Effectiveness of occupational e-mental health interventions: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective This systematic review and meta-analysis investigated the effectiveness of occupational e-mental health interventions aimed at stress, depression, anxiety, burnout, insomnia, mindfulness, well-being, and alcohol misuse and their potential treatment moderators. Methods We systematically reviewed randomized control trials published in English using three electronic databases (MEDLINE, PsycINFO, CINAHL) and three register trials. A pooled effect size for each mental health area was calculated using random-effects modelling. For each meta-analysis, we conducted an analysis of potential moderators (ie, type of recruitment, age, gender, initial psychological symptoms, guidance, therapy type, and study quality). Results In total, 50 studies were included in the systematic review, and 34 studies were included in the metaanalyses. We noted moderate treatment effects on stress (Hedges'g=0.54), insomnia (g=0.70), and burnout (g=0.51) and small treatment effects on depression (g=0.30), anxiety (g=0.34), well-being (g=0.35), and mindfulness (g=0.42). The pooled effect on alcohol intake was small and nonsignificant. Conclusions Our results suggest that occupational e-mental health interventions are associated with significant health improvements. However, more research is required to understand which factors contribute to the variation in effectiveness of particular interventions depending on the mental health area and characteristics of participants and interventions.

Work and mental health: what do we know and how can we intervene?

“…The interventions included e-mental health interventions, cognitive behavior therapy, stress management, psycho-education and physical activity. The authors conclude that there was strong evidence that e-mental health and cognitive behavior techniques had a positive effect on workers' mental health, whereas the evidence for intervention on physical activity was less clear, echoing the conclusions by Phillips et al (18) and Bordado Sköld et al (19).…”

“…Phillips and colleagues identified 50 randomized controlled trials using e-mental health interventions, including 34 of those in meta-analyses (18). The interventions focused on making changes in the individual, with about two-thirds based on cognitive behavioral therapy.…”

“…First, interventions based on cognitive behavior therapy, including e-mental health interventions, seem to be an effective tool for protecting and enhancing workers' mental health (18,20). However, as Phillips et al noted (18), more than two-thirds of the participants in e-mental health studies were highly educated (having at least some years of university education), and jobs in knowledge-intensive occupational sectors, such as information technology, were overrepresented. Considering that mental disorders are more prevalent in individuals of lower socioeconomic position (21-23), one may be concerned that e-mental health interventions do not reach those who need help most.…”

“…But e-mental health interventions could have been about guidance for changing working conditions and workplace health promotion does not have to be limited to health behaviors and cognitive changes but could also target the work environment, as it has been proposed in the concepts of "Comprehensive Health Promotion" (24) and "Total Worker Health TM " (25). However, these type of interventions did not seem to have qualified for the review on e-mental health (18) or the meta-review on workplace health promotion (20).…”

“…Considering the above-delineated evidence for an association between adverse working conditions and the risk of developing mental disorders (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) and the ongoing discussion about using work matched to one's "knowledge, skills and circumstances, and undertaken in a safe, healthy and supportive working environment" (13) as a therapeutic tool for individuals with prevalent mental health problems and disorders (13,(15)(16)(17), it is disconcerting that organizational-level, work environment interventions to protect or enhance workers' mental health seem either not to qualify for systematic reviews (18,20) or, if they do, show rather weak or inconsistent results (26,27).…”