Introduction
There is strong evidence that work itself, despite its risks, reduces the risk of depression and improves mental health (Waddell & Burton, 2006; van der Noordt, IJzelenberg, Droomers, & Proper, 2014). Mental health, like mental illness, is a vaguely defined concept. Mental health is a non-contextual concept which can be defined as absence of mental illness and with the opportunity to develop and flourish with high levels of emotional, psychological and social well-being (Keyes, 2005). The concept of wellbeing at work is inclusive. It relates to the physical environment, work-related risks, organization of work and tasks, relationships with colleagues, personal health and work ability and even family-related stress (Suomaa Leo, Yrjänheikki Erkki, Savolainen Heikki, & Hannu, 2011). It can also be seen as an important determinant of productivity at the individual, corporate and community levels (Schulte & Vainio, 2010).
"Healthy factors" for mental health in the workplace are factors and circumstances at work that may have a preventive and/or promotional effect on mental health and wellbeing of the workers. These factors can serve as resources (buffers) against negative consequences of various risks at work, but they may also be factors that, by themselves, create positive health benefits for the individual and the workplace.
The large numbers of work-related mental unhealthy in the western world (not the least in Sweden), call for actions in improving working conditions, but which are the important determinants of positive mental health and wellbeing at work to be influenced? A review of indicators for healthy workplaces has recently been performed (Lindberg & Vingård, 2012), but we have not found any comprehensive review explicitly concerning positive mental health at work. Hence, the aim of this study was to review current knowledge concerning determinants for mental health and wellbeing at work.
Method
Two comprehensive literature searches were conducted in nine scientific databases, EBSCO (includes Academic Search Elite, Cinahl, PsycINFO och PsycARTICLES), Emerald, PubMed, Scopus and Web of Science, for relevant articles written in English, German or the Scandinavian languages. The first search, covering 2000-2014, was done for a Swedish government report (Lindberg & Karlsson, 2015). The second search, covering 2014 - June 2016, updated the previous data for the purpose of a scientific publication. Exclusion of articles was made stepwise by title, abstract and full text. The quality of included articles was assessed by acknowledged guidelines (STROBE Statement) and done separately by two researchers. The combined results are being analysed and will be presented in Montreal.
Search terms were: work OR workplace OR "healthy workplace" OR "healthy work" OR "healthy work* environment" OR "good work* environment" AND "depressive disorder" OR depression OR "behavioral symptoms" OR "anxiety disorders" OR "stress, psychological" OR "common mental disorders" OR "mental health" OR "sustainable mental health” OR "mental wellbeing" OR "mental well-being" OR "job wellbeing" OR "job well-being" OR "positive mental health" OR "good mental health" OR "positive mental wellbeing" OR "positive mental well-being" AND prevention OR promotion.
Results
According to preliminary analyses 5378 unique publications were found, of these 30 review-, cohort-, cross sectional-, and qualitative studies are included.
In the included studies 25 individual or categories of related factors promoting positive mental health and wellbeing at work were identified. Below is a list of the twelve most frequently researched factors listed in order of descending frequency.
- Style of leadership
- Empowerment; Autonomy; Control at work; Participation
- Possibilities for own development
- Positive work climate
- Social support from supervisor
- Communication supervisor-employee
- Clear goals
- Appreciation from supervisors, colleagues, customers
- Work time control; Enough time
- Effort-reward balance
- Intellectually stimulating
- Job security
As seen above the most frequently investigated factor was the impact of leadership on mental health. It was found that “good leadership”, i.e. fair, supportive and empowering, gave positive health changes and increased well-being, that increased quality of a staff-oriented leadership reduced sickness absence in the company and that transformational leadership increased psychological wellbeing and job satisfaction among workers.
Conclusion
Independent of study design leadership was the most scrutinized factor. Apart from possibly being a research trend (?), this may be interpreted as an understanding of both its explicit influence on the well-being of the employees, and its implicit influence by having the authority to facilitate communication, empowerment, control, support, respect, work content, feedback, etc.
Practical implications
Working conditions arise in the interaction between the individual and the organization, but creating working conditions that promote mental health cannot be put on the individual. It must be organized in the workplace for the employees in that special context, whereby the leadership seems to be paramount for the promotion of mental health and wellbeing at work.