A cluster RCT to improve workplace mental health in a policing context: Findings of a mixed-methods implementation evaluation

A Framework for Protecting and Promoting Employee Mental Health through Supervisor Supportive Behaviors

The attention to workplace mental health is timely given extreme levels of burnout, anxiety, depression and trauma experienced by workers due to serious extraorganizational stressors - the COVID-19 pandemic, threats to climate change, and extreme social and political unrest. Workplace-based risk factors, such as high stress and low support, are contributing factors to poor mental health and suicidality (Choi, 2018; Milner et al., 2013, 2018), just as low levels of social connectedness and belonging are established risk factors for poor mental health (Joiner et al., 2009), suggesting that social support at work (e.g., from supervisors) may be a key approach to protecting and promoting employee mental health. Social connections provide numerous benefits for health outcomes and are as, or more, important to mortality as other well-known health behaviors such as smoking and alcohol consumption (Holt-Lundstad et al., 2015), and can serve as a resource or buffer against the deleterious effects of stress or strain on psychological health (Cohen & Wills, 1985). This manuscript provides an evidence-based framework for understanding how supervisor supportive behaviors can serve to protect employees against psychosocial workplace risk factors and promote social connection and belongingness protective factors related to employee mental health. We identify six theoretically-based Mental Health Supportive Supervisor Behaviors (MHSSB; i.e., emotional support, practical support, role modeling, reducing stigma, warning sign recognition, warning sign response) that can be enacted and used by supervisors and managers to protect and promote the mental health of employees. A brief overview of mental health, mental disorders, and workplace mental health is provided. This is followed by the theoretical grounding and introduction of MHSSB. Suggestions for future research and practice follow, all with the focus of developing a better understanding of the role of supervisors in protecting and promoting employee mental health in the workplace.

Child and adolescent mental health services in a devolved healthcare system: a qualitative exploration of sustainable practices

BACKGROUND

The transference of research evidence into routine healthcare practice remains poorly understood. This includes understanding the prerequisites of longer-term viability. The present study investigated the sustainable practices of GM i-THRIVE, a programme which reconceptualizes mental health services for children and young people (CYP) in Greater Manchester, United Kingdom. We aimed to establish whether a sustainable future was likely, and to identify areas of focus to improve that likelihood.

METHODS

The NHS Sustainability Model, typically completed as a questionnaire measure, was converted into interview questions. The responses of nine professionals, from a variety of roles across the CYP mental health workforce, were explored using inductive thematic framework analysis. Selected participants completed the original questionnaire.

RESULTS

Five themes (communication; support; barriers to implementation; past, present, and future: the implementation journey; and the nuances of GM i-THRIVE) and 21 subthemes formed the final thematic framework. Relationships with senior leaders and with colleagues across the workforce were seen as important. Leaders' roles in providing meaning and fit were emphasized. Whilst training delivered the programme's aims well, monitoring its dissemination was challenging. Widespread issues with dedicating sufficient time to implementation were raised. The flexibility of the programme, which can be applied in multiple ways, was discussed positively. This flexibility links to the idea of GM i-THRIVE as a mindset change, and the uniqueness of this style of intervention was discussed. To varying degrees, themes were supported by responses to the quantitative measure, although several limitations to the use of the questionnaire were discovered. Consequently, they were used to infer conclusions to a lesser degree than originally intended.

CONCLUSIONS

Professionals involved with GM i-THRIVE reported many elements that indicate a positive future for the programme. However, they suggested that more attention should be given to embedding the core concepts of the model at the current stage of implementation. Limitations relating to its use within our study are discussed, but we conclude that the NHS Sustainability Model is a suitable way of guiding qualitative implementation research. It is especially valuable for localized interventions. The constraints of our small sample size on transferability are considered.