111 Residual work capacity and (in)ability to work fulltime among applicants with mental disorders INTRODUCTION Mental health-related disability poses one of the greatest social and labour market policy challenges in OECD countries. Around one-third of the annual number of new work disability benefit grants is attributable to mental and behavioural disorders [1,2,3] and there is a trend increase in most OECD countries [4, 5]. Besides huge economic costs at population level [4, 6], long-term disability in general and due to mental and behavioural disorders in particular, is associated at the individual level with lower socio-economic status, reduced quality of life and higher morbidity/mortality rates [7]. It is therefore of great importance to prevent the transition of short-term sickness absence into long term or permanent disability and to rehabilitate those persons already on long term disability benefit by facilitating return to work. In the Netherlands, long-term sick-listed employees may apply for a work disability benefit after two years of sick-leave, to compensate for income loss. The insurance physician of the Dutch Social Security Institute: The Institute for Employee Benefits Schemes (UWV) assesses the health situation of an applicant and whether the applicant is able to work. When the applicant has no possibilities to perform any work at all, he or she is assessed with no residual work capacity. No residual work capacity can be assessed when an applicant is, for example, not self-reliant due to a severe mental disorder or a physical disorder [8]. When applicants are able to (partly) work, they are assessed with residual work capacity. In this latter case, the possible limitations in their mental and physical functioning caused by their disease are indicated according to the Functional Ability List (FAL) [9, 10]. This part of the assessment results in a conclusion about the (in)ability to work fulltime, reported as the number of hours the applicant can sustain working activities per day. Particularly energy deficit, fatigue and increased need for rest are primary indicators of inability to work fulltime [11, 12]. Both residual work capacity and (in)ability to work fulltime are important outcomes of work disability assessments, which usually lead to the decision of granting the benefit or not. Not only in the Netherlands, but also in many other European countries, assessing residual work capacity and (in)ability to work fulltime are part of the current work disability assessments [13, 14]. In a recent study, we showed, using register data of a year cohort of applicants assessed with residual work capacity, that the prevalence of inability to work fulltime strongly varied between different types of disease groups [15]. Moreover, we found that being diagnosed with a mental or behavioural disorder showed a significant increased risk for being assessed with inability to work fulltime compared to applicants having a disorder of another disease group. Furthermore, for applicants diagnosed with a mental or behavioural disorder, female gender and higher age were associated with an increased risk to be assessed with inability to work fulltime [15]. 6
RkJQdWJsaXNoZXIy MTk4NDMw