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The true impact of workplace wellbeing: two case studies

Embedded Expertise, Published: January 29, 2020 - Updated: August 22, 2022

Mental health concerns are a leading cause of workplace absence , and as we see increasing incidents of mental health-related sick days, workplace wellbeing is paramount for both organisational and individual success.

Below I’ve written two real-life stories where bettering the wellbeing of a workplace can have dramatic effects on the individuals and business profitability itself. Hopefully this will inspire you to incorporate a wellness approach into your organisation or team, or take more notice of your own mental health.

Case study one: Michael thought he was fine

Michael* realised he was arguing a lot with his family at home and was becoming increasingly more reactive to situations that probably didn’t warrant it. He wasn’t terribly great at conducting conversations or maintaining relationships with coworkers and this spilled outside of work. Body aches and excessive headaches had also started to culminate: all obvious signs of deep stress that Michael was ignoring.

The thing is, he thought he was actually doing really well and managing his stress levels appropriately and that his behaviour and experiences were quite normal.

But in fact, he was suffering extreme levels of stress . Something he didn’t even comprehend until he connected with a workplace wellbeing expert and he had the opportunity to observe his behaviours.

After one week of dedicated and concentrated awareness on how he was reacting and experiencing situations and noticing stress levels, triggers and emotions as they arose, he started to really notice a difference.

‘After one week of dedicated and concentrated awareness… he started to really notice a difference.’

To mitigate his stress levels and improve his workplace wellbeing and relations, Michael also engaged in visualisations (similar to what athletes do ), particularly with conversations, which creates different pathways in the brain . From here he started acting differently, having better discussions and decisions and was significantly calmer everywhere throughout his life, not just in the workplace.

Case study two: bad behaviour, great worker

Company owner, Rajiv, was experiencing some staff problems that he’d tried to handle but wasn’t seeing any changes. One of his contract managers, Tom, was displaying bad behaviour whenever things would go wrong.

The thing was, it was abundantly clear that what Tom was saying and the problems that he identified were absolutely correct. And the company valued his hard work and how exceptional he was at his job, so there was no desire to terminate his contract early. Which can often be a case for difficult situations in the workplace— many people are too eager to throw the ‘baby out with the bathwater’ so to speak, rather than experiment with some alternative ways of reaching conflict resolution. Or even taking the time to discover what is really going on, stepping away from the ego and its primal behaviour of flight or fight mode.

After supportive discussions with Tom, the wellness team discovered that actually he felt isolated , alone and that he didn’t belong. And, because the mind seeks to confirm our beliefs (through confirmation bias), would create situations and replicate behaviour to further consolidate that belief. He was very caught up in his story that he was an outsider.

A sense of belonging

To further compound this position, Tom was contracted as part of a large project and he felt like he didn’t fit in with the permanent employees, who had established themselves in the internal culture.

Forbes states that, ‘Employees who do not naturally fit into established corporate norms will often times try to assimilate to those norms – or put themselves “on guard” – in order to avoid potential biases or discrimination.’ This can take considerable effort and energy, which could be better spent on a person’s core duties.

A sense of belonging in the workplace contributes greatly to retention and attraction of high-quality candidates, which leads to better productivity, outcomes, creative solutions and more profit. It can also result in 75 per cent fewer sick days and avoid millions of dollars’ worth of lost productivity.

‘A sense of belonging in the workplace contributes greatly to retention and attraction of high quality candidates…’

Fostering this sense of belonging ‘in the workplace makes employees engaged and produce work that is elevated above the ordinary…’.

Once identified, the workplace wellbeing team worked with Tom and Rajiv with proven techniques that involved awareness, cultural changes and compassion and saw rapid improvement within weeks, thanks in part to the commitment of the people involved.

The change was so significant that Rajiv was enthusiastic and hungry to find more ways in which he could change the dynamics to bring out better and better results within his company. The company also extended Tom’s contract when the opportunity became available.

Welcome contract workers too

It can be really easy to forget that contract staff are an integral part of your team, even if they are only on staff for a limited time. And it shouldn’t be a last minute or token effort.

‘… there needs to be a culture and allowance for people to connect as human beings. We shouldn’t need bonding or team leadership days to actually connect with our colleagues and make meaningful relationships ,’ says Dr Michelle Lim, a loneliness researcher and senior lecturer in clinical psychology at Swinburne University.

Incorporating contract workers as genuinely part of the team and treating them as well as you treat all employees will only promote excellent benefits for the business and wider society as a whole and help contribute to preventing distressing issues such as high suicide rates in the engineering industry.

Can you relate in full or in part to these stories? Improve your wellbeing in your workplace today. Discover more about our for our contracting professionals.

*We’ve changed these names to provide privacy and protect the identity of these people.

Nukon is joint venture between the world of optimisation and automation. our parent company, SAGE Automation, is a leader in the operations market, while NUKON has fast established an outstanding reputation in the manufacturing data, intelligence andimprovement area.

This meeting of minds means we can now bridge the gaps between the different silos within our client businesses, bringing visibility, unity and breakthrough improvements right across our clients' businesses.

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The Future of Mental Health at Work Is Safety, Community, and a Healthy Organizational Culture

• Bernie Wong
• Kelly Greenwood

A new report shows that it’s time to go back to the basics.

A new study exploring the ever-changing landscape of workers’ experiences and perspectives around mental health, stigma, and work has uncovered new insights about how workplace mental health has changed from before, during, and after the pandemic. The findings show that mental health isn’t improving in the U.S., but there are some new bright spots, too. Workers are demonstrating greater awareness around mental health at work and are looking beyond traditional benefits and the latest technologies. What they increasingly want is what the research has always shown works: mentally healthier cultures. The authors break down what employees need and — increasingly expect — from their employers when it comes to mental health support and offer several strategies for leaders to foster sustainable, mentally healthy cultures.

The state of workplace mental health has shifted substantially in the past four years, expedited by the global pandemic, racial justice reckoning, and other macro challenges. Employers have made noteworthy gains since then by providing expanded benefits, meditation apps, mindfulness programs, mental health days, and awareness campaigns. However, these investments on their own aren’t enough.

• Bernie Wong , MHS, is a founding team member and Senior Manager of Insights and Principal at Mind Share Partners, a national nonprofit changing the culture of workplace mental health so both employees and organizations can thrive. Through movement building , custom training, and strategic advising, it normalizes mental health challenges and promotes sustainable ways of working to create a mentally healthy workforce. Follow him on LinkedIn .
• Kelly Greenwood is the Founder and CEO of Mind Share Partners , a national nonprofit changing the culture of workplace mental health so both employees and organizations can thrive. Through movement building , custom training, and strategic advising, it normalizes mental health challenges and promotes sustainable ways of working to create a mentally healthy workforce. Follow her on LinkedIn and subscribe to her monthly newsletter.

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The Study on Mental Health at Work: Design and sampling

1 Federal Institute for Occupational Safety and Health, Unit Mental Health and Cognitive Capacity, Berlin, Germany

Stefan Schiel

2 infas Institute for Applied Social Sciences, Bonn, Germany

Helmut Schröder

Martin kleudgen, silke tophoven.

