Providing mental health first aid in the workplace: a Delphi consensus study

BACKGROUND: Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one's approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace context.

METHODS: A systematic search of websites, books and journal articles was conducted to develop a questionnaire with 246 items containing actions that someone may use to offer mental health first aid to a co-worker or employee. Three panels of experts from English-speaking countries were recruited (23 consumers, 26 managers and 38 workplace mental health professionals), who independently rated the items over three rounds for inclusion in the guidelines.

RESULTS: The retention rate of the expert panellists across the three rounds was 61.7 %. Of the 246 items, 201 items were agreed to be important or very important by at least 80 % of panellists. These 201 endorsed items included actions on how to approach and offer support to a co-worker, and additional considerations where the person assisting is a supervisor or manager, or is assisting in crisis situations such as acute distress.

CONCLUSIONS: The guidelines outline strategies for a worker to use when they are concerned about the mental health of a co-worker or employee. They will be used to inform future tailoring of Mental Health First Aid training when it is delivered in workplace settings and could influence organisational policies and procedures.

Development of guidelines for workplace prevention of mental health problems : a Delphi consensus study with Australian professionals and employees

The purpose of the research was to conduct a Delphi expert consensus study (with employer, health professional and employee experts) to develop guidelines for the workplace prevention of mental health problems. A systematic review of websites, books, pamphlets and journal articles was conducted; a 363-item survey developed; and 314 strategies were endorsed as essential or important by at least 80% of all three panels. The endorsed strategies provided information on: creating a positive work environment; reducing job strain; rewarding employee efforts; workplace fairness; provision of supports; supportive change management; provision of training; provision of mental health education; and employee responsibilities.

Workplace prevention of mental health problems: Guidlelines for organisations

These guidelines consist of actions organisations can take to prevent common mental health problems in the workplace. It is hoped that they will be used to improve the practices of organisations as they work to reduce the risk of job stress and mental health problems in the workplace. The guidelines are intended to complement existing legislative requirements for occupational health and safety and the prevention and management of discrimination and harassment.

Workplace suicide prevention: a systematic review of published and unpublished activities

 There are a number of published studies on workplace suicide prevention activities, and an even larger number of activities that are not reported on in academic literature. The aim of this review was to provide a systematic assessment of workplace suicide prevention activities, including short-term training activities, as well as suicide prevention strategies designed for occupational groups at risk of suicide. The search was based on Meta-analysis of Observational Studies in Epidemiology (MOOSE) Guidelines. The databases used for the searches were the Cochrane Trials Library and PubMed. A range of suicide prevention websites were also searched to ascertain the information on unpublished workplace suicide prevention activities. Key characteristics of retrieved studies were extracted and explained, including whether activities were short-term training programmes or developed specifically for occupations at risk of suicide. There were 13 interventions relevant for the review after exclusions. There were a few examples of prevention activities developed for at-risk occupations (e.g. police, army, air force and the construction industry) as well as a number of general awareness programmes that could be applied across different settings. Very few workplace suicide prevention initiatives had been evaluated. Results from those that had been evaluated suggest that prevention initiatives had beneficial effects. Suicide prevention has the potential to be integrated into existing workplace mental health activities. There is a need for further studies to develop, implement and evaluate workplace suicide prevention programmes.

An integrated workplace mental health intervention in a policing context: protocol for a cluster randomised control trial

BACKGROUND: In this paper, we present the protocol for a cluster-randomised trial to evaluate the implementation and effectiveness of a workplace mental health intervention in the state-wide police department of the south-eastern Australian state of Victoria. n. The primary aims of the intervention are to improve psychosocial working conditions and mental health literacy, and secondarily to improve mental health and organisational outcomes.

METHODS/DESIGN: The intervention was designed collaboratively with Victoria Police based on a mixed methods pilot study, and combines multi-session leadership coaching for the senior officers within stations (e.g., Sergeants, Senior Sergeants) with tailored mental health literacy training for lower and upper ranks. Intervention effectiveness will be evaluated using a two-arm cluster-randomised trial design, with 12 police stations randomly assigned to the intervention and 12 to the non-intervention/usual care control condition. Data will be collected from all police members in each station (estimated at >20 per station). Psychosocial working conditions (e.g., supervisory support, job control, job demands), mental health literacy (e.g., knowledge, confidence in assisting someone who may have a mental health problem), and mental health will be assessed using validated measures. Organisational outcomes will include organisational depression disclosure norms, organisational cynicism, and station-level sickness absence rates. The trial will be conducted following CONSORT guidelines. Identifying data will not be collected in order to protect participant privacy and to optimise participation, hence changes in primary and secondary outcomes will be assessed using a two-sample t-test comparing summary measures by arm, with weighting by cluster size.

DISCUSSION: This intervention is novel in its integration of stressor-reduction and mental health literacy-enhancing strategies. Effectiveness will be rigorously evaluated, and if positive results are observed, the intervention will be adapted across Victoria Police (total employees ~16,500) as well as possibly in other policing contexts, both nationally and internationally.

