Workplace mental health interventions that improve psychological health and social support

Transcription

1 Workplace mental health interventions that improve psychological health and social support Learning from research, Part III Presenters: Shannon Wagner PhD & Corinne Koehn PhD University of Northern British Columbia Creating and sustaining psychologically healthy workplaces: Learning from research and practice, June 26, 2014, UBC

2 Co-investigators/Stakeholders WorkSafeBC Project Marc White, Principal Investigator, Department of Family Practice, UBC Shannon Wagner, School of Health Sciences, UNBC, Corinne Koehn, Counselling specialization in School of Education, UNBC, Henry Harder, School of Health Sciences, UNBC Izabela Schultz, Department of Educational and Counselling Psychology and Special Education, UBC Kelly Williams-Whitt, Faculty of Management, University of Lethbridge, Lethbridge Clermont Dionne, Département de réadaptation, Faculté de medicine, Université Laval Mieke Koehoorn, School of Population and Public Health, UBC *Rick Iverson, School of Business, Simon Fraser University (deceased May 2012) Community Partners Vernita Hsu, BC Construction Safety Alliance Lisa McGuire, The FIOSA-MIOSA Safety Alliance of BC Irma Lama, Healthcare Benefit Trust Adrienne Hook, Health Employers Association of British Columbia Doug Kube, Stantec Inc

3 Items found through database search Items found through other sources IDENTIFICATION Total number (#) of items identified from database searches n = 3643 # of additional unique items found from sources to be screened for inclusion n = 19 # of duplicate citations excluded (internal + external) n = 299 SCREENING ELIGIBILITY INCLUDED # of citations after duplicated removed n = 3363 # of citations excluded by record (title/abstract) n = 3248 # of full text articles reviewed for inclusion n = 115 # of full text articles excluded, with reasons Not Systematic Review n = 8 Systematic Review of Systematic Review n = 3 Doctoral Thesis = 1 No Intervention n = 1 Intervention Not Managed by the Workplace n = 3 No Risk Factors of Interest n = 5 No Work-Related Outcomes n = 48 No psychological, social support or supervisory intervention n = 28 # of studies found that met eligibility criteria n = 18 Psychological Health & Social Support

4 Psychological Interventions Number of Systematic Reviews 14 high quality systematic reviews in total 6 systematic reviews for off-work workers 8 systematic reviews for general (at-work) workers Outcomes of Interest Absenteeism Work productivity Financial outcomes Canadian Institute for the Relief of Pain and

5 Who Was Studied? The research samples used in the individual studies included in the systematic reviews consisted of workers (on or off work) from a wide variety of work sectors (e.g., health care, education, industry and trades, service sector, military, etc.) Samples included both men and women Canadian Institute for the Relief of Pain and

6 What Types of Psychological Interventions? Some examples of psychological interventions included cognitive-behavioral therapy relaxation techniques empathic counselling pamphlets & education in vivo and imaginal exposure communication skills marital therapy Canadian Institute for the Relief of Pain and

7 Findings: Off-work Workers 6 reviews total All 6 systematic reviews reported a positive impact of psychological interventions on one or more of our outcomes of interest 4 reviews found evidence that interventions containing cognitivebehavioral therapy or behavioral components improved absenteeism (Carroll et al; Corbiere & Shen; Noordik et al; Palmer et al.) Included workers with primarily MH conditions (e.g., anxiety disorders), as well as workers who had MH issues associated with physical injuries Interventions included for example, CBT; in vivo exposure used for workers with anxiety disorders such OCD, phobias, or PTSD 1 review found no effect for low-intensity interventions on absenteeism factors (e.g., identifying sources of stress and generating solutions) (Pomaki et al.) Canadian Institute for the Relief of Pain and

8 Findings: 2 reviews reported evidence that psychological interventions benefitted financial outcomes (CBT, identifying reasons for stress & generating solutions, behavioral interventions) (Pomaki et al; Tompa et al.) 2 reviews reported psychological interventions improved work functioning (e.g., CBT, in vivo exposure) (Noordik et al., Pomaki et al) Also, interventions that facilitated access to clinical treatment and/or facilitated navigation through disability mgt system improved work outcomes (Pomaki et al.) Moderate evidence of positive effect = 2; Limited evidence = 1; Not specify level of evidence = 3 Limited evidence overall (trending toward moderate) Canadian Institute for the Relief of Pain and

9 Findings: General (at-work)workers 8 reviews total 4 component: mental health education; physical health education; activity modification; physical work modification. Moderate evidence that in the intermediate term only led to reduced sick time. Effect absent when less than 4 components (Aas et al.) Limited evidence that multidisciplinary rehab programs were beneficial to workplace outcomes (Dick et al.) Moderate evidence that multidisciplinary interventions to improve mental health or psychosocial components were related to reduced sick leave (Tveito et al.) Based on 4 studies looking at absenteeism, no evidence that cognitive approaches or relaxation training led to reduced absenteeism (van der Klink et al.) Corbière et al (2009) suggested that mental health interventions resulted in positive and significant results for work and mental health outcomes in workers Several authors noted that not enough research regarding mental health interventions and work outcomes was available to suggest any type of conclusion (Czbala et al.; Furlan et al.; Richardson & Rothstein) Overall, there is currently only limited evidence that mental health interventions are favourable for work outcomes. Additional research is needed for clear conclusions to be drawn.

