How does capacity for work change before and after psychiatric treatment?

A Norwegian study of more than 2600 patients — with everything from mild to severe mental health challenges — set out to find out.

Norwegian University of Science and Technology (NTNU) researchers seeking to understand the role of psychiatric treatment in return to work following mental health challenges have found that it is no guarantee of success. “For many people, the start of treatment does not mark a return to working life, but rather the beginning of prolonged or increasing absence,” said Jakob Lundqvist, a PhD research fellow at NTNU’s Department of Psychology.

With a focus on Norway, which ranks at the very top among the OECD countries when it comes to absence due to illness and disability benefit, the study — published open access in BMC Health Services Research (doi: 10.1186/s12913-025-12856-w) — found that the number of people granted sick leave increased sharply in the months before treatment began, but decreased somewhat afterwards. Notably, it was observed that the use of long-term benefits — such as, in Norway, the work assessment allowance (AAP) — also increased. What this means is that the level of absence due to illness remained relatively stable in the year following the start of treatment.

Jakob Lundqvist. Photo: Kjetil Svensen, NTNU

“The result was that over 30% of the respondents were on sick leave, receiving AAP, or on disability benefit one year after treatment for mental health problems had begun,” Lundqvist said. Drilling down into the data, three groups were identified as at particularly high risk of ending up on a pathway towards increased incapacity for work, these were: women, elderly people, and patients receiving specialist healthcare services.

The research also suggests that the speed with which patients receive access to treatment has an impact, in settings where the referral process and waiting time before starting treatment were usually longer — resulting in an absence from work for long periods of time before treatment begins — increasing the risk of patients dropping out of working life permanently. “This may mean that it is not just about the patients’ mental health problems, but also about how the health services are organised,” Lundqvist said.

Lundqvist, a psychologist, also observes that perspectives of those providing treatment in Norway may be playing a part — the author observing that psychological treatment often focuses on reducing symptoms, while ability to function in everyday life and capacity for work are often not prioritised. “Sick leave should not be seen as a form of treatment,” Lundqvist said. “It may be necessary, but it rarely improves the person’s capacity for work. If we are to succeed, clinicians must strengthen both ability to function in everyday life and capacity for work in parallel with symptom relief. Only then can we reverse the trend.”

Top image credit: iStock.com/izusek. Stock image used is for illustrative purposes only.