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The importance of employment in recovery from mental health illness has led to broad recognition of the integration of employment-oriented support into mental health treatment. However, there is variation in the extent to which an employment orientation permeates healthcare services. This article explores how managers and advisors in health and welfare services in Norway function as “change agents”, who work to increase an employment orientation in mental health services.

The empirical material consists of 20 interviews with change agents in health and welfare organisations. They work to implement a model – individual placement and support – to integrate an employment orientation in healthcare services. The findings are analysed using the framework of “institutional work” to elucidate the strategies used by change agents.

The findings underscore a consensus on the health advantages of employment and that employment-oriented support belongs in mental health treatment. However, this concept requires further cultivation within healthcare services, with individual actors playing a key role as change agents. Depending on the stage of the various organisations in the change process and the actors’ positions within the institutional context, the actors engaged in both creative and maintenance institutional work.

The article´s findings are significant for how health organisations can work to achieve desired changes.

This article contributes to the literature on collaboration and implementation of employment-oriented practices in healthcare by directing attention to the dynamics of organisational change processes and the efforts of individual actors to promote change.

The purpose of this paper is to investigate line managers’ influence on employee usage of a web-based system for occupational health management.

Questionnaires were used to measure line managers’ transformational leadership at baseline and their change-supportive managerial activities during weeks 16–52. Employee initial (weeks 16–52) and sustained (weeks 53–144) use of the web-based system was measured by extracting their frequency of logins to the system from electronic records. Data were collected from six white-collar organizations from 2011 through 2013. Mixed Poisson regressions were used to analyze the influence of transformational leadership and change-supportive managerial activities on employee usage.

As predicted, line managers’ change-supportive activities influenced the employees’ initial and sustained use of the system. Line managers’ transformational leadership had no direct effect on employees’ use of the system, however transformational leadership was indirectly associated with employees’ initial and sustained use of the system through line managers’ change-supportive activities.

The study adds to the understanding of the role line managers’ play during the implementation of occupational health interventions. The findings suggest that the line managers’ change-supportive activities directed toward the intervention are important for employees’ initial and sustained use of the system. The influence of transformational leadership was indirect, suggesting that line managers may need to direct their leadership behaviors toward the intervention to facilitate implementation.