Long-term follow-up of participants with mental ill health in the Danish return-to-work program: A secondary analysis of a controlled trial

Background The Danish return-to-work (RTW) program was a coordinated, tailored and multidisciplinary intervention aimed at improving sickness benefit management at municipal jobs and benefits offices in Denmark.Objective To estimate long-term effects of the Danish RTW program for participants with mental ill health.Methods The study population consisted of 8655 20-54 year-old citizens in 21 Danish municipalities who were sick-listed due to self-reported mental health problems (anxiety (4%), depression (47%), stress/ burnout (37%), or other (12%)) in 2010-2012. Of these, 5252 received the intervention while 3403 (the control group) received ordinary case management. Multinomial logistic regression was used to estimate odds ratios (intervention vs. control) for health and non-health related welfare dependency at a 1, 3 and 5-year follow-up in national registers.Results We did not find effects on the odds of receiving health related welfare benefits at 1 (OR = 0.90, 99% CI: 0.78-1.05), 3 (1.00, 0.85-1.17) and 5 years (0.98, 0.85-1.14). We did also not find effects on the odds of receiving non-health related welfare benefits at 1 (1.11, 0.95-1.29) and 3 years (0.94, 0.81-1.09), but found an effect at the 5-year follow-up OR = 0.81 (0.69-0.96).Conclusion For persons with mental ill health at baseline, a structured RTW program reduced the risk of unemployment at 5-year follow-up, suggesting an impact on a process that can only be measured after several years. The intervention did not have long-term effects on the odds of receiving health related welfare benefits.