Unemployed persons have poorer health compared to employed persons. Also, persons with a poor health are less likely to enter the workforce than healthy persons. So, more insight is needed in determinants of re-employment and effective re-employment programs for unemployed persons with health problems. The three research goals of this thesis are:
1. To study the influence of health and cognitions on re-employment among long-term unemployed persons.
2. To study the relation between re-entering paid employment and health of unemployed persons.
3. To study the effectiveness of re-employment intervention s on health, social participation and re-employment of persons with mental health problems.
Persons with a poor health were more likely to become long-term unemployed compared to persons in good health. Poor health negatively influenced job-search cognitions and coping resources, which in turn resulted in less active job-search behavior and lower likelihood to gain paid employment. Entering paid employment had a positive effect on perceived health and quality of life and also anxiety and depressive symptoms decreased after re-employment. Among persons who entered paid employment, physical health improved (+16%) and anxiety and depressive symptoms decreased (-15%), whereas among persons who continued to be unemployed their health remained unchanged. Paid employment can be considered an effective intervention to improve the health disadvantage among unemployed persons.
The interdisciplinary reemployment program, in which employment specialists as well as mental health specialists work together in interdisciplinary teams, showed no added value compared to the regular re-employment programs. The most important missing components of the re-employment intervention were rapid job placement, coaching on the job, and direct connection and communication of employment specialists with employees.
The systematic review and meta-analysis showed some indications that re-employment programs based on the place-then-train model had a positive effect on quality of life with a pooled effect size of 0.28 (95% CI 0.04 to 0.52). In conclusion, among persons with mental health problems, (health related) quality of life is positively influenced by job placement as part of programs that integrate health services with employment services.

A. Burdorf (Alex) , M. Schuring (Merel)
Erasmus University Rotterdam
Department of Epidemiology

Carlier, B. (2017, October 31). Health, Social Participation and Entering Paid Employment among Unemployed Persons. Retrieved from http://hdl.handle.net/1765/102430