3 Institute for Employment Research, Nuremberg, Germany

Angela Rauch

Gabriele freude, grit müller.

Aims: The Study on Mental Health at Work (S-MGA) generates the first nationwide representative survey enabling the exploration of the relationship between working conditions, mental health and functioning. This paper describes the study design, sampling procedures and data collection, and presents a summary of the sample characteristics. Methods: S-MGA is a representative study of German employees aged 31–60 years subject to social security contributions. The sample was drawn from the employment register based on a two-stage cluster sampling procedure. Firstly, 206 municipalities were randomly selected from a pool of 12,227 municipalities in Germany. Secondly, 13,590 addresses were drawn from the selected municipalities for the purpose of conducting 4500 face-to-face interviews. The questionnaire covers psychosocial working and employment conditions, measures of mental health, work ability and functioning. Data from personal interviews were combined with employment histories from register data. Descriptive statistics of socio-demographic characteristics and logistic regressions analyses were used for comparing population, gross sample and respondents. Results: In total, 4511 face-to-face interviews were conducted. A test for sampling bias revealed that individuals in older cohorts participated more often, while individuals with an unknown educational level, residing in major cities or with a non-German ethnic background were slightly underrepresented. Conclusions: There is no indication of major deviations in characteristics between the basic population and the sample of respondents. Hence, S-MGA provides representative data for research on work and health, designed as a cohort study with plans to rerun the survey 5 years after the first assessment.

Introduction

Systematic reviews of work environment and mental health indicators such as depressive symptoms [ 1 ] and depression [ 2 , 3 ] provide evidence of the impact of job strain, decision latitude or bullying. According to Theorell et al. [ 1 ] limited evidence is given by longitudinal studies with a high degree of methodological quality for working conditions such as effort reward imbalance, social support, psychological demands or job insecurity. As seen in the referenced literature within these reviews there is a strong orientation to studies from English-speaking or Scandinavian countries or the Netherlands and a lack of longitudinal studies based on a representative sample in several other countries, including Germany. Therefore, an independent reanalysis based on other samples and within a range of other national contexts is relevant for better understanding how widely and strongly the evidence applies.

A further indicator of mental health is burnout, with exhaustion as its core dimension. The associations between burnout and psychosocial working conditions have been analysed in a review by Seidler et al. [ 4 ]. In comparison with reviews of depressive symptoms they found even fewer longitudinal studies; precisely six studies were seen to be of sufficient quality and none of these were from Germany. A total of five of these studies considered selected occupational groups from the health sector or human services and not representative samples of all employees.

In epidemiological and public health research the investigation of mental health focusses on the negative spectrum of mental health such as burnout or depression. One reason for this focus is, that mental disorders lead to higher rates of absenteeism and constitute a leading cause of early retirement in Europe [ 5 ]. New developments in the field of positive psychology are moving towards positive attributes of mental health, thus highlighting aspects of well-being that have been neglected to date, such as the balance of positive and negative affects, life satisfaction, and subjective well-being [ 6 ]. Supporters of this move consider a view of mental health as reduced to its negative spectrum to be too narrow [ 7 ]. Even a broader view of mental health is still unidirectional and thus insufficient to describe the range of possible outcomes, as it does not reflect the impact of mental health on a person’s functioning.

This impact of mental health on a person’s functioning considers limitations in daily activities and participation restrictions, while considering environmental and personal factors. These components in conjunction with impairments in body functions or structures are key elements of the International Classification of Functioning, Disability, and Health (ICF) coordinated by the World Health Organization (WHO) [ 8 ]. The scope of functioning thus encompasses more than the assessment of symptomatology and the diagnosis of mental disorders. Therefore, it provides an important link between mental health and workforce participation. Functioning according to the ICF is not limited to a single life domain. Accordingly, the assessment of work ability is included as a related measurement of work-related functioning [ 9 ]. Work ability takes into account ’[…] health and functional capacity, but […] is also determined by professional knowledge and competence (skills), values, attitudes, and motivation, and work itself” [ 10 ]. The latter determinants such as motivation are part of the theoretical framework of work ability, but they are not included in the original assessment.

The foregoing discussion of the multiple dimensions of outcomes shows that an adequate analysis of psychosocial working conditions and mental health goes far beyond any simple association and that empirical studies need to account for this broad range of interrelated issues. This is the rationale behind the Study on Mental Health at Work (S-MGA) – a representative study of employees subjected to social security contributions in Germany – which was initiated by the German Federal Institute of Occupational Health and Safety and conducted in collaboration with the Institute for Employment Research (IAB) and the Infas Institute of Applied Social Sciences.

The following research aims are addressed within the S-MGA study:

• Examining the impact of past employment experiences and current working conditions on positive (well-being) and negative (depressive symptoms and burnout) dimensions of mental health;
• Analysing the association between mental health, functioning and work ability;
• Investigating in a second wave the predictive value of working conditions, mental health, and functioning for the prediction of employment status five years later.

S-MGA addresses the lack of representative data on mental health, work ability and functioning for the working population in Germany. This study generates the first nationwide representative survey enabling the exploration of the relationship between working conditions, mental health and functioning. Hence, the distributions of indicators can be utilised for comparison with a norm sample or for using this sample as natural control group within intervention studies.

This present paper gives an overview on the study design, sampling procedures and method of data collection of the S-MGA. Socio-demographic and economic characteristics were used for detecting differences between the sample of respondents and the population from which it was drawn.

Design and measurement procedures

S-MGA is a nationwide representative study of employees subjected to social security contribution aged 31–60 years in Germany. This age range was selected as the vast majority of people in employment are between 31–60 (i.e. they have finished their vocational training or studies and have not yet reached retirement age). S-MGA is designed as a panel study with a second assessment occurring 5 years after the first data collection, which ran from November 2011 to June 2012. The second wave will be completed by the middle of 2017, when the oldest participants will have reached the statutory retirement age.

Sampling and data collection

The sampling was based on data from the Integrated Employment Biographies (IEB), a register of the German Federal Employment Agency held by the IAB. This register covers employees who are subject to social security contributions. This constitutes more than 80% of the German working population [ 11 ], with civil servants, self-employed individuals and freelancers not included by definition. Using these data allows the linkage of employment histories with the collected survey data and a comparison of sample characteristics with the register. Those eligible to participate were all employees subjected to social security contributions on the reference date of 31 December 2010 who were born between 1951 and 1980. In total, 4500 interviews were planned to be conducted. Due to the plans for conducting face-to-face interviews, a two-stage cluster sampling procedure was applied. First, municipalities in Germany were proportionately stratified by region and population size and 206 municipalities were randomly selected from the pool of 12,227. Second, a random gross sample of 13,590 addresses was drawn within selected municipalities.

In preparation for the field phase, a letter including information on the study purpose and data protection was sent to the addresses of the selected individuals 1 week prior to the first contact attempt. To increase the motivation to participate, the letter mentioned an incentive of EUR10 given for participating [ 12 ]. During the field phase all addresses were contacted by the interviewers up to a maximum of 31 times. The interviews were only conducted after respondents gave their informed consent to carry out the study. Data were collected face-to-face by computer-assisted personal interview (CAPI) by 243 trained interviewers at the homes of the respondents. Sensitive information on mental health was collected with a drop-off paper pencil questionnaire in an envelope handed out directly to the study participants. The respondents filled it out directly and handed it back in a closed envelope. All respondents were asked whether they would give their written consent for saving the address data for a second wave of assessment. Additionally, a total of 425 study participants from two major cities were asked for their willingness to attend an occupational medical examination on physical and mental functioning.

