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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

Returning people with persistent pain to work using Individual Supported Employment placements (ReISE)

Alternative title: Arbeidsplassering med individuelle støttetiltak for å hjelpe personer med langvarige smerter tilbake i arbeid. (ReISE)

Awarded: NOK 11.8 mill.

What is the problem? Many Norwegians are not able to work because of pain. This is often back, joint, or muscle pain. It can be hard for those affected to get back to work. We know that being in work is good for people’s physical and mental health and that supported employment measures can help people with mental health problems get back into work. But what about pain? What do we want to find out? We want to know if a similar approach will help unemployed people with persistent pain get back to work, and how much this might improve their overall health. We have already done a feasibility study in England where we found that a support package featuring work placements was well received by unemployed people with persistent pain. A full-scale study is now needed to compare this approach with usual Norwegian support to get back to work. How will we do this? We will recruit people who have been out of work for at least one month, and who have had pain that has affected their ability to work for more than three months. We will then select one-in-four to be offered supportive employment placements. Those offered the placements will be chosen randomly by a computer. For those selected, case managers will assess work ability, identify obstacles to working, provide support and practical advice, match people to a six-week work placement, and help agree a work plan. During the placement, the case manager will support both the individual and the employer, and refer to work-focused health care if necessary. Three, six, and 12 months after joining we will ask people who were selected, and those who were not selected, to tell us if they are working, how bad their pain is, and report on their overall quality of life. By doing this we will be able to find out if our support package is worth offering to all those who are unemployed with persistent pain. ReISE is a collaboration with Manpower, OsloMet, the University of Warwick and the Council for Musculoskeletal Health.

Increasing work participation for people with persistent pain improves their health, quality of life, well-being, and reduces poverty. However, it is not clear how best to help unemployed people who have persistent pain. While existing employment services in Norway are flexible, they are not usually coordinated with work-focused healthcare. Supported employment is effective for helping people with mental health challenges and there is interest in adapting this for people living with persistent pain. However, while mental health challenges often accompany persistent pain, people with pain may also need physical and organisational workplace accommodations. We have developed an intervention with matched supportive work placements and coordinated work-focused healthcare. A trained case manager helps a person identify obstacles to working and collaboratively agree a return to work plan. The case manager matches the person to a placement, acts as a bridge between systems, provides support, and makes referrals for work-focused healthcare where necessary. In a UK feasibility study, we confirmed this intervention was feasible and valued by those involved. Around 20% obtained paid employment within the short six-month follow-up period. This is promising considering that after two years (without intervention) the probability of return to work in the foreseeable future is thought to be close to zero in this population. A full-scale trial is needed to explore the effectiveness and cost-effectiveness conclusively. With Manpower, a leading staffing provider (for placements), a healthcare council, OsloMet, and University of Warwick, UK, we will adapt the intervention for use in Norway, pilot its delivery, and do a full-scale trial to examine whether the intervention is cost-effective for improving return to work and health-related quality of life. If successful, the intervention will have the potential to help a large group of people who are unemployed and have persistent pain.

Funding scheme:

HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester