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Abstract
Purpose – Benefits of positive mental health have been demonstrated across work and non-work
domains. Individuals reporting positive mental health experience better work performance, better
social relationships and better physical health. Additionally, positive work environments can
contribute to employee mental health. The purpose of this paper is to develop “expert” consensus
regarding practical, actionable strategies that organisations can implement to promote positive mental
health in the workplace.
Design/methodology/approach – A Delphi consensus method was used to establish expert consensus
on strategies to promote positive workplace mental health. A 278-item questionnaire was developed and
strategies were rated over three survey rounds by two panels comprising 36 workplace mental health
practitioners and 36 employer representatives and employees (27 and 9, respectively), employees with
experience of promoting positive mental health and well-being in the workplace (total – 72 panellists).
Findings – In total, 220/278 strategies were rated as essential or important by at least 80 per cent of
both panels. Endorsed strategies covered the topics of: mental health and well-being strategy, work
environment that promotes positive mental health, positive leadership styles, effective communication,
designing jobs for positive mental health, recruitment and selection, supporting and developing
employees, work-life balance, and positive mental health and well-being initiatives.
Originality/value – The guidelines arising from this study represent expert consensus on what is
currently appropriate for promoting positive mental health at work from the perspectives of workplace
mental health practitioners, employers and employees, and constitute a resource for translating the
growing body of knowledge in this area into policy and practice.
Keywords Workplace health, Delphi, Positive psychology, Well-being, Positive mental health
Paper type Research paper
Introduction
International Journal of Workplace
Work is a primary determinant of socio-economic position and plays a critical role in Health Management
mental and physical well-being (Paul and Moser, 2009). People who are employed Vol. 9 No. 4, 2016
pp. 411-427
report greater life satisfaction and self-worth, as well as more effective and meaningful © Emerald Group Publishing Limited
1753-8351
personal relationships (Chen and Cooper, 2014; Dutton et al., 2011). High-quality DOI 10.1108/IJWHM-01-2016-0001
IJWHM workplaces can also contribute to greater employee mental health and consequently,
9,4 more effective organisations.
Until relatively recently, research into the links between work and mental health has
tended to focus on the adverse effects of a poor psychosocial work environment, with
evidence that this can increase the risk of mental health problems, particularly
depression (Bonde, 2008; Stansfeld and Candy, 2006). However, the growing interest in
412 positive mental health and positive psychology has had a considerable influence on
workplace practices and efforts to enhance employee health and well-being. Promoting
the positive aspects of work (wellness focus) complements and extends the traditional
occupational health and safety emphasis on the prevention and control of work-related
harm to mental health (illness focus). We have argued that an optimal and
integrated approach to workplace mental health would thus include preventing
work-related harms, promoting of the positive aspects of work, and addressing mental
health problems regardless of cause (LaMontagne et al., 2014). Of the three aspects of
such an integrated approach, the evidence-base for promoting the positive is the least
developed (LaMontagne et al., 2014). Thus the need for this research to develop
consensus regarding practical, actionable strategies that can be implemented to
promote positive mental health in the workplace.
Insights from the study of positive organisational behaviour and positive psychology
indicate that employees who experience positive mental health and greater psychological
capital are more satisfied, committed and productive (Seligman and Csikszentmihalyi,
2000; Youssef and Luthans, 2007). However, while evidence regarding the strategies that
individuals can personally engage in to promote positive mental health has grown in
recent years (Sin and Lyubomirsky, 2009), research evidence regarding the actions that
individuals, teams and organisations can take in a workplace setting to promote positive
mental health is still in its infancy (Meyers et al., 2013).
In parallel to the growing emphasis on promoting positive mental health at work, a
number of organisations have been implementing strategies to increase employee
well-being and therefore have valuable practical evidence to share with researchers and
other organisations. The aim of this research was therefore to “close the gap” between
research and practice by generating expert consensus regarding the strategies that
organisations can implement to promote positive mental health at work.
