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EP31: Do individual mental health interventions work? Maybe not · Safe As Podcast

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  The toll on mental health and Wellness from work related
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  sources are well known, but if our best intentions aren't
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  translating into real well being, what are we missing?
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  So if patching up individuals isn't the answer, where do we
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  shift our focus for lasting change?
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  Is it about looking beyond the person to the work itself?
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  Good day everyone. I'm Ben Hutchinson and this is
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  Safe as a podcast dedicated to the thrifty analysis of safety
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  risking performance research. Visit safetyinsights.org for
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  more research. Today's article is from Fleming
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  2024 titled Employee well being outcomes from individual level
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  mental health interventions cross sectional evidence from
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  United Kingdom published in Industrial relations.
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  This study surveyed over 46,000 workers across 233 organisations
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  in the UK. It's main goal was to explore
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  the real world impact of individual level workplace
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  mental health interventions. To give some background,
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  promoting worker well being is really common in workplaces
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  today. Recent data suggests that at
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  least in the UK, over half of the employers have some sort of
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  formal well being strategy. When we talk about mental well
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  being interventions, they generally fall into two
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  brackets, those trying to change the individual or those aiming
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  to change your organisation itself.
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  Now here's a crucial point that the author makes.
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  Even though there are formal recommendations like those from
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  the National Institute for Health and Care Excellence, and
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  even evidence showing that organisational change and work
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  redesign are more effective for improving worker well being,
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  interventions that target the individual worker are still by
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  far the most common approaches. Think about examples like
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  employee assistance programmes, general counselling, resilience
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  training, stress management courses or even campaigns
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  promoting healthy lifestyles and fruit bowls.
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  All well intentioned but targeted at the individual.
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  So this paper focuses specifically on those kinds of
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  practises, the ones meant to boost positive psychological
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  functioning and help sort of reverse the progression of
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  mental ill health. For clarity, mental well being
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  here is a very broad term covering both mental health and
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  mental illness as both components of overall well
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  being. Now, prior research on
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  individual interventions has been pretty extensive, with some
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  systematic reviews reporting moderately positive effects.
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  However, this is a really big but the authors of these past
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  studies consistently raised concerns about their
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  methodological limitations. They point to issues around
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  inconsistent effects, difficulties we determine in
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  cause and effect, publication bias, and etcetera.
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  So what was found in this study? Across multiple indicators of
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  subjective well being, participants in these individual
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  level interventions appeared no better off.
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  In fact, the study found that those who participated in
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  individual level interventions had the exact same levels of
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  mental well being as those who didn't participate at all.
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  The analysis essentially found no support for the idea that
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  these interventions are broadly beneficial for workers
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  subjective well being. So in other words, the null
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  hypothesis mean no statistical effect was found to be better
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  substantiated. This suggests that interventions
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  aren't providing the additional or appropriate resources workers
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  need in order to respond to their job demands.
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  Delving deeper, all these findings don't completely rule
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  out any positive effects for some individual workers.
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  Paper suggests that any such positive effect might simply be
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  averaged out by a negative effect elsewhere.
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  Importantly, this lack of impact was consistent across different
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  demographics. It held true for all genders,
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  all ethnic groups, and all income levels that were
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  surveyed. These results really echo other
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  research that has found low level interventions like these
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  tend to be ineffective for mental well being unless they're
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  directly linked to preventative, structural or organisational
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  change. The author uses the Job Demands
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  Resources model to explore why these interventions might not be
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  working. For example, interventions like
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  resilience training or mindfulness aim to teach workers
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  croping mechanisms to better manage job demands.
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  However, the current study implies that these interventions
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  might not actually be supporting workers effectively, or they
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  might not just be relevant to the specific job demands workers
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  face. Another interesting point is
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  that while workers might report feelings supported in their
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  stress levels, this feeling doesn't translate into better
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  subjective well being. The study suggests this might be
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  because the focus remains squarely on what the individual
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  needs to do, rather than addressing the organisational
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  support structures or the demands directly themselves.
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  So participants in these initiatives were actually more
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  likely to report experiencing unrealistic time pressures. 1
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  explanation is that the interventions might make workers
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  more aware of the unrealistic demands that they face, but
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  without actually giving them the psychological tools or more
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  importantly, the organisational changes needed to cope with or
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  reduce those demands that they now are better able to
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  recognise. So in essence, the programmes
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  might enhance a worker's skill in identifying job demands.
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  We are enhancing the ability to psychologically manage or
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  mitigate those demands. Now there was actually an
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  exception to these findings, volunteering work.
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  Volunteering was found to have a small positive effect on well
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  being, suggesting that contributing to something larger
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  than oneself might be beneficial.
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  However, given what I've just covered, the paper does
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  acknowledge that highly controlled high quality research
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  like randomised controlled trials might still find
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  statistically significant impacts from these sorts of
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  individual level interventions. However, the issue might be
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  their broad large scale implementation and evaluation in
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  the wild. Outside of controlled research
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  settings. It just may be really difficult
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  to actually detect men for change out in the wild.
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  So some of the limitations. First, it's cross sectional many
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  it captured a snapshot in time but can't really clearly
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  identify cause and effect relationships.
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  Second, well, the survey was large.
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  It had limited specific information about the exact
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  nature of each of these interventions, and it evaluated
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  them separately rather than considering more of a holistic
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  approach. So what are some practical
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  implications from this research? One is focus on systemic change.
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  The core message is clear, the meaningful improvements in
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  employee mental well being. Organisations really should
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  prioritise preventative structural change and work
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  redesign over, or at least in conjunction with individual
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  level interventions. They should also re evaluate
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  individual interventions. If you're offering these
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  individual level programmes, an organisation should critically
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  assess whether these programmes are actually effective at
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  addressing the underlying issues of stress and poor well being,
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  or are they simply shifting the burden of coping onto the
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  individual? Organisations need to match
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  interventions to demands, so consider whether individual
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  level interventions are genuinely providing relevant
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  tools for workers to cope with the specific contextual job
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  demands rather than just generic skills.
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  Organisations need to do more than just raising awareness.
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  Awareness might be important, but awareness on its own might
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  inadvertently worsen employ psychological states.
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  Also maybe consider broader well being initiatives.
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  So while the individual level programmes might have some
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  limited impact, this study's findings on volunteering suggest
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  exploring other non traditional well being initiatives that
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  foster a sense of purpose or community and maybe invest in
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  better measurement. Organisations need to move
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  beyond simply tracking participation rates.
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  Maybe focus on robustly measuring some sort of actual
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  changes in employee well being, some sort of proxies or other
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  outcome measures or input measures over time.
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  That's it on Safe as I'm Ben Hutchinson, please help share
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  rate and review and checkoutsafetyinsights.org for
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  more research. Finally, feel free to support
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  Safe As by shouting a coffee link in the show notes.