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Hallett N, Rees H, Hannah F, Hollowood L, Bradbury-Jones C. Workplace interventions to prevent suicide: A scoping review. PLoS One 2024; 19:e0301453. [PMID: 38696511 PMCID: PMC11065308 DOI: 10.1371/journal.pone.0301453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/17/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVES To map organisational interventions for workplace suicide prevention, identifying the effects, mechanisms, moderators, implementation and economic costs, and how interventions are evaluated. BACKGROUND Suicide is a devastating event that can have a profound and lasting impact on the individuals and families affected, with the highest rates found among adults of work age. Employers have a legal and ethical responsibility to provide a safe working environment for their employees, which includes addressing the issue of suicide and promoting mental health and well-being. METHODS A realist perspective was taken, to identify within organisational suicide prevention interventions, what works, for whom and in what circumstances. Published and unpublished studies in six databases were searched. To extract and map data on the interventions the Effect, Mechanism, Moderator, Implementation, Economic (EMMIE) framework was used. Mechanisms were deductively analysed against Bronfenbrenner's socio-ecological model. RESULTS From 3187 records screened, 46 papers describing 36 interventions within the military, healthcare, the construction industry, emergency services, office workers, veterinary surgeons, the energy sector and higher education. Most mechanisms were aimed at the individual's immediate environment, with the most common being education or training on recognising signs of stress, suicidality or mental illness in oneself. Studies examined the effectiveness of interventions in terms of suicide rates, suicidality or symptoms of mental illness, and changes in perceptions, attitudes or beliefs, with most reporting positive results. Few studies reported economic costs but those that did suggested that the interventions are cost-effective. CONCLUSIONS It seems likely that organisational suicide prevention programmes can have a positive impact on attitudes and beliefs towards suicide as well reducing the risk of suicide. Education, to support individuals to recognise the signs and symptoms of stress, mental ill health and suicidality in both themselves and others, is likely to be an effective starting point for successful interventions.
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Affiliation(s)
- Nutmeg Hallett
- School of Nursing and Midwifery, University of Birmingham, Birmingham, United Kingdom
| | - Helen Rees
- Health and Allied Professionals, Nottingham Trent University, Nottingham, United Kingdom
| | - Felicity Hannah
- Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Lorna Hollowood
- School of Nursing and Midwifery, University of Birmingham, Birmingham, United Kingdom
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Joo MJ, Jang YS, Jang YS, Park EC. Association between work-related physical activity and depressive symptoms in Korean workers: data from the Korea national health and nutrition examination survey 2014, 2016, 2018, and 2020. BMC Public Health 2023; 23:1752. [PMID: 37684616 PMCID: PMC10485943 DOI: 10.1186/s12889-023-16631-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND The workplace experiences of employees can impact their mental health. Depressive symptoms, which are experienced by workers, are a mental health issue that deserves attention. Several studies have evaluated physical activity to prevent possible depression in workers in a work environment, however, research on physical activity and depression symptoms directly related to work is still insufficient. Therefore, we aimed to identify the relationship between work-related physical activity and depression among South Korean workers. METHODS We used data from the Korean National Health and Nutrition Examination Survey conducted in 2014, 2016, 2018, and 2020, which included 31,051 participants. We excluded, participants aged < 15 years (n = 4,663), unemployed and economically inactive persons (n = 9,793), those who did not engage in work-related physical activities (n = 1,513) and leisure physical activities (n = 1,558), or those with missing data (n = 450). Therefore, the study included 13,074 participants. Work-related activity was measured by self-reporting, while depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). Multiple logistic regression analysis was performed to investigate the association between work-related physical symptoms and depressive symptoms among workers. RESULTS Individuals who engaged in work-related physical activity had higher PHQ-9 scores than those who did not (male: odds ratio [OR]: 1.71, 95% confidence interval [CI]: 1.16-2.52; female: OR: 2.33, 95% CI: 1.66-3.29). High-intensity work-related physical activity significantly increased depressive symptoms (male: OR: 2.15, 95% CI: 1.04-4.43; female: OR: 2.90, 95% CI: 1.46-5.96). When classified according to the severity of depressive symptom, the OR of depressive symptoms of workers engaged in both leisure and work-related physical activities tended to be lower than that of those engaged only in work-related physical activities. CONCLUSION Korean workers who engaged in work-related physical activities exhibited more depressive symptoms. Therefore, our findings suggest that balancing work-related and leisure physical activities can help Korean workers prevent development of depressive symptoms.
