精神疾患の復職支援要因の分析―地方公務員復職者に対するアンケート調査の結果

Analysis of the Support Systems Available to Restore the Mentally Ill Local Public Workers：A questionnaire survey

抄録

　神奈川県下のある自治体において，精神疾患による長期休職後に復職した職員127名を対象に，復職に影響した支援についてアンケート調査を実施した。休職期間の前後で，職場の変化や制度的な事柄，受診状況などについて質問した。調査の結果，95名から回答が得られた。復職に役立った支援として，慣らし勤務，業務内容への配慮，上司の共感，業務量への配慮が多く選択されていた。また，復職後には職場での病気への理解は改善したと感じられていた。業務量の軽減や業務内容の変更は，ベック抑うつ質問票(BDI-Ⅱ)による抑うつ度の低下と相関していた。復職後の異動希望については，回答者の99％が配慮の必要性を認めていた。主治医への満足度は高かったが，満足度の高さは，BDI-Ⅱによる抑うつ度の高さと相関していた。

　The incidence of long-term absence from work due to mental illness has been increasing among the local public workers in Japan since 1988. A questionnaire survey was conducted (N＝127) in one of the city of Kanagawa to know the view of the views of the subjects on the available support systems that would motivate them to resume work. The questions requested details about the patient's attitude toward change in the work place and the support systems and medical care available, before and after sick leave. We received replies from 95 local public workers. Many subjects preferred trial work attendance, reduction in the workload, and sympathy from supervisors as helpful support methods. The reinstated subjects found an improvement in the understanding shown by their co-workers with regard to their mental illness. Reduction in the work-load and change in the type of work were associated with a decrease in the depression, as evaluated by the Beck depression inventory-second edition (BDI-Ⅱ). Many subjects reported the usefulness of attendance on trial work. Transfer requests of approximately 99% of the subjects were considered at the time of reinstatement. The treatments by the family doctors highly satisfied the subjects, although BDI-Ⅱ showed a correlation between higher satisfaction rate and higher depression score.