Eight month post program completion: change in risk factors for chronic disease amongst participants in a four-month pedometer workplace health program

Objective: To evaluate whether participation in a 4-month, pedometer-based, physical activity, workplace health program is associated with long-term sustained improvements in risk factors for type 2 diabetesand cardiovascular disease, 8 months after the completion of the program.Design and Methods: A sample size of 720 was required. 762 Australian adults employed in primarily sedentary occupations and voluntarily enrolled in a workplace program were recruited. Demographic, behavioral, anthropometric and biomedical measurements were completed at baseline, 4 and 12 months.Results: About 76% of participants returned at 12 months. Sustained improvements at 12 months were observed for self-reported vegetable intake, self-reported sitting time and independently measured bloodpressure. Modest improvements from baseline in self-reported physical activity and independently measured waist circumference at 12 months indicated that the significant improvements observed immediately after the health program could not be sustained. Approximately half of those not meetingguidelines for physical activity, waist circumference and blood pressure at baseline, were meeting guidelines at 12 months.Conclusions: Participation in this 4-month, pedometer-based, physical activity, workplace health program was associated with sustained improvements in chronic disease risk factors at 12 months. These results indicate that such programs can have a long-term benefit and thus a potential role to play in population prevention of chronic disease.

Daily step-count and change in waist circumference during a workplace pedometer program

Background: The health benefit associated with a daily step-count target within pedometer pro- grams is unclear. The aim of this study was to determine if the daily step-count attained during a four month pedometer-based workplace health program was associated with change in waist circumference (WC).

Methods: 762 Australian adults enrolled in a workplace pedometer pro- gram were recruited from ten workplaces in 2008. At the end of the program (four months), 436 participants were eligible for the current analysis. Data included demographics, perceived physical activity change during the program, measured WC at baseline and follow-up, and reported daily pedometer step-counts throughout the program. The association between daily step count and change in WC was examined using linear re- gression.

Results: WC improved by an average of –1.61cm (95% CI: –2.13, –1.09) by the end of the program. There was no relationship between daily step-count and the degree of change in WC. However, among participants reporting an in- crease in physical activity during the program a relationship between daily step count and change in WC was observed, such that those who un-dertook on average 10,000 steps or more per day improved their WC by –1.38cm (95%CI: –2.14, –0.63) more than those who did not achieve an average of 10,000 steps per day. Similarly, among individuals not meeting WC guidelines at baseline a greater daily step count was associ-ated with a greater decrease in WC.

Conclusions: Within a workplace pedometer program, reported daily step count was not associated with greater reductions in WC. However, it was a useful in-dicator of potential health benefits in those who increased their level of physical activity during the program. Pedometer programs need to com- municate clearly the importance of both a step goal and improvement in step count to manage participant expectations about improvements in health markers.

Impact of a pedometer-based workplace health program on cardiovascular and diabetes risk profile

OBJECTIVE: To evaluate whether participation in a four-month, pedometer-based, physical activity, workplace health programme results in an improvement in risk factors for diabetes and cardiovascular disease. METHODS: Adults employed within Australia in primarily sedentary occupations and voluntarily enrolled in a workplace programme, the Global Corporate Challenge®, aimed at increasing physical activity were recruited. Data included demographic, behavioural, anthropometric and biomedical measurements. Measures were compared between baseline and four-months. RESULTS: 762 participants were recruited in April/May 2008 with 79% returning. Improvements between baseline and four-months amongst programme participants were observed for physical activity (an increase of 6.5% in the proportion meeting guidelines, OR(95%CI): 1.7(1.1, 2.5)), fruit intake (4%, OR: 1.7(1.0, 3.0)), vegetable intake (2%, OR: 1.3(1.0, 1.8)), sitting time (-0.6(-0.9, -0.3) hours/day), blood pressure (systolic: -1.8(-3.1, -.05) mmHg; diastolic: -1.8(-2.4, -1.3) mmHg) and waist circumference (-1.6(-2.4, -0.7) cm). In contrast, an increase was found for fasting total cholesterol (0.3(0.1, 0.4) mmol/L) and triglycerides (0.1(0.0, 0.1) mmol/L). CONCLUSION: Completion of this four-month, pedometer-based, physical activity, workplace programme was associated with improvements in behavioural and anthropometric risk factors for diabetes and cardiovascular disease. Long-term evaluation is required to evaluate the potential of such programmes to prevent the onset of chronic disease.

Efficacy of a workplace osteoporosis prevention intervention: a cluster randomized trial

BACKGROUND: Osteoporosis is a debilitating disease. Adequate calcium consumption and physical activity are the two major modifiable risk factors. This paper describes the major outcomes and efficacy of a workplace-based targeted behaviour change intervention to improve the dietary and physical activity behaviours of working women in sedentary occupations in Singapore.

METHODS: A cluster-randomized design was used, comparing the efficacy of a tailored intervention to standard care. Workplaces were the units of randomization and intervention. Sixteen workplaces were recruited from a pool of 97, and randomly assigned to intervention and control arms (eight workplaces in each). Women meeting specified inclusion criteria were then recruited to participate. Workplaces in the intervention arm received three participatory workshops and organization-wide educational activities. Workplaces in the control/standard care arm received print resources. Outcome measures were calcium intake (milligrams/day) and physical activity level (duration: minutes/week), measured at baseline, 4 weeks and 6 months post intervention. Adjusted cluster-level analyses were conducted comparing changes in intervention versus control groups, following intention-to-treat principles and CONSORT guidelines.

RESULTS: Workplaces in the intervention group reported a significantly greater increase in calcium intake and duration of load-bearing moderate to vigorous physical activity (MVPA) compared with the standard care control group. Four weeks after intervention, the difference in adjusted mean calcium intake was 343.2 mg/day (95 % CI = 337.4 to 349.0, p < .0005) and the difference in adjusted mean load-bearing MVPA was 55.6 min/week (95 % CI = 54.5 to 56.6, p < .0005). Six months post intervention, the mean differences attenuated slightly to 290.5 mg/day (95 % CI = 285.3 to 295.7, p < .0005) and 50.9 min/week (95 % CI =49.3 to 52.6, p < .0005) respectively.

CONCLUSION: This workplace-based intervention substantially improved calcium intake and load-bearing moderate to vigorous physical activity 6 months after the intervention began. TRIAL REGISTRATION: Australia New Zealand Clinical Trial Registry ACTRN12616000079448 . Registered 25 January 2016 (retrospectively registered).

How can organisations help employees thrive? the development of guidelines for promoting positive mental health at work

Purpose - Benefits of positive mental health have been demonstrated across work and non-work domains. Individuals reporting positive mental health experience better work performance, better social relationships and better physical health. Additionally, positive work environments can contribute to employee mental health. The purpose of this paper is to develop "expert" consensus regarding practical, actionable strategies that organisations can implement to promote positive mental health in the workplace. Design/methodology/approach - A Delphi consensusmethod was used to establish expert consensus on strategies to promote positive workplace mental health. A 278-item questionnaire was developed and strategies were rated over three survey rounds by two panels comprising 36 workplace mental health practitioners and 36 employer representatives and employees (27 and 9, respectively), employees with experience of promoting positive mental health and well-being in the workplace (total - 72 panellists). Findings - In total, 220/278 strategies were rated as essential or important by at least 80 per cent of both panels. Endorsed strategies covered the topics of: mental health and well-being strategy, work environment that promotes positive mental health, positive leadership styles, effective communication, designing jobs for positive mental health, recruitment and selection, supporting and developing employees, work-life balance, and positive mental health and well-being initiatives. Originality/value - The guidelines arising from this study represent expert consensus on what is currently appropriate for promoting positive mental health at work from the perspectives of workplace mental health practitioners, employers and employees, and constitute a resource for translating the growing body of knowledge in this area into policy and practice.

E-training or e-learning : towards a synthesis for the knowledge-era workplace

Many E-training environments and processes are based on participatory learning models in which participants share their understandings and aim to develop new insights into their workplace knowledge through discussion, questioning. mentoring and personal reflection. Knowledge production is assumed to occur through the cumulative elfect of these actions. However, equally likely outcomes include the sharing of ignorance or the development of erreneous understandings. Cognitive and social views of learning posit, however, that humans learn by thinking (not just hy interacting), and that unless this is explicitly taken into account in developing training programs. optimal leaming outcomes may not be achieved. This paper examines the importance of incorporating cognitive and social-Ieaming perspectives in E-training environments in order to maximise the potential for optimal leaming to occur. and provides suggestions for a synthesis of participatory and cognitive models.

Workplace "bargaining" and the wages/working time nexus: counting the cost of decentralisation

The impact of deregulation on dispersion of earnings in Victoria has been
acknowledged in the findings of the recent task force enquiry into industrial relations in Victoria. This paper argues that the link between hours worked and rates of pay has played a significant role in this increased dispersion. Drawing upon detailed analysis of hours and wages in Victorian agreements, data is presented on declining take-home pay flowing from the loss of penalty rates. This, we argue, is attributable to
the lack of substantive and procedural protections available to Victorian workers under schedule 1A of the Workplace Relations Act, and formerly under the Victorian Employee Relations Act, 1992. We contrast these findings with collective agreements trading off penalty rates certified by the Australian Industrial Relations Commission, and Australian Workplace Agreements approved by the Office of the Employment
Advocate. We conclude by suggesting there is a scale of fair outcomes attached to the wages/hours trade-off, directly attributable to the various institutional mechanisms now influencing Australian wage determination.

Remedies for unfair dismissal under the Workplace Relations Act 1996 - a fair go all round?

Background to unfair termination laws - remedies at common law - remedies for unfair termination under Federal Awards - overview of remedies under the Workplace Relations Act 1996 - compensation - reinstatement.