Method
There are various formal methods available to measure expert consensus in health
research. The Delphi method selected for this study is a widely used and accepted
methodology for achieving consensus of opinion. It is designed as a group
communication process in which relevant groups make private ratings of agreement
with a series of statements ( Jorm, 2015).
A systematic search of lay and scientific literature was conducted to collate practical,
actionable strategies that individuals, teams and organisations could use to promote
positive workplace mental health. Once strategies were collated from the systematic
search, they were presented to two panels for rating. There was a panel of practitioners
and a panel of expert employers/employees of positive organisations. This study was
approved by the Human Research Ethics Committee of the Deakin University.
Panel formation
The research team recruited two panels including:
• Panel 1: practitioners (including psychologists, organisational psychologists,
academics, occupational/organisational health consultants and senior advisors
in creating healthy workplaces); and
• Panel 2: expert employer representatives and employees (including directors,
general managers, employers and employees of organisations that have been
recognised for promoting positive mental health and well-being in the workplace).
Participants from both Panels 1 and 2 were recruited via an e-mail invitation from the
project funder SuperFriend, a mental health promotion foundation that aids “all profit to
member” superannuation funds in promoting and supporting the mental health and
well-being of their members through the workplace, or via invitation by members of
the research team. The e-mail invitation outlined eligibility criteria and a description of the
study, including requirements of participants and the voluntary nature of involvement.
Eligibility criteria for potential panellists included having an excellent understanding of
promoting workplace positive mental health by providing meaningful work, opportunities
for social connection and achievement, promoting the positive aspects of work and
providing education on activities that promote mental health. Additionally, the eligibility Positive
criteria included experts in the field of positive psychology (e.g. identified through mental health
publication), experts identified as market leaders in positive mental well-being in the
workplace and experts who had been award nominees and recipients for positive mental
at work
health and well-being (e.g. Martin Seligman Award for Health and Well-being, Best Places
to Work Award and The WorkSafe Health and Safety Award).
Methods used to recruit practitioners included the use of LinkedIn to identify 415
experts (e.g. through groups such as the Psychologically Healthy Workplaces Network,
Psychologically Healthy Workplaces Australia, Positive Psychology at Work,
Organisational Psychology in Australia, Health and Work Productivity Portal and
Employee Well-being), and through identification of organisations who had promoted
and implemented strategies to improve employee “well-being” as well as “positive
psychology” or “positive well-being” strategies. Potential panellists contacted were also
invited to recommend others who fit the eligibility criteria and who might be interested
in participating.
The average number of participants in a Delphi panel is between 15 and 60 in order to
ensure that no one participant can have an overly significant influence on the outcome,
and to allow a reliable consensus to be reached (Hasson et al., 2000). Accordingly, we
sought a minimum of 30 in each panel of this study. Participants who were screened for
their eligibility criteria were sent an e-mail invitation to participate in the Delphi survey.
Recruited panellists were largely from Australia (n ¼ 58), with additional respondents
from the USA (n ¼ 8), UK (n ¼ 1) and Canada (n ¼ 5). Panel membership totalled 72, with
36 practitioners and 36 expert employers/employees. Representatives from organisations
included a cross-section of industries and included both large and small/medium
enterprises. In total, 60 per cent of panel members were female (58 per cent of
practitioners and 61 per cent of expert employers/employees). The median age was
47 years for the practitioners and 42.5 years for the expert employers/employees.
overview of the study and reiterated the voluntary and anonymous nature of the survey.
It was also stated in the introduction that completion of the survey will signify that
informed consent has been gained. Panellists were asked to rate the importance of each
strategy. The rating scale was “Essential”, “Important”, “Depends”, “Unimportant”,
“Should not be included”,“Don’t know”. Panel members had the opportunity to suggest
additional strategies or make suggestions to improve current strategies in comment
boxes during the first round of surveys. These suggested strategies were included in the
subsequent rounds for all panellists to rate. Each panellist received a summary of group
ratings after the first two survey rounds. This enabled panellists to determine whether or
not they wanted to change or maintain their ratings. Overall, a list of statements that
received substantial consensus in ratings (or essential or important) was developed, while
statements that received low or conflicting ratings were discarded.
