Workplace mental health and the role of organisational leaders : a training needs analysis and evaluation of an online program to reduce depression-related stigma
Background: The effective management of employees with depression represents an emerging organisational challenge for leaders. Depression is a common mental health problem that, if left untreated, has far-reaching effects on the individual, their family, the health system and, increasingly, on the organisation in which they work. Despite these impacts, depression is generally not managed well, particularly in the workplace setting. While most large Australian organisations offer Employee Assistance Programs and are beginning to provide mental health relevant training to staff and front-line managers, it is very rare that the issue of managing mental health in the workplace is built into leadership education and development programs. As a result, the relevant skills and knowledge precariously rest with individual employees, rather than being built into the culture of organisations in a sustainable way. However, online technologies offer new opportunities for the delivery of workplace mental health information and stigma reduction interventions. This delivery channel may be particularly suited to the learning needs of time-poor leaders. Aims: The aim of the current research was to investigate whether a sustained change in the stigma and mental health literacy of organisational leaders in relation to managing depression in the workplace could be achieved as a result of completing an online workplace mental health program. An additional aim was to examine whether change in stigma level and mental health literacy led to behavioural change. This would indicate that the learning was transferred from the training environment to the workplace, and was thus, more likely to be embedded in the organisational culture. Methods: An exploratory online survey of 379 leaders (N = 215 females, N = 164 males) and 364 human resources and learning and development professionals (N = 288 females, N = 76 males) was undertaken as a training needs analysis to determine the training needs of organisational leaders in relation to workplace mental health. Building on this information, a brief online workplace mental health program was developed in conjunction with an Australian mental health charity, beyondblue. The program was designed to provide leaders with information, tools and practical actions to help them create a mentally healthy workplace and reduce stigma in their workplace. A total of 311 organisational leaders (N = 163 females, N = 148 males) participated in a mixed methods, randomised controlled, 'in the field' evaluation study. Participants signed-up to the study, filled in a pre-survey online, were randomly assigned to either the experimental (n=155) or the wait-list control (n=156) groups. Approximately one week later, leaders in the experimental group were sent a link to the online program and asked to complete the post-survey at the end of the program. At the same time, leaders in the control group were asked to complete the post-survey online. Six months later, participants were asked to complete a final online survey as a follow-up assessment. The following variables were measured in the evaluation: various demographics, depression knowledge, stigma, organisational strategies and norms, pre-training motivation, reactions to the online program, the usability of the program and training transfer. Finally, 16 organisational leaders participated in semi-structured interviews to explore their application of knowledge learned from the program. Results: The training needs of leaders were identified by the training needs analysis and incorporated into the design of the workplace mental health program. Analysis of the quantitative and qualitative data from the evaluation study revealed several important findings. For example, at baseline male leaders employed in the private sector and leaders without prior experience of depression, reported higher levels of stigma. Analysis of pre and post data revealed significant reductions in behavioural, affective and total stigma scores in the leaders who completed the online program. These reductions were sustained at 6-month follow-up. No main effects were found for mental health literacy (that is, knowledge about depression), social distance or the cognitive component of stigma. Further, qualitative interviews revealed a range of individual and contextual factors that either enabled or hindered the application of learning from the online program into the workplace. These factors included the nature of the work environment itself, the collective readiness and capability of the organisation to address these issues, the attitudes of others at work and the broader political context. Conclusions: The online program was shown to be effective in reducing stigma. While this effect was sustained over time, the program did not improve knowledge about depression. However, there was evidence that leaders were using the material in the program to increase the mental health knowledge of others in their workplace and in other organisations. In addition, the evaluation study has shown that positive attitudes and high levels of knowledge are not in themselves sufficient to ensure leaders are able to apply program learning into their work environments. A range of contextual factors emerged as significantly influencing the extent to which new knowledge is applied in the workplace. Several limitations with the evaluation study are highlighted, including the convenience sampling approach utilised and the impact of social desirability bias. However, the utilisation of mixed methods and randomised control in the research design produced robust and reliable results. The evaluation study has practical implications, particularly in relation to the targeting and tailoring of workplace mental health programs, in order to reach an identified priority group for stigma reduction initiatives. It also highlights the importance of harnessing the commitment of those leaders who are already motivated to act in this area (most likely due to a personal experience of depression) and engaging them as champions. Several areas of future research are also identified, including the effectiveness of online programs like the current one to reduce stigma related to other mental health conditions and the impact of this program on the business and on other employees working with leaders who participated. These would strengthen what is currently known about how best to ensure learning from programs such as these is embedded in organisational culture, so that resultant changes in attitudes and behaviours can be sustained over time.