Authors:

Rachèle HÉBERT, research professional, Université de Sherbrooke
Rébecca LEFEBVRE, research professional, Université de Sherbrooke
Étienne Fouquet, research assistant, Université de Sherbrooke
Marie-Ève MAJOR, associate professor, ergonomics, Faculty of kinesiology, Université de Sherbrooke

Several international guides and standards are available to help employers implement mental health promotion and mental illness prevention in the workplace. But how effective are these guides and standards? Which best meet the specific needs of an organization? What criteria should their selection be based on? To answer these questions, we examined Memish and colleagues’ study published in 2017, which aimed to evaluate workplace mental health guidelines developed for employers 1) by conducting an international review of those guidelines and 2) assessing their comprehensiveness in terms of prevention, detection, and management of mental health problems in the workplace.

What do we mean by guidelines ?

There are many workplace mental health guidelines but, depending of the country, the legislative context, and the organizations that develop them, they vary in terms of content, applicability, and impact. Moreover, these guidelines can take the form of standards, guides, or frameworks outlining best workplace practices.

Standards

A standard is a document that sets established benchmarks for organizations to use in developing products and processes. Standards provide a framework for developing and deploying best practices.*

Standards are produced by recognized standardization bodies (provincial, national, or international) and lead to certification. The International Organization for Standardization (ISO) publishes international standards created to harmonize national standards.

Guides

Guides are tools made available and published by agencies or organizations, for example, to inform and suggest quality intervention strategies. They may provide forms, step-by-step approaches, and evaluation procedures related to best practices for promoting workplace mental health.

* Definition provided by CSA Group: https://www.csagroup.org/codes-standards/about-standards/

What do the results of the study tell us?

Four documents about workplace mental health stand out.

The authors conducted an international review of the quality and comprehensiveness of 20 documents developed for employers (standards, guides, frameworks), based on the following criteria:

• stakeholder involvement
• applicability
• coherence with legal requirements

Method

Systematic review of the literature

2. Consultation with experts in medicine, psychology, public health, mental health promotion, and workplace health and safety management to establish a best practice framework for mental health management.

Systematic reviews follow a step-by-step plan to summarize and evaluate information found in the scientific literature.

Grey literature is literature that is produced by government, academics, business, and industry but is not controlled by commercial publishers.  

The following table summarizes the four documents that received the highest scores by the authors of the study.

“Key takeaways” are indicated for each documents analyzed. These refer to the factors addressed by the recommended actions in documents. Special attention must be paid to evaluating these factors to implement an action plan adapted to employees needs. Depending of the context and the organization’s concerns, its workplace mental health program may be based on one these documents in accordance with practical considerations and the advantages referred to in the table.

1.

Standards name: Psychological Health and Safety in the Workplace – Prevention and guidance to staged implementation Organization that developed standard: Mental Health Commission, Bureau de normalisation du Québec, Canadian Standards Association (CSA Group) Country: Canada

Key takeaways

This standard covers the most factors, ranging from risk factors to outcome factors for the environment:

• Psychological support
• Organizational culture
• Clear leadership and expectations
• Civility and respect
• Psychological job demands
• Growth and development
• Recognition and rewards
• Involvement and influence
• Workload management
• Engagement
• Work/life balance
• Psychological protection from violence, bullying, and harassment
• Physical integrity protection

2.

Framework’s name: Psychosocial risk management excellence framework Organization that developed framework: PRIMA-EF Consortium Country: European Union

Key takeaways

Based on theoretical concepts, this framework identifies the psychosocial risksthat must be taken into account in an organization’s policies and practices:

• Work content
• Workload and pace of work
• Work schedule
• Control (or autonomy)
• Work environment and equipment
• Organizational culture
• Interpersonal relationships at work (support)
• Roles organization
• Work/life balance

3.

Guide name: Heads up: a guide for employers and employees Organization that developed guide: The Mentally Healthy Workplace Alliance Country: Australia  

Key takeaways

This guide highlights factors that contribute to workplace stress and poor staff health:

• Excessive job demands (physical, emotional, and mental)
• Low control (or autonomy)
• Weak support from superiors
• Roles conflict or lack of clarity in roles
• Poor relationship management
• Low level of recognition and rewards

4.

Document Name: Managing the causes of work-related stress: A step-by-step approach using the Management Standards Organization that developed document: Health and Safety Executive Country: United Kingdom

Key takeaways

This document identifies six  management practices to be evaluated as primary prevention strategies to reduce various sources of stress:

• Job demands (workload or requirements)
• Control (autonomy)
• Relationships (support)
• Role
• Change

N.B.: From one standard or guide to another, the same risk factors need to be assess: workload (or job demands or requirements), support (or interpersonal relationships), recognition and control (or influence or autonomy). These factors have been scientifically proven to affect workplace mental health – either positively or negatively. Decreasing these risk factors is the cornerstone of a workplace mental health intervention.

Recommendation from our expert

What should you focus on before, during, and after implementing workplace mental health guidelines?

Before launching a workplace mental health approach, the organization must be prepared!

• It must commit to implementing an approach that will involve taking actions based not only on its own priorities and concerns but also on the needs of its employees. Once employees have been informed of this approach, they will no doubt have high expectations about the organization.
• Senior management must be visible and set an example. Incorporating the prevention of mental health problems in its practices and policies is a first step.
• The stakeholders (e.g., trade union, human resources) must be consulted.
• The organization must support communications because they are essential at every stage of the implementation process.

Actions based on the above four points will facilitate the step-by-step implementation of the overall approach.

A review of the various guides, standards, and frameworks can be done to ensure the selected approach corresponds to the needs, capacities, and concerns of the organization. The article by Memish (2017), analyzed here, can guide the organization at this stage.

The choice of mental health guidelines is a significant component of this approach, but the organization’s commitment to its chosen approach is essential.   

The evaluation of workplace mental health risks is included in the suggested guidelines and is crucial to implementing the best actions:

• The employer and the stakeholders may have an idea of employees problems or needs, but an accurate assessment will either confirm that impression or reveal unsuspected needs.
• A committee, ideally representative (e.g., of departments, job categories, locations) can support the approach and lend credibility to it within the organization.
• The people in charge of the implementation must have knowledge and skills in workplace mental health. They must be trained and provided with the necessary tools.

To meet the employees expectations, short, medium and long term actions must be taken to demonstrate the organization’s commitment to this approach.  

To carry out an accurate evaluation, we suggest consulting this on-line tool on Global-Watch.com: Reminder: 20 points to consider in collecting data  from your employees

The various documents mentioned often refer to the three levels of prevention (primary, secondary, and tertiary) as well as individual and organisational interventions.

• Primary prevention actions, which change the organization of work at the source and aim to reduce the risk factors of poor mental health (e.g., reduce workload, increase employee involvement in decision making, etc.), are recognized as being the most effective because of their lasting impact. However, reducing illness-related absenteeism and staff turnover will be seen only over the long term.

It is thus important to combine primary prevention actions at the organizational level with secondary prevention actions (which aim to intervene in the early stages of a disease, such as when the symptoms of stress first appear) and tertiary prevention actions (which primarily target individuals to reduce relapses and disabilities and limit complications and consequences of disease.) For example, a network offering support to people in difficult situations could help them adapt to their work environment and intervene if mental health problems arise.

If you wish to evaluate the impact of your workplace mental health approach, give yourself time! Take into account the various organizational factors that may have arisen during the implementation process (e.g., reorganization of departments, technology changes, performance management) and frequently review the needs of employees and workplace health problems.

Implement a continuous improvement approach to mental health to promote your success and ensure your employees enjoy good mental health!