Individuals with chronic diseases and mental disorders often experience work-related problems, such as unemployment, absenteeism, reduced productivity and stigmatization in the workplace, leading to negative consequences at individual, national and European level. The rising prevalence of chronic diseases and mental disorders as well as the current economic crisis make this issue even more problematic, requiring action in terms of innovative strategies to improve the participation of these persons in the labor market. Unfortunately, this is hindered by a lack of knowledge of which strategies are available in the different European countries and their effectiveness, and a lack of clarity regarding the employment-related needs of these individuals, leading to gaps between what is offered and what is needed. Therefore, PATHWAYS aims a) to identify integration and re-integration strategies that are available in Europe and beyond, b) to determine their effectiveness, c) to assess the specific employment-related needs of persons with chronic diseases and mental disorders and d) to develop guidelines supporting the implementation of effective professional integration and reintegration strategies. Involvement in PATHWAYS of 12 partners with vast expertise in the area of chronic and mental conditions and employment from 10 different European countries allows to compare strategies between different European regions, taking into account cultural, social, and political differences. Stakeholder consultations, including advocacy organizations, employers, policy makers, international organizations, and European Union delegates, will provide useful insights as to the development and implementation of policy recommendations to improve their integration or reintegration into the workplace. In this way, PATHWAYS will provide the first steps to work towards a more inclusive labor market in which persons with chronic diseases and mental disorders can meaningfully participate.

Chronic diseases and mental health issues can often lead individuals to experience a series of work-related problems, resulting in negative consequences at individual, national and European level. The rising prevalence of persons with chronic diseases (PwCDs) and mental disorders as well as the current economic crisis magnify the issue, requiring action in terms of innovative strategies to improve the participation of these persons in the labour market.
These findings are intended for governing bodies, organizations, policy makers, employers, service providers, patients’ organizations and all relevant stakeholders involved with the reintegration in work process.
The response of EU to this need for knowledge on chronic diseases and employment is provided by PATHWAYS (12 EU countries, 10 multidisciplinary partners)
PATHWAYS proposed policy recommendations provide meaningful guidelines for both national and European policy makers and stakeholders to prioritize the development and implementation of strategies and to establish a more inclusive labour market for all. “European strategies for integration and re-integration to work for persons with chronic conditions.
Report on available evidence on effectiveness”, available on: https://www.path-ways.eu/wp content/uploads/pathways_report_evaluate.pdf

Mapping of strategies for professional (re-)integration of PwCDs, including mental health conditions, available at both European and national levels. Strategies considered include strategies at the level of policies, systems, and services;
Evaluation of the effectiveness of strategies – including policies, systems and services – targeting professional integration and reintegration of people with chronic diseases in Europe;
Assess specific employment related needs of persons with chronic diseases and mental health issue by conducting a needs assessment study;
Develop policy recommendations focusing on the implementation of strategies for the labour market.

Stakeholders analysis was performed; stakeholders from 10 EU countries were grouped in different categories: international, national, political, commercial/private, public, non-governmental organization (NGO)/civil society, labour, users/consumers and scientific societies. Also European global organizations were listed.
Evaluation plan was defined and an evaluation questionnaire was created and circulated every three months to all the partners of the Consortium.
A systematic review on the existing strategies available in Europe was performed and quantitative and qualitative data were collected at national level through questionnaires and in depth interviews with relevant stakeholders
A structured database on effectiveness of the extracted information was created.
A Questionnaire to explore the employment needs of people with chronic conditions was developed and distributed to patients through relevant advocacy groups identified in each country.
Data from the WHO burden of disease was used to decide which diseases to use. In order to identify relevant contents to include at the questionnaire on employment needs, a systematic mapping of the literature was performed.
Policy recommendations and corresponding actions for the implementation of inclusive strategies were developed (https://www.path-ways.eu)

Raise awareness of the role of employment for persons with chronic diseases.
Strengthen EU-level policies that promote inclusive labour markets for all.
Ensure adequate National legislation that promotes inclusive labour markets for all.
Develop and monitor strategic approaches and directions that promote inclusive labour markets for all.
Develop and monitor measures that promote inclusive labour markets for all.
Promote research on effective and innovative inclusion and reintegration strategies and use the available evidence for developing solutions for employment for all.

Good knowledge of EU praxis on employment of PwCDs, including mental conditions, highlighting potential differences and common features and creation of a harmonised and clear description of the actual situation.
Enhanced knowledge of the effectiveness and the feasibility of existing integration and re-integration into work strategies for persons with chronic conditions.
In-depth knowledge of employment needs of PwCDs and of the needs covered by the existing integration and reintegration strategies and of the unmet needs of PwCDs including mental conditions.
Development of policy recommendations supporting the implementation of strategies to improve the employment situation of PwCDs and to fill the unmet needs of people with chronic illness and mental disorders.
Policy recommendations and the 34 corresponding actions designed by engaging stakeholder and patients perspective provide : (a) are evidence-based and originate from PATHWAYS ; (b) include a number of empirically-based actions; (c) are categorized and presented based on the level of action that has to be considered in their implementation process (policy, system, service); and (e) are linked to one or more examples of good practice(s) implemented in different European countries and beyond. PATHWAYS findings are intended for governing bodies, organizations, policy makers, employers, service providers, patients’ organizations and all relevant stakeholders involved with the reintegration in work process. Policy recommendations provide meaningful guidelines for both national and EU policy makers and stakeholders to prioritize the development and implementation of strategies and to establish a more inclusive labour market for all.

The Dissemination strategy of the PATHWAYS project was mainly focused on giving presentations about the project to inform the scientific community and the relevant identified stakeholders, but also to disseminate results and raise awareness among the general public. Besides several oral presentations and leaflets distribution at regular scientific meetings and events organized by relevant medical centers (focusing on vocational rehabilitation and disabilities), a Final Conference “EMPLOYMENT & CHRONIC DISEASES: NEW PATHWAYS IN EUROPE International Conference”, took place in March 2018 at the European Parliament and presented the results and policy recommendations to support employment of people with chronic diseases.
The dissemination activities have led to a better interaction among identified stakeholders and a better awareness in terms of political and social interventions at EU level in relation to the subject of the project: the reintegration of people suffering from disabilities and chronic diseases into the labour market. The activities also provided extensive visibility making the project outputs and deliverables available to the relevant European and international stakeholders, (advocacy groups, labour organizations, government, and other interested parties, including the EC).