Statistical analysis
Following the completion of each round, the results from the survey were analysed by
obtaining percentages of agreement/disagreement with each strategy, according to
each panel (i.e. one rating for Panel 1 and one rating for Panel 2). The following criteria
were used to accept, re-rate or reject a strategy.
Criteria for accepting a strategy. If at least 80 per cent of both panels rated a strategy
as essential or important as a guideline for organisations promoting positive workplace
mental health, it was included in the guidelines.
Criteria for re-rating a strategy. Panel members were asked to re-rate a strategy in
the following survey round if:
• in total, 80 per cent or more of the panel members in one group rated a strategy
as essential or important, but o 80 per cent the other panel members rated it as
essential or important (e.g. 85 per cent of Panel 1 rated a strategy as essential or
important, but only 70 per cent of Panel 2 rated the strategy as essential or
important); and
• in total, 70-79 per cent of panel members in both groups rated a strategy as either
essential or important.
Criteria for rejecting a strategy. Any strategies that did not meet the above conditions
were excluded.
IJWHM Results
9,4 The participation rate of those who took part in all three survey rounds was
58.3 per cent (61.1 per cent practitioners and 55.6 per cent expert employers/employees).
See Table III for the number of panel members who completed each round.
As Figure 1 illustrates, across the three rounds, 220/278 strategies were rated as
essential or important by at least 80 per cent of the two panels.
418
Round 1
Questionnaire
(278 strategies)
Round 2
Questionnaire
(102 strategies)
Round 3
Questionnaire
(29 strategies)
Discussion
Overall, 220 of 278 positive workplace strategies identified from a systematic literature
search were endorsed by both panels of experts. Endorsed strategies were developed
into a set of open-access web-published guidelines to serve as a resource for promoting
positive mental health in the workplace and are available at: www.superfriend.com.au/
uploads/page/533/Promoting-Positive-Mental-Health-in-the-Workplace-Guidelines-for-
organisations.pdf. These guidelines are intended to be used by organisations and
people in a wide range of roles, as well as individuals operating in policy, practice or
research settings.
Most of the 278 strategies presented to the expert panels were endorsed as essential
or important with a high level of agreement between panels (220/278 ¼ 79 per cent).
At the organisational level, considerable agreement was seen between panels for the
development of a mental health and well-being strategy, and specifically for the
inclusion of positive mental health and well-being provisions within this strategy.
Workplace health promotion research has highlighted that a major barrier to the
effectiveness of mental health initiatives is the gap that exists between the strategy
planning and implementation phases (LaMontagne and Noblet, 2009; LaMontagne
et al., 2012). The results from this study confirm the importance of effective means of
implementation. Specifically, panel members from both expert groups were consistent
in their views on the need to ensure adequate support and resources for the
implementation of a positive mental health strategy. Strategies including the visible
involvement of middle and senior managers and the provision of training and
development for employees and managers were highly endorsed.
The role of communication in promoting positive mental health was prominent
throughout the strategies that received endorsement. Consistent with the literature on
IJWHM employee voice (Morrison, 2011), effective communication between team members and
9,4 between managers and employees was viewed as essential or important for the
development and continued improvement of positive mental health in the workplace.
Particular practical strategies that received high-level endorsement from both panels
were those emphasising the communication of activities, issues and developments
within the organisation as well as those reflecting the use of multiple (and appropriate)
422 communication channels to advocate positive work behaviours, clarifying role
requirements and encouraging open dialogue between managers and employees.
Previous guidelines relating to the prevention of mental illnesses also consider
organisational communication an essential component of a healthy workplace (Reavley
et al., 2014), thus these findings together reiterate the importance of organisational
communication for overall employee well-being.
The importance of authenticity in the workplace was also a prominent feature of the
final guidelines. The finding that both panels tended to rate strategies regarding the
authentic actions of managers and employees as equally important is consistent with
this being a central concept in the positive organisational behaviour literature (Avoilio
and Garnder, 2006). However, previous evidence has rarely indicated specific actions
and activities that can be generalised to multiple organisational contexts. The findings
of this study indicate that authenticity should specifically be promoted within the
workplace through values-based goal setting and by ensuring that there is an
organisational culture that openly promotes behaviour motivated by personal values
and convictions, rather than through the motivation to achieve status, reward or
personal benefits.
Supportive leadership behaviours have been linked to both the reduced prevalence
of mental health problems (van Dierendonck et al., 2004) as well as the promotion of
employee capabilities, optimal performance and satisfaction (Mayfield and Mayfield,
2004). Consistent with the known benefits of positive and capable organisational
leaders, the results from this study emphasised leadership strategies that were viewed
as important for the development of positive mental health. In particular, leaders
adapting their style to suit the needs and preferences of the employee, and involving
employees in decision making, problem solving and the development of goals were
highly endorsed. Many strategies were drawn directly from the literature regarding
effective managerial behaviour and as such emphasised the role of feedback,
recognition and rewards (Reavley, 2013).
Panellists were encouraged to comment after the completion of each round of
surveys and to indicate where additional strategies would be relevant for the
promotion of positive mental health. In line with the vast majority of the academic
literature surrounding positive workplace mental health, the first round survey of this
study was heavily focussed on the role of senior and middle managers within
organisations. The panellists made numerous comments highlighting the role
that employees themselves have in promoting positive workplaces; accordingly
subsequent rounds of surveys incorporated employee responsibilities. High levels
of agreement between panels with respect to those responsibilities that are
shared between managers and employees included the identification and
application of individual strengths; both panels believed that it was essential
that employees as well as managers were responsible for reflecting on what an
individual’s strengths are and for identifying where these might be best utilised.
Additionally, both panels believed that a positive culture should be fostered by
role modelling a positive approach in the workplace, and also through employees’
behaviours (e.g. through the expression of gratitude or noticing and appreciating Positive
positive work experiences). mental health
What was not endorsed?
at work
Approximately one in five strategies was not endorsed by members of either panel. Of
note were those strategies relating to socialising and encouraging personal interaction.
A number of strategies including those relating to holding retreats or team-building 423
sessions were rated as being unimportant to positive mental health or strategies that
should not be included. Similarly, panels did not endorse strategies relating to managers
socialising with staff as a way to demonstrate their care for team members. The
provision of rewards and recognition is generally noted as a key strategy to demonstrate
appreciation for employee contributions. Importantly, the panellists in this study viewed
recognition and rewards as highly individual and some forms of reward were unlikely to
suit all employees. In particular, those forms of reward that involved public recognition
were not endorsed. Similarly, where items referred to employee restoration outside of
work, there were low levels of endorsement for those strategies that were overly
prescriptive (e.g. encouraging employees to take multiple short periods of leave rather
than one long holiday). To achieve a positive climate, strategies that were endorsed
included those relating to the development of a “positive work environment” such as
expressing pride in team members when they achieve, viewing mistakes as opportunities
to learn and being appropriately positive about team members. Accordingly, these
should be a focus for improving the social and interpersonal elements of the workplace.
Conclusions
There is a considerable amount of academic literature that advocates the use of positive
workplace practices, yet limited guidance for organisations on how to do it. This study
makes a unique contribution to the workplace mental health literature by reporting on
the development of guidelines that specifically focus on promoting positive mental
health in the workplace. The majority of strategies identified from a systematic search
of the relevant literature were endorsed by the two expert panels surveyed. It is hoped
that the results of this study will support organisations and individuals to take
practical steps towards the promotion of positive mental health in the workplace
setting, as well as informing future intervention research in this growing area.
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Corresponding author
Lauren J. Davenport can be contacted at: lauren.purnell@deakin.edu.au
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