10 Findings: Social Support Two high quality studies and a moderate quality study suggested social support contributed to reduced absenteeism and increased performance stakeholders working together and offers of accommodation (Carroll et al; Franche et al) moderate evidence that work disability duration and cost was reduced through early contact with the worker by the workplace, and presence of a return to work coordinator (Franche) Medium quality, clear evidence that social support led to reduced absenteeism and improved productivity (Richardson and Rothstein) One high quality showed limited evidence that social support benefited employees with carpal tunnel syndrome (Aase et al.) Overall, there is strong evidence that social support is beneficial to work outcomes Canadian Institute for the Relief of Pain and

11 Findings: Supervisory Quality Cancelliere et al. provided high quality, strong evidence that supervisory quality was linked to reduced presenteeism Brewer et al. provided high quality,moderate level evidence that improved supervisory practices lead to positive effects on absences and/or injuries Pearson et al. provided a medium quality review that found no particular style or attribute of the leader that was sufficient to definitively create a positive work environment There is moderate evidence that interventions to improve supervisory quality lead to better workplace outcomes Canadian Institute for the Relief of Pain and

12 Conclusions Psychological interventions may be helpful in reducing absenteeism, improving work productivity, and/or improving financial outcomes Research limitations include a lack of studies, lack of standardization of outcome measures, and tendency of research studies to focus on clinical improvements (e.g., less stress) rather than work-related outcomes Additional research on mental health and work outcomes will be necessary prior to drawing more confident conclusions. Evidence suggests that strong social support and good supervisory quality are both important to good work outcomes

13 References Carroll LJ, Cassidy JD, Peloso PM et al. Methods for the best evidence synthesis on neck pain and its associated disorders: the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976 ) 2008;33(4 Suppl):S33-S38. Corbiere M, Shen J. A systematic review of psychological return-to-work interventions for people with mental health problems and/or physical injuries. Canadian Journal of Community Mental Health 2006;25(2): Noordik E, van d, Klingen EF, Nieuwenhuijsen K, van D. Exposure-in-vivo containing interventions to improve work functioning of workers with anxiety disorder: a systematic review. [Review]. BMC Public Health 2010;10: 598. Palmer KT, Harris EC, Linaker C et al. Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review. [Review]. Rheumatology 2012;51(2): Pomaki G, Franche RL, Murray E, Khushrushahi N, Lampinen TM. Workplace-based work disability prevention interventions for workers with common mental health conditions: a review of the literature. [Review]. Journal of Occupational Rehabilitation 2012;22(2): Tompa E, de O, Dolinschi R, Irvin E. A systematic review of disability management interventions with economic evaluations. [Review]. Journal of Occupational Rehabilitation 2008;18(1): Aas RW, Tuntland H, Holte KA et al. Workplace interventions for neck pain in workers. [Review]. Cochrane Database of Systematic Reviews 2011;(4):CD008160, Dick FD, Graveling RA, Munro W, Walker-Bone K, Guideline D. Workplace management of upper limb disorders: a systematic review. [Review]. Occupational Medicine (Oxford) 2011;61(1): Tveito TH, Hysing M, Eriksen HR. Low back pain interventions at the workplace: a systematic literature review. [Review]. Occupational Medicine (Oxford) 2004;54(1):3-13.

14 References van der Klink JJ, Blonk RW, Schene AH, van Dijk FJ. The benefits of interventions for work-related stress. Am J Public Health 2001;91(2): Corbiere M, Shen J, Rouleau M, Dewa CS. A systematic review of preventive interventions regarding mental health issues in organizations. Work 2009;33(1): Czabala C, Charzynska K, Mroziak B. Psychosocial interventions in workplace mental health promotion: an overview. Health Promot Int 2011;26 Suppl 1:i70-i84. Furlan AD, Gnam WH, Carnide N et al. Systematic review of intervention practices for depression in the workplace. Journal of Occupational Rehabilitation 2012;22(3): Richardson KM, Rothstein HR. Effects of occupational stress management intervention programs: a meta-analysis. J Occup Health Psychol 2008;13(1): Franche RL, Baril R, Shaw W, Nicholas M, Loisel P. Workplace-based return-to-work interventions: optimizing the role of stakeholders in implementation and research. J Occup Rehabil 2005;15(4): Cancelliere C, Cassidy JD, Ammendolia C, Cote P. Are workplace health promotion programs effective at improving presenteeism in workers? A systematic review and best evidence synthesis of the literature. [Review]. BMC Public Health 2011;11:395, Brewer S, King E, Amick BC et al. A Systematic Review of Injury/Illness Prevention And Loss Control Programs (IPCs). Toronto,ON: Institute for Work and Health; Pearson A, Laschinger H, Porritt K, Jordan Z, Tucker D, Long L. Comprehensive systematic review of evidence on developing and sustaining nursing leadership that fosters a healthy work environment in healthcare. Int J Evid Based Healthc 2007;5(2): Canadian Institute for the Relief of Pain and

15 Jot down any questions for the Q&A Do you want to help?? Marc White PhD Tonya Hyde