Table 1.

Characteristics of included studies (N = 25)

First author, (Year of publication) and country	Study aim/research questions	Study design, data collection method	Details of linked intervention (if applicable)	Employer participant characteristics		Size and type of organisational setting	Health condition/s of employees supported by employers	Contextual reason/s for employer support (e.g., work retention)
Sample size, Gender, Age, Race/ethnicity	Occupational role/s and responsibilities
Bush, 2016 [58] USA	To explore how adults with TBI and the people associated with them describe employment experiences post-injury	Multiple case study Semi-structured interviews	Not applicable	N = 1 Female: n = 1 Age and race/ethnicity not reported	Job supervisor	Crop insurance agency. No further details reported	Severe TBI	Post-injury RTW
Coole, 2013 [53] UK	To explore perceptions and experiences of employer stakeholders in supporting employees to RTW post-stroke, identify key aspects linked to successful RTW, and obtain their views regarding a VR RTW service	Qualitative study Semi-structured interviews	Not applicable	N = 18 Gender, age and race/ethnicity not reported	Human resources staff (n = 3), occupational health physician (n = 1), occupational health nurse (n = 3), small business owners (n = 3), a managing director (n = 1), a manager (n = 1), line manager/supervisors (n = 3), and a disability employment advisor (n = 1)	Organisations in service (n = 12), manufacturing (n = 2), engineering (n = 3) or various industries (n = 1). Based in private (n = 10), public (n = 5), or voluntary sectors (n = 3). Most organisations were large (> 250 employees: n = 8); others were micro- (< 10 employees: n = 4), small- (10–50 employees; n = 1), or medium-sized (>50–250; n = 3)	Stroke	Post-stroke RTW
Devonish, 2017 [60] Barbados	Research questions related to managerial definitions and views of mental health and illness in the workplace, their experiences with people with mental illness, and perceived support/resources needed to manage and support employees with mental illness within the workplace	Explorative qualitative research design Two focus groups (one for public sector managers, one for private sector managers)	Not applicable	N = 16 Male: n = 8 Female: n = 8 Age range: 32–59 years Race/ethnicity not reported	Public sector managers (n = 8): included supervisory and/or managerial job roles, e.g., senior executive/accounting/administrative officers, and a sergeant from the local police force Private sector managers (n = 8): included front line supervisors, and HR and operations managers.	Public sector managers worked in the civil service Private sector managers worked in personal and health services, finance, tourism and hospitality, construction, and retail/wholesale industries	Mental illness	General support for employees with mental illness to cope with their condition within the workplace
Donker-Cools, 2018 [15] Netherlands	To investigate which factors provide solutions to RTW problems, or hinder or facilitate RTW as experienced by patients with ABIs and employers	Explorative qualitative study Semi-structured interviews	Not applicable	N = 7 Male: n = 4 Female: n = 3 Middle-aged. Race/ethnicity reported	Supervisor (n = 1), line manager (n = 3), HR manager (n = 2), director (n = 1)	Organisational settings included a town hall (1900 employees), an academic hospital (11,000 employees), a national sports federation (29 employees), a police office (1230 employees), a factory (240 employees), and two schools (2965 and 140 employees)	Non-progressive ABI	Post-injury RTW
Gignac, 2021 [48] Canada	To increase understanding of employer representatives’ perspectives on disability communication-support processes	Explorative qualitative study Semi-structured interviews	Not applicable	N = 27 Male: n = 7 Female: n = 20 Age and race/ethnicity not reported	Supervisor/manager (n = 4), disability manager (n = 7), HR personnel (n = 5), worker advocates/union representatives (n = 5), labour lawyers representing workers, a large union or large organisation (n = 3), medical director and OH nurse (n = 2), health and safety representative (n = 1). Also included 5 employer representatives with lived experience of physical or mental episodic disability	Small (< 100 employees) = 6, medium or large (≥100 employees) = 21 Organisations were based in business, finance and professional services (n = 4), education or government (n = 6), healthcare (n = 6), manufacturing, construction or utilities (n = 4), non-profit (n = 1), service or retail (n = 1), or multiple sectors (n = 5)	Episodic disabilities (e.g., depression, anxiety, arthritis)	Work retention of employees with episodic disabilities