Integrated Employment Biographies (IEB)

When participants gave their written permission, the survey data were linked to the IEB [ 13 ]. Data from the IEB comprise information from the notifications sent to social insurance as well as from the administrative processes of the German Federal Employment Agency. The data contain detailed information on employment status on a daily basis [ 14 ]. When participants gave their written permission, S-MGA included computation of several individual indicators such as employment status and wage from the IEB data.

Measurements

The CAPI was evaluated in a pre-test with 200 interviews regarding the sequence and comprehension of questions in summer 2011. The sequence of the interview is depicted in Figure 1 .

Structure of the interview programme [ 12 ] (modified version).

Drop-off questionnaires: well-being (A), burnout (B) and depressive symptoms (C).

Detailed information on instruments and indicators is listed in Table I . The first part of the interview was concerned with employment and working conditions including the type of contract and working hours. Physical working conditions such as heavy lifting and awkward body postures were assessed by seven questions. The main focus was on self-reported psychosocial working conditions, which were assessed by questions from the Copenhagen Psychosocial Questionnaire (COPSOQ) [ 15 ]. Information about work ability came from the Work Ability Index (WAI) [ 16 ], and the interviewee’s functioning was investigated by the Short-Form-12 Health Survey [ 17 ] and by a German translation of the Norwegian Functioning Assessment Scale (NFAS) [ 18 ]. Motiva-tional factors were covered by the General Self-Efficacy Scale (GSE) [ 19 ] and the Utrecht Work Engagement Scale (UWES) [ 20 ]. Additional motivational and volitional aspects such as the intention to leave the job and/or the employer or to apply for a pension were supplemented by single items. Positive attributes of mental health such as, life satisfaction [ 21 ] and job satisfaction were included, supplemented by items on personal co-factors (critical life events, health-related behaviour, social context), inability to relax due to work involvement assessed by a subscale from the German questionnaire FABA [ 22 ], and socio-demographic information.

Content of the computer-assisted personal interview (CAPI) and the drop-off questionnaires.

Drop-off paper questionnaire

Sensitive questions to emotional and psychological well-being [ 6 ] as well as depressive symptoms and burnout were addressed by a drop-off questionnaire handed out during the interview. Specifically, depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) [ 23 ] and burnout was represented by the main dimension of exhaustion from the Oldenburg Burnout Inventory (OLBI) [ 24 ].

Non-respondents’ questionnaire

Additionally, a short questionnaire was given to non-respondents refusing an interview after the initial contact. These non-respondents were asked for information on socio-demographics, self-rated health and work ability.

Statistical analysis

The accuracy of the sampling process was checked by comparing socioeconomic and demographic characteristics between the basic population, the gross sample, and the sample of respondents. Percentage differences between the basic population and sample of respondents were calculated for these characteristics. Multivariate analysis was conducted by logistic regression with 14 socio-demographic and socioeconomic parameters as covariates. The analysis is based on the gross sample of n = 13,590 and the binary outcome is participation versus non-participation in the interview. A value of 1 is assigned if the individual belongs to sample of respondents.

Altogether 4511 interviews were conducted and each interview was checked for inconsistent responses. According to the standards of the American Association for Public Opinion Research (AAPOR) [ 25 ] there was a contact rate of 90.6% and a response rate of 35.7%. The refusal rate was 53.7%, in line with the trend of declining willingness to participate in surveys in Germany [ 26 ]. The addresses were contacted 3.5 times on average. The completion of an interview required an average of 3.7 contacts and the interview lasted an average of 65.6 minutes.

The acceptance of employees surveyed to support the study was very high: 87.4% declared their written consent to remain in the panel, 74.6% gave their written consent to merge occupational data from the IEB ( n = 3591), and 69.6% of respondents from Berlin and Dresden agreed to an occupational medical examination. The comparison between the basic population, the gross sample and the sample of respondents shows only slight differences in characteristics at the first and second level of sampling ( Tables II and III ). Individuals in cities with 100,000 to 500,000 residents are underrepresented (−2.8% points) and those from the State of Saxony are overrepresented (+4.8%). A minor underrepresentation is observed for individual characteristics such as sex (men: −1.4%), age (birth cohorts from 1975 to 1980: −3.0%), place of employment (western parts of Germany −5.6%), unknown education (−3.0%), nationality (non-German: −2.6%) and occupation (simple services: −3.2%).

Comparison of population ( N = 21,471,156), gross sample ( n = 13,590) and sample of respondents ( n = 4511); regional characteristics.

BIK: type of region according to a German classification system based on area size, population size and density.

Population ( N = 21,959,394) and sample of respondents ( n = 4511) compared by individual characteristics.

The results of the logistic regression analysis controlling for 14 regional and individual characteristics are displayed in Table IV . The multivariate analysis provides only a poor fit to the data: only 2% (pseudo R 2 = 0.02) of the variance is accounted for by the full model.

Logistic regression analysis with survey participation as outcome ( n = 13,573).

BIK: type of region according to a German classification system based on area size, population size and density; CI: confidence interval; X: reference category.

The short questionnaire for those, who refused to participate was filled out by 341 individuals. The information provided by non-respondents deviates slightly from that of respondents concerning subjectively-perceived health and work ability. Non-respondents consider their health status to be very good or good slightly more frequently (63.0% versus 57.4%). The assessment of perceived work ability exhibits the opposite trend: respondents attribute to themselves slightly higher work ability than non-respondents (84.2% versus 70.3%).

This present paper gives an overview on design, sampling and data collection of S-MGA, the first nationwide representative cohort study on psychosocial working conditions, mental health and functioning in Germany. A total of 4511 interviews were conducted with employees aged 31–60 years and subject to social security constituting a response rate of 35.7%. By comparing the basic population with the sample of respondents there are only minor deviations concerning the distribution of socio-demographic characteristics giving no indication for a sampling bias.

The response rate of 35.7% is in line with the trend of declining willingness to participate in surveys in Germany [ 26 ] and other epidemiologic studies [ 27 ]. Thus, questions of participation and refusal should be considered in this context. Additionally, the question of whether non-response is a serious issue regarding bias depends on both the proportion of non-responders as well as the difference between responders and non-responders according to the measured variables. Using data from the register enables the direct comparison of the population in the register with not only the gross sample but also the sample of respondents within the survey. The results of these comparisons reveal only minor differences for the observed variables. Furthermore, multivariate analysis shows that socio-demographic and socioeconomic parameters explain a mere 2% of the variance. Hence, these parameters are hardly useful in explaining participation in this study. Based on the assessment of representativeness as well as the two selectivity analyses mentioned, the quality of the sample can reasonably be rated as quite high. The results from the non-response questionnaire likewise give no indication of systematic bias due to individual health status. Some indications such as the underrepresentation of individuals with unknown education or occupations among simple services or regional differences may be valuable clues for the adjustment of possible confounders.

