Evidence-based management of return to work in common mental disorders: a roadmap for interventional practice and process coordination
DOI:
https://doi.org/10.25118/2763-9037.2026.v16.1653Keywords:
return to work, mental disorders, sick leave, rehabilitation, occupational healthAbstract
Introduction: Common mental disorders are among the leading causes of prolonged work absence, and their incidence is rising rapidly, including in Brazil. A persistent gap separates symptom improvement from effective and sustainable return to work. Objective: To critically synthesize the evidence on the management of return to work of people on sick leave due to common mental disorders and to propose a practical, interventional and coordinated roadmap. Method: Critical narrative review with searches in six databases (MEDLINE/PubMed, Embase, PsycINFO, Scopus, Web of Science and LILACS) covering the last ten years, guided by criteria SANRA for the assessment of narrative reviews, with thematic synthesis and prudent characterization of the strength of the evidence. Results: Workers' expectations and self-efficacy robustly predict the outcome, at times beyond diagnostic severity. The psychosocial work environment predicts return even after adjustment for symptoms. Structured workplace contact and work-focused interventions shorten time to return, whereas clinical improvement alone is insufficient. Return is heterogeneous, with distinct trajectories and a relevant risk of relapse. Case coordination and digital tools are promising, though supported by still incipient evidence. Conclusion: Effective management requires shifting the focus from symptom remission to functional recovery, adjustment of job demands and coordination among stakeholders, with local validation of recommendations.
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