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Well-being, Mental Health and Prevention of Psychosocial Risks in Contemporary Working Life

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (29 February 2020) | Viewed by 88583

Special Issue Editors

Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL—Italian Workers’ Compensation Authority, Monte Porzio Catone, 00078 Rome, Italy
Interests: occupational health and safety; public health; occupational risks; risk assessment; evaluation of interventions; work-related stress
Special Issues, Collections and Topics in MDPI journals
1. Department of Management and Marketing, Cork University Business School, University College Cork, Cork T12 K8AF, Ireland
2. Centre for Organizational Health and Development, School of Medicine, University of Nottingham, NG8 1BB, Nottingham, UK
1. Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstrasse 1, 40225 Düsseldorf, Germany
2. Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce the Special Issue on ‘’Well-being, Mental Health, and the Prevention of Psychosocial Risks in Contemporary Working Life’’, which we are editing in the International Journal of Environmental Research and Public Health

Mentally healthy workplaces are crucial for sustaining workers’ well-being and preventing mental illness. EU- OSHA’s cost estimate of mental diseases was €240 billion a year in 2014, and 57% of these diseases were linked to a loss of productivity including sick leave (EU-OSHA, 2014). According to the World Health Organization’s definition of positive mental health, mentally healthy individuals “can cope with the normal stresses of life, can work productively and fruitfully, and … will perform better in their work.” To remain competitive, organizations need to invest in creating mentally healthy workplaces where a positive organizational environment and social context are being promoted and work design and work organization are well-managed to avoid their detrimental effect on workers’ health and safety and employee well-being.

Researchers and practitioners can support organizations providing up-to-date methods, tools, and practical solutions at organizational and policy levels in the field of occupational health and safety to effectively manage psychosocial risks at work and prevent their potential negative impact on workers’ health, well-being, and organizational sustainability.  

The purpose of this Special Issue is to publish original, high-quality research papers as well as review articles addressing recent advances in occupational health psychology with a special focus on psychosocial risk prevention in the workplace and the promotion of workers’ mental health and well-being. We particularly welcome multidisciplinary contributions, papers on policy impact, studies with strong implications for practice, and papers reporting occupational health interventions and their outcomes and/or process evaluations.

All submitted manuscripts will be processed through a peer review process.

We look forward to hearing from you soon.

Prof. Dr. Sergio Iavicoli
Prof. Dr. Stavroula Leka
Dr. Jian Li
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Mental health
  • Psychosocial risks
  • Well-being at work
  • Mentally healthy workplaces
  • Work-related stress
  • Job content and work organization
  • Working conditions
  • Social and interpersonal context at work
  • Individual and organizational factors and their interactions
  • Positive individual resources and coping strategies
  • Bullying and harassment at work
  • Intervention evaluation process
  • Mental health policies
  • Workers’ well-being promotion
  • Cost of stress at work.

Published Papers (12 papers)

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Research

Jump to: Review

14 pages, 745 KiB  
Article
Improving Working Conditions and Job Satisfaction in Healthcare: A Study Concept Design on a Participatory Organizational Level Intervention in Psychosocial Risks Management
by Cristina Di Tecco, Karina Nielsen, Monica Ghelli, Matteo Ronchetti, Ivan Marzocchi, Benedetta Persechino and Sergio Iavicoli
Int. J. Environ. Res. Public Health 2020, 17(10), 3677; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103677 - 23 May 2020
Cited by 17 | Viewed by 4458
Abstract
This paper contributes to the literature on organizational interventions on occupational health by presenting a concept study design to test the efficacy of a Participatory Organizational-level Intervention to improve working conditions and job satisfaction in Healthcare. The Participatory Organizational-level Intervention is developed using [...] Read more.
This paper contributes to the literature on organizational interventions on occupational health by presenting a concept study design to test the efficacy of a Participatory Organizational-level Intervention to improve working conditions and job satisfaction in Healthcare. The Participatory Organizational-level Intervention is developed using the Italian methodology to assess and manage psychosocial risks tailored to Healthcare. We added an additional step: evaluation, aiming to examine how the intervention works, what worked for whom and in which circumstances. This ongoing study is conducted in collaboration with two large Italian hospitals (more than 7000 employees). The study design comprises a quasi-experimental approach consisting of five phases and surveys distributed pre- and post-intervention aiming to capture improvements in working conditions and job satisfaction. Moreover, to evaluate the efficacy of the Intervention in terms of process and content, we use a realist evaluation to test Context-Mechanisms-Outcome (CMO) configurations. We collect contextual factors at baseline and during and post-intervention process data on the key principles of line manager support and employees participation. This study is expected to provide insights on methods and strategies to improve working conditions and employees’ job satisfaction and on national policies in the occupational health framework. Full article
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18 pages, 1424 KiB  
Article
Social Dialogue and Psychosocial Risk Management: Added Value of Manager and Employee Representative Agreement in Risk Perception and Awareness
by Irene Houtman, Marianne van Zwieten, Stavroula Leka, Aditya Jain and Ernest de Vroome
Int. J. Environ. Res. Public Health 2020, 17(10), 3672; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103672 - 22 May 2020
Cited by 10 | Viewed by 2405
Abstract
The present study aimed to explore the added value of managers’ and employee representatives’ agreement in risk perception and awareness in explaining the management of more ‘subjective’ psychosocial risks as compared to the more ‘objective’ traditional OSH risks. The general assumption tested was [...] Read more.
The present study aimed to explore the added value of managers’ and employee representatives’ agreement in risk perception and awareness in explaining the management of more ‘subjective’ psychosocial risks as compared to the more ‘objective’ traditional OSH risks. The general assumption tested was whether the added value of agreement in risk perception and awareness between these parties would be larger for psychosocial risk management as compared to traditional OSH risk management. European Survey of Enterprises on New and Emerging Risks (ESENER-1) data were used from 7226 enterprises in which both managers and employee representatives were interviewed. Answers by employee representatives and managers to mirror questions on risk perception and awareness were used as independent variables, and answers to questions on risk management by the manager were used as dependent variables. Polynomial regression with response surface analysis was used. Differences in risk perception and awareness between managers and employee representatives explained more variance in psychosocial risk management as compared to more traditional OSH risk management. The implications of these findings and the importance of ‘social dialogue’ particularly in the case of psychosocial risk management as opposed to general OSH management are discussed. Full article
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25 pages, 399 KiB  
Article
The Interplay among Age and Employment Status on the Perceptions of Psychosocial Risk Factors at Work
by Valerio Ghezzi, Tahira M. Probst, Laura Petitta, Valeria Ciampa, Matteo Ronchetti, Cristina Di Tecco, Sergio Iavicoli and Claudio Barbaranelli
Int. J. Environ. Res. Public Health 2020, 17(10), 3611; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103611 - 21 May 2020
Cited by 8 | Viewed by 3268
Abstract
While the role of individual differences in shaping primary appraisals of psychosocial working conditions has been well investigated, less is known about how objective characteristics of the employee profile (e.g., age) are associated with different perceptions of psychosocial risk factors. Moreover, previous research [...] Read more.
While the role of individual differences in shaping primary appraisals of psychosocial working conditions has been well investigated, less is known about how objective characteristics of the employee profile (e.g., age) are associated with different perceptions of psychosocial risk factors. Moreover, previous research on the link between employment status (i.e., work contract) and such perceptions has provided mixed results, leading to contradictory conclusions. The present study was conducted on a nationally representative sample of theItalian employed workforce surveyed with computer-assisted telephone interviewing (CATI) methodology. The principal aim of the study is to bridge this gap in the extant literature by investigating the interplay between two key characteristics of the employee profile (i.e., age and work contract) in shaping employees’ perceptions of psychosocial risk factors. Given the disparate literature scenario on the interplay between age and employment status in shaping primary appraisals of psychosocial stressors, we formulated and compared multiple competitive informative hypotheses. Consistent with the principles of the conservation of resources (COR) theory, we found that older contingent employees reported a higher level of psychosocial risk than their permanent peers who, in turn, were more vulnerable than middle-aged and younger workers (regardless of their employment status). These results highlight the importance of simultaneously assessing multipleobjective variables of the employee profile (i.e., age and employment status) which may act to shape subjective perceptions of psychosocial risk factors for work-related stress. Given our findings, employers and policy makers should consider older contingent employees as one of the workforce sub-populationsmost vulnerable to negative work environments. Full article
12 pages, 451 KiB  
Article
Accumulated Long-Term Exposure to Workplace Bullying Impairs Psychological Hardiness: A Five-Year Longitudinal Study among Nurses
by Kristina Vaktskjold Hamre, Ståle Valvatne Einarsen, Øystein Løvik Hoprekstad, Ståle Pallesen, Bjørn Bjorvatn, Siri Waage, Bente E. Moen and Anette Harris
Int. J. Environ. Res. Public Health 2020, 17(7), 2587; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072587 - 10 Apr 2020
Cited by 12 | Viewed by 4953
Abstract
Personality has been hypothesized to act as antecedent as well as an outcome of workplace bullying. Still, investigations on the longitudinal relationship between bullying and personality are scarce. We investigated the relationship between accumulated exposure to bullying at work and subsequent changes in [...] Read more.
Personality has been hypothesized to act as antecedent as well as an outcome of workplace bullying. Still, investigations on the longitudinal relationship between bullying and personality are scarce. We investigated the relationship between accumulated exposure to bullying at work and subsequent changes in psychological hardiness. Additionally, we examined whether hardiness predicted subsequent exposure to bullying. The data were based on the Survey of Shiftwork, Sleep, and Health (SUSSH), a cohort study with annual surveys among Norwegian nurses. The participants who completed standardized instruments measuring exposure to bullying behavior at T1 (2008/09) to T4 (2012) and psychological hardiness at T1 (2008/09) and T5 (2012) were included (n = 938). The results showed that accumulated exposure to bullying (sum of exposure from T1–T4) was associated with reduced psychological hardiness at T5, adjusted for age, sex, and hardiness at baseline (β = –0.16, t = –5.70, p < 0.001). Accumulated exposure to bullying behaviors explained 2.3% of the change in hardiness. Less hardy individuals experienced higher levels of subsequent exposure to bullying behaviors, adjusted for age, sex, and bullying at baseline (β = –0.04, t = –2.21 p < 0.05). Long-term accumulated exposure to bullying behaviors seemed to be a stronger predictor for changes in hardiness as compared to hardiness in predicting exposure to bullying. Full article
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15 pages, 908 KiB  
Article
Psychosocial Working Conditions and Well-Being of Migrant Workers in Spain
by Francisco Díaz Bretones, Aditya Jain, Stavroula Leka and Pedro A. García-López
Int. J. Environ. Res. Public Health 2020, 17(7), 2547; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072547 - 08 Apr 2020
Cited by 11 | Viewed by 3067
Abstract
This study examines the relationship beween employment and psychosocial working conditions and well-being of native and migrant workers in the working population of Spain. Data from the 7th Spanish Survey of Working Conditions was used to conduct a confirmatory factor analysis (n = [...] Read more.
This study examines the relationship beween employment and psychosocial working conditions and well-being of native and migrant workers in the working population of Spain. Data from the 7th Spanish Survey of Working Conditions was used to conduct a confirmatory factor analysis (n = 8508) to identify the main latent variables that influenced well-being. Using structural equation modeling and multivariate analysis, we found different patterns and perceptions of well-being and working conditions in these two groups. We discuss the reasons for these differences and suggest directions for further research in this area. Full article
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15 pages, 997 KiB  
Article
The Interactive Effects of Personal Resources on Teachers’ Work Engagement and Withdrawal Intentions: A Structural Equation Modeling Approach
by Sergio Mérida-López, Natalio Extremera and Nicolás Sánchez-Álvarez
Int. J. Environ. Res. Public Health 2020, 17(7), 2170; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072170 - 25 Mar 2020
Cited by 14 | Viewed by 3548
Abstract
This research contributes to the current knowledge on teacher well-being by examining an integrated model with a personal resource (i.e., emotional intelligence) explaining teacher withdrawal intention through a mediator (i.e., work engagement) and considering the moderator effect of a second personal resource (i.e., [...] Read more.
This research contributes to the current knowledge on teacher well-being by examining an integrated model with a personal resource (i.e., emotional intelligence) explaining teacher withdrawal intention through a mediator (i.e., work engagement) and considering the moderator effect of a second personal resource (i.e., teacher self-efficacy) in this relationship. Adopting a cross-sectional design, a total of 702 teachers (63.2% female) working at different educational levels took part in this study. The results showed that emotional intelligence and teacher self-efficacy were positively related to work engagement and negatively related to withdrawal intentions. Most importantly, the results demonstrated support for the hypothesized model—that is, teacher self-efficacy moderated the relationship between emotional intelligence and work engagement. Taken together, our findings highlight both emotional intelligence and teacher self-efficacy as positive individual resources for increased work engagement and reduced withdrawal intentions. This study has implications for the development of intervention programs aiming at increasing occupational well-being in educational settings. Full article
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17 pages, 694 KiB  
Article
Facilitating Eudaimonic Well-Being in Mental Health Care Organizations: The Role of Servant Leadership and Workplace Civility Climate
by Susan der Kinderen, Amber Valk, Svetlana N. Khapova and Maria Tims
Int. J. Environ. Res. Public Health 2020, 17(4), 1173; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17041173 - 12 Feb 2020
Cited by 23 | Viewed by 7025
Abstract
Demanding and complex work within mental health care organizations places employee well-being at risk and raises the question of how we can positively influence the psychological well-being and functioning of these employees. This study explores the role of servant leadership and workplace civility [...] Read more.
Demanding and complex work within mental health care organizations places employee well-being at risk and raises the question of how we can positively influence the psychological well-being and functioning of these employees. This study explores the role of servant leadership and workplace civility climate in shaping eudaimonic well-being among 312 employees in a Dutch mental health care organization. The findings showed that servant leadership had a stronger relationship with eudaimonic well-being when workplace civility climate was high. Furthermore, the results showed that servant leadership was positively related to workplace outcomes, partially through eudaimonic well-being, and that this mediating process varied across different levels of workplace civility climate. This study contributes to the scholarly understanding of the role of servant leadership and a positive work climate in shaping psychological well-being at work. Full article
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9 pages, 389 KiB  
Article
The Role of Leisure-Time Physical Activity in the Change of Work-Related Stress (ERI) over Time
by Jean-Baptist du Prel, Johannes Siegrist and Daniela Borchart
Int. J. Environ. Res. Public Health 2019, 16(23), 4839; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16234839 - 02 Dec 2019
Cited by 5 | Viewed by 2985
Abstract
Background: Every second employee in Europe complains about work-related stress. Occupational stress due to an imbalance between efforts spent and rewards gained (effort-reward imbalance = ERI) is well investigated and it is associated with mental and physical health. A common guess is that [...] Read more.
Background: Every second employee in Europe complains about work-related stress. Occupational stress due to an imbalance between efforts spent and rewards gained (effort-reward imbalance = ERI) is well investigated and it is associated with mental and physical health. A common guess is that leisure-time physical activity (LTPA) has beneficial effects on work-related stress. Yet, evidence in support of this assumption is weak, especially regarding ERI-stress. Longitudinal studies investigating the role of LTPA on ERI are missing. Therefore, this study aims to investigate the effect of LTPA on work-related stress by ERI over time. Methods: 3961 socially insured employees that were born in 1959 or 1965 and working in the first (t1: 2011) and second wave (t2: 2014) of the lidA-study were included. Work-related stress was measured by ERI, LTPA by the self-rated weekly frequency of physical activities. Besides the direct effect, a moderating effect of LTPA on ERI over time was tested in the multiple linear regression analysis. Results: The ERI at t1 was strongly associated with ERI at t2. While LTPA had no direct effect on ERI(t2), it was a significant moderator of ERI from t1 to t2: The higher the frequency of LTPA, the lower ERI was over time. This interaction of LTPA with ERI remained after adjustment for socio-demographic factors. Conclusions: The long-term moderating effect of LTPA on ERI is in agreement with former investigations on the role of LTPA on work-related stress, generally, and on its cross-sectional effect on ERI-stress, specifically. Some of Hill’s criteria of a causal association in epidemiology (biological gradient, temporality, consistency) support our findings. As LTPA has also been shown to exert a protective effect on health outcomes that are associated with ERI, the moderation of ERI by LTPA could partly explain this protective effect. Future observational and interventional studies are required to support our results over more than two age groups and study times. Full article
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13 pages, 386 KiB  
Article
Psychosocial Risks and Violence Against Teachers. Is It Possible to Promote Well-Being at Work?
by Sabrina Berlanda, Marta Fraizzoli, Federica de Cordova and Monica Pedrazza
Int. J. Environ. Res. Public Health 2019, 16(22), 4439; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224439 - 12 Nov 2019
Cited by 25 | Viewed by 4519
Abstract
Teaching has been reported to be one of the most stressful occupations, with heavy psychological demands, including the need to develop positive relationships with students and their parents; relationships that, in turn, play a significant role in teachers’ well-being. It follows that the [...] Read more.
Teaching has been reported to be one of the most stressful occupations, with heavy psychological demands, including the need to develop positive relationships with students and their parents; relationships that, in turn, play a significant role in teachers’ well-being. It follows that the impact of any violence perpetrated by a student or parent against a teacher is particularly significant and represents a major occupational health concern. The present study examines for the first time the influence of the Job Demands-Control-Support Model on violence directed against teachers. Six hundred and eighty-six teachers working in elementary and high schools in north-east Italy completed an online, self-report questionnaire. Our findings reveal the role played by working conditions in determining teachers’ experience of violence: greater job demands are associated with most offense types, whereas the availability of diffused social support at school is associated with lower rates of harassment. Workload should be equally distributed and kept under control, and violence should gain its place in the shared daily monitoring of practices and experiences at school in order to provide a socially supportive work environment for all teachers. Full article
25 pages, 1007 KiB  
Article
Risk Factors for Workplace Bullying: A Systematic Review
by Fernando R. Feijó, Débora D. Gräf, Neil Pearce and Anaclaudia G. Fassa
Int. J. Environ. Res. Public Health 2019, 16(11), 1945; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16111945 - 31 May 2019
Cited by 65 | Viewed by 14627
Abstract
Objective: The goal of this study was to systematically review risk factors for workplace bullying. Methods: The search was carried out in two databases. Studies with estimates of risk factors for workplace bullying were included in the review. We assessed the [...] Read more.
Objective: The goal of this study was to systematically review risk factors for workplace bullying. Methods: The search was carried out in two databases. Studies with estimates of risk factors for workplace bullying were included in the review. We assessed the quality of the selected studies using an adapted version of the Downs and Black checklist. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines were used for reporting papers. Results: Fifty-one papers were included, and 70.6% were from European countries. Women were reported to be at higher risk of being bullied in most studies (odds ratio (OR) from 1.17 to 2.77). Authoritarian and laissez-faire leadership styles were positively associated with bullying. Several psychosocial factors, such as stress (OR from 1.37 to 4.96), and occupational risks related to work organization, such as flexible work methods, role conflict, role ambiguity, monotonous or rotating tasks, high demands, pressure of work, and unclarity of duties were strongly associated with bullying. Discussion: The findings highlight the central role of organizational factors in bullying. Policies to prevent bullying must address the culture of organizations, facing the challenge of developing a new management and leadership framework. Full article
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Review

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24 pages, 412 KiB  
Review
The Role of Occupational Health Services in Psychosocial Risk Management and the Promotion of Mental Health and Well-Being at Work
by Aditya Jain, Juliet Hassard, Stavroula Leka, Cristina Di Tecco and Sergio Iavicoli
Int. J. Environ. Res. Public Health 2021, 18(7), 3632; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073632 - 31 Mar 2021
Cited by 28 | Viewed by 7501
Abstract
The development and enhancement of occupational health services (OHS) at the national level is central to ensuring the sustainable health, well-being and work engagement of the working population. However, due to differences in national health, social security and occupational safety and health systems, [...] Read more.
The development and enhancement of occupational health services (OHS) at the national level is central to ensuring the sustainable health, well-being and work engagement of the working population. However, due to differences in national health, social security and occupational safety and health systems, the content, capacity, coverage and provisions of OHS vary considerably across national contexts. Obtaining a better understanding in terms of such similarities and variations internationally is essential as such comparative information can help inform evidenced-based decision-making on OHS at both policy and practice levels. This paper therefore reviews and analyses the key policies, standards and approaches in OH systems and services, using both academic and grey literature, across 12 industrialised countries (Australia, Canada, Finland, France, Germany, Ireland, Italy, Japan, The Netherlands, Poland, United Kingdom and the United States of America). It provides a detailed overview and categorization of OHS in these selected countries in terms of the legal and policy context, organisation and financing and coverage and staffing while specifically discussing variations aimed at psychosocial risk management and the promotion of mental health and well-being at work. It draws conclusions on key development needs of OHS internationally to ensure psychosocial risk management and mental health promotion are prioritised effectively in a preventive manner. Full article
22 pages, 566 KiB  
Review
Workplace-Based Organizational Interventions Promoting Mental Health and Happiness among Healthcare Workers: A Realist Review
by Patricia Gray, Sipho Senabe, Nisha Naicker, Spo Kgalamono, Annalee Yassi and Jerry M. Spiegel
Int. J. Environ. Res. Public Health 2019, 16(22), 4396; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224396 - 11 Nov 2019
Cited by 131 | Viewed by 28727
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, [...] Read more.
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. Full article
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