April 28, 2023 is World Day for Safety & Health at Work. An important part of this is successful reintegration after illness or long-term absence. Ard van Oosten (55), psychiatrist at U-center, gives useful tips and advice for employees and employers. How do you ensure a successful return to work?
He gives an example of a missed opportunity: "Imagine you drop out in the summer. And that your doctor says, 'Go do fun things.' So you go for a nice walk and one day spontaneously walk in to work to have a chat. With a sunburnt face, while everyone else has bags under their eyes and is walking on their gums. And then you say, "I'm so glad I can walk every day now. That can short-circuit colleagues, because you can't see mental illness on the outside. Good preparation here would have been half the battle."
The consequences of miscommunication in reintegration
He notes that many things go wrong in worker reintegration, which can have negative consequences. Employers lose staff who are already hard to find. Workers lose quality of life and enjoyment - their families also suffer. It also costs society a lot of money in assistance and benefits.
How U-center helps workers reintegrate
At U-center, Ard helps employees with their reintegration. For example, by making agreements with their employer. By helping them think about what they can and cannot say about the situation. And by practicing having conversations. As a psychiatrist and business expert, he has also been researching work as medicine for ten years. That too is an important part of treatment at U-center.
How can employees and employers ensure successful reintegration? Ard offers the following tips:
Tip 1: Think about work faster
Recover first and then think about work? That doesn't work in many cases, according to Ard. The threshold to work then becomes higher. You also lose contact with your employer. Then it becomes increasingly complicated to come back.
"Work can indeed have serious side effects, be toxic or even deadly," he says. "Think, for example, of Japanese people dying in their car in front of the factory." But he also argues that many people recover more easily when they work. Though not necessarily the same work.
That's why he says it's important to consider what work means to you. Is it something you get pleasure from, or does it feel like a necessary evil? Does it give you energy and help you recover, or does it get in the way of your recovery? That can determine whether you focus on your old work or look for something new.
Tip 2: Keep work and care separate
According to Ard, it is also important for employers not to sit in the counselor's chair. "Focus on how the employee is functioning. On how you can help them now to do their job as well as possible." On the other hand, he advises employees to think more about their work: "What do I need in my tasks and in my workplace to recover and function as well as possible?"
Tip 3: Engage with each other (really engage in conversation)
"A lot remains unsaid on paper and often only half-answers are given," Ard observes. He therefore recommends really engaging with each other. So that you get more information and cooperation. "Privacy laws are too quickly flaunted, while much more consultation is possible than people think. For example, the company doctor can invite the supervisor to call in during a conversation with the employee. If the employee agrees, of course."
Tip 4: Prepare conversations well
"Don't step blindly into a conversation of 'I'll see how it goes.' That can have unpleasant consequences," says Ard. That's why, together with the UVW and others, he developed the manual Labor as Medicine. It is intended for employees to prepare well for an interview with the company doctor or other care providers. It contains questions and information about: 'what do I want and what can I do, what do I need and from whom?' And 'what am I going to suggest to my supervisor?'
Employers can also use the manual as a source of inspiration. For example, to determine: what is the purpose of the conversation, what is a good time and who do I involve?
More information on how to prepare for an interview can be found at www.arbeidalsmedicijn.nl.
Tip 5: You don't have to say everything
Are you coming back to work? Then of course colleagues want to know how things are going and what's going on. According to Ard, it's important to think carefully beforehand about what information you share then. "Some information is so private that it is not meant for others. Before you know it, you're saying things that will determine in a negative way how things continue," he warns. "Only tell that part of the story that allows others to understand how your work is going. And that helps in your recovery."
Some mental illnesses, such as psychosis, for example, still carry a stigma. While there are so many kinds. Ard then sometimes advises not saying anything about it, if it doesn't affect your functioning. With depression, he says, it is sometimes better to say something like, "I struggled for a while and had a very hard time because of some events in my life. As a result, I couldn't do my job the way I wanted to.' "So share a story that is true AND that helps all parties."
Tip #6: Think in terms of growth
"You have employers who say, 'I only hire people who have had burnout. They don't drop out so easily anymore,'" Ard says. "That might be a bit extreme. But it's better than employers who say, 'People with mental illness are unfit.'" According to him, we think too much in disorder and too little in growth. "For example, we talk about post-traumatic stress disorder, but too little about post-traumatic growth. Whereas, in fact, I have seen many people grow through overcoming trauma."
Tip 7: Take a close look at the work environment.
"Very often illness is individualized," says Ard. "It's about the employee who drops out and, according to the employer, needs to become more flexible." But is it already the fourth employee with burnout? Then he says it's time to ask: Isn't there something wrong with the work environment? With the interior, the facilities, the culture, the processes....
He also allows employees to dwell more on the work environment they need. Are you alert all the time and want to have an overview. "Then don't sit with your back to the door," he cites as an example. "And do you need a lot of stimuli? Then don't go reintegrating as a locksmith. Because too little stress also makes you sick."
Tip 8: Make an achievable plan
"Don't say out of some sort of helpless feeling, 'I'm here again! What can I do?'" says Ard. Think in advance about how you envision your reintegration. And what is a reasonable plan you have confidence in. The company doctor or another social worker can help you with that. Because if you think it's not going to work, chances are it won't."
This tip, according to him, is actually about "taking the wheel of your own life. Just like his other nine tips. He finds, "The best part is when you can share your recovery process in such a way that it re-energizes you. That your supervisor and colleagues also understand it. And that you both feel: something meaningful is happening here."
Tip 9: Make clear agreements
"If you think every day: shall I work an hour more or less now? Then you are already almost building in that things will go wrong," says Ard. "Because that creates a lot of stress and ambiguity." So he advises: make good arrangements about what you do, when you come and how long you stay. Start with tasks you can actually do. Make strides in your reintegration. And don't set the bar too high."
Tip 10: Better prevention than cure
"Having to prove that you're sick. Letting people everywhere know how bad you are and that you can't work. That also does something to your psyche," Ard says. While his tips are helpful, he says the biggest gains are to be made by preventing dropouts. But this also requires a change in society.
"How nice it would be if you could say, 'I'm functioning fine, but this job doesn't suit me. If I continue with this, I will get sick. That's why I'm quitting and spending the next six weeks looking for something else.' Without losing all rights to an income. But we have organized everything around illness and not around health. So that has to change. We are losing enormous opportunities now."