Managing mental health at work: a systematic review of interventions

This literature review is the first report in a series of studies that seek to improve the management of mental health in NSW workplaces. This systematic literature review aimed to examine the literature on interventions for mental health at work. The search strategy was co-designed with the NSW Centre for Work Health and Safety, and used four relevant databases to find scholarly research articles and reviews on that were specific to mental health interventions within organisational contexts published in English after 2000. Grey literature was included in the review and sourced from relevant government agencies, institutions, professional associations and targeted internet searches. A total of 71 scholarly resources and 32 grey literature were finally included in the review following an extensive screening and full text review process. Broadly, the literature reviews and grey literature supported the importance of organisational-level interventions, while the empirical records focused on individual-level interventions. A range of interventions were considered in the records, most notably training based interventions, stress management and mindfulness interventions. Mixed evidence was found for these interventions, depending on the nature and duration of the intervention. Several papers were compromised by small samples, a lack of appropriate controls, bias in self-selection of participants and adherence. Some evidence was found for the positive effects of health promotion interventions, though it is difficult to establish which elements of these interventions were driving these effects, as they were multifactorial (e.g. including exercise, mental wellbeing strategies). Across these studies the outcome variables measured tended to be based on individuals (e.g. ratings of wellbeing, symptoms of depression and anxiety; perceived stress) rather than organisational, though there was some inclusion of absenteeism and ratings of productivity. Participatory interventions, though few in number, were supported as a strategy for organisational interventions. A range of factors likely explain the focus on individual rather than organisational level interventions, including the relative complexity of performing research on organisational level interventions (due to organisational participation, timelines, funding, organisational change), and the research designs that are most appropriate for this kind of research. A WHS framework for mental health interventions was developed based on the literature, which helps identify intervention priorities for organisations. In addition, we discuss models for encouraging organisations to share records of their own experience as research, and partnering to enable shifting of roles between research generation and practice. Process evaluation, whereby factors in implementation that affect the outcome of organisational interventions are evaluated, rather than only evaluating the outcomes themselves, is an important strategy for future research.