The mental health impacts of health and human service work: Longitudinal evidence about differential exposure and susceptibility using 16 waves of cohort data

Does job stress mediate the risk of work disability due to common mental disorders among social workers compared with other health and social care, education, and non-human service professionals? A prospective cohort study of public sector employees in Finland

OBJECTIVE

This study aimed to investigate (i) the risk of work disability (>10-day sickness absence spell or disability pension) due to common mental disorders (CMD) among social workers compared with other health and social care, education, and non-human service professionals and (ii) whether the risk was mediated by job stress.

METHODS

A cohort of 16 306 public sector professionals in Finland was followed using survey data from baseline (2004 or if not available, 2008) on job stress [job strain or effort-reward imbalance (ERI)] and register data on work disability due to CMD from baseline through 2011. A Cox proportional hazards model was used to analyze the risk of work disability due to CMD between three occupation-pairs in a counterfactual setting, controlling for age, sex, job contract, body mass index, alcohol risk use, smoking, and physical inactivity.

RESULTS

Social workers' job stress was at higher level only when compared to education professionals. Thus, the mediation hypothesis was analyzed comparing social workers to education professionals. Social workers had a higher risk of work disability due to CMD compared with education professionals [hazard ratio (HR) 2.08, 95% confidence interval (CI) 1.58-2.74]. This HR was partly mediated by job strain (24%) and ERI (12%). Social workers had a higher risk of work disability than non-human service professionals (HR 1.54, 95% CI 1.13-2.09), but not compared with other health and social care professionals.

CONCLUSIONS

Job stress partly mediated the excess risk of work disability among social workers only in comparison with education professionals.

Prepandemic Mental Health and Well-being: Differences Within the Health Care Workforce and the Need for Targeted Resources

BACKGROUND

Occupational stress and diminished well-being among health care workers were concerning even before the coronavirus disease 2019 pandemic exacerbated existing stressors and created new challenges for this workforce. Research on the mental health of health care workers has focused on physicians and nurses, with less attention to other occupations.

METHODS

To assess pre-coronavirus disease mental health and well-being among workers in multiple health care occupations, we used 2017 to 2019 data from the Behavioral Risk Factor Surveillance System.

RESULTS

Across the health care workforce, insufficient sleep (41.0%) and diagnosed depression (18.9%) were the most common conditions reported. Counselors had the highest prevalence of diagnosed depression. Health care support workers had elevated prevalences for most adverse health conditions.

CONCLUSIONS

Ensuring a robust health care workforce necessitates identifying and implementing effective occupation-specific prevention, intervention, and mitigation strategies that address organizational and personal conditions adversely affecting mental health.

Suicide in welfare support workers: a retrospective mortality study in Australia 2001-2016

OBJECTIVES

Employees working in the welfare and healthcare industry have poorer mental health than other occupational groups; however, there has been little examination of suicide among this group. In this study, we examined suicide rates among welfare support workers and compared them to other occupations in Australia.

METHODS

We used data from the National Coroners Information System to obtain suicide deaths between the years 2001 and 2016. Using the Australian standard population from 2001 and Census data from 2006, 2011 and 2016, we calculated age-standardised suicide rates and rate ratios to compare suicide rates across different occupational groups.

RESULTS

Overall, the age-standardised suicide rate of welfare support workers was 8.6 per 100 000 people. The gender-stratified results show that male welfare support workers have a high suicide rate (23.8 per 100 000 people) which is similar to male social workers and nurses (25.4 per 100 000). After adjusting for age and year of death, both males (rate ratio 1.48, 95% CI 1.23 to 1.78) and female welfare support workers (rate ratio 1.49, 95% CI 1.20 to 1.86) have higher suicide rate ratios compared with the reference group (excluding occupations from the comparison groups).

CONCLUSION

The age-standardised suicide rates of male welfare support workers are comparable to occupations which have been identified as high-risk occupations for suicide. Both female and male welfare support workers are at elevated risk of suicide compared with other occupations. Further research is required to understand the drivers of the elevated risk in this group.

The effect of gender on mental health service use: an examination of mediation through material, social and health-related pathways

PURPOSE

We aimed to understand how much of the gender difference in mental health service use could be due to the joint mediation of employment, behavioural and material factors, social support and mental health need.

METHODS

We used data from employed individuals aged 18-65 years who participated in the 2015-2017 waves of the Household, Income and Labour Dynamics in Australia survey. The exposure (male, female) and confounders were measured in 2015, mediators in 2016 and the outcome-whether a person had seen a mental health professional in the previous year-was measured in 2017. We estimated natural mediation effects using weighted counterfactual predictions from a logistic regression model.

RESULTS

Men were less likely to see a mental health care provider than women. The total causal effect on the risk difference scale was  - 0.045 (95% CI  - 0.056,  - 0,034). The counterfactual of men taking the mediator values of women explained 28% (95% CI 1.7%, 54%) of the total effect, with the natural direct effect estimated to represent an absolute risk difference of  - 0.033 (95% CI  - 0.048,  - 0.018) and the natural indirect effect  - 0.012 (95% CI  - 0.022,  - 0.0027).

CONCLUSION

Gendered differences in the use of mental health services could be reduced by addressing inequalities in health, employment, material and behavioural factors, and social support.