A powerful intervention: General Practitioners' use of sickness certification in depression

Sara Macdonald, Margaret Maxwell, Philip Wilson, Michael Smith, Will Whittaker, Matt Sutton , Jill Morrison

Research output: Contribution to journalArticle

17 Citations (Scopus)
3 Downloads (Pure)

Abstract

Background
Depression is frequently cited as the reason for sickness absence, and it is estimated that sickness certificates are issued in one third of consultations for depression. Previous research has considered GP views of sickness certification but not specifically in relation to depression.

This study aimed to explore GPs views of sickness certification in relation to depression.

Methods
A purposive sample of GP practices across Scotland was selected to reflect variations in levels of incapacity claimants and antidepressant prescribing. Qualitative interviews were carried out between 2008 and 2009.

Results
A total of 30 GPs were interviewed. A number of common themes emerged including the perceived importance of GP advocacy on behalf of their patients, the tensions between stakeholders involved in the sickness certification system, the need to respond flexibly to patients who present with depression and the therapeutic nature of time away from work as well as the benefits of work. GPs reported that most patients with depression returned to work after a short period of absence and that it was often difficult to predict which patients would struggle to return to work.

Conclusions
GPs reported that dealing with sickness certification and depression presents distinct challenges. Sickness certificates are often viewed as powerful interventions, the effectiveness of time away from work for those with depression should be subject to robust enquiry.

Keywords: Depression; Mood disorder; Primary care; Occupational; Environmental medicine; Doctor-patient relationship; Mental health
Original languageEnglish
Article number82
Number of pages9
JournalBMC Family Practice
Volume13
DOIs
Publication statusPublished - 9 Aug 2012

Fingerprint

Certification
General Practitioners
Depression
Environmental Medicine
Return to Work
Scotland
Mood Disorders
Antidepressive Agents
Primary Health Care
Mental Health
Referral and Consultation
Interviews
Research

Keywords

  • depression
  • mood disorder
  • primary care
  • occupational
  • environmental medicine
  • doctor-patient relationship
  • mental health

Cite this

A powerful intervention : General Practitioners' use of sickness certification in depression. / Macdonald, Sara; Maxwell, Margaret; Wilson, Philip; Smith, Michael ; Whittaker, Will; Sutton , Matt ; Morrison , Jill.

In: BMC Family Practice, Vol. 13, 82, 09.08.2012.

Research output: Contribution to journalArticle

Macdonald, Sara ; Maxwell, Margaret ; Wilson, Philip ; Smith, Michael ; Whittaker, Will ; Sutton , Matt ; Morrison , Jill. / A powerful intervention : General Practitioners' use of sickness certification in depression. In: BMC Family Practice. 2012 ; Vol. 13.
@article{4cfa87c07e0c4fb7b48e4aa0a67a0d3f,
title = "A powerful intervention: General Practitioners' use of sickness certification in depression",
abstract = "BackgroundDepression is frequently cited as the reason for sickness absence, and it is estimated that sickness certificates are issued in one third of consultations for depression. Previous research has considered GP views of sickness certification but not specifically in relation to depression.This study aimed to explore GPs views of sickness certification in relation to depression.MethodsA purposive sample of GP practices across Scotland was selected to reflect variations in levels of incapacity claimants and antidepressant prescribing. Qualitative interviews were carried out between 2008 and 2009.ResultsA total of 30 GPs were interviewed. A number of common themes emerged including the perceived importance of GP advocacy on behalf of their patients, the tensions between stakeholders involved in the sickness certification system, the need to respond flexibly to patients who present with depression and the therapeutic nature of time away from work as well as the benefits of work. GPs reported that most patients with depression returned to work after a short period of absence and that it was often difficult to predict which patients would struggle to return to work.ConclusionsGPs reported that dealing with sickness certification and depression presents distinct challenges. Sickness certificates are often viewed as powerful interventions, the effectiveness of time away from work for those with depression should be subject to robust enquiry.Keywords: Depression; Mood disorder; Primary care; Occupational; Environmental medicine; Doctor-patient relationship; Mental health",
keywords = "depression, mood disorder, primary care, occupational , environmental medicine, doctor-patient relationship, mental health",
author = "Sara Macdonald and Margaret Maxwell and Philip Wilson and Michael Smith and Will Whittaker and Matt Sutton and Jill Morrison",
year = "2012",
month = "8",
day = "9",
doi = "10.1186/1471-2296-13-82",
language = "English",
volume = "13",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BioMed Central",

}

TY - JOUR

T1 - A powerful intervention

T2 - General Practitioners' use of sickness certification in depression

AU - Macdonald, Sara

AU - Maxwell, Margaret

AU - Wilson, Philip

AU - Smith, Michael

AU - Whittaker, Will

AU - Sutton , Matt

AU - Morrison , Jill

PY - 2012/8/9

Y1 - 2012/8/9

N2 - BackgroundDepression is frequently cited as the reason for sickness absence, and it is estimated that sickness certificates are issued in one third of consultations for depression. Previous research has considered GP views of sickness certification but not specifically in relation to depression.This study aimed to explore GPs views of sickness certification in relation to depression.MethodsA purposive sample of GP practices across Scotland was selected to reflect variations in levels of incapacity claimants and antidepressant prescribing. Qualitative interviews were carried out between 2008 and 2009.ResultsA total of 30 GPs were interviewed. A number of common themes emerged including the perceived importance of GP advocacy on behalf of their patients, the tensions between stakeholders involved in the sickness certification system, the need to respond flexibly to patients who present with depression and the therapeutic nature of time away from work as well as the benefits of work. GPs reported that most patients with depression returned to work after a short period of absence and that it was often difficult to predict which patients would struggle to return to work.ConclusionsGPs reported that dealing with sickness certification and depression presents distinct challenges. Sickness certificates are often viewed as powerful interventions, the effectiveness of time away from work for those with depression should be subject to robust enquiry.Keywords: Depression; Mood disorder; Primary care; Occupational; Environmental medicine; Doctor-patient relationship; Mental health

AB - BackgroundDepression is frequently cited as the reason for sickness absence, and it is estimated that sickness certificates are issued in one third of consultations for depression. Previous research has considered GP views of sickness certification but not specifically in relation to depression.This study aimed to explore GPs views of sickness certification in relation to depression.MethodsA purposive sample of GP practices across Scotland was selected to reflect variations in levels of incapacity claimants and antidepressant prescribing. Qualitative interviews were carried out between 2008 and 2009.ResultsA total of 30 GPs were interviewed. A number of common themes emerged including the perceived importance of GP advocacy on behalf of their patients, the tensions between stakeholders involved in the sickness certification system, the need to respond flexibly to patients who present with depression and the therapeutic nature of time away from work as well as the benefits of work. GPs reported that most patients with depression returned to work after a short period of absence and that it was often difficult to predict which patients would struggle to return to work.ConclusionsGPs reported that dealing with sickness certification and depression presents distinct challenges. Sickness certificates are often viewed as powerful interventions, the effectiveness of time away from work for those with depression should be subject to robust enquiry.Keywords: Depression; Mood disorder; Primary care; Occupational; Environmental medicine; Doctor-patient relationship; Mental health

KW - depression

KW - mood disorder

KW - primary care

KW - occupational

KW - environmental medicine

KW - doctor-patient relationship

KW - mental health

U2 - 10.1186/1471-2296-13-82

DO - 10.1186/1471-2296-13-82

M3 - Article

VL - 13

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

M1 - 82

ER -