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What do we know about the non-work determinants of workers' mental health? A systematic review of longitudinal studies.

ABSTRACT: In the past years, cumulative evidence has convincingly demonstrated that the work environment is a critical determinant of workers' mental health. Nevertheless, much less attention has been dedicated towards understanding the pathways through which other pivotal life environments might also concomitantly intervene, along with the work environment, to bring about mental health outcomes in the workforce. The aim of this study consisted in conducting a systematic review examining the relative contribution of non-work determinants to the prediction of workers' mental health in order to bridge that gap in knowledge.We searched electronic databases and bibliographies up to 2008 for observational longitudinal studies jointly investigating work and non-work determinants of workers' mental health. A narrative synthesis (MOOSE) was performed to synthesize data and provide an assessment of study conceptual and methodological quality.Thirteen studies were selected for evaluation. Seven of these were of relatively high methodological quality. Assessment of study conceptual quality yielded modest analytical breadth and depth in the ways studies conceptualized the non-work domain as defined by family, network and community/society-level indicators. We found evidence of moderate strength supporting a causal association between social support from the networks and workers' mental health, but insufficient evidence of specific indicator involvement for other analytical levels considered (i.e., family, community/society).Largely underinvestigated, non-work determinants are important to the prediction of workers' mental health. More longitudinal studies concomitantly investigating work and non-work determinants of workers' mental health are warranted to better inform healthy workplace research, intervention, and policy.

SUBMITTER: Beauregard N

PROVIDER: S-EPMC3141446 | biostudies-other | 2011 Jun

REPOSITORIES: biostudies-other

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What do we know about the non-work determinants of workers' mental health? A systematic review of longitudinal studies.

Beauregard Nancy N Marchand Alain A Blanc Marie-Eve ME

BMC public health 20110606

<h4>Background</h4>In the past years, cumulative evidence has convincingly demonstrated that the work environment is a critical determinant of workers' mental health. Nevertheless, much less attention has been dedicated towards understanding the pathways through which other pivotal life environments might also concomitantly intervene, along with the work environment, to bring about mental health outcomes in the workforce. The aim of this study consisted in conducting a systematic review examinin ...[more]

PMID: 21645393

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Project description:ObjectiveTo assess existing literature on the effectiveness of mental health training courses for non-specialist health workers, based on the WHO guidelines (2008).DesignA systematic review was carried out, complying with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.Data sourcesAfter examination of key studies in the literature, a comprehensive search was performed within the following electronic databases on 31 May 2017: PubMed, PsycINFO, CINAHL (using EBSCOHost interface), Cochrane, Web of Science.Eligibility criteriaSearches were conducted for articles published in English from January 2008 to May 2017, using search terms related to mental health, training, community care and evaluation/outcome, following the Participants, Interventions, Comparators and Outcomes process for evidence-based practice.OutcomesData were collected across the following categories: trainees (number and background), training course (curriculum, teaching method, length), evaluation method (timing of evaluation, collection method and measures assessed) and evaluation outcome (any improvement recorded from baseline). In addition, studies were assessed for their methodological quality using the framework established by Liu et al (2016).Results29 studies with relevant training courses met the inclusion criteria. These were implemented across 16 countries since 2008 (over half between 2014 and 2017), with 10 in three high-income countries. Evaluation methods and outcomes showed high variability across studies, with courses assessing trainees' attitude, knowledge, clinical practice, skills, confidence, satisfaction and/or patient outcome. All 29 studies found some improvement after training in at least one area, and 10 studies found this improvement to be significant.ConclusionsTraining non-specialist workers in mental healthcare is an effective strategy to increase global provision and capacity, and improves knowledge, attitude, skill and confidence among health workers, as well as clinical practice and patient outcome. Areas for future focus include the development of standardised evaluation methods and outcomes to allow cross-comparison between studies, and optimisation of course structure.Prospero registration numberCRD42016033269.

Project description:Background: Interpreters often play a crucial role in the health care of refugees. Although interpreters working with refugees are regularly confronted with emotionally stressful content, little is known about their work-related stress and psychological well-being. Primarily qualitative studies indicate increased emotional stress in interpreters, and difficulties in handling the traumatic content from their clients. Additionally, the working conditions of interpreters appear to be demanding, due to low payment and a lack of supervision or adequate preparation. Objective: The presented systematic review aimed to identify and summarise quantitative and qualitative research on the mental health of interpreters in the mental health care of refugees. Method: A systematic search was performed in five databases, and specific interpreting journals were searched. After removal of duplicates, 6,920 hits remained. Eligible studies included quantitative, qualitative, and mixed-methods studies as well as case studies and grey literature. The studies aimed to examine mental health aspects or work experiences of spoken language interpreters in mental health care settings for adult refugees. Results: Altogether, 25 studies were identified, including six quantitative and 19 qualitative studies. Studies were analysed and presented narratively. In the analysis of the qualitative studies, three themes emerged: "Emotions, behaviour, and coping strategies," "Working in a triad," and "Working environment." In the quantitative studies, interpreters showed heightened levels of emotional stress and anxiety, and secondary traumatic stress reactions. In several qualitative studies, interpreters described a devaluing health care system and stressful working conditions with a lack of support structures. Conclusion: Overall, the results indicate a high level of stress among interpreters working with refugees. Quantitative data are sparse, and studies employ heterogeneous assessments in diverse study settings. Therefore, future quantitative research is necessary to consistently investigate interpreters' mental health in different mental health care settings. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42019117948.

