VT RETAIN: An early return-to-work intervention model centered in primary care for individuals with work-limiting health conditions

BackgroundThe Vermont Retaining Employment and Talent After Injury and Illness Network (VT RETAIN) demonstration project was designed to evaluate an early stay-at-work/return-to-work (SAW/RTW) program model centered in primary care addressing the unmet needs of individuals facing work disability in Vermont with a focus on mental health barriers to work.ObjectiveTo describe the design of Phase 1 and Phase 2 of the VT RETAIN project and summarizes the baseline characteristics of enrolled participants.MethodsThe target population was individuals with work-limiting, work-related or non-work-related, health conditions receiving care at participating primary care clinics. Participating clinics and patients received evidence-based SAW/RTW resources. Additionally, half the clinics were randomized to receive professional Work-Health Coaching, which included SAW/RTW coordination for patients enrolled from the participating clinics.ResultsVT RETAIN enrolled 120 primary care practices and 881 participants across the state. Participants (mean age 43 years ±13) were 62% female and 88% white, with 41% reporting a mental health disorder or substance use related disorder as the main condition limiting work, and 73% reporting depression as a comorbidity; 19% were from professional occupations and 18% from health care.ConclusionsThe VT RETAIN project successfully scaled evidence-based SAW/RTW strategies statewide; reached the target population with work-limiting mental health conditions; and integrated mental health and social determinants of health screenings for all participants. These results show that employment, healthcare, mental health, and social services can be coordinated to support work ability across a population. This information can inform other SAW/RTW programs or services.