Germany: Psychotherapy in the workplace

A research project of the Ulm University Hospital (Germany) helps people with mental stress directly at work. The goal: Avoiding chronic symptoms, and reducing costs for social systems.

Preventive mental health management to avoid absenteeism

A research project of the Ulm University Hospital (Germany) helps people with mental stress directly at work. The goal: Avoiding chronic symptoms, and reducing costs for social systems.

Mental illnesses are often only diagnosed when they are already well advanced. There are many reasons for this: Employees don't dare to seek medical help or go to psychotherapy, they don't immediately find the right therapist on an outpatient basis, and sometimes those affected ignore the need for therapy. A new study conducted by the Department of Psychosomatic Medicine and Psychotherapy at the Ulm University Hospital and the Ulm Centre of Competence for Mental Health at Work (German acronym: LPCU), which is funded by the Karl Schlecht Foundation, focuses precisely on this problem. Together with the Institute for Occupational, Social and Environmental Medicine at the University of Düsseldorf, Ulm Psychosomatics is leading a research cooperation initiative in this field.

A team led by senior physician Dr. Eva Rothermund is going to small and medium-sized companies, administrations and larger companies and offers psychosomatic early counselling once a week. If necessary, therapy sessions for mentally ill employees are also possible during the course of the study. The aim: to ensure “presenteeism” in the workplace by preventive strategies to tackle professional absenteeism. "The early intervention and job-related rehabilitation of mentally ill employees helps above all those affected to receive appropriate help in good time. But it also helps the respective company, as it reduces absenteeism and relieves the burden on social security funds," says Dr. Eva Rothermund, a specialist in psychosomatic medicine and psychotherapy.

Preventive options have existed for 8 years

The consultations and, if necessary, subsequent therapy sessions take place anonymously; the employer does not know who comes to the consultations and therapy, and does not receive any information about them. The company physician mediates and is consulted with the consent of the employees, but is subject to confidentiality. Psychosomatic consultations in the company usually take place once a week. The physicians and therapists of the Ulm University Hospital provide advice at companies in the region. "Previous experience suggests that our offer is clinically very useful," said Professor Dr. Harald Gündel, Medical Director of the Department of Psychosomatic Medicine and Psychotherapy at the Ulm University Hospital.

This preventive offer has already been in existence for eight years and has produced promising results in preliminary studies. The effectiveness of this preventive offer is now to be tested in a Germany-wide randomized study. For the study, this means that one group of patients will receive a rapid initial clinical consultation, specialist diagnostics and, if necessary, therapy recommendations from the therapists at the University Hospital, but will not receive subsequent treatment in the company, but will be referred to outpatient services. The other group receives short-term therapy at the workplace in addition to the initial consultation. If medically necessary, in-patient rehabilitation treatment, acute psychosomatic treatment and support for subsequent reintegration into the workplace are added in individual cases.

Study runs until 2024

Mentally ill employees of the participating companies who suffer, for example, from anxiety disorders, sleep disorders or somatoform disorders such as fatigue, exhaustion or pain symptoms can participate in the study. The study will start on June 1st, 2020 with preparations for the study, and will run until 2024 at a total of five participating locations in Germany, involving 500 to 600 test persons. From September 2021 onward, consultations and therapies will then begin in the companies. 2.3 million euros in funding were provided by the German Federal Ministry of Education & Research and the German Pension Insurance Fund.

"We expect that the mentally ill employees, to whom we also offer therapy, will benefit clinically and that the periods of their incapacity to work will also be shorter," said Professor Gündel. The project is supported by the insurance group AOK Baden-Württemberg, the German Federation of Pension Insurances (Deutsche Rentenversicherung Bund) and the pension insurance companies of the Baden-Württemberg and Braunschweig-Hannover regions. The ultimate goal: a permanent establishment for this therapy option at the workplace in the catalogue of the statutory health insurance companies.

"Mentally ill people are often limited in their ability to perform at the workplace, but consider this to be personal failure. In a vicious circle of withdrawal, shame and reduced performance capacity, those affected often also suffer social damage," Dr. Rothermund knows. That is bad for both sides, for the patient and for the employers. Therefore, the project is also about "stay at work" as an essential extension of the already known and also involved concept of "return to work" research. It is assumed that the current corona-induced structural changes in many areas of work will lead to an increase in mental stress at the workplace, making this project all the more important.