A Participatory Intervention to Improve the Psychosocial Work Environment and Mental Health in Human Service Organisations. A Mixed Methods Evaluation Study.

Emma Cedstrand,Magnus Alderling,Sara Sanchez-Bengtsson,Gun Johansson,Helle Mölsted Alvesson,Anna Nyberg,Theo Bodin,Hanna Augustsson

doi:10.3390/ijerph18073546

Abstract

Work-related stress is a global problem causing suffering and economic costs. In Sweden, employees in human service occupations are overrepresented among persons on sick leave due to mental health problems such as stress-related disorders. The psychosocial work environment is one contributing factor for this problem, making it urgent to identify effective methods to decrease stress at the workplace. The aim of the study is to evaluate a participatory intervention to improve the psychosocial work environment and mental health using an embedded mixed methods design. The study is a controlled trial with a parallel process evaluation exploring fidelity and participants’ reactions to the intervention activities, experiences of learning and changes in behaviours and work routines. We collected data through documentation, interviews and three waves of questionnaires. Our results show small changes in behaviours and work routines and no positive effects of the intervention on the psychosocial work environment nor health outcomes. One explanation is end-users’ perceived lack of involvement over the process causing the intervention to be seen as a burden. Another explanation is that the intervention activities were perceived targeting the wrong organisational level. A representative participation over both content and process can be an effective strategy to change psychosocial working conditions and mental health.

Highlights

Common mental disorders are the predominant cause of sick leave in Sweden today.During the last three decades, the share of psychiatric diagnoses in sick leave spells over two months increased from 13 to 45 percent among women and from 16 to 33 percent among men [1]
The intervention led to few changes in learning, behaviours and work routines, which was a prerequisite for improvements in work environment and mental health
The analysis shows that the component where full participation was applied did not lead to any reported changes in behaviours or work routines, nor was it appreciated

Summary

Introduction

Common mental disorders are the predominant cause of sick leave in Sweden today. During the last three decades, the share of psychiatric diagnoses in sick leave spells over two months increased from 13 to 45 percent among women and from 16 to 33 percent among men [1]. Stress-related disorders account for the largest increase among the psychiatric diagnoses, exhaustion syndrome, a diagnosis with a specific ICD-10 code in Sweden, with sick leaves lasting approximately half a year [1]. Impaired sleep is a common symptom in common mental disorders, such as depression and exhaustion [2]. We measure burnout and impaired sleep as symptoms of common mental disorders. Experiment vs Control 24 Months Baseline Measure Burnout Mean diff.

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