Will NICE guidance for employers improve workers' mental health?

Abstract

The UK National Institute for Health and Clinical Excellence (NICE) has published guidance for employers on promoting mental wellbeing. A national audit in 2011 found wide variation between English National Health Service (NHS) trusts (organizations providing health care) in the implementation of this guidance, but it is not known whether fuller compliance with the guidance results in improved mental wellbeing of staff. To explore whether there is an association between implementation of NICE guidance on mental wellbeing by NHS trusts in England and mental health outcomes as reported by staff. A cross-sectional analysis relating mental health outcomes by trust from the NHS staff surveys in 2009 and 2010 to findings from the 2011 audit of compliance with NICE guidelines. NHS staff survey scores for mental health were significantly poorer in mental health and ambulance trusts than in acute trusts and mental health problems were significantly more frequent in London than in most other areas of England. Mental health scores tended to be better in trusts where the audit showed that staff health and wellbeing was a regular board agenda item, although not significantly so. There was no indication of better scores in trusts with policies on mental wellbeing or those that provided psychological therapies for staff. No clear relationship was found between implementation of the NICE guidance and self-reported mental health outcomes. There are several possible explanations for this finding which require further exploration.