Mental Health App Helps Sick Workers Return Faster, but Real-World Use Remains Unclear
A new study of mWorks, a web-based tool designed to help employees with depression and anxiety return to work, reveals the intervention works in controlled settings—but significant gaps remain in how it's actually used and sustained outside clinical environments. The findings highlight critical barriers to scaling digital mental health solutions that employers and policymakers must address to reduce sick leave costs.
Originaltitel: A Web-Based Self-Management Intervention for Return-to-Work Among Persons With Common Mental Disorders on Sick Leave: Case Study of mWorks.
**Webbaserad återgång till arbete för psykisk ohälsa visar genomförbarhet i svensk vård** En ny studie från Lund University presenterar mWorks, en webbaserad självhjälpsintervention för sjukskrivna personer med vanliga psykiska störningar under återgång till arbete. Implementeringen följde sin planering med minimal anpassning, och alla sex deltagare höll fast vid programmet under tioveckorsperioden. Dialogmöten mellan patient och arbetsrehabilitering värderades högt. Användare tillgodogick sig interventionen flexibelt både under sjukskrivning och återkomst till arbetsplats. Potentiella effekter inkluderade ökad acceptans, självkänsla och känsla av kontroll samt möjlighet att förebygga återfall i psykisk ohälsa. Studien, genomförd vid primär- och specialistvård i Sverige, identifierade rekrytering som huvudutmaning under pandemin. För regionala inköpschefer och sjukvårdsledare signalerar resultaten att digitala återintegreringsprogram kan passa in i befintlig vårdprocess utan omfattande omställning.
BACKGROUND: mWorks is a co-designed, web-based self-management intervention developed to empower persons with common mental disorders who are on sick leave during the return-to-work process. However, limited knowledge of how mWorks is delivered and engaged with in real-world settings constrains further development and implementation. In line with the Medical Research Council framework for complex intervention evaluation, such an approach is required to examine (1) contextual factors influencing implementation, (2) fidelity and variation in delivery, and (3) how service users and professionals experience and respond to the intervention. OBJECTIVE: This study aimed to evaluate the process of implementing mWorks, specifically focusing on assessing the intervention's delivery in relation to the context, implementation process, and mechanisms of impact. METHODS: This single-case study was bounded by the delivery period of 10 weeks in a primary and specialist mental health service context. During this period, return-to-work professionals (n=2) and service users (n=6) collaborated to initiate mWorks usage. Both qualitative and quantitative methods were used to triangulate multiple data sources. RESULTS: The pandemic and mental health problems posed contextual barriers, particularly during recruitment. However, perceptions of mWorks as a credible and relevant intervention facilitated its implementation. The delivery was performed according to plan, with minimal adaptations. All users adhered to the intervention, and dialogue meetings were highly valued. mWorks was used flexibly according to users' needs, both during sick leave and at work. The potential impacts included a transformative process for users, fostering acceptance, self-esteem, self-compassion, and a sense of control. It also had the potential to prevent mental ill health, transform negatives into positives, facilitate disclosure of mental health, and support goal setting. The use of quantitative measures for empowerment, engagement, self-efficacy, depression stigma, and quality of life proved feasible and supported the assumptions and direction of results. CONCLUSIONS: The recruitment stage of the implementation program encountered significant contextual barriers. However, once the delivery stage began, the implementation of mWorks proved to be feasible. Despite the limited scope of this study, with its small number of participants, the triangulation of data suggests that both users and professionals benefited from mWorks.