Project description:BACKGROUND:Sex workers are at disproportionate risk of violence and sexual and emotional ill health, harms that have been linked to the criminalisation of sex work. We synthesised evidence on the extent to which sex work laws and policing practices affect sex workers' safety, health, and access to services, and the pathways through which these effects occur. METHODS AND FINDINGS:We searched bibliographic databases between 1 January 1990 and 9 May 2018 for qualitative and quantitative research involving sex workers of all genders and terms relating to legislation, police, and health. We operationalised categories of lawful and unlawful police repression of sex workers or their clients, including criminal and administrative penalties. We included quantitative studies that measured associations between policing and outcomes of violence, health, and access to services, and qualitative studies that explored related pathways. We conducted a meta-analysis to estimate the average effect of experiencing sexual/physical violence, HIV or sexually transmitted infections (STIs), and condomless sex, among individuals exposed to repressive policing compared to those unexposed. Qualitative studies were synthesised iteratively, inductively, and thematically. We reviewed 40 quantitative and 94 qualitative studies. Repressive policing of sex workers was associated with increased risk of sexual/physical violence from clients or other parties (odds ratio [OR] 2.99, 95% CI 1.96-4.57), HIV/STI (OR 1.87, 95% CI 1.60-2.19), and condomless sex (OR 1.42, 95% CI 1.03-1.94). The qualitative synthesis identified diverse forms of police violence and abuses of power, including arbitrary arrest, bribery and extortion, physical and sexual violence, failure to provide access to justice, and forced HIV testing. It showed that in contexts of criminalisation, the threat and enactment of police harassment and arrest of sex workers or their clients displaced sex workers into isolated work locations, disrupting peer support networks and service access, and limiting risk reduction opportunities. It discouraged sex workers from carrying condoms and exacerbated existing inequalities experienced by transgender, migrant, and drug-using sex workers. Evidence from decriminalised settings suggests that sex workers in these settings have greater negotiating power with clients and better access to justice. Quantitative findings were limited by high heterogeneity in the meta-analysis for some outcomes and insufficient data to conduct meta-analyses for others, as well as variable sample size and study quality. Few studies reported whether arrest was related to sex work or another offence, limiting our ability to assess the associations between sex work criminalisation and outcomes relative to other penalties or abuses of police power, and all studies were observational, prohibiting any causal inference. Few studies included trans- and cisgender male sex workers, and little evidence related to emotional health and access to healthcare beyond HIV/STI testing. CONCLUSIONS:Together, the qualitative and quantitative evidence demonstrate the extensive harms associated with criminalisation of sex work, including laws and enforcement targeting the sale and purchase of sex, and activities relating to sex work organisation. There is an urgent need to reform sex-work-related laws and institutional practices so as to reduce harms and barriers to the realisation of health.

Project description:PurposeLesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals experience high rates of adverse mental health outcomes due to the stressors they experience in families, communities, and society more broadly. Work and workplaces have the potential to influence these outcomes given their ability to amplify minority stress, and their ability to influence social and economic wellbeing in this already marginalized population. This study aims to identify how sociodemographic characteristics and characteristics of work, including degree of precarity, industry and perceived workplace support for LGBTQ people, influence self-reported mental health among LGBTQ people in two Canadian cities.MethodsSelf-identified LGBTQ workers ≥16 years of age (n = 531) in Sudbury and Windsor, Ontario, Canada were given an online survey between July 6 and December 2, 2018. Multivariate ordinal logistic regression was used to calculate odds ratios (OR) to evaluate differences in gender identity, age, income, industry, social precarity, work environment, and substance use among workers who self-reported very poor, poor, or neutral mental health, compared with a referent group that self-reported good or very good mental health on a five-point Likert scale about general mental health.ResultsLGBTQ workers with poor or neutral mental health had greater odds of: being cisgender women or trans compared with being cisgender men; being aged <35 years compared with ≥35 years; working in low-wage service sectors compared with blue collar jobs; earning <$20,000/year compared with ≥$20,000/year; working in a non-standard work situation or being unemployed compared with working in full-time permanent employment; feeling often or always unable to schedule time with friends due to work; feeling unsure or negative about their work environment; and using substances to cope with work.ConclusionsBoth precarious work and unsupportive work environments contribute to poor mental health among LGBTQ people. These factors are compounded for trans workers who face poorer mental health than cis-LGBQ workers in similar environments.

Project description:To synthesize current understanding of how community-based health worker (CHW) programs can best be designed and operated in health systems.We searched 11 databases for review articles published between 1 January 2005 and 15 June 2017. Review articles on CHWs, defined as non-professional paid or volunteer health workers based in communities, with less than 2 years of training, were included. We assessed the methodological quality of the reviews according to AMSTAR criteria, and we report our findings based on PRISMA standards.We identified 122 reviews (75 systematic reviews, of which 34 are meta-analyses, and 47 non-systematic reviews). Eighty-three of the included reviews were from low- and middle-income countries, 29 were from high-income countries, and 10 were global. CHW programs included in these reviews are diverse in interventions provided, selection and training of CHWs, supervision, remuneration, and integration into the health system. Features that enable positive CHW program outcomes include community embeddedness (whereby community members have a sense of ownership of the program and positive relationships with the CHW), supportive supervision, continuous education, and adequate logistical support and supplies. Effective integration of CHW programs into health systems can bolster program sustainability and credibility, clarify CHW roles, and foster collaboration between CHWs and higher-level health system actors. We found gaps in the review evidence, including on the rights and needs of CHWs, on effective approaches to training and supervision, on CHWs as community change agents, and on the influence of health system decentralization, social accountability, and governance.Evidence concerning CHW program effectiveness can help policymakers identify a range of options to consider. However, this evidence needs to be contextualized and adapted in different contexts to inform policy and practice. Advancing the evidence base with context-specific elements will be vital to helping these programs achieve their full potential.

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What do we know about the non-work determinants of workers' mental health? A systematic review of longitudinal studies.

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What do we know about the non-work determinants of workers' mental health? A systematic review of longitudinal studies.

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