Gordon, 2015 [62] New Zealand	To investigate the factors critical in enabling and sustaining open employment of mental health service users, from perspectives of employees and their employees	Multiple case study Semi-structured interviews	Not applicable	N =  14 Male: n = 4 Female: n = 10 Age and race/ethnicity not reported	Occupational role/responsibilities not reported	Private sector (n = 7; e.g., small owner operated bakery, electrical retailer, pharmacy, very large supermarket) Public sector (n = 4, e.g., school, university, police force) Non-governmental organisations based in mental health sector (n = 3)	Mental illness (five employees also had co-morbid physical illnesses or disabilities - no further details reported)	General management and support for employees with mental illness in open employment
Gouin, 2019 [49] Canada	To explore influence of decision-making processes on the RTW of employees with common mental disorders or musculoskeletal conditions	Secondary analysis of three multiple case studies Semi-structured interviews	Interdisciplinary work rehabilitation intervention with content relating to reassurance, avoidance behaviour, reduction of fears, collaboration between stakeholders and a progressive RTW	N =  19 Gender, age and race/ethnicity not reported	Immediate supervisors (n = 14) and human resources managers (n = 5)	Those who supported employees with mental illness were based in the service sector; within a government organisation and a large private organisation (> 500 employees)	Common mental disorders or musculoskeletal conditions	RTW due to mental illness or musculoskeletal condition
Hellman, 2016 [42] Sweden	To describe and explore stakeholders’ views of important aspects of the RTW process for stroke survivors, and explore how their contrasting perspectives may influence RTW services	Exploratory qualitative study Focus groups	Not applicable	N = 5 Male: n = 3 Female: n = 2 Age and race/ethnicity not reported	Not reported	Not reported	Stroke (occurred 7–18 years prior to study)	Post-stroke RTW
Holmlund, 2022a [43] Sweden	To identify ethical issues arising during RTW coordination for employees with common mental disorders	Descriptive qualitative study Semi-structured interviews	Not applicable	N = 10 Male: n = 2 Female: n = 8 Age and race/ethnicity not reported	Coordinator (n = 2), OHS nurse (n = 2), CEO (n = 2), HR personnel (n = 4)	Details not reported	Mild-to-moderate depression, adjustment disorder, or anxiety	RTW due to mental illness
Holmlund, 2022b [44] Sweden	To explore employee and managerial perceptions of reasons for sick leave resulting from common mental disorders, using a transactional perspective of gender norms and everyday life occupation	Exploratory qualitative study Semi-structured interviews	Intervention offered as one arm of an RCT. Aimed to improve RTW process of participant. Coordinator supported employees and employers to collaboratively identify RTW issues and come up with solutions to issues	N = 11 Male: n = 4 Mean age (years) (range): 49 (36–63) Female: n = 7 Mean age (years) (range): 44 (32–54) Race/ethnicity not reported	First-line managers (n = 7), chief executive officer (n = 1), school principal (n = 1). Details of other two managers’ roles not reported. All were responsible for rehabilitation of a participant included in the linked RCT	Private sector (n = 7), municipality or regional sector (n = 4)	Mild-to-moderate depression, adjustment disorder, or anxiety	Work retention of employees, just prior to them being absent due to mental illness
