Humanitarian Aid Workers' Mental Health and Duty of Care

Universal, selective and indicated interventions for supporting mental health at the workplace: an umbrella review of meta-analyses

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.

Barriers to accessing psychosocial support for humanitarian aid workers: a mixed methods inquiry

International and national humanitarian aid workers were recruited for this study via purposive sampling techniques using social media. Eight interviews and one focus group discussion were carried out (n=13), and a survey disseminated (n=62), to garner a broad range of perspectives on barriers to aid workers seeking out and accessing psychosocial support. A thematic analysis was performed on the transcriptions of the interviews and focus group discussion. The hypothesis was that participants would describe a variety of personal, professional, and environmental obstacles, with 'tough-guy macho culture' and/or 'martyr culture' being the strongest deterrents. Fourteen barriers in total were identified: accessibility; appropriateness; attitude; availability; confidentiality and trust; duty of care; guidance; normalisation; experience; repercussions; self-awareness; self-reliance; stigma; and time. It is recommended that organisations improve the provision of quality, appropriate psychosocial support for staff, and that it is communicated regularly, and they train staff in pinpointing when others are in need of assistance.