Article Text

Workplace mental health screening: a systematic review and meta-analysis
  1. Jessica Strudwick1,
  2. Aimee Gayed1,2,
  3. Mark Deady1,2,
  4. Sam Haffar1,
  5. Sophia Mobbs1,
  6. Aiysha Malik3,
  7. Aemal Akhtar4,5,
  8. Taylor Braund1,2,
  9. Richard A Bryant4,
  10. Samuel B Harvey1,2
  1. 1 Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
  2. 2 Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
  3. 3 Department of Mental Health and Substance Use, World Health Organization, Geneve, Switzerland
  4. 4 School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
  5. 5 Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
  1. Correspondence to Dr Aimee Gayed, Black Dog Institute, University of New South Wales, Randwick, NSW 2034, Australia; a.gayed{at}blackdog.org.au

Abstract

Workplaces are an important location for population mental health interventions. Screening to detect employees at risk of or experiencing mental ill health is increasingly common. This systematic review and meta-analysis examined the efficacy of workplace mental health screening programmes on employee mental health, work outcomes, user satisfaction, positive mental health, quality of life, help-seeking and adverse effects. PubMed, PsycINFO, EMBASE, CENTRAL, Global Index Medicus, Global Health and SciELO were searched (database inception–10 November 2022) and results screened by two independent reviewers. Controlled trials evaluating screening of workers’ mental health as related to their employment were included. Random effects meta-analysis was performed to calculate pooled effect sizes for each outcome of interest. Grading of Recommendations Assessment, Development and Evaluation was conducted to evaluate the certainty of findings. Of the 12 328 records screened, 11 were included. These reported 8 independent trials collectively assessing 2940 employees. Results indicated screening followed by advice or referral was ineffective in improving employee mental health symptoms (n=3; d=−0.07 (95% CI −0.29 to 0.15)). Screening followed by facilitated access to treatment interventions demonstrated a small improvement in mental health (n=4; d=−0.22 (95% CI −0.42 to –0.02)). Limited effects were observed for other outcomes. Certainty ranged from low to very low. The evidence supporting workplace mental health screening programmes is limited and available data suggest mental health screening alone does not improve worker mental health. Substantial variation in the implementation of screening was observed. Further research disentangling the independent effect of screening alongside the efficacy of other interventions to prevent mental ill health at work is required.

  • Occupational Health
  • Mental Health
  • Public Health Surveillance
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Footnotes

  • Twitter @Jess_Strudwick, @AimeeGayed, @DrMarkDeady, @Taylor_Braund, @Samuel_Harvey

  • Contributors JS implemented and oversaw the review process, drafted and finalised the protocol, conducted the search, conducted screening and risk of bias assessment, conducted quantitative and GRADE analyses, and produced the initial draft and revised the paper. AG conducted screening and risk of bias assessment, secured funding, drafted, and revised the paper. MD secured funding, drafted, and revised the paper. SH and SM conducted screening, risk of bias assessment, and data extraction, and revised the paper. TB drafted the protocol and drafted and revised the paper. AM and AA scoped the research question, reviewed the protocol and drafted and revised the paper. SBH and RAB secured funding, conceptualised the review, implemented and oversaw the review process, conducted GRADE analysis, and drafted and revised the paper.

  • Funding JS, AG, MD, TB, RAB and SBH are supported by funding from the iCare Foundation (No. RG193295). SBH is also supported by a National Health and Medical Research Council (NHMRC) investigator grant (No. 1178666). RAB is supported by a NHMRC Grant (No. 1173921). This work was commissioned by the WHO as part of the Guidelines for Mental Health at Work (No. not applicable).

  • Disclaimer The author is a staff member of the World Health Organization. The author alone is responsible for the views expressed in this publication and they do not necessarily represent the views, decisions or policies of the World Health Organization.

  • Competing interests JS, SH, SM, AG, MD, TB and SBH are employed by the Black Dog Institute, a not-for-profit research institute that provides mental health training to a range of organisations.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.