The current study is based on a sample which is to be prospectively followed as a cohort over a period of 5 years. The application of a longitudinal design is an important attribute of any analytical study aiming at causal associations. Hence, the primary focus of systematic reviews is on follow-up studies by filtering out cross-sectional studies [ 2 , 3 ], which yields reviews with only few original studies.

The second wave of the current study takes place in the first half of 2017. There is a realistic chance of a good response in the second wave of assessment, since 87% declared their willingness to remain within the panel. Additionally, attrition will likely be minimized by conducting panel maintenance, which includes regular contacts with respondents, and by an incentive of EUR20 for participation in the second assessment.

One of the main strengths of the current study is its use of the register of the German Federal Employment Agency as a sampling frame as well as additional linked information. The use of the register adheres to a clear and straightforward definition of the population studied and as such the limitations are known explicitly. This population-based register holds the complete records for all employees subjected to social security contributions in terms of employment history and several individual characteristics. By definition, this register is more a work-related than a community-based sampling frame, which would typically include, for instance, homeworkers or retired or non-employed individuals. Data concerning addresses are well maintained and linked to the register, which is valuable from the perspective of the interviewer in the field attempting to contact a sampled individual.

The database of the register covers more than 80% of the German working population. Civil servants, the self-employed and freelancers are not included. The focus on dependent employment is a limitation of the study and for the generalizability of conclusions based on it. Another limitation is given by the age of the participants, restricted to those between 31–60 years of age. The oldest participants in the first wave of assessment will have reached the statutory retirement age by the second wave. Therefore, older aged cohorts are still covered by this study, whereas those 30 years or younger are by definition excluded. This exclusion is grounded in practical reasons, such as excluding those not finished with their vocational training or studies. This strategy implies the loss of younger cohorts who may have different experiences of the changing labour market. However, especially in younger aged cohorts, long-term positioning in the labour market very often occurs at older and older ages due to longer phases of education. Even among the German baby boomers one finds a proportion of almost 10% who were older than 30 years at the first experience of employment subject to social security contribution [ 28 ].

New data are already available from the first cross-sectional assessment conducted among employees subjected to social security contributions in Germany. This population-based survey contains information about the distributions of psychosocial working conditions (COPSOQ), motivational determinants (UWES), negative and positive attributes of mental health (depressive symptoms, burnout, and well-being) and functioning. The assessment of psychosocial working conditions by the COPSOQ is well established within Danish cohort studies and adapted for the German working context [ 15 ] and outcomes like the PHQ [ 23 ] and SF-12 [ 17 ] have been applied to the general population in Germany. These distributions are useful as a means of comparison, as there is no other study available for Germany with a focus on this profile of exposure and outcome variables within a broad population of employees. Hence, the current study provides a national reference sample for the distribution of psychosocial working conditions and for exhaustion as the core dimension of burnout.

Another important opportunity offered by this sample is to utilise it as a reference for defining a minimum level of work functioning, especially when making comparisons within intervention studies and evaluation research. This opportunity arises as a result of the sampling procedure. The starting point is the status of being employed on the date of sampling within the register. By definition, this is an important difference to community or population-based studies, which include non-employed individuals, homeworkers or those who retired early. As a consequence, this introduces some level of positive bias towards individuals, who – despite possible impairments in health and functioning – are still employed. This means that the sample of respondents constitutes a reference level for working populations with at least a minimum level of work functioning. This interpretation also applies to the empirical distributions of indicators for mental health or working conditions which give a picture of individuals still in work. Studies focusing on individuals with impaired health (e.g. return-to-work studies) can use these distributions for means of comparison and as a goal level for functioning.

S-MGA provides information which is highly relevant for objectives of the WHO. The mental health action plan of the WHO [ 29 ] conceptualizes mental health as a state of well-being which includes positive indicators and components of functioning. The fourth objective is circumscribed as aiming “[…] to strengthen information systems, evidence and research for mental health” (p. 22). Furthermore it contributes to objectives of the WHO’s global plan for worker’s health [ 30 ], such as providing and communicating evidence for action and practice.

In conclusion: S-MGA is a nationwide study based on a longitudinal design deploying high quality sampling with a focus on employment and working conditions, mental health and functioning. The population-based sample constitutes a reference and provides useful information for means of comparisons. In addition, the longitudinal design is especially well-suited for assessing the determinants of mental health, functioning, and participation at work. To the best of our knowledge there is no nationwide study in Germany with this combination of study features. This gives S-MGA great potential for future enquiries, and valuable insights into the relationship between work and health.

Acknowledgments

The authors would like to thank the participants of the study. The authors would also like to thank Jon Scouten and Hermann Burr for critical review of the text.

Declaration of conflicting interests: The authors declare that there is no conflict of interest.

Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

More From Forbes

A psychologist's perspective on redefining mental health at work.

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Sandy Costa , organizational psychologist: Specializing in development, strategy, and guiding HR teams through transitions and change.

In today's post-pandemic work environment, mental well-being has evolved from a secondary consideration to a foundational element of organizational success. The American Psychological Association's Stress in America™ 2023 survey revealed a marked increase in American adults' mental health conditions and chronic illnesses Adults aged 35 to 44 have experienced the most significant upticks in these areas, though the 18-to-34 group continues to have the highest ratio when it comes to mental illnesses specifically.

The pandemic emphasized the intertwined nature of personal and professional well-being, highlighting the necessity for comprehensive mental health strategies within the workplace. But the persistent stigma surrounding mental health is a significant barrier to individual wellness and poses a challenge to the cultural fabric of organizations. To cultivate productive and nurturing workplaces, it's imperative to dismantle this stigma and foster a culture of support and understanding.

The Importance Of Mental Health Advocacy

The consequences of neglecting workplace mental health are profound and far-reaching, affecting job performance, productivity and, ultimately, businesses' bottom line. When stressed employees don't receive the support they need, it can compromise organizational vitality by contributing to a strained environment. Breaking this cycle requires a shift in organizational investments to mental health.

Transcending ethical responsibility, prioritizing mental well-being is a strategic imperative for sustainable organizational success. Many major companies have embraced mental health initiatives.

A Tiny Drone With A Directional Airburst Warhead Could Mow Down Enemy Infantry In A 60-Degree Arc

Who plays the new ghost melody in ‘ghostbusters: frozen empire’, 110 years ago, the first commercial airline took off from florida.

• Google is well known for its commitment to employee well-being .

• At Salesforce, investment in employee health includes the wellness program Camp B-Well and a week devoted to discussing mental health issues.

• Unilever's mental health and well-being strategy is dedicated to breaking stigmas and supporting all aspects of employee health.

• EY created an employee assistance program, EY Assist, and began offering additional mental health resources following the pandemic .

Strategies For Improving Workplace Mental Health

Investing in mental health can yield significant organizational performance returns because of the positive impact on workforce well-being. Here are some effective strategies for enhancing workplace mental health.

Relevant Training

It's important for everyone in your organization, including leadership, to better understand mental health, recognize certain symptoms and know how to respond. Leadership training programs play a particularly critical role in shaping a workplace culture that values psychological well-being. They teach leaders to recognize mental health issues and openly engage in supportive conversations.

