Occupational Medicine & Health Affairs
Open Access

Mental disorders; Mental health; Young adult; Psychologists

Introduction

Problems with mental health are a major issue for public health and work-life balance. Mental disorders are more prevalent in young adults than in any other age group, with mood disorders having a median onset age of 30 years. Additionally, young workers already experience a high prevalence of work-related stress, and every third European worker experiences stress on the job [1]. Over the long run, delayed pressure and gentle psychological well-being issues may lead to more extreme problem, expanded utilization of medical care administrations and infection nonappearance (SA) from work. Because SA imposes a significant financial burden on individuals, employers, and society as a whole, reducing and preventing it is an extremely important goal.

Every employer is required by law to offer their workers preventive occupational health services. As a result, rather than treating illnesses, the focus is on early intervention for health risks associated with work and the prevention of work-related disability [2]. In most cases, the same occupational health care that provides preventive services to its employees also buys primary care services for treating all illnesses that aren't related to work. Preventive and primary care services were provided to 94% of Finnish workers covered by occupational health insurance in 2017. The employer pays for the primary care services, which are partially subsidized by the Social Insurance Institution (SII).

With specially trained occupational health professionals like occupational health nurses, occupational health psychologists (OHP), occupational health physiotherapists, and occupational health physicians, occupational health services can be provided by employerowned units, private clinics, or public sector health centers [3].

Result

Mental health issues are linked to frequent utilization of occupational health services, and increased SA rates due to mental disorders and disability retirement are also linked to frequent utilization. However, in occupational health care, early intervention and support for work ability may be useful in preventing mental health issues from arising or getting worse, thereby reducing the utilization of occupational health services and preventing work disability. Work ability support for employees can be provided in the Finnish occupational health care system, for example through OHP appointments [4]. Individual visits to OHP can be for a variety of reasons, including issues with workrelated conditions, organization, and interpersonal relationships, as well as personal issues like sleep and mood issues. The majority of employees are likely to benefit from just one or two visits, but more serious mental health issues like anxiety or depression may emerge, necessitating more psychologist visits and additional treatments like psychotropic medication and psychotherapy [5].

Discussion

Using observational data, it is difficult to determine whether occupational health psychologist appointments reduce subsequent mental health issues. An advanced statistical method known as quasi-experiment can be used to examine observational data and better capture causality between the predictor and outcome than conventional statistical methods can [6]. Observational studies have some advantages over randomized controlled trials the gold standard for causal inference such as better reflection of the real world and lower costs. A randomized controlled trial may also be impractical or even unethical in some instances. For instance, it would be unethical to carry out this study as a randomized controlled trial; however, we were able to carry out a quasi-experiment by making use of the extensive register data that was readily available [7].

A quasi-experimental research design has not previously been used to investigate the impact of OHP appointments on SA. Using register data, we sought to determine whether OHP appointment for work ability support can reduce SA due to mental disorders among Finnish employees aged 18 to 39 with an existing mental disorder. For the quasi-experiment, key register-derived sociodemographic, socioeconomic, and health-related covariates were used to match the treatment (OHP appointment) and control groups.

The present investigation is a component of the ongoing Helsinki Health Study that examines the employees of the City of Helsinki, Finland's largest employer with approximately 40,000 workers. Data on the OHP appointment (the treatment) and covariates like primary care visits at the occupational health service were gathered using register data from the Occupational Health Helsinki, which provides comprehensive occupational health services to all City of Helsinki employees. Any causes of SA as well as social and work-related covariates were gathered using data from the City of Hawaii personnel register. Information on sickness allowance, or the outcome (ICD-10, F-diagnosed SA), and prescribed reimbursed psychotropic medication purchases as a covariate, was gathered using data from the Social Insurance Institution of Finland register. Pseudonymized personal identity codes were used to link the data together.

Conclusion

The eligibility and inclusion criteria for the study were as follows: 1. All City of Hilo employees with at least one year of continuous employment between 2008 and 2017 were eligible to participate (n = 61,959). 2. Eligible participants (n = 7867) included participants whose ICD-10 F-diagnosed sickness allowance period (SA) ended during the employment period. 3. At the conclusion of the SA period, participants between the ages of 18 and 39 were included (n = 2726 eligible participants). We used the following exclusions to control for confounding for analytical reasons. We excluded the top 10% based on SA length, i.e. those with more than 57 SA days (n = 275), as preliminary analyses suggested that individuals with extensively long F-diagnosed SA periods did not receive the OHP treatment. In addition, we excluded those who had received OHP treatment prior to the treatment inclusion period (n = 45) and the follow-up. Five participants (n = 5) were left out because there was no information on their job title. The final analytic sample (n = 2286, 84 percent women) included City of Helsinki employees aged 18 to 39 with F- diagnosed SA from 2008 to 2017.

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