How effective are interventions in optimizing workplace mental health and well-being? A scoping review of reviews and evidence map by Waddell A,
This Evidence Check was commissioned by the NSW Ministry of Health, as part of a project to improve how preventive, sensitive health issues are raised in general practice. The review looked at what is known about discussing sensitive preventive health issues from both patients and GPs perspectives and approaches and factors that have been shown to be effective. The identified evidence was generally of moderate to high methodological quality. General behaviour change approaches that are applicable to this challenge include creating non-judgemental environments that normalise sensitive health issues; simulation training; and public campaigns that reduce stigma and challenge unhelpful cultural norms. Lack of time in consultations was identified as a challenging issue. Significant system-level change would be required to extend standard consultation times; focusing on optimising workflows may therefore be more feasible. Addressing GP patient–gender mismatch through diverse GP representation may also be feasible in larger practices. The key theme identified was the use of prompting, screening or other structured tools by GPs. Collectively, these approaches have two main features. First, they are a way of approaching sensitive health conversations less directly, for example by focusing on underlying risk factors for sensitive health conditions such as obesity and mental illness rather than addressing the issues directly. Second, through either risk-factor or more general question prompts, these approaches take the onus away from GPs and patients to come up with a way of asking the question using their own words.
Residential rehabilitation for alcohol and other drug dependence aims to provide a structured environment for people to break addiction and reintegrate into society within a community rather than in outpatient or other settings. This Evidence Snapshot aimed to identify the community impacts of residential alcohol and drug rehabilitation services. Ten studies were reviewed, seven of which were from the US and two from Australia. A consistent theme across five studies examining community perceptions and impact was that initial concerns around the potential impacts of drug treatment facilities, including residential rehabilitation, were largely unfounded or did not materialise in the long term. Studies also reported a number of positive impacts on communities as reflected by participation in events at community rehabilitation centres, residents making contributions to communities through volunteering, and longer-term employment and associated economic impacts stemming from successful reintegration into the community following rehabilitation. Three studies examining impacts on property values reported mixed findings. One study reported negative impacts, however two studies demonstrated either no effect or higher sales in houses close to sober-living houses over time. A large study examining crime rates showed that drug treatment centres had similar crime rates to areas around liquor stores and lower rates than near corner and convenience stores. A US-based study of economic impacts reported positive impacts. The review findings raise a number of important considerations. Initial community concerns are not based on lived experience of residential rehabilitation in their area and appear to diminish once the centres are established. A number of gaps in the evidence - including a dearth of studies; lack of exploration of community knowledge; and potential under-measurement of complex outcomes such as community attitudes and sentiment – should be borne in mind when interpreting review findings.
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