Background and aim <p>Increasing numbers of people are unable to work due to mental illness and this is an increasing problem on both a personal and societal level. In Germany, a workplace integration management system (BEM) has been legally required since 2004 to support return to work (RTW). However, its uptake and success, especially regarding mental illnesses, is still unclear. This study was conducted to identify the current state of RTW after episodes of mental illnesses from the perspective of workplace integration managers and explore potential barriers and facilitators that influence the course and outcome of the BEM process.</p> Methods <p>Semi-structured interviews with BEM managers (<i>N</i> = 14) from the greater Munich area were performed and analyzed using Thematic Analysis.</p> Results <p>In their work, BEM managers tend to find themselves in a field of tension between the personal concerns of returning employees and the employer’s business interests. They experience mistrust and lack of openness on the part of the returnees, while employers show little willingness to fully invest in the process. Lack of or incorrect information about BEM and on mental illness seems to promote these disruptive factors, as well as others.</p> Conclusion <p>Broad education on BEM appears to be a promising means to reduce fear among returnees and to better reach the processes potential. In addition, a more open approach to mental illness could simplify the process for all involved.</p>