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Affiliation(s)
- Min Jeong Joo
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Ye Seul Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Yun Seo Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
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Dai T, Wang J, Gan G, zhang C, Dong X, Yang P, Wang Y, Xie J, Xiao R, Duan Y. The moderating role of physical activity on the relationship between work intensity and depressive symptoms among the employees. SSM Popul Health 2023; 23:101435. [PMID: 37252289 PMCID: PMC10220476 DOI: 10.1016/j.ssmph.2023.101435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 05/31/2023] Open
Abstract
Our aim was to examine the associations between work intensity and depressive symptoms among the working population, as well as to identify the impact of physical activity (PA) on these relationships. Spearman correlation analysis was conducted to analyze the correlations among work intensity, PA, and depressive symptoms. Working hours and working days were positively correlated with depressive symptoms (r = 0.108, 0.063; all p values were <0.001). Regular PA, exercise time, exercise frequency, and exercise years were negatively correlated with depressive symptoms (r = -0.121, -0.124, -0.152, -0.149; all p values were <0.001) and working days (r = -0.066, -0.050, -0.069, -0.044; all p values were <0.001), working hours (r = -0.113. -0.106, -0.161, -0.123; all p values were <0.001). Working days was positively correlated with working hours (r = 0.512, p < 0.001). Different levels of PA alleviated the effect of working hours or working days on depressive symptoms. Working hours seemed to be more correlated with depressive symptoms than working days. The results suggest that PA at any level could buffer against the effects of work intensity and might prove a helpful strategy for improving mental health issues among employees.
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Affiliation(s)
- Ting Dai
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, 410013, China
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, 410013, China
| | - Jiangang Wang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, 410013, China
| | - Gang Gan
- Xiangya Nursing School, Central South University, Changsha, 410017, China
| | - Chun zhang
- Xiangya Nursing School, Central South University, Changsha, 410017, China
| | - Xiaoqian Dong
- Xiangya Nursing School, Central South University, Changsha, 410017, China
| | - Pingting Yang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, 410013, China
| | - Yaqin Wang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, 410013, China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, 410013, China
| | - Rui Xiao
- Hospital Management Office, The Third Xiangya Hospital of Central South University, Changsha, 410013, China
| | - Yinglong Duan
- Emergency Department, The Third Xiangya Hospital of Central South University, Changsha, 410013, China
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Taylor RW, Male R, Economides M, Bolton H, Cavanagh K. Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial. JMIR Form Res 2023; 7:e41590. [PMID: 37327027 DOI: 10.2196/41590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/02/2023] [Accepted: 04/14/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Depressive symptoms are highly prevalent and have broad-ranging negative implications. Digital interventions are increasingly available in the workplace context, but supporting evidence is limited. OBJECTIVE This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of 3 digital interventions for depressive symptoms in a sample of UK-based working adults experiencing mild to moderate symptoms. METHODS This was a parallel, multiarm, pilot randomized controlled trial. Participants were allocated to 1 of 3 digital interventions or a waitlist control group and had 3 weeks to complete 6 to 8 short self-guided sessions. The 3 interventions are available on the Unmind mental health app for working adults and draw on behavioral activation, cognitive behavioral therapy, and acceptance and commitment therapy. Web-based assessments were conducted at baseline, postintervention (week 3), and at 1-month follow-up (week 7). Participants were recruited via Prolific, a web-based recruitment platform, and the study was conducted entirely on the web. Feasibility and acceptability were assessed using objective engagement data and self-reported feedback. Efficacy outcomes were assessed using validated self-report measures of mental health and functioning and linear mixed models with intention-to-treat principles. RESULTS In total, 2003 individuals were screened for participation, of which 20.22% (405/2003) were randomized. A total of 92% (373/405) of the participants were retained in the study, 97.4% (295/303) initiated their allocated intervention, and 66.3% (201/303) completed all sessions. Moreover, 80.6% (229/284) of the participants rated the quality of their allocated intervention as excellent or good, and 79.6% (226/284) of the participants were satisfied or very satisfied with their intervention. All active groups showed improvements in well-being, functioning, and depressive and anxiety symptoms compared with the control group, which were maintained at 4 weeks. Hedges g effect sizes for depressive symptoms ranged from -0.53 (95% CI -0.25 to -0.81) to -0.74 (95% CI -0.45 to -1.03). CONCLUSIONS All interventions were feasible and acceptable, and the preliminary efficacy findings indicated that their use may improve depressive symptoms, well-being, and functioning. The predefined criteria for a definitive trial were met. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN13067492; https://www.isrctn.com/ISRCTN13067492.
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Rapisarda F, Bergeron N, Dufour MM, Guay S, Geoffrion S. Longitudinal assessment and determinants of short-term and longer-term psychological distress in a sample of healthcare workers during the COVID-19 pandemic in Quebec, Canada. Front Psychiatry 2023; 14:1112184. [PMID: 37275978 PMCID: PMC10232907 DOI: 10.3389/fpsyt.2023.1112184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/27/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Previous research has demonstrated the negative impact of the COVID-19 pandemic emergency on the wellbeing of healthcare workers. However, few research contributions reported a longitudinal evaluation of psychological distress and examined determinants of its duration and course over time. The present study aims to explore the impact of the pandemic emergency on HCWs mental health by adopting a longitudinal design and assessing mental health as combination of overlapping clinical symptoms (post-traumatic stress disorder, depression and anxiety). Methods Data were collected weekly through a mobile application during and after the first wave of COVID-19 in the province of Quebec, Canada, in 2020. Analysis was conducted on a final sample of 382 participants. Participants were grouped into "resilient" (RES) if they did not manifest clinical-level psychological distress during monitoring, "short-term distress" (STD) if distress exceeded the clinical threshold for 1-3 weeks, and longer-term distress (LTD) if it occurred for four or more weeks, even if not consecutively. Descriptive statistics for all variables were computed for each subgroup (RES, STD and LTD), and pairwise comparisons between each group for every descriptive variable were made using chi square statistics for categorical variables and t-test for continuous variables. Predictors of distress groups (STD and LTD vs RES) were assessed running multinomial hierarchical logistic regression models. Results In our sample, almost two third (59.4%) HCWs did not manifest moderate or severe distress during the monitoring time. Short-term distress, mostly post-traumatic symptoms that lasted for less than 4 weeks, were the most common distress response, affecting almost one third of participants. Longer psychological distress occurred only in a smaller percentage (12.6%) of cases, as a combination of severe posttraumatic, depressive and anxiety symptoms. Perceived occupational stress was the most significant risk factor; moreover individual, peritraumatic work and family risk and protective factors, were likely to significantly affect the stress response. Discussion Results tend to provide a more complex and resiliency-oriented representation of psychological distress compared to previous cross-sectional studies, but are in line with stress response studies. Findings allow us to better describe the profiles of distress response in STD and LTD groups. Participants that manifest short term distress experience acute stress reaction in which the interplay between personal, family and professional life events is associated with the stress response. Conversely, longer term distress response in HCWs presents a more complex mental health condition with an higher level of impairment and support needs compared to participants with short-term distress.
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Affiliation(s)
- Filippo Rapisarda
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
| | - Nicolas Bergeron
- Département de psychiatrie et d'addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Marie-Michèle Dufour
- École de psychoéducation, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Guay
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
- Département de psychiatrie et d'addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- École de criminologie, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
| | - Steve Geoffrion
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
- École de psychoéducation, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
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Hogg B, Moreno-Alcázar A, Tóth MD, Serbanescu I, Aust B, Leduc C, Paterson C, Tsantilla F, Abdulla K, Cerga-Pashoja A, Cresswell-Smith J, Fanaj N, Meksi A, Ni Dhalaigh D, Reich H, Ross V, Sanches S, Thomson K, Van Audenhove C, Pérez V, Arensman E, Purebl G, Amann BL. Supporting employees with mental illness and reducing mental illness-related stigma in the workplace: an expert survey. Eur Arch Psychiatry Clin Neurosci 2023; 273:739-753. [PMID: 35867155 PMCID: PMC9305029 DOI: 10.1007/s00406-022-01443-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/29/2022] [Indexed: 11/28/2022]
Abstract
An expert survey was designed to support the development of a workplace-based multi-country intervention tackling depression, anxiety, and mental illness-related stigma in small- and medium-sized enterprises (SMEs). Academic experts and representatives of SME organisations, specific sector organisations, labour or advocacy groups, and occupational health organisations, were contacted across eight European countries and Australia. The survey comprised closed and open text questions to assess expert opinion about interventions for employees with mental health difficulties, interventions supporting their managers, and anti-stigma interventions. The survey was available in six languages. The online platform Qualtrics was used for data collection. Quantitative data was analysed through descriptive statistics and qualitative data was analysed through thematic analysis. Sixty-five of 146 experts responded, representing a 42% response rate. Results showed only 26.2% of experts agreed that employees could speak openly about mental health issues, and 81.5% of experts indicated a large or medium unmet need for support for employees with mental health issues. Psychoeducational materials, face-to-face workshops and interventions based on cognitive behavioural therapy were ranked most likely to be taken up by employees. Experts rated as most useful for managers' guidelines on how to act if an employee has mental health issues (67.7%). The greatest number of experts indicated workshops of people with lived experience of mental illness (80.0%) and awareness campaigns (78.5%) were most required to tackle stigma. Responses were consistent between experts from different countries and areas of expertise. Experts in this multinational survey assessed that interventions supporting mental health in the workplace and tackling stigma are greatly needed. A multicomponent intervention with a wide range of materials and tools is supported.
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Affiliation(s)
- Bridget Hogg
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Programme, Dept. of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Semmelweis Egyetem Magatartástudományi Intézet, Budapest, Hungary
| | - Ilinca Serbanescu
- Faculty of Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Charlotte Paterson
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, Scotland
| | - Fotini Tsantilla
- LUCAS, Center for Care Research and Consultancy, Faculty of Medicine, KU Leuven, Louvain, Belgium
| | - Kahar Abdulla
- European Alliance Against Depression E.V, Leipzig, Germany
| | - Arlinda Cerga-Pashoja
- Population Health, London School of Hygiene and Tropical Medicine, London, England
- Global Public Health, Public Health England, Greenwich, UK
| | | | | | | | | | - Hanna Reich
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany
- German Depression Foundation, Leipzig, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Qld, Australia
| | - Sarita Sanches
- Phrenos Center of Expertise for Severe Mental Illness, Utrecht, the Netherlands
| | - Katherine Thomson
- International Association for Suicide Prevention (IASP), Washington, DC, USA
| | - Chantal Van Audenhove
- LUCAS, Center for Care Research and Consultancy, Faculty of Medicine, KU Leuven, Louvain, Belgium
| | - Victor Pérez
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Dept. of Psychiatry and Forensic Medicine, Pompeu Fabra University, Barcelona, Spain
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Qld, Australia
- International Association for Suicide Prevention (IASP), Washington, DC, USA
| | - Gyorgy Purebl
- Institute of Behavioural Sciences, Semmelweis University, Semmelweis Egyetem Magatartástudományi Intézet, Budapest, Hungary.
