ability' (n = 83), and 'at risk' (n = 97). The 'at risk' profile encompassed individuals with reduced work ability (36.0, 34.73 to 37.37), only mild clinical symptoms (PHQ-9 5.7, 4.92 to 6.53), no signs of work-related stress and good quality of life. A higher proportion of the 'at risk' group than of the 'severe' group sought help via the psychotherapeutic consultation in the workplace (OR 0.287, P < 0.01); this effect remained after controlling for gender.
  
  
  CONCLUSIONS
  Offering secondary mental health care in the workplace is feasible and accepted by users. Offering treatment in the workplace as an alternative to standard outpatient settings is a viable strategy for improving access to treatment for common mental disorders.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany.
authors.forename: Eva
authors.identifier: http://orcid.org/0000-0002-8295-2632
authors.initials: E
authors.lastname: Rothermund
authors.affiliation: Department of Psychiatry II, University Hospital Ulm, BKH Günzburg, Germany.
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kilian
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany.
authors.forename: Edit
authors.initials: E
authors.lastname: Rottler
authors.affiliation: Health and Safety, Daimler AG, Sindelfingen, Germany.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Mayer
authors.affiliation: Sonnenbergklinik, Stuttgart, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hölzer
authors.affiliation: Institute for Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Competence Centre Health Services Research, Medical Faculty Tübingen, Germany.
authors.forename: Monika A
authors.initials: MA
authors.lastname: Rieger
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Gündel
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001008:Anxiety Disorders / Q000628:therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012017:Referral and Consultation; D013001:Somatoform Disorders / Q000628:therapy; D017132:Workplace