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.
Highlights
MethodsIn our exploratory review of literature relevant to our question of interest, we surveyed research in the areas of global mental health, mental health and the workplace, mental health and the healthcare workplace, mental wellbeing and happiness, happiness and the workplace, workplace-based mental health interventions, and workplace-based mental health interventions for healthcare workers
Mental illness is estimated to globally account for 32.4% of years lived with a disability [1] and to generate significant impacts on workplaces with depression and anxiety disorders costing US$1 trillion dollars in lost productivity in 2017 [2]
The collection of studies included in this review highlights the complexity of factors at the organizational level that influence mental health and the work environment
Summary
In our exploratory review of literature relevant to our question of interest, we surveyed research in the areas of global mental health, mental health and the workplace, mental health and the healthcare workplace, mental wellbeing and happiness, happiness and the workplace, workplace-based mental health interventions, and workplace-based mental health interventions for healthcare workers. A search of MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO was conducted in November 2018 (see Appendix A: Search Terms). MEDLINE was selected based on its extensive and premier coverage of health and biomedical research. CINAHL was selected to capture studies related to nursing and allied health professionals. PsycINFO was selected for its command of psychology, which is relevant for the subject area of the review: mental health. All three databases were searched for journal articles published since the inception of the respective databases (i.e., there were no restrictions placed on the dates of coverage)
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