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Dept. of Psychiatry and Forensic Medicine, Pompeu Fabra University, Barcelona, Spain
- Dept. of Psychiatry and Psychotherapy, Ludwig Maximilian University Hospital Munich, Nussbaumstraße 7, Munich, Germany
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Miguel C, Amarnath A, Akhtar A, Malik A, Baranyi G, Barbui C, Karyotaki E, Cuijpers P. Universal, selective and indicated interventions for supporting mental health at the workplace: an umbrella review of meta-analyses. Occup Environ Med 2023; 80:225-236. [PMID: 36828633 PMCID: PMC10086469 DOI: 10.1136/oemed-2022-108698] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/19/2023] [Indexed: 02/26/2023]
Abstract
The current umbrella review aimed to assess and summarise evidence on universal, selective and indicated interventions for mental health at the workplace. This umbrella review forms one of the evidence reviews which were commissioned by the WHO to develop global guidelines on mental health at work. We conducted systematic searches in five bibliographic databases (PubMed, Embase, PsycINFO, Cochrane and Global Medicus Index) and included meta-analyses of randomised trials examining psychosocial, physical activity and lifestyle interventions delivered to all general workers (universal interventions), at-risk workers (selective interventions) and workers already experiencing symptoms of mental disorders (indicated interventions). We included outcomes from seven domains: symptoms of mental health conditions, positive mental health, quality of life, work-related outcomes, substance use, suicide-related outcomes and potential adverse effects. We identified 16 meta-analyses producing 66 pooled effect sizes of the examined interventions, mostly on symptoms of mental health conditions (n=43 pooled effect sizes) (eg, burnout, insomnia, stress) and positive mental health (n=15) (eg, well-being). Most of the evidence on universal, selective and indicated interventions was focused on psychosocial interventions, showing small to moderate effects across the various outcomes. Certainty levels according to GRADE (Grading of Recommendations Assessment, Development and Evaluation) were low to very low in almost all of the examined outcomes. The results of existing meta-analyses are promising for the use of preventative and early treatment interventions in the workplace. However, the quality and certainty of the evidence were very modest, and further research on the effectiveness of these interventions is warranted.
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Affiliation(s)
- Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Arpana Amarnath
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aemal Akhtar
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aiysha Malik
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Gergő Baranyi
- Society and Health, The University of Edinburgh, Edinburgh, UK
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Armaou M, Araviaki E, Dutta S, Konstantinidis S, Blake H. Effectiveness of Digital Interventions for Deficit-Oriented and Asset-Oriented Psychological Outcomes in the Workplace: A Systematic Review and Narrative Synthesis. Eur J Investig Health Psychol Educ 2022; 12:1471-1497. [PMID: 36286087 PMCID: PMC9601105 DOI: 10.3390/ejihpe12100102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Digital psychological interventions can target deficit-oriented and asset-oriented psychological outcomes in the workplace. This review examined: (a) the effectiveness of digital interventions for psychological well-being at work, (b) associations with workplace outcomes, and (c) associations between interventions' effectiveness and their theory-base. METHODS six electronic databases were searched for randomised controlled trials (RCT) and quasi-experimental studies. The methodological quality of studies that used randomisation was conducted with the "Cochrane Collaboration's Risk of Bias" tool, while the "JBI Critical Appraisal Checklist" was used for non-randomised studies. Studies' theory-base was evaluated using an adaptation of the "theory coding scheme" (TSC). Due to heterogeneity, narrative synthesis was performed. RESULTS 51 studies were included in a synthesis describing four clusters of digital interventions: (a) cognitive behavioural therapy, (b) stress-management interventions and workplace well-being promotion, (c) meditation training and mindfulness-based interventions, and (d) self-help interventions. Studies demonstrated a high risk of contamination effects and high attrition bias. Theory-informed interventions demonstrated greater effectiveness. Cognitive behavioural therapy demonstrated the most robust evidence for reducing depression symptoms among healthy employees. With the exception of the Headspace application, there was weak evidence for meditation training apps, while relaxation training was a key component of effective stress-management interventions.
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Affiliation(s)
- Maria Armaou
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
| | | | - Snigdha Dutta
- Cambridge Centre for Teaching and Learning, University of Cambridge, Cambridge CB2 3PT, UK
| | | | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
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Evans R, Bell S, Brockman R, Campbell R, Copeland L, Fisher H, Ford T, Harding S, Powell J, Turner N, Kidger J. Wellbeing in Secondary Education (WISE) Study to Improve the Mental Health and Wellbeing of Teachers: A Complex System Approach to Understanding Intervention Acceptability. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:922-933. [PMID: 35305231 PMCID: PMC9343291 DOI: 10.1007/s11121-022-01351-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2022] [Indexed: 11/27/2022]
Abstract
Teaching staff report poorer mental health and wellbeing than the general working population. Intervention to address this issue is imperative, as poor wellbeing is associated with burnout, presenteeism, and adverse student mental health outcomes. The Wellbeing in Secondary Education (WISE) intervention is a secondary school-based programme aimed at improving the mental health and wellbeing of teachers and students. There are three components: awareness-raising for staff; a peer support service delivered by staff trained in Mental Health First Aid (MHFA); and Schools and Colleges Mental Health First Aid (MHFA) training for teachers. A cluster randomised controlled trial with integrated process and economic evaluation was conducted with 25 secondary schools in the UK (2016-2018). The intervention was largely ineffective in improving teacher mental health and wellbeing. This paper reports process evaluation data on acceptability to help understand this outcome. It adopts a complex systems perspective, exploring how acceptability is a dynamic and contextually contingent concept. Data sources were as follows: interviews with funders (n = 3); interviews with MHFA trainers (n = 6); focus groups with peer supporters (n = 8); interviews with headteachers (n = 12); and focus groups with teachers trained in Schools and Colleges MHFA (n = 7). Results indicated that WISE intervention components were largely acceptable. Initially, the school system was responsive, as it had reached a 'tipping point' and was prepared to address teacher mental health. However, as the intervention interacted with the complexities of the school context, acceptability became more ambiguous. The intervention was seen to be largely inadequate in addressing the structural determinants of teacher mental health and wellbeing (e.g. complex student and staff needs, workload, and system culture). Future teacher mental health interventions need to focus on coupling skills training and support with whole school elements that tackle the systemic drivers of the problem.
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Affiliation(s)
- Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales.
| | - Sarah Bell
- Bristol Medical School, University of Bristol, Bristol, England
| | - Rowan Brockman
- Bristol Medical School, University of Bristol, Bristol, England
| | - Rona Campbell
- Department of Population Health Sciences, University of Bristol, Bristol, England
| | - Lauren Copeland
- DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales
| | - Harriet Fisher
- Bristol Medical School, University of Bristol, Bristol, England
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Sarah Harding
- School for Policy Studies, University of Bristol, Bristol, England
| | - Jillian Powell
- School for Policy Studies, University of Bristol, Bristol, England
| | - Nicholas Turner
- Bristol Medical School, University of Bristol, Bristol, England
| | - Judi Kidger
- Bristol Medical School, University of Bristol, Bristol, England
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Herrman H, Patel V, Kieling C, Berk M, Buchweitz C, Cuijpers P, Furukawa TA, Kessler RC, Kohrt BA, Maj M, McGorry P, Reynolds CF, Weissman MM, Chibanda D, Dowrick C, Howard LM, Hoven CW, Knapp M, Mayberg HS, Penninx BWJH, Xiao S, Trivedi M, Uher R, Vijayakumar L, Wolpert M. Time for united action on depression: a Lancet-World Psychiatric Association Commission. Lancet 2022; 399:957-1022. [PMID: 35180424 DOI: 10.1016/s0140-6736(21)02141-3] [Citation(s) in RCA: 301] [Impact Index Per Article: 150.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Sangath, Goa, India; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Claudia Buchweitz
- Graduate Program in Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania L Vanvitelli, Naples, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Myrna M Weissman
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe; Centre for Global Mental Health, The London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Louise M Howard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christina W Hoven
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shuiyuan Xiao
- Central South University Xiangya School of Public Health, Changsha, China
| | - Madhukar Trivedi
- Peter O'Donnell Jr Brain Institute and the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Lakshmi Vijayakumar
- Sneha, Suicide Prevention Centre and Voluntary Health Services, Chennai, India
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11
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Psychische Erkrankungen. Public Health 2022. [DOI: 10.1016/b978-3-437-22262-7.00026-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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12
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Kidger J, Evans R, Bell S, Fisher H, Turner N, Hollingworth W, Harding S, Powell J, Brockman R, Copeland L, Araya R, Campbell R, Ford T, Gunnell D, Morris R, Murphy S. Mental health support and training to improve secondary school teachers’ well-being: the WISE cluster RCT. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Health and Safety Executive data show that teachers are at heightened risk of mental health difficulties, yet few studies have attempted to address this. Poor teacher mental health may impact on the quality of support provided to young people, who also report increased mental health difficulties themselves.
Objective
To test the effectiveness of an intervention aiming to improve secondary school teachers’ well-being through mental health support and training.
Design
A cluster randomised controlled trial with embedded process and economic evaluations.
Setting
Twenty-five mainstream, non-fee-paying secondary schools in the south-west of England and South Wales, stratified by geographical area and free school meal entitlement, randomly allocated to intervention or control groups following collection of baseline measures (n = 12, intervention; n = 13, control) between May and July 2016.
Participants
All teachers in the study schools at any data collection. All students in year 8 (baseline) and year 10 (final follow-up).
Intervention
Each intervention school received three elements: (1) a 1-day mental health first aid for schools and colleges training session delivered to 8% of all teachers; (2) a 1-hour mental health session delivered to all teachers; and (3) 8% of staff trained in the 2-day standard mental health first aid training course set up a confidential peer support service for colleagues. Control schools continued with usual practice.