Irvine, 2023 [56] UK	To explore how small business contexts influence support and management of mental health problems in work environments	Exploratory qualitative study Semi-structured/narrative interviews	Not applicable	N = 21 Male: n = 4 Female: n = 17 Age and race/ethnicity not reported	Managers (N = 21)	Small businesses of 50 or less employees, in charity (n = 7) or private sectors (n = 14). Industries included social care (n = 3), healthcare (n = 4), skilled manual (n = 1), manufacturing/sales (n = 1), consultancy (n = 3), law (n = 1), community development (n = 3), construction (n = 1), digital marketing (n = 1), food production/retail (n = 1), animal care (n = 1), and information and advice (n = 1).	Mental health problems (e.g., anxiety, depression, or stress)	Work retention of employees with mental health problems
Lemieux, 2011 [50] Canada	To record supervisors’ perceptions of factors hindering or facilitating RTWs of employees with common mental disorders	Exploratory qualitative study Semi-structured interviews	Not applicable	N = 11 Male: n = 8 Female: n = 3 Age and race/ethnicity not reported	Supervisors with experience in RTW of employees absent due to common mental disorders.	Medium (n = 4) or large-sized companies (n = 7) in education (n = 4), financial (n = 3), food retail (n = 1), transportation (n = 1), public service (n = 1) and health (n = 1) sectors	Common mental disorders	RTW due to mental illness
Lexén, 2019 [45] Sweden	To develop a model to explain how attitudes, knowledge and experiences of employers and rehabilitation professionals influence strategies utilised during RTW of employees with mental illness	Grounded theory Interviews (type not reported)	Not applicable	N = 23 Male: n = 9 Female: n = 14 Mean age (years) = 51.8 Race/ethnicity not reported	Details of occupational roles/responsibilities not reported	Manufacturing (n = 3); pedagogic work (n = 4); installation, operation and maintenance (n = 1); healthcare (n = 5); hotel/restaurant (n = 1); sales, purchasing and marketing (n = 2); information technology (n = 3); construction (n = 2); administration, economy and law (n = 1); and police (n = 1). Based in private (n = 14), public (n = 6), and governmental (n = 3) sectors, with numbers of employees including < 5 (n = 6), 5–10 (n = 8), and > 50 (n = 10)	Mental illness	RTW due to mental illness
Libeson, 2021 [63] Australia	To understand experiences of employers of TBI survivors who have received comprehensive VR, what is involved in supporting these employees, and the needs of the employers themselves	Explorative qualitative study Semi-structured interviews	State-run VR program led by TBI-specialist VR occupational therapist (OT). Included work-site assessments, employer liaison, cognitive strategies, tailored work modifications, and ongoing support and monitoring in the workplace	N = 12 Male: n = 6 Female: n = 6 Age range (years): 30–70 Race/ethnicity not reported	Direct manager (n = 8); RTW/HR coordinator (n = 2); Director and direct manager (n = 2)	Small-sized organisations (n = 2; private entertainment, private public relations); medium-sized organisation (n = 1, public hospital); large-sized organisations (n = 9, private finance, public service/government, private retail, private hospital, public service/construction, private hospitality)	TBI	Post-TBI RTW
Marois, 2020 [51] Canada	To evaluate the feasibility of a RTW program for employees with common mental disorders, from the perspectives of employers, insurers, employees and unions	Sequential mixed-methods design Group discussion	Adapted Therapeutic Return-to-Work (TRW) Program aimed to facilitate RTW of employees with common mental disorders. Included Work Disability Diagnosis Interview; preparation; therapeutic RTW; coaching to develop employee work capacity; and maintenance support	N = 7 Female: n = 7 Median (range) in years: 37 (29–60) Race/ethnicity not reported	Employers worked in a health office (n = 5) or in HR (n = 2)	No details of organisational settings reported	Common mental disorders	RTW following sick leave of ≥ 6 months due to mental illness
Morant, 2021 [54] UK	To explore experiences and views of employees with mental health problems, mental health clinicians, and managers of social firms, on the value of social firms for VR, wellbeing and employment of individuals with mental health problems	Explorative qualitative study Semi-structured interviews, focus group	Not applicable	N = 12 Details on age and race/ethnicity not reported	Managers of social firms, where at least one employee had a mental health problem	Social firms were mostly small (average number of people employed = 7), all based in England. Range of sectors including training (n = 2); recycling (n = 2); and one each of gardening, printing, market research, health foods, framing, textiles, and travel agent	Mental health problems	Work retention of employees with mental health problems within social firms
