Employment Support Program in Cooperation With the Public Employment Service for Major Depressive Disorder: A Report of Two Cases With Employer Interviews

People with common mental disorders often take recurrent sick leave and experience difficulty sustaining employment, highlighting the need for practical models linking clinical care to workplace support. The Employment Support Program in Cooperation With the Public Employment Service (ESPCP) is a psychiatric day care-based program delivered in partnership with public employment service officials. It combines an intensive, group-based Work Readiness Program with structured coordination with employers during job entry and after placement. We report two cases of patients with major depressive disorder who completed the ESPCP and achieved successful work outcomes. We also integrate employer perspectives collected via semi-structured interviews. Case 1 involved a woman in her 30s with repeated short-term clerical jobs and job loss related to caregiving demands and depressive relapses. Following a three-month ESPCP phase, she obtained a fixed-term position in in-house cleaning (20 hours/week) and remained employed for 12 months, after which she voluntarily transitioned to full-time employment at another company. Key interventions emphasized relapse prevention, crisis planning, and post-hiring consultations regarding interpersonal issues. Case 2 involved a man in his 40s who left a sales position following symptom exacerbation and hospitalization. He completed two consecutive three-month ESPCP phases to rebuild confidence and strengthen relapse prevention with family psychoeducation. He obtained competitive employment in factory manufacturing, starting at 10 hours/week and progressing stepwise to 40 hours/week, with sustained full-time employment at the two-year follow-up visit. Employers described collaboration with the psychiatric day care team and related employment-support professionals as beneficial for sharing timely information, having a clear consultation window, and enabling flexible work design and unified support approaches. The encountered challenges included balancing confidentiality with the need for operational information and deciding the appropriate frequency and content of communication. These cases suggest that ESPCP functions as a practical bridge between clinical services and workplaces for people with depressive disorders and that structured employer collaboration contributes to sustained employment.