The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review
Authors: Aust Birgit , Leduc Caleb , Cresswell-Smith Johanna , O’Brien Clíodhna , Rugulies Reiner , Leduc Mallorie , Dhalaigh Doireann Ni , Dushaj Arilda , Fanaj Naim , Guinart Daniel , Maxwell Margaret , Reich Hanna , Ross Victoria , Sadath Anvar , Schnitzspahn Katharina , Tóth Mónika Ditta , van Audenhove Chantal , van Weeghel Jaap , Wahlbeck Kristian , Arensman Ella , Greiner Birgit A. ,   MENTUPP consortium members, O’Connor Ainslie , Moreno-Alcázar Ana , Meksi Andia , Szekely Andras , LaMontagne Anthony , Como Ariel , Pashoja Arlinda Cerga , Doukani Asmae , Justicia Azucena , Amann Benedikt , Hogg Bridget , Paterson Charlotte , Lockwood Chris , McDaid David , Zsak Eva , Griffin Eve , Coppens Evelien , Tsantila Fotini , Burazeri Genc , Qirjako Gentiana , Purebl György , Serbanescu Ilinca , Luyten Jeroen , Eustace Joe , Kilroy Joseph , Alcaraz Juan Carlos Medina , Hug Juliane , Kõlves Kairi , Abdulla Kahar , Michell Karen , Mulcahy Karen , Thomson Katherine , de Winter Lars , Cox Laura , van der Ham Lia , D’Alessandro Luigia , Fontana Marta , Reavley Nicola , Trembeczky Peter , Driessen Pia , Hauck Pia , Corcoran Paul , Lohmann-Devantier Rebecca , Rapeli Saara , Ihinonvien Sarah , Mustafa Sevim , Hackel Stefan , Alexander Susan , King Tanya , Hegerl Ulrich , Scott Vanda , Orchard Wendy 
Published: May 2024

Abstract
Objective
To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing.

Methods
Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible.

Results
We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type “Job and task modifications” and a moderate level of evidence for the types “Flexible work and scheduling” and “Changes in the physical work environment”. For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed.

Conclusion
Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.