Referral to treatment of absent employees diagnosed with burnout in the Netherlands

Background Despite large amounts of research on determinants of burnout, research on its treatment is scarce. In the Netherlands, occupational physicians (OPs) can officially diagnose burnout and have to offer return-to-work (RTW) guidance to employees on sick leave, which includes referral to treatment. This research aimed to explore 1) characteristics of treatment for burnout and 2) how employee-, complaint- and employer characteristics relate to referral to treatment by the OP and to employee RTW expectation. Methods All 212 employees (45% male, 42.5 years of age, 35% high educated) diagnosed with burnout at one occupational health service during February-June 2020 were included. Register data (gender, age (years), education, organization size) and self-reported data collected online (living situation; Burnout Assessment Tool (BAT) score; cause of absence mainly work-related (0/1); treatment (0/1); on waiting list (0/1); type of treatment; treatment focused on RTW (0/1); employee RTW expectation high (0/1)) were tested with Chi2, ANOVA and logistic regression analyses. Results Of all employees, 75.9% (n = 161) were referred to treatment by their OP, of which 25.5% (n = 41) were currently on a waiting list. The majority received treatment from a nurse practitioner (51.7%) or psychologist (23.3%) These practitioners focused on RTW less often (51.6%-60.7%) than the other practitioners (81.5-100%) (p = 0.042). Multivariate tests showed age to relate to referral to treatment (OR 0.956; 95% CI 0.928-0.986) and BAT score to employee RTW expectation (OR 0.635; 95% CI 0.407-0.991). Conclusions OPs referred three quarters of the employees on sick leave with burnout to treatment. Referral by OPs related only to younger age and employee RTW expectation only to BAT score. The practitioners that were referred to most often, focused less on RTW. As burnout is a work-related syndrome, these findings suggest room for improving the treatment's focus on (returning to) work. Key messages OPs referred 75.9% of the burned out employees on sick leave to treatment, particularly younger employees. The practitioners that were referred to most often, focused less on RTW.