Workplace-Based Organizational Interventions Promoting Mental Health and Happiness among Healthcare Workers: A Realist Review

Abstract

Mental illness, deemed globally to account for 32% of years lived with a disability, generates significant impacts on workplaces. In particular, healthcare workers experience high rates of mental ill health such as burnout, stress, and depression due to workplace conditions including excessive workloads, workplace violence and bullying, which also produces negative effects on patients as well as on the happiness and wellbeing of those who remain at work. This review was undertaken to synthesize the evidence on workplace-based interventions at the organizational level promoting mental health and wellbeing among healthcare workers, to identify what has been receiving attention in this area and why, especially considering how such positive effects are produced. A search of three premier health-related databases identified 1290 articles that discussed healthcare workers, workplace interventions, and mental health. Following further examination, 46 articles were ultimately selected as meeting the criteria specifying interventions at the organizational level and combined with similar studies included in a relevant Cochrane review. The 60 chosen articles were then analyzed following a realist framework analyzing context, mechanism, and outcome. Most of the studies included in the realist review were conducted in high-income countries, and the types of organizational-level interventions studied included skills and knowledge development, leadership development, communication and team building, stress management as well as workload and time management. Common themes from the realist review highlight the importance of employee engagement in the intervention development and implementation process. The literature review also supports the recognized need for more research on mental health and happiness in low- and middle-income countries, and for studies evaluating the longer-term effects of workplace mental health promotion.

Examining Negative Emotional Symptoms and Psychological Wellbeing of Australian Sport Officials

“…Cuskelly and Hoye [1] suggested flexible scheduling may be essential in assisting them to manage their own MH and PWB. This approach has been successful in the healthcare professions [54] and general organisational psychology literature [46]. Practically this may be difficult due to limited numbers of registered officials but may be an important component of managing negative emotional symptoms.…”

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“…This quest for savings often is counterproductive and more costly because an employee's failure to obtain healthcare can lead to greater negatives for the employee and for the organization, including a lengthier and more expensive treatment period, more lost time from work, and possibly disability or even death. Thus, multi-pronged organizational interventions should be aimed at promoting a culture of employee health and safety in multi-dimensional healthcare settings (Gray et al 2019, Tong et al 2019. Interventions that adequately embed multilevel worksite wellness programs can improve employee health and work performance (Hendriksen et al 2016, Bakker andDemerouti 2018).…”

A Two-Day Acceptance and Commitment Therapy (ACT) Workshop Increases Presence and Work Functioning in Healthcare Workers

“…In conclusion, the economic burden of mental health disorders is high, i.e. the relative returns from investing in mental health to fight depression and anxiety lead to a four-fold return in better health and ability to work of every dollar invested ( 3 , 4 ). Especially healthcare workers experience high rates of burn out, anxiety disorders, stress, and depression, e.g.…”

“…half of the physicians at least in America experience symptoms of burn out and this situation even seems to worsen over the last years ( 5 ). Workplace conditions that compromise mental health in the healthcare system are especially excessive workloads, increase of bureaucracy, working in emotionally-charged situations, stigma against seeking care, low job control and high job demand, an imbalance between effort and reward and night shifts ( 4 ). In conclusion, healthcare staff has been consistently shown to experience above average rates of mental health problems.…”

“…Mental health disorders in psychiatric staff again affect the quality of patient care, patient satisfaction, and organizational success. Indeed, the mental health of healthcare workers has been reported to be associated with patient safety outcomes, therapeutic incidents, quality of care, patient satisfaction, medical errors, and infections ( 4 , 6 – 9 ). In contrast to a huge financial and qualitative damage caused by these disorders, there is only a small proportion of clinically distressed workers that gain access to evidence-based psychotherapeutic interventions ( 4 ).…”