Mental Health and Well-being in the Public Sector and SMEs: Evaluating Multi-Level Intervention Strategies

Background: The current global landscape is confronting an escalation in mental health issues, both in frequency and intensity. This disturbing escalation has catalysed a widespread acknowledgement of the imperative to prioritise mental health and well-being, especially in the workplace. The H-WORK project adopted a comprehensive approach—multi-level organisational health interventions to tackle this issue effectively. These interventions were implemented at the individual, group, and leader levels, acknowledging the synergy of these levels in shaping overall mental health. The aim extends beyond merely attenuating stress and adverse health determinants; it also involves bolstering the factors that nurture mental health and well-being. The crux of this presentation lies in evaluating the distal outcomes of these interventions, reflecting on their indirect and causally far-reaching impacts. It is vital to underscore the importance of balance in implementing these initiatives as an exclusive concentration on interventions at the individual level can lead to a skewed understanding, attributing obstacles solely to the individual without addressing broader systemic challenges. Method: Data collection occurred from December 2020 to March 2023, aligning with the implementation phase informed by insights from extensive needs analyses. This phase involved an assessment conducted before, during, and after the interventions. We utilised linear mixed-effects modelling to scrutinise the within- and between-group differences in distal measures (e.g., mental health quality of life [MHQoL], work engagement, and burnout) over time and added age and gender as covariates. The study included two groups: a no-intervention group (n = 114) and an intervention group (n = 108). The participants hailed from four European countries—the Czech Republic, Germany, Italy, and Spain. The study encompassed the public (i.e., health care and higher education) and private sectors (three small businesses). Results: The multi-level H-WORK interventions did not bring about meaningful changes in some of the positive components of mental health and well-being (i.e., job satisfaction, vigour, and dedication). Interestingly, both the intervention and no-intervention groups eventually reached similar levels in terms of MHQoL and absorption. However, a divergence emerged in the trajectories. The intervention group experienced an increase in MHQoL, indicating a positive shift in their overall mental health perception. Conversely, the no-intervention group saw a decline in absorption levels, suggesting a potential vulnerability to disengagement. On the flip side, the interventions demonstrated a protective effect against negative mental health and well-being components, notably burnout. However, it's crucial to note a nuanced finding related to perceived stress. While the interventions did not worsen overall mental health, there was a slight uptick in perceived stress levels among the intervention group post-interventions. Conclusion: The multi-level interventions showcased mixed results, with improvements in certain aspects of mental health and well-being, a neutral impact on others, and a slight elevation in perceived stress. These findings underscore the intricate nature of mental health interventions (especially during a pandemic) and the importance of considering diverse outcomes for a holistic assessment. In the future, we recommend that any effect evaluation be interpreted together with a process evaluation to understand what works, for whom, and under which circumstances.