Nielsen, 2023 [57] UK	To examine line managers’ supportive behaviours towards employees who had returned from work following long-term sickness absence due to common mental disorders	Longitudinal descriptive qualitative study Semi-structured interviews (managers interviewed up to three times if they were managing a returned worker at the time of the data collection)	Not applicable	N = 20 Male: n = 7 Female: n = 13 Age (years): 25–34: n = 1 35–44: n = 5 45–54: n = 7 55 or older: n = 4 Not reported: n = 3. Details on age/ethnicity not reported	Line managers	Sizes of organizations not reported. Managers worked in publishing (n = 1), information technology (n = 1), police and emergency services (n = 2), education and research (n = 2), administration (n = 8), and healthcare services (n = 6)	Common mental disorders (i.e., stress, anxiety, depression)	Work retention of employees with common mental disorders
Öst Nilsson, 2019 [46] Sweden	To describe and explore managerial and co-workers’ experiences of RTW processes involving a stroke survivor colleague who took part in a client-centred VR programme	Qualitative explorative design Two semi-structured interviews per employer: conducted ≤3 weeks after beginning of work trial, and then 8–9 weeks later	Person-centred, individually tailored VR intervention delivered by OTs. Employers received information regarding impact of stroke on work abilities, and met with OTs, stroke survivor employees (and social insurance officers) to plan and evaluate work trials	N = 4 Gender, age and race/ethnicity not reported	Managers who worked closely with the stroke survivor employees and had insight into their RTW process	Organisations in following sectors: Transport (n = 1; 100 employees); manufacturing (n = 2; 20–50 employees); and education (n = 1; 12 employees)	Mild or moderate stroke	Post-stroke RTW during a VR programme
Porter, 2019 [33] Sweden	To explore employers’ knowledge, beliefs, and strategies used to provide support for employees with mental illness	Grounded theory Interviews	Not applicable	N = 24 Male: n = 10 Female: n = 14 Mean (range) in years: 49.2 (39–62) Race/ethnicity not reported	Details of occupational roles/responsibilities not reported	Politics/government (n = 1); administration, economy and law (n = 1); police (n = 1); construction (n = 1); information technology (n = 2); sales, purchasing and marketing (n = 4); hotel or restaurant (n = 1); installation, operation and maintenance (n = 1); healthcare (n = 4); manufacturing (n = 3); and education (n = 5).	Mental illness	General management and support for employees with mental illness to cope with their condition within the workplace
Radford, 2018a [55] UK	Group 1: To identify the most valued intervention components in practice, from the perspectives of TBI survivors and employers Group 2: To identify the most important outcomes of VR, from the perspectives of TBI survivors, service providers, and employers	Part of mixed methods process evaluation nested within feasibility trial of a VR intervention Semi-structured interviews	Aim of the Early Specialist Traumatic brain injury Vocational Rehabilitation (ESTVR) intervention is to prevent job loss among employed TBI survivors. Individually tailored, delivered by OTs. Employers and family members are supported to increase their understanding of the impact of the injury on the individual and their work ability.	Group 1: n = 6 Group 2: n = 12 Gender, age, and race/ethnicity not reported	Group 1: Coordinator (n = 1); manager (n = 2); head of department (n = 1); staff member from occupational health service (n = 1); and an assistant director (n = 1) Group 2: Human Resource manager (n = 1); occupational health doctor (n = 1); occupational health nurse (n = 1); disability employment advisor (n = 1); line managers (n = 7); and a personal injury solicitor (n = 1)	Group 1: A recycling charity, a disability inclusion service, a Trust in the National Health Service, a restaurant, a university occupational health service, and a school. Group 2: Private occupational health companies (n = 2), manufacturing companies (n = 2), universities (n = 2), TBI charities (n = 3), a voluntary sector organisation (n = 1), a private solicitor (n = 1), and a government employment agency (i.e., JobCentrePlus) (n = 1).	TBI	Post-injury RTW and work retention
