Work Productivity in Psychiatry: Trends in Interventions and Outcomes
Pamela L. Moriearty
This article contrasts trends in addressing work productivity in severe mental illnesses (SMI) such as schizophrenia and in affective disorders. Citations from searches of 8 reference databases were reviewed. The negative impact of SMI on employment is indisputable, as is the fact that people with these disorders could be employed more frequently than is the case. For those with SMI, work rehabilitation treatment models have been developed, but their implementation in disease management programs has lagged behind those of other diseases. In contrast to the situation with SMI, treatment outcomes in affective and anxiety disorders have been defined primarily in terms of symptom relief and interpersonal functioning. Attention to work productivity has emerged more recently as employers have become important stakeholders in healthcare decision making. Since most patients with affective disorders are already in the work force, some work productivity initiatives and outcomes developed for SMI may not be appropriate for patients with affective disorders. Attention to work productivity has not been systematically incorporated into treatment planning for affective disorders, and specific work-related psychiatric interventions are not yet available. In conclusion, the cost effectiveness of work productivity interventions in psychiatry requires their integration into comprehensive disease management programs. In making resource allocation decisions, appropriate incorporation of work productivity within a larger ethical framework of healthcare decision making is essential. The furtherance of work productivity initiatives in psychiatry requires collaboration among numerous stakeholders in professional education, service delivery and research.
Cost of illness, Pharmacoeconomics, Psychiatric disorders
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