• G W Simpson, P Byrne, M B Gabbay, and A Rannard.
• Health Services Research Department, Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3GL, UK. glenn.simpson@liv.ac.uk.
• Occup Med (Lond). 2015 Jul 1; 65 (5): 367-72.

BackgroundCommon mental health disorders (CMHDs) are a leading cause of sickness absence. To address this, a Fit for Work Service (FFWS) was introduced in Greater Manchester, UK, in 2010, offering case-managed and multidisciplinary interventions to early-stage sickness absentees experiencing physical health conditions and/or associated psychosocial problems, to enable a speedy return to work.AimsTo explore the illness experiences of employees who contacted or were referred to the Greater Manchester FFWS (GM-FFWS).MethodsA qualitative in-depth study, using narrative interviews with GM-FFWS service users who experienced mental ill-health. Interviews were recorded, transcribed and analysed for key themes.ResultsThere were 21 interviews available for analysis. Multiple disruptive life events overwhelmed employees' capacity to cope, triggering mental ill-health. For some individuals, the onset of mental ill-health was unexpected and had profound psychological effects on participants' sense of self and personal identity. In certain cases, previous bouts of emotional distress contributed to an underlying psychology of low self-esteem. Mobilizing resources was often a significant factor in supporting recovery. The illness experience led to a process of self-re-evaluation among some participants.ConclusionsDisruptive events at work have the potential to threaten an individual's sense of self. Employee's experiences of CMHDs can only be fully understood if there is awareness of how these experiences emerge from a person's biography and subsequently inform their responses to contemporary life events. The design of future clinical and non-clinical workplace interventions should take account of these biographical aspects of the illness experience.© The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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