Santy 2016 [59] USA	To explore implications of the RTW transition for TBI survivors for policy, address the literature gap, and identify factors contributing to success of RTW programs in Washington State	Ethnographic study Semi-structured interviews	Not applicable	N = 6 Male: n = 3 Female: n = 3 Age range: 52–62 years Race/ethnicity not reported	Business owner (n = 1), director (n = 1), adjudicator (n = 1), consultant (n = 1) and a manager (n = 1)	Number of employees per organisation ranged from 12 to 75000 in the private sector (n = 2), and 3000 to 3200 in the public sector (n = 2). Total of 75 employees in one non-profit organisation	Mild to moderate TBI	Post-injury RTW and work retention
Soeker, 2019 [64] South Africa	To explore perceptions and experiences of employers and caregivers of individuals with TBI RTW after completing a VR program based on the Model of Occupational Self-Efficacy (Moose)	Exploratory qualitative study Semi-structured interviews	Four-stage VR intervention. Involved reflective processes, enhancement of individual capabilities, work simulation, and RTW for ≥4 months	N = 10 Gender, age and race/ethnicity not reported	Junior supervisor (n = 1), senior supervisor (n = 1), floor manager (n = 4), general manager (n = 2), manager (no other details reported) (n = 1), business owner (n = 1)	Food outlets (n = 6), a local beverage factory, a security company and a non-governmental organisation	Mild to moderate TBI	Post-injury RTW (linked to a VR intervention)
St-Arnaud, 2011 [52] Canada	To define the paradigms and practices of workplace stakeholders involved in managing and following up RTW of employees following sickness absence due to mental illness	Qualitative study Semi-structured interviews	Not applicable	N = 24 Gender, age and race/ethnicity not reported	Senior managers (n = 7): Responsibilities included surveying workforce in relation to organisational climate, and producing and disseminating absence statistical information Direct supervisors (n = 10): Responsibilities included supporting staff, and preventing and managing staff absence OH officers (n = 7): Responsibilities included medical and administrative follow-up of employees who received disability insurance, ensuring adequacy of treatment plans, and reviewing scheduled RTW dates	Participants recruited from 7 out of 11 departments in one workplace. This workplace had an in-house OH department	Mental illness	RTW due to mental illness
Thisted, 2020 [61] Denmark	To investigate employers’ attitudes for management of employees’ depression, with focus on the employers’ challenges and opportunities in providing support	Qualitative study Semi-structured interviews	Not applicable	N = 5 Male: n = 1 Female: n = 4 Age range (years): 45–72 Race/ethnicity not reported	Management positions, all with more than 5 years leadership experience	Private psychological care clinic (n = 1), and public sector organisations based in education (n = 2), healthcare (n = 1), and the social sector (n = 1) Organisations were small- (< 50 employees; n = 2) or medium- sized (50–250 employees; n = 3)	Depression	General management and support for employees with mental illness to cope with their condition within the workplace
Tjulin, 2010 [47] Sweden	To explore experiences of workplace actors’ social relations, and how work-based organisational dynamics in RTW extend before and after initial return of sick-listed employees	Grounded theory Interviews	Not applicable	N = 8 Male: n = 1 Female: n = 7 Age and race/ethnicity not reported	Supervisors (n = 6), HR managers (n = 2)	Seven work units within three public sector organisations	Of the 7 employees, four had been diagnosed with mental illnesses (two had co-morbid physical conditions); three others had musculoskeletal issues	RTW after illness (with sick leave lasting at least 1 month)