A Minute in Time to Save Minds: Psychosocial Safety Climate (PSC– 4) Cut-Points for Early Detection of Mental Distress

Abstract

Background: Mental health disorders are a major public health issue (1) accounting for 10% of the global burden of disease (2), and are the single largest contributor to global disability (3). An important social determinant of worker mental health is the corporate climate for psychological health (i.e., Psychosocial Safety Climate, PSC). This study aimed to develop PSC-4 risk levels for predicting job strain and mental ill-health and determine the population attributable risk (PAR) of these criteria to PSC. Methods: Australian Workplace Barometer survey interviews were used yielding cross-sectional (Time 1, n=2970; Time 2, n=4140) and longitudinal (n=1476) databases. PSC-4 risk levels were determined by comparative mean level and ROC analyses. Logistic regression assessed the predictive validity of PSC-4 risk on criteria controlling for baselines and PAR was estimated. Findings: Workers reported high job strain (jobs combining high demands and low control) (20%), mild/moderate to severe symptoms of psychological distress (16%), and depression (8%). PSC-4 risk levels were estimated as > 13 low risk and < 12 high risk for job strain and worker mental ill-health. The PAR revealed that eliminating high risk PSC could reduce 22% of the Australian worker population burden of psychological distress, 32% of depressive symptoms, and 12% of job strain. Interpretation: This easy-to-use one minute tool could help shift clinical medical thinking to social determinants of mental health, such as the corporate climate. PAR results show large scope for job strain and mental ill-health prevention by improving PSC. Advocacy by public health, psychiatrists, and physicians could bolster social protection for worker mental health. Funding Statement: Australian Research Council, WorkSafe Victoria WorkWell program, Safe Work Australia, SafeWork SA. Declaration of Interests: There are no known conflicts of interest. Ethics Approval Statement: Ethics for the study was obtained by the University of South Australia Human Research Ethics committee, protocol number 0000033122.