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Effectiveness of workplace interventions to prevent mental ill-health

In recent years, a number of partially very detailed reviews on the effectiveness of different interventions for the promotion of mental health and the reduction of mental disorders have been published.

Different designations and/or classifications for stress interventions can be found in literature. A distinction is made between three levels: individual, organizational and individual-organizational interventions.

• Individual stress interventions:
  Stress interventions on an individual level aim at an increased awareness of stress and the dealing with it. The health-related impacts and the possibilities of prevention should be demonstrated to the employees. Stress interventions are techniques intended to help judging and/or assessing stressful situations and/or to make effective coping with the symptoms easier. Examples of individual interventions include relaxation techniques, time management and exercise programs.
  
  
• Organizational interventions:
  Organizational interventions aim at minimizing the stress load of employees by changing the organizational, social and technical conditions. Examples include modifications of the working process (job rotation) and the responsibilities as well as modification of the job tasks.
  
  
• Individual-organizational interventions:
  These interventions represent the interface between individual and organizational level. They concern questions on role allocation (lack of clarity regarding responsibilities, role conflicts) and the involvement of employees in decisions. Methods include e.g. conversations for solving role conflicts and participation in decision-making processes.

Stress interventions focus on the individual level. They are also carried out more frequently in practice than measures on the organizational level. The increased presence of stress interventions in science and practice can be explained by the following reasons, among others: on the one hand, these measures can be integrated more easily into existing company structures without influencing them. Moreover, they are considered to be more cost-effective. Furthermore, these interventions are more easily examined and evaluated than those of the organizational level. Individual-related interventions have been more widespread in practice so far since, in most cases, the reasons of existing problems are still assumed to be caused by the individual person and thus have to be addressed on this level.

The reviews of individual measures reflect a large variety of interventions. According to the evidence found, they can absolutely be effective. However, it also becomes clear that they cannot effectively counteract all sources of stress. Organization related causes of stress such as management style, working atmosphere or company culture can hardly be influenced by these interventions. Stress management interventions that exclusively focus on the individual person ? without reducing the sources causing the stress ? will have a limited effect. There are references in literature pointing out that primary preventive measures on the organizational level are important. These interventions could be used to address the causes of stress and thus of a negative affection of mental health. Individual stress interventions reduce the symptoms, but, in most cases, they do not have any effect on the causes.

On account of the results, the evidence for the effectiveness on this level can now be assessed to some extent only. All in all, the reviews show that interventions on the organizational level of workplace absolutely have the potential to create positive effects.

In their evaluation, the authors state that there is no evidence for a superiority of certain individual interventions over others. They point out that it is less a question of using certain individual interventions, but rather of analyzing the need and necessity. Conversations with employees and the identification of risks should be used to find out where and which changes are required. The studies show evidence for the fact that the use of stress management interventions and of programs of prevention only has a small and/or no long-term benefit when the necessity and the field of application are not analyzed before. Companies have to develop a comprehensive  strategy for recognizing their specific needs and adapt the interventions accordingly.

The evaluation of the reviews included shows that individuals and organizations benefit from stress intervention measures. There is moderate evidence for it. The following recommendations for practice can be derived from the results found:

• use of a combination of interventions of the individual and the organizational level,
• use of a comprehensive approach,
• analysis of the necessity and of the field of application before the implementation of the intervention as well as
• use of continual offers.

Source: IGA-Report 13e "Effectiveness and economic benefits of workplace health promotion and prevention. Download (PDF 0.6 MB)

During the course of its current initiative "Promoting Good Practice for Mental health at the Workplace" the ENWHP will publish guides for employers and employees in Europe which will help simplify the implementation of quality-based mental health-related WHP.