Preventing depression through mental health programs at work
09 May 2014
Mental health programs delivered through the workplace can reduce depression symptoms, according to research published in the open access journal BMC Medicine. The results of this systematic review of randomized controlled trials, suggest that a range of workplace programs are able to reduce depression symptoms amongst employees.
Over recent decades, mental illness has become the leading cause of long-term absence from work in the developed world. However, despite the increasing size of this problem, to date it hasn’t been clear how or if work-based prevention programs could help. This strategy of preventing rather than curing is well established in other health areas, such as heart disease, but is a relatively new concept in mental health. There is now growing evidence that many mental illnesses may be preventable.
The results of nine workplace-based randomized controlled trials were analyzed in a systematic review by researchers from the University of New South Wales, the Norwegian Institute of Public Health and the Black Dog Institute. Five of the studies identified were based on cognitive behavioral therapy (CBT), which helps people better understand their emotions, thoughts and behaviors in a range of stressful situations. Two of the included studies were focused on mental health literacy, one was based on increasing physical activity, and another based on team participation.
The researchers only looked at studies that were delivered to entire working populations - universal prevention - rather than people at risk of developing mental illness, or those already developing symptoms. Universal prevention has traditionally been difficult to research, but has many practical benefits, as there is no need to screen people and an entire workforce can be reached without fear of stigmatization, labeling and the associated perceived negative effects on employment.
Samuel Harvey, a psychiatrist and the senior author of study, says: “Previously it has been assumed that mental health interventions will only help those who are already suffering from significant symptoms. Here we have shown that a range of relatively simple programs can reduce the level of depression symptoms across an entire workforce. This provides evidence that workplaces can be proactive, rather than reactive, when considering workers' mental health.“
The researchers noted some limitations in their study. Due to the small number of studies included and the inherent difficulties in researching universal prevention, they were unable to make direct comparisons to determine which approach worked best. But a separate meta-analysis performed as part of this study found that CBT-based interventions were effective. All the studies were based on self-report data, so the conclusions are based on a reduction in symptoms rather than clinical diagnoses.
The results of this study suggest that the workplace is a good location to deliver preventative mental health programs. This represents a shift away from the usual thinking about work and mental health, which dictates that work can only be a stress which impairs mental health. Given the high and rising cost of depression for employers in terms of absence and reduced performance, these results provide encouragement for private and public organizations to become involved in funding or promoting work-based interventions.
Samuel Harvey says: “We believe our results show that the workplace can be a central component of future depression prevention programs. More research is needed to determine the extent to which such interventions can prevent new cases of depression and to establish cost effective and practical strategies for wide scale implementation.”
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Notes to editor:
1. Preventing the development of depression at work: a systematic review and meta-analysis of universal interventions in the workplace
Leona Tan, Min-Jung Wang, Matthew Modini, Sadhbh Joyce, Arnstein Mykletun,
Helen Christensen and Samuel B Harvey
BMC Medicine 2014, 12:74
Article available at journal website here.
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