• Seymour L, Grove B. Workplace interventions for people with common mental health problems: evidence review and recommendations. London (UK): British Occupational Health Research Foundation (BOHRF); 2005 Sep. 96 p. [83 references]

This is the current release of the guideline.

Definition of Common Mental Health Problems

Common mental health problems as those that:

• Occur most frequently and are more prevalent
• Are mostly successfully treated in primary rather than secondary care settings
• Are least disabling in terms of stigmatising attitudes and discriminatory behaviour

Prevention of Common Mental Health Problems

• Amongst employees who have not manifested with common mental health problems or who are not at high risk, the evidence suggests that a range of stress management interventions can have a beneficial and practical impact.
• These interventions also provide employees with a range of useful skills that can be exploited to their own and their organisation's wider benefit.
• The extent to which any of these interventions prevent common mental health problems remains unclear.

Retention at Work

• Amongst employees deemed to be at risk, either through their job role or who have been assessed as at risk, the evidence from the included studies demonstrates that individual rather than organisational approaches to managing common mental health problems are most likely to be effective.
• However it is imperative that those populations are identified accurately so that interventions can be correctly targeted and applied and the anticipated benefits of retaining key skills in organisations can be realised.

Rehabilitation

• For people already experiencing common mental health problems at work, the evidence from the included studies demonstrates that, the most effective approach is brief (up to 8 weeks) of individual therapy, especially cognitive behavioural in nature (CBT).
• The research on CBT delivered via computer-aided software would ideally benefit from a corroborative study. This approach appears promising, although its effectiveness has currently only been demonstrated in the short term (i.e., at one month).
• A stronger effect is associated with employees in high-control jobs.

Recommendations for Practice

The recommendations for practice have emerged from the data pool that supports evidence of effective practice.

• The evidence supports the use of CBT in brief therapy sessions of up to 8 weeks with people already presenting with common mental health problems.
• CBT is most effective for jobs that already involve a high degree of decision latitude.
• Jobs with low decision latitude should prioritise increasing control potential accompanied by CBT interventions.
• Early psychological interventions are effective for common mental health problems, delivered in the workplace, comprising 4-5 sessions of CBT to increase activity and coping skills for those off sick for two weeks (van der Klink et al., 2003)
• Interventions conducted by general practitioners (GPs) or occupational health (OH) Physicians or referred by them to psychologists or psychotherapists should be cognitive in nature.
• Supervisors should keep in touch with employees on mental ill health sickness absence at least once every two weeks (Nieuwenhuijsen et al., 2004)
• No intervention has effects that last forever; training programmes might be more effective at sustaining changes if they include booster and follow-up sessions (Reynolds et al., 1993)

Interventions worth Consideration

Although the evidence base did not strongly support these practices, the guideline Working Group members think that any are worthy of implementation and review if a workplace cannot implement the recommendations for practice.

• Other cognitive/educational approaches (sometimes described as directive or activating)
• Multi-modal interventions (especially via the Internet or other forms of facilitated self help) for employees identified or deemed to be at high risk
• Interventions to train and improve supervisory behaviour
• Selective use of case management with those at risk of long term absence
• Computer-aided CBT available in an amended 3-4 session format, to make it more acceptable to employees.

None provided

The evidence included 19 experimental studies dealing with various aspects of management relevant to occupational health guidelines (see Table I in the original guideline document for details) and 12 non-experimental and narrative studies (see Table II in the original guideline for details). The 19 experimental studies included randomized controlled trials, quasi-randomized controlled studies, controlled intervention studies, systematic literature reviews, and a meta-analysis.

• Seymour L, Grove B. Workplace interventions for people with common mental health problems: evidence review and recommendations. London (UK): British Occupational Health Research Foundation (BOHRF); 2005 Sep. 96 p. [83 references]

Not applicable: The guideline was not adapted from another source.

2005 Sep

British Occupational Health Research Foundation - Private Nonprofit Organization

British Occupational Health Research Foundation

The Research Working Group

Group Members: Dr Kit Harling (Chair) Consultant Occupational Physician, Avon Partnership Occupational Health Service; Director, NHS Plus; Dr Ira Madan (Vice Chair) Consultant Occupational Physician, Guy's & St Thomas's NHS Foundation Trust; Dr Bob Grove (Senior Researcher) Director Employment Programme, Sainsbury Centre for Mental Health; Linda Seymour (Scientific Secretary) Research & Policy Development Manager, mentality @ The Sainsbury Centre for Mental Health; Dr Jed Boardman, Consultant/Senior Lecturer in Social Psychiatry, South London and Maudsley NHS Trust and Health Services Research Dept, Institute of Psychiatry King's College London; Dr Dennis Ferriday, Director Health Services (Europe), Ford Motor Company; Dr Fiona Ford (representing RCGP) Senior Lecturer in General Practice, University of Central Lancashire; Ann Kelly, Representing Chartered Management Institute; Dr Noel McElearney (BOHRF Trustee) Director Health Safety & Environment, Scottish & Newcastle plc; Tom Mellish (resigned March 2005) Health & Safety Officer, TUC; Hugh Robertson (from April 2005) Senior Health & Safety Officer, TUC; Susan Scott-Parker, Chief Executive, Employers Forum on Disability; Simon Pickvance, Senior Occupational Health Adviser, Sheffield Occupational Health Advisory Service; Professor Jenny Secker, Professor of Mental Health, Anglia Polytechnic University & South Essex Partnership NHS Trust; Professor Justine Schneider, Professor of Mental Health & Social Care, Nottingham University; Grahame Whitfield, Department for Work and Pensions; Ben Willmott, Employee Relations Adviser, CIPD; Brian Kazer, Chief Executive, British Occupational Health Research Foundation

Conflicts of interest were formally reviewed in respect of all members of the research working group. No conflicts of interest were found.

This is the current release of the guideline.

None available

This NGC summary was completed by ECRI on May 7, 2007. The information was verified by the guideline developer on May 23, 2007.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.