چکیده (انگلیسی):

Background:Depression is a major cause of work absenteeism that general practitioners (GPs) face directly since
they are responsible for sickness certification and for supervising the return to work (RTW). These activities give GPs
a key role in preventing long-term work disability, yet their practices in this regard remain poorly documented. The
objectives of this study were therefore to describe GPs’ practices with people experiencing work disability due to
depressive disorders and explore how GPs’ work context may impact on their practices.
Methods:We conducted semi-structured individual interviews with 13 GPs and six mental healthcare professionals
in two sub-regions of Quebec. The sub-regions differed in terms of availability of specialized resources offering public
mental health services. Data were anonymized and transcribed verbatim. Thematic analysis was performed to identify
patterns in the GPs’ practices and highlight impacting factors in their work context.
Results:Our results identified a set of practices common to all the GPs and other practices that differentiated them.
Two profiles were defined on the basis of the various practices documented. The first is characterized by the integration
of the RTW goal into the treatment goal right from sickness certification and by interventions that include the workplace,
albeit indirectly. The second is characterized by a lack of early RTW-oriented action and by interventions that include
little workplace involvement. Regardless of the practice profile, actions intended to improve collaboration with
key stakeholders remain the exception. However, two characteristics of the work context appear to have an impact: the
availability of a dedicated mental healthnurse and the regular provision of clinical information by psychotherapists. These
conditions are rarely present but tend to make a significant difference for the GPs.
Conclusions:Our results highlight the significant role of GPs in the prevention of long-term work disability and
their need for support through the organization ofmental health services at the primary care level.