Main outcome measures
The primary outcome was teacher well-being (using the Warwick–Edinburgh Mental Wellbeing Scale). Secondary outcomes were teacher depression, absence and presenteeism, and student well-being, mental health difficulties, attendance and attainment. Follow-up was at 12 and 24 months. Data were analysed using intention-to-treat mixed-effects repeated-measures models.
Economic evaluation
A cost–consequence analysis to compare the incremental cost of the intervention against the outcomes measured in the main analysis.
Process evaluation
A mixed-methods study (i.e. qualitative focus groups and interviews, quantitative surveys, checklists and logs) to examine intervention implementation, activation of the mechanisms of change outlined in the logic model, intervention acceptability and the wider context.
Results
All 25 schools remained in the study. A total of 1722 teachers were included in the primary analysis. We found no difference in mean teacher well-being between study arms over the course of follow-up (adjusted mean difference –0.90, 95% confidence interval –2.07 to 0.27). There was also no difference in any of the secondary outcomes (p-values 0.203–0.964 in the fully adjusted models). The average cost of the intervention was £9103 (range £5378.97–12,026.73) per intervention school, with the average cost to Welsh schools being higher because of a different delivery model. The training components were delivered with high fidelity, although target dosage was sometimes missed. The peer support service was delivered with variable fidelity, and reported usage by teachers was low (5.9–6.1%). The intervention had high acceptability, but participants reported low support from senior leadership, and minimal impact on school culture.
Limitations
Participants and the study team were unblinded, self-report for the main outcome measures and inaccurate measurement of peer support service usage.
Conclusions
The Wellbeing in Secondary Education (WISE) intervention was not effective at improving teacher or student well-being, or reducing mental health difficulties, possibly because of contextual barriers preventing it becoming embedded in school life.
Future work
Identification of ways in which to achieve system-level change and sustained support from senior leaders is important for future school-based mental health interventions.
Trial registration
Current Controlled Trials ISRCTN95909211.
Funding
This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 12. See the NIHR Journals Library website for further project information. Intervention costs were met by Public Health Wales, Public Health England and Bristol City Council.
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Affiliation(s)
- Judi Kidger
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Rhiannon Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Sarah Bell
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Harriet Fisher
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Nicholas Turner
- Population Health Sciences, University of Bristol, Bristol, UK
- Bristol Randomised Trials Unit, University of Bristol, Bristol, UK
| | | | - Sarah Harding
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Jillian Powell
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Rowan Brockman
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Ricardo Araya
- Centre for Population Neuroscience and Precision Medicine, King’s College London, London, UK
| | - Rona Campbell
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - David Gunnell
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Richard Morris
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Simon Murphy
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
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13
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Primary prevention of depression: An umbrella review of controlled interventions. J Affect Disord 2021; 294:957-970. [PMID: 34375224 DOI: 10.1016/j.jad.2021.07.101] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Primary prevention has the potential to modify the course of depression, but the consistency and magnitude of this effect are currently undetermined. METHODS PRISMA and RIGHT compliant (PROSPERO:CRD42020179659) systematic meta-review, PubMed/Web of Science, up to June 2020. Meta-analyses of controlled interventions for the primary prevention of depressive symptoms [effect measures: standardized mean difference (SMD)] or depressive disorders [effect measure: relative risk (RR)] were carried out. Results were stratified by: (i) age range; (ii) target population (general and/or at-risk); (iii) intervention type. Quality (assessed with AMSTAR/AMSTAR-PLUS content) and credibility (graded as high/moderate/low) were assessed. USPSTF grading system was used for recommendations. RESULTS Forty-six meta-analyses (k=928 individual studies, n=286,429 individuals, mean age=22.4 years, 81.1% female) were included. Effect sizes were: SMD=0.08-0.53; for depressive symptoms; RR=0.90-0.28 for depressive disorders. Sensitivity analyses including only RCTs did not impact the findings. AMSTAR median=9 (IQR=8-9); AMSTAR-PLUS content median=4.25 (IQR=4-5). Credibility of the evidence was insufficient/low in 43 (93.5%) meta-analyses, moderate in two (4.3%), and high in one (2.2%): reduction of depressive symptoms using psychosocial interventions for young adults only, and a combination of psychological and educational interventions in primary care had moderate credibility; preventive administration of selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in individuals with a stroke had high credibility. LIMITATIONS Intervention heterogeneity and lack of long-term efficacy evaluation. CONCLUSIONS Primary preventive interventions for depression might be effective. Among them, clinicians may offer SSRIs post-stroke to prevent depressive disorders, and psychosocial interventions for children/adolescents/young adults with risk factors or during the prenatal/perinatal period.
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Hogg B, Medina JC, Gardoki-Souto I, Serbanescu I, Moreno-Alcázar A, Cerga-Pashoja A, Coppens E, Tóth MD, Fanaj N, Greiner BA, Holland C, Kõlves K, Maxwell M, Qirjako G, de Winter L, Hegerl U, Pérez-Sola V, Arensman E, Amann BL. Workplace interventions to reduce depression and anxiety in small and medium-sized enterprises: A systematic review. J Affect Disord 2021; 290:378-386. [PMID: 34082284 DOI: 10.1016/j.jad.2021.04.071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/14/2021] [Accepted: 04/25/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Depression and anxiety are the most prevalent mental health difficulties in the workplace, costing the global economy $1 trillion each year. Evidence indicates that symptoms may be reduced by interventions in the workplace. This paper is the first to systematically review psychosocial interventions for depression, anxiety, and suicidal ideation and behaviours in small-to medium-size enterprises (SMEs). METHODS A systematic search following PRISMA guidelines, registered in PROSPERO (CRD42020156275), was conducted for psychosocial interventions targeting depression, anxiety, and suicidal ideation/behaviour in SMEs. The PubMed, PsycINFO, Scopus, and two specific occupational health databases were searched, as well as four databases for grey literature, without time limit until 2nd December 2019. RESULTS In total, 1283 records were identified, 70 were retained for full-text screening, and seven met the inclusion criteria: three randomised controlled trials (RCTs), three before and after designs and one non-randomised trial, comprising 5111 participants. Study quality was low to moderate according to the Quality Assessment Tool for Quantitative Studies. Five studies showed a reduction in depression and anxiety symptoms using techniques based on cognitive behavioural therapy (CBT), two reported no significant change. LIMITATIONS Low number and high heterogeneity of interventions and outcomes, high attrition and lack of rigorous RCTs. CONCLUSIONS Preliminary evidence indicates CBT-based interventions can be effective in targeting symptoms of depression and anxiety in SME employees. There may be unique challenges to implementing programmes in SMEs. Further research is needed in this important area.
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Affiliation(s)
- Bridget Hogg
- Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; PhD Programme, Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Carles Medina
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Itxaso Gardoki-Souto
- Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; PhD Programme, Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ilinca Serbanescu
- European Alliance Against Depression e.V., Leipzig, Germany; Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBERSAM, Madrid, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Arlinda Cerga-Pashoja
- Population Health, London School of Hygiene and Tropical Medicine, London, England; Global Public Health, Public Health England, United Kingdom
| | - Evelien Coppens
- LUCAS, Centre for Care Research and Consultancy, University of Leuven, Belgium
| | - Mónika Ditta Tóth
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | | | - Birgit A Greiner
- School of Public Health, College of Medicine and Health, National Suicide Research Foundation, University College Cork, Ireland
| | - Carolyn Holland
- National Suicide Research Foundation, Cork, Ireland; Health Service Executive, Cork, Ireland
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, Griffith University
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Scotland, United Kingdom
| | - Gentiana Qirjako
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Lars de Winter
- Phrenos Center of Expertise for severe mental illness, Utrecht, the Netherlands
| | - Ulrich Hegerl
- European Alliance Against Depression e.V., Leipzig, Germany; Research Centre of the German Depression Foundation, Leipzig, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt, Frankfurt, Germany
| | - Victor Pérez-Sola
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBERSAM, Madrid, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Barcelona, Spain
| | - Ella Arensman
- School of Public Health, College of Medicine and Health, National Suicide Research Foundation, University College Cork, Ireland; National Suicide Research Foundation, Cork, Ireland; Australian Institute for Suicide Research and Prevention, Griffith University; International Association for Suicide Prevention (IASP), Washington DC, USA.
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBERSAM, Madrid, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Barcelona, Spain
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15
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Klasen SH, van Amelsvoort LG, Jansen NW, Slangen JJ, Tjin A Ton G, Kant IJ. Efficacy of an indicated prevention strategy on sickness absence and termination of the employment contract: a 5-year follow-up study. Scand J Work Environ Health 2021; 47:258-267. [PMID: 33410497 PMCID: PMC8091073 DOI: 10.5271/sjweh.3945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective: It was shown that an indicated prevention strategy (IPS), based on screening and early intervention, can considerably decrease future risk of long-term sickness absence (LTSA>28 days) over one year. Given the nature of the interventions, the potential of an effect extending beyond the original one year of follow-up might be present. This study aims to determine the efficacy of this IPS on LTSA and termination of employment contract over five years by extended follow up of IPS trials. Methods: Company records on sickness absence and termination of employment contract over five years were used from two randomized controlled trials (RCT) on the efficacy of the IPS (RCT I employees at high-risk for LTSA: intervention: N=263; RCT II high-risk employees with concurrent mild depressive complaints: intervention: N=139). Survival analysis was used to model time until the first LTSA episode and termination of employment contract. Results: RCT I showed a decrease of 43.2 days of sickness absence (P=0.05) and a lower 5-year risk of LTSA in the intervention, as compared to the control group [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.41–0.90], however no considerable impact on employment contract (HR 0.85, 95% CI 0.54–1.35) (intention-to-treat, ITT). For RCT II, we found no large difference in days of SA and no difference in LTSA risk over five years (HR 1.31, 95% CI 0.70–2.47), whereas the risk of termination of the employment contract was lower (HR 0.62, 95% CI 0.39–0.99) (ITT). Conclusion: Effects of the IPS were observed over five years, albeit differential between the two approaches. A combination of elements of both interventions might lead to optimal results but needs further study.
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Affiliation(s)
- Sophie H Klasen
- CAPHRI School for Public Health and Primary Care. Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
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Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis. Harv Rev Psychiatry 2021; 29:196-215. [PMID: 33979106 DOI: 10.1097/hrp.0000000000000294] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention). METHODS We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number. RESULTS 295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features. CONCLUSION Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.
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The effectiveness of preventive group cognitive-behavioral interventions on enhancing work performance-related factors and mental health of workers: a systematic review. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01562-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176401. [PMID: 32887475 PMCID: PMC7504457 DOI: 10.3390/ijerph17176401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/21/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023]
Abstract
The aim of this systematic review and meta-analysis was to identify and evaluate the impact of interventions to improve or reduce insomnia in the workforce through randomized clinical trials. Following the recommendations of the PRISMA and MARS statement, a systematic literature search was carried out on the PubMed, Web of Science, CINHAL, and PsycINFO databases, with no restrictions on the language or publication date. For the meta-analysis, a random-effects model and the Insomnia Severity Index were used as outcome measures. To assess the risk of bias and the quality of evidence, the Cochrane Collaboration tool and the GRADE method were used, respectively. Twenty-two studies were included in the systematic review and 12 studies in the meta-analysis, making a total of 14 intervention groups with a sample of 827 workers. Cognitive behavioral therapy was the most widely used intervention. According to the estimated difference between the means, a moderate effect for the reduction of insomnia symptoms after the intervention (MD -2.08, CI 95%: [-2.68, -1.47]) and a non-significant degree of heterogeneity were obtained (p = 0.64; I2 = 0%). The quality of the evidence and the risk of bias were moderate. The results suggest that interventions on insomnia in the workplace are effective for improving workers' health, and that improvements in the quality of sleep and a decrease in the symptoms of insomnia are produced, thanks to an increase in weekly sleeping hours and a reduction in latency at sleep onset. As regards work, they also led to improvements in productivity, presenteeism, and job burnout.
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Eccles H, Nannarone M, Lashewicz B, Attridge M, Marchand A, Aiken A, Ho K, Wang J. Perceived Effectiveness and Motivations for the Use of Web-Based Mental Health Programs: Qualitative Study. J Med Internet Res 2020; 22:e16961. [PMID: 32735216 PMCID: PMC7428897 DOI: 10.2196/16961] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/30/2020] [Accepted: 06/03/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The prevalence of depression is high and has been stable despite increased treatment, research, and dissemination. People encounter barriers to seeking traditional mental health services, which could be mitigated by using web-based prevention methods. OBJECTIVE This study aims to understand what people at high risk for depression perceive as effective aspects of web-based mental health programs and what motivates people at high risk for depression to use web-based mental health programs. METHODS We conducted an inductive content analysis using telephone interview data from 77 participants at high risk for depression who were recruited from 2 randomized controlled trials (RCTs). Participants from the first RCT were working men who had been randomly assigned to 1 of the following 3 groups: control group, who had access to general depression information from a website called BroMatters; intervention group 1, who had access to the BroMatters website along with the associated BroHealth web-based mental health program; and intervention group 2, who had access to the BroMatters website, the BroHealth web-based mental health program, and telephone sessions with a life coach. Participants from the second RCT were men and women who had been assigned to the intervention group, who received access to the HardHat web-based mental health program, or the control group, who only received access to the HardHat web-based mental health program following completion of the RCT. Participants for this inductive content analysis study were recruited from the intervention groups in both RCTs. Two groups of participants (n=41 and n=20) were recruited from the BroHealth RCT, and a third group comprised 16 participants that were recruited from the HardHat RCT. RESULTS We generated four categories regarding the perceived effectiveness of web-based programs and five categories related to what motivates the use of web-based programs. Participants identified awareness, program medium and functionality, program content, and coaches as categories related to the effectiveness of the programs. Categories of motivators to use web-based programs included providing reminders or incentives, promotion of the programs, providing appropriate medium and functionality, appropriate content, and perceived need. The final category related to motivators reflects perceptions of participants who were either unsure about what motivates them or believed that there is no way to motivate use. CONCLUSIONS Conflicting evidence was obtained regarding the perceived effectiveness of aspects of the content and functionality of web-based programs. In general, web-based mental health programs were perceived to help increase mental health awareness, especially when it includes live access to a coach. However, the results also revealed that it is difficult to motivate people to begin using web-based mental health programs. Strategies that may motivate the use of such programs include perceived personal need, effective promotion, providing incentives and reminders, and improving functionality.
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Affiliation(s)
- Heidi Eccles
- Work & Mental Health Research Unit, The Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Molly Nannarone
- Work & Mental Health Research Unit, The Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences,, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mark Attridge
- Attridge Consulting, Inc, Minneapolis, MN, United States
| | - Alain Marchand
- School of Industrial Relations, University of Montreal, Montreal, QC, Canada
- Public Health Research Institute, University of Montreal, Montreal, QC, Canada
| | - Alice Aiken
- Office of Research and Innovation, Dalhousie University, Halifax, NS, Canada
| | - Kendall Ho
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jianli Wang
- Work & Mental Health Research Unit, The Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
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