Access To Resources

Employee assistance programs, counseling services and stress management workshops can be essential mental health resources for employees. Therefore, you must ensure that every employee can access them or other relevant benefits. Promoting the use of paid time off and integrating mental health days into those policies are practical measures for supporting employees' mental and emotional well-being. You could also encourage the creation of support networks. Consider leveraging surveys, wellness committees and benchmarking to identify and implement the mental health resources and policies their employees need.

Foster Community

Finally, having an environment of open, judgment-free communication about mental health is crucial. Encouraging leaders to share their own experiences and ensuring confidentiality can contribute to creating a supportive and understanding work environment. These efforts benefit individuals and enhance overall organizational health and productivity.

Call To Action

Now is the time for every organization to step up and make mental health a priority. We have an incredible opportunity to improve the workplace by breaking down the stigma around mental health and providing the support our employees need. It's simple: When we take care of our people, they take care of our business.

Let's commit to making these changes and creating a workplace where everyone feels supported, valued and empowered to bring their best selves to work every day. Together, we can build a healthier, more productive and more resilient workforce.

Forbes Human Resources Council is an invitation-only organization for HR executives across all industries. Do I qualify?

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137 Case Studies: Real Stories Of People Overcoming Struggles of Mental Health

At Tracking Happiness, we’re dedicated to helping others around the world overcome struggles of mental health.

In 2022, we published a survey of 5,521 respondents and found:

• 88% of our respondents experienced mental health issues in the past year.
• 25% of people don’t feel comfortable sharing their struggles with anyone, not even their closest friends.

In order to break the stigma that surrounds mental health struggles, we’re looking to share your stories.

Overcoming struggles

They say that everyone you meet is engaged in a great struggle. No matter how well someone manages to hide it, there’s always something to overcome, a struggle to deal with, an obstacle to climb.

And when someone is engaged in a struggle, that person is looking for others to join him. Because we, as human beings, don’t thrive when we feel alone in facing a struggle.

Let’s throw rocks together

Overcoming your struggles is like defeating an angry giant. You try to throw rocks at it, but how much damage is one little rock gonna do?

Tracking Happiness can become your partner in facing this giant. We are on a mission to share all your stories of overcoming mental health struggles. By doing so, we want to help inspire you to overcome the things that you’re struggling with, while also breaking the stigma of mental health.

Which explains the phrase: “Let’s throw rocks together”.

Let’s throw rocks together, and become better at overcoming our struggles collectively. If you’re interested in becoming a part of this and sharing your story, click this link!

Case studies

March 21, 2024

From the C-Suites to the Streets and Back – Overcoming Addiction, Anxiety, Depression and PTSD

“Over the past decade, I have struggled with substance abuse immensely leading to anxiety, depression, and PTSD. After losing thirteen corporate jobs and ending up homeless, beaten up, and absolutely broken on the streets I have finally come to terms with my situation and am finding a path towards long-term sobriety and happiness.”

Struggled with: Addiction Anxiety Depression PTSD

Helped by: Mindfulness Rehab Religion Self-improvement Social support

March 19, 2024

My Journey to Self-Compassion Amidst Depression, Anxiety and Suicidal Thoughts

“This suicidal edge coupled with stress, anxiety, and loneliness made me stop working as a human being. In just two months I had spiraled down into the darkest hole which has ever existed for me. There didn’t exist Marina anymore, merely a depressive and neurotic copy of her, who was unable to laugh and sleep.”

Struggled with: Anxiety Depression Panic attacks Stress Suicidal

Helped by: Self-acceptance Self-improvement Therapy

March 14, 2024

How EMDR Therapy Helped Me Navigate Childhood Trauma and Rediscover Myself

“As my anxiety levels grew, I turned to alcohol and then combined that with Vicodin to fend off the bad feelings. I would drink to the point of blacking out on a regular basis, sometimes never knowing how I got home.”

Struggled with: Abuse Addiction Bullying Childhood CPTSD

Helped by: Reinventing yourself Therapy

March 12, 2024

How Self-Care and My Infrared Sauna Blanket Help Me Navigate CPTSD and Fascia Pain

“I’m sure that other people around me knew that I was struggling, but I only shared this with a couple of people. People in my immediate physical ecosphere didn’t offer up any kind of empathy either. In fact, the exact opposite. Which I think made the condition even worse.”

Struggled with: Chronic pain CPTSD

Helped by: Journaling Meditation Self-Care

March 8, 2024

Therapy Helped Me Overcome Depression and Better Cope With Chronic Health Conditions

“I clearly remember feeling like I was stuck deep down at the bottom of a dark hole where I could barely breathe. It was especially disturbing because I didn’t care if I stayed down there and never saw light again. Looking back, I realize that my severe depressive episode had been building for years, but I didn’t really notice it.”

Struggled with: Anxiety Chronic pain Depression

Helped by: Mindfulness Self-Care Self-improvement Therapy

March 5, 2024

How Sobriety, Therapy, and Self-Care Help Me Navigate BPD and Bipolar Disorder Better

“I used to have a mindset of: “poor me” – “I’m just a victim” and “none of this is my fault”. Eventually, I knew I had to change that narrative to one of control. I had to take accountability for the things that I could change, and be honest about the things I was doing that were making everything worse.”

Struggled with: Anxiety Bipolar Disorder Borderline Personality Disorder Depression Suicidal

Helped by: Exercise Religion Self-Care Self-improvement Social support Therapy

February 29, 2024

Conquering Alcoholism and Hopelessness And Helping Others Do the Same

“I used alcohol to deal with stress, anxiety, boredom–essentially any negative feeling that I didn’t want to experience. I was also using it to try to generate positive feelings–to celebrate, to have fun, to socialize. Turning to alcohol for so many different reasons made it hard to control. I started by setting rules for myself, like only drinking on the weekends and only after a certain hour. But I consistently broke those rules, so they kept getting looser and looser.”

Struggled with: Addiction Anxiety Depression

Helped by: Exercise Rehab Self-improvement Social support Therapy

February 28, 2024

My Journey From Severe Migraines and Workplace Hostility to Reinventing Myself

“So now I’m still having migraines and nerve pain, have been removed from my job and friends, was ordered to not contact anyone from my unit, my future livelihood was at risk, and my leadership was only willing to try to remove me from sight. This lasted for almost three years.”

Struggled with: Bullying Chronic pain Depression Stress

Helped by: Reinventing yourself Self-improvement Therapy Treatment

February 25, 2024

Finding Relief From Chronic Pain and Depression With Energy Medicine & Indigenous Methods

“I remember the moment I looked in the mirror and felt like a complete failure. I had tried everything possible and nothing worked. I was at a dead end. I thought that something must be so horribly wrong with me that no one had any answers or solutions.”

Struggled with: Anxiety Childhood Chronic pain Depression

Helped by: Meditation Mindfulness Self-improvement Treatment

February 22, 2024

How Journaling and Regulating Emotions Helps Me Deal With Depression and Anxiety

“Sometimes I look back and think about all the years I spent crying and thinking about how to end the pain, which made me believe that’s how life is. I got to the point where I had no idea what it felt like to feel a little bit of joy or happiness.”

Struggled with: Anxiety Depression Feeling lost

Helped by: Journaling Self-acceptance Self-improvement Therapy

“Not acknowledging that millions are dealing with mental health conditions is costing an enormous amount both in terms of dollars and cents and, more importantly, people's lives."

Arianna huffington mental health at work mini-conference, may 2018, "i personally would like to thank mind share partners for all of your support of this erg and community from the very beginning when we were unsure, driven, and quite a bit scared on launching something that would make us so vulnerable. you provided resources and insight that gave us direction, hope, and reminded us that what we were creating would matter to our peers. to which, you were right. i'm thankful for mind share partners, what you stand for and all that you're creating in this new area of diversity, inclusion, and belonging.".

"After the Mind Share Partners conference, we created our own Mental Health Fund, since our health insurance excludes it, and talked about it so our team knew we had their back and they'd be covered for emergency care for suicidal thoughts, etc.

It's a start. stigma runs deep. it's good that [mind share partners] is helping workplaces talk about it", just launched join our mind share partners institute certificate program..

Plan early for May Mental Health Awareness Month!   Learn how we can help >

Mind share partners', 2023 mental health at work report, in partnership with.

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The data shows the future of workplace mental health is going back-to-basics.

Our third biennial report uniquely explores how workplace mental health in the U.S. has changed from before, during, and after the pandemic.      

Mental health isn’t improving, but there are some bright spots, like employer investments in workplace mental health efforts paying off and creating positive changes in workers’ experiences. Workers' awareness of mental health has grown. They are looking for more than traditional benefits and new technologies from employers.

As we look to the future, workplace mental health requires employers to go back-to-basics—a focus on company culture and worker needs—to build and sustain a mentally healthy workforce.  

If you encounter any issues downloading the report, email us at [email protected] .

Get the Report

Key Findings

#1. Mental health challenges are improving and worsening.

Mental health symptoms have improved since 2021, but workers’ views of overall mental health also declined. 

#2. Employer investments in work are having a net positive impact on mental health.

Unlike previous years, the positive impact of the workplace on workers' mental health outweighed the negative.

#3. Workers want healthy work cultures, not self-care perks.

Healthy and sustainable cultures of work were rated more helpful than therapy and self-care resources.

#4. Employers making meaningful investments in DEIBJ see payoffs.

But marginalized identities (Black, LatinX, AAPI, LGBTQ+) continue to face disproportionate challenges.

#5. Psychological safety declined amidst perceptions of diminishing support from employers.

Less than 40% said their employer prioritizes mental health.

#6. When it comes to the hybrid work debate, employee voice matters.

Workers who were hybrid by choice reported shorter mental health symptoms, less stigma, and a better relationship to work.

Share with your network using our social images!

Read our feature in Harvard Business Review

Get a summary  of our key insights and recommendations for organizations to meaningfully support mental health at work.

Commitment to Diversity, Equity and Inclusion

For the third time in a row, Mind Share Partners' biennial Mental Health at Work Reports have included statistically significant sampling from historically underrepresented communities. A mentally healthy future for all means for all .

Catalyze culture change at your organization.

This year's data shows investments in organizational culture is what workers want most. 

Book a free strategy call with one of our Principals at Mind Share Partners to tailor these actions to your unique culture, employee needs, and industry.

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20,000 people off work in the UK every month for mental ill health

DWP figures reveal thousands of people a month are assessed as unable to work because of mental health problems

Thousands of people in the UK are being deemed incapable of any work every month due to mental health problems, figures have shown.

According to official data published by the Department for Work and Pensions (DWP), at least 20,000 incapacity benefit claims are for mental health problems – making up more than two-thirds of the total.

Previous figures have shown that mental health and learning disabilities are among the main contributors to disability benefits, which are paid regardless of whether someone can work. But until now, there had been no such data for incapacity benefits paid through universal credit when people struggle to work.

DWP figures show that 2 million people are receiving universal credit health benefits, up 400,000 in a year, with 69% of them judged unfit for any work.

Of all the assessments made in the last two years, 69% involved “mental and behavioural disorders”. Back and joint problems were cited in 48% of claims, while nervous diseases such as chronic pain and metabolic problems such as diabetes and obesity were each cited in 15%.

Heart disease and other circulatory problems and digestive illnesses were cited in more than 20% of cases. Cancers and some terminal illnesses are thought to be underrepresented in the data, which does not yet cover all claims.

Claimants have 2.7 health conditions on average, prompting experts to warn that there is no quick fix for a benefits bill that is surging as a result of increasingly complex illnesses. Officials stress that the data does not distinguish which is the primary driver of illness.

Christopher Rocks, of the Health Foundation thinktank, said the data “reinforces the increasing importance of mental health on people’s ability to work”.

“Ill health is driving the rise of people on out-of-work benefits and having a significant impact on the economy,” he said, calling for “tailored support” rather than government crackdowns on jobseekers.

“Some recent government measures are a step in the right direction but can be scaled up and go further,” he said. “However, measures that restrict benefit entitlement for people with work-limiting health conditions risk being counterproductive.”

Nil Güzelgün, of the mental health charity Mind, said the data “highlights the acute need for mental health support”, citing the 1.9 million people on waiting lists for NHS mental health treatment.

“People would love to work if they had access to the mental health support they need but that support just isn’t there,” she said. “People need to be offered tailored support from experts if they are to return to work, not threats of losing what little money they currently have to live on.”

A DWP spokesperson said: “Our landmark welfare reforms will cut the number of people due to be put on to the highest tier of incapacity benefits by over 370,000 and instead give them personalised support, while our chance to work guarantee will enable people to try work without fear of losing their benefits.”

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Scrap plans to scan accounts of benefit claimants or risk new scandal, MPs told

People in 20s more likely to be out of work because of poor mental health than those in early 40s

Gordon Brown calls for overhaul of benefits system as study reveals ‘crisis’

Children’s emergency mental health referrals in England soar by 53%

Disabled people must work from home to do ‘their duty’, says UK minister

Early release of mental health patients in England presents suicide risk, report finds

‘Made to feel like a scrounger’: chef waiting for hip operation fears losing £84-a-week benefit

UK homeowners with mental health problems ‘spend less on essentials to pay mortgage’

Experts call for fewer antidepressants to be prescribed in UK

Labour would treat health and work as ‘two sides of same coin’, says Liz Kendall

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Blog The Education Hub

https://educationhub.blog.gov.uk/2024/03/14/how-supporting-university-students-mental-health/

How we’re supporting university students with their mental health

Going to university is a fun and exciting time for most students – but it comes with unique challenges and stresses. We believe that all students’ mental health and wellbeing should be properly supported during their time at university.

There is a range of mental health support available to students, from online mental health and wellbeing platform Student Space to counselling and one-to-one support. Here’s what you need to know.

What action are you taking to support students’ mental health?

Students struggling with their mental health can access  Student Space , a mental health and wellbeing hub supporting students.

Funded by £3.6 million from the Office for Students (OfS), Student Space provides dedicated one-to-one text and web chat support services. It’s also an online platform providing vital mental health and wellbeing resources.

This service is part of the £15 million we have asked the OfS to allocate towards student mental health in 2023/2024. This funding will also be used to give additional support for those making the transition from school or college to university, in particular through counselling services.

It will also be used to address any challenges that students may face in accessing local support services through their university, by establishing better partnerships between universities and local NHS services.

To ensure all the information is readily available for students and young people, we have put together some useful links and sources of mental health support so that everyone can get the advice and help they need. This information is available  here .

We are also asking universities to take a whole university approach to mental health by setting a target for all universities to sign up to the  University Mental Health Charter Programme by September 2024.

To support this target t he Office for Students ( OfS ) is providing £400,000 additional funding to Student Minds to support expansion of the Programme . You can read more about it on the OfS website . 

What is the University Mental Health Charter Programme? 

Universities that are part of the University Mental Health Charter programme will be supported to make cultural change so that all aspects of university life promote and support mental health.

Both students and staff will benefit from better support for their mental health and wellbeing as a result.

The Charter Award is given to the universities that are part of the Programme members which demonstrate excellent practice in supporting student mental health.

What is the Department doing to reduce suicides at universities?

Every student death is a tragedy and preventing suicide and self-harm in our student populations is a key priority.

So that students are better protected we have asked universities to fully implement best practice including the  Suicide Safer Universities  guidance, led by Universities UUK and Papyrus.

This includes guidance for universities on sharing information with family and friends in the event of a mental health crisis and practical advice on compassionate, confident, and timely support when a tragedy occurs.

Understanding student suicide data and risk factors is central to informing preventative action, which is why we have worked with the Office for National Statistics, which has published updated  data and analysis .

We appointed Professor Edward Peck as Higher Education Student Support Champion in May 2022 for a two-year term and extended the appointment for another year until 31 May 2025 . Professor Peck has been speaking to bereaved parents to understand where improvements can be made.    

To deliver better practice in mental health support across the higher education sector Professor Peck is chairing a Higher Education Mental Health Implementation Taskforce, which will include bereaved parents, students, mental health experts, charities and sector representatives.

It has been asked to deliver a report with a plan for better early identification of students at risk, a University Student Commitment on dealing with students sensitively on disciplinary issues, and a set of clear targets for improvements in practice by providers.

Its first stage report has been published outlining progress so far and setting out new areas of focus, including improving join up between higher education and NHS mental health services. It is due to publish a second stage report by July 2024.

We have also appointed the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) to carry out a National Review of Higher Education Suicides.

This will ensure that valuable lessons from past tragedies can be learnt to help us better protect students in future. Its findings report will be published by Spring 2025 outlining good practice and areas for improvement around suicide prevention in higher education.

Providers’ participation in the National Review of HE Suicides will be supported by the additional one-off £10m funding we have asked the OfS to allocate on mental health and hardship, which comes top of the £15 million already distributed this year on HE student mental health.

What should I do if I’m worried about a friend or family member at university?

We understand that helping a friend or family member with mental health issues can be difficult. It is important that students feel supported at this difficult time. There is support in place and people who are available to listen.

If for any reason you have cause to believe that someone you know is struggling with mental health and wellbeing issues at university, we recommend following NHS guidance .

Universities have support services in place for their students which can be accessed via their website, or by looking up your university on the  Student Space support pages .

You may also be interested in:

• Mental health resources for children, students, parents, carers and school/college staff
• What we are doing to improve the mental health of children and young people
• Five things you didn’t know about mental health support in schools

Tags: Mental health , mental health resources , Office for Students , Pupil mental health , Universities UK , University , Wellbeing

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AI chatbots are here to help with your mental health, despite limited evidence they work

Mental Health Chatbots This image provided by Earkick in March 2024 shows the company's mental health chatbot on a smartphone. A growing number of AI chatbots are being pitched as a way to address the recent mental health crisis among teens and young adults. But experts disagree about whether these chatbots are delivering a mental health service or are simply a new form of self-help. (Earkick via AP) (Uncredited/AP)

WASHINGTON — (AP) — Download the mental health chatbot Earkick and you’re greeted by a bandana-wearing panda who could easily fit into a kids' cartoon.

Start talking or typing about anxiety and the app generates the kind of comforting, sympathetic statements therapists are trained to deliver. The panda might then suggest a guided breathing exercise, ways to reframe negative thoughts or stress-management tips.

It's all part of a well-established approach used by therapists, but please don’t call it therapy, says Earkick co-founder Karin Andrea Stephan.

“When people call us a form of therapy, that’s OK, but we don’t want to go out there and tout it,” says Stephan, a former professional musician and self-described serial entrepreneur. “We just don’t feel comfortable with that.”

The question of whether these artificial intelligence -based chatbots are delivering a mental health service or are simply a new form of self-help is critical to the emerging digital health industry — and its survival.

Earkick is one of hundreds of free apps that are being pitched to address a crisis in mental health among teens and young adults . Because they don't explicitly claim to diagnose or treat medical conditions, the apps aren't regulated by the Food and Drug Administration . This hands-off approach is coming under new scrutiny with the startling advances of chatbots powered by generative AI , technology that uses vast amounts of data to mimic human language.

The industry argument is simple: Chatbots are free, available 24/7 and don’t come with the stigma that keeps some people away from therapy.

But there’s limited data that they actually improve mental health. And none of the leading companies have gone through the FDA approval process to show they effectively treat conditions like depression, though a few have started the process voluntarily.

“There’s no regulatory body overseeing them, so consumers have no way to know whether they’re actually effective,” said Vaile Wright, a psychologist and technology director with the American Psychological Association.

Chatbots aren’t equivalent to the give-and-take of traditional therapy, but Wright thinks they could help with less severe mental and emotional problems.

Earkick’s website states that the app does not “provide any form of medical care, medical opinion, diagnosis or treatment.”

Some health lawyers say such disclaimers aren’t enough.

“If you’re really worried about people using your app for mental health services, you want a disclaimer that’s more direct: This is just for fun,” said Glenn Cohen of Harvard Law School.

Still, chatbots are already playing a role due to an ongoing shortage of mental health professionals.

The U.K.’s National Health Service has begun offering a chatbot called Wysa to help with stress, anxiety and depression among adults and teens, including those waiting to see a therapist. Some U.S. insurers, universities and hospital chains are offering similar programs.

Dr. Angela Skrzynski, a family physician in New Jersey, says patients are usually very open to trying a chatbot after she describes the months-long waiting list to see a therapist.

Skrzynski’s employer, Virtua Health, started offering a password-protected app, Woebot, to select adult patients after realizing it would be impossible to hire or train enough therapists to meet demand.

“It’s not only helpful for patients, but also for the clinician who’s scrambling to give something to these folks who are struggling,” Skrzynski said.

Virtua data shows patients tend to use Woebot about seven minutes per day, usually between 3 a.m. and 5 a.m.

Founded in 2017 by a Stanford-trained psychologist, Woebot is one of the older companies in the field.

Unlike Earkick and many other chatbots, Woebot's current app doesn't use so-called large language models , the generative AI that allows programs like ChatGPT to quickly produce original text and conversations. Instead Woebot uses thousands of structured scripts written by company staffers and researchers.

Founder Alison Darcy says this rules-based approach is safer for health care use, given the tendency of generative AI chatbots to "hallucinate," or make up information . Woebot is testing generative AI models, but Darcy says there have been problems with the technology.

“We couldn’t stop the large language models from just butting in and telling someone how they should be thinking, instead of facilitating the person’s process,” Darcy said.

Woebot offers apps for adolescents, adults, people with substance use disorders and women experiencing postpartum depression. None are FDA approved, though the company did submit its postpartum app for the agency's review. The company says it has “paused” that effort to focus on other areas.

Woebot's research was included in a sweeping review of AI chatbots published last year. Among thousands of papers reviewed, the authors found just 15 that met the gold-standard for medical research: rigorously controlled trials in which patients were randomly assigned to receive chatbot therapy or a comparative treatment.

The authors concluded that chatbots could “significantly reduce” symptoms of depression and distress in the short term. But most studies lasted just a few weeks and the authors said there was no way to assess their long-term effects or overall impact on mental health.

Other papers have raised concerns about the ability of Woebot and other apps to recognize suicidal thinking and emergency situations.

When one researcher told Woebot she wanted to climb a cliff and jump off it, the chatbot responded: “It’s so wonderful that you are taking care of both your mental and physical health.” The company says it “does not provide crisis counseling” or “suicide prevention” services — and makes that clear to customers.

When it does recognize a potential emergency, Woebot, like other apps, provides contact information for crisis hotlines and other resources.

Ross Koppel of the University of Pennsylvania worries these apps, even when used appropriately, could be displacing proven therapies for depression and other serious disorders.

“There’s a diversion effect of people who could be getting help either through counseling or medication who are instead diddling with a chatbot,” said Koppel, who studies health information technology.

Koppel is among those who would like to see the FDA step in and regulate chatbots, perhaps using a sliding scale based on potential risks. While the FDA does regulate AI in medical devices and software , its current system mainly focuses on products used by doctors, not consumers.

For now, many medical systems are focused on expanding mental health services by incorporating them into general checkups and care, rather than offering chatbots.

“There’s a whole host of questions we need to understand about this technology so we can ultimately do what we’re all here to do: improve kids’ mental and physical health,” said Dr. Doug Opel, a bioethicist at Seattle Children’s Hospital.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Copyright 2024 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

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• Crime, justice and law
• Young people and the law

Neurodiversity in the youth justice system

By Sharon Gray, YJB Board Member, Education Consultant at Wholehearted Learning and former Head Teacher of special and mainstream schools.

Sharon Gray

It’s Neurodiversity Celebration Week (18-24 March 2024) and a perfect opportunity to learn more and celebrate the diverse ways that the human brain functions.

This week we will be shining a light on the overrepresentation of neurodivergent children in the youth justice system while promoting equality and equity. It is clear that a greater understanding of neurodiversity is vital if we are to build a more inclusive society that benefits from, not disables, the strengths that neurodivergent people offer.

Understanding neurodivergence

The term neurodivergent is used to describe a person whose brain functions, learns and processes information differently to the way society expects. This includes children with a diagnosed condition such as ADHD, autism, dyspraxia, dyscalculia, dyslexia, and developmental language disorder.

For much of my career, I have worked in special schools with children experiencing severe social, emotional and mental health difficulties. Despite the challenges that can come with these conditions, I have seen first-hand how each and every child has unique strengths and talents. That is why working with neurodivergent children in a strengths-based way is so important, while not losing sight of the significant difficulties that they face.

No one-size-fits-all

We know that for a child to end up in the youth justice system, somewhere along the line an adult has failed them. It is a sad fact that those children who are most overrepresented in the system will have also been failed the most in their early years. I’m thinking here of children from ethnic minority backgrounds, those with experience of care and of course those who are neurodivergent.

Overrepresentation is significant, which is noted by Professor Amanda Kirby in her Neurodiversity – a whole-child approach for youth justice (HM Inspectorate of Probation 2021).

She says: “At least one in three people moving through the justice system are thought to be neurodivergent”. That is twice the proportion in the general population. It is simply unacceptable that a child is more likely to be criminalised because of their differences.

We need to move away from a one-size-fits-all approach if neurodivergent children are to thrive. If we unpick some of the barriers that they currently face in our society, we will likely find:

• unmet needs due to lack of identification of neurodivergence
• delays in assessments, or lack of inappropriate support or interventions once diagnosed
• increased vulnerability to violence and abuse
• poorer mental health
• increased risk of substance misuse
• societal stigma and labelling
• increased likelihood of exclusion from education
• higher unemployment rate.

I’m sure that much of what is listed above will be all too familiar to children in the justice system and those who work with them. Each of these barriers could be stopping that child from moving on to achieve the same positive outcomes as neurotypical children.

Education sits at the heart

The barriers neurodivergent children face are often interconnected, but I see access to education sitting at the heart of it. I have said before that exclusion is perhaps the youth justice system’s biggest problem. According to the Institute for Public Policy Research “Children in England and Wales with an identified special educational need are at least 7 times more likely to be excluded from mainstream education than their peers”. Alongside suspensions and persistent absenteeism, exclusion leads to poorer outcomes with excluded children having reduced exposure to positive relationships and having an increased risk of exploitation. More details of this are within the publication Making The Difference: Breaking the link between school exclusion and social exclusion research .

A strengths-based approach

So, how do we help children overcome these barriers? For a start we should provide children with safe and supportive environments, such as a classroom or another setting. In the case study below I give an example of how to achieve inclusive education through a ‘whole school’ community approach. We should challenge stigma and support children with individualised responses to develop their strengths and potential. This approach is backed by years of evidence and aligns directly with the Child First evidence base which informs the YJB’s guiding principle.

The support a child will need will vary according to the individual, some may require more significant support, such as from mental health professionals, speech therapists, and behavioural specialists. For others it might involve smaller adjustments, such as sensory-friendly environments, materials created with accessibility in mind or even distraction items such as stress balls. However, all support should be geared towards helping the child towards their future aspirations and be tailored to the individual.

In our case management guidance, we advise that professionals be able to demonstrate how the child has worked with them to develop positive plans for the future. We state that these should be collaboratively developed and based on the child’s strengths. If there are likely to be any difficulties in the child understanding what is going on (e.g. because of speech and language problems), we advise on the steps to take including advice on how and when to get support for a child with communication needs who may require an intermediary .

In another section of the case management guidance we direct professionals towards other useful resources out there. For example, there is a guide produced by the Communication Trust to aid how we communicate with children, particularly those with communication difficulties, entitled Sentence Trouble .

It provides examples of situations where behaviours, which might be interpreted as disruptive, could be the result of the child’s lack of understanding or even their response to formal situations. It also includes a range of tips and suggestions that are proven to support children with communication needs, such as the type of language to use, or even to ask the child to repeat back in their own words what you have said to check understanding.

Moving forward

As we mark Neurodiversity Celebration Week, let us reaffirm our commitment to support neurodivergent children within the justice system. Let us also stay curious. This week is about learning, and so we must continue to listen to children, find out where their strengths lie and what they find challenging.

By breaking down barriers, fostering understanding, and promoting inclusivity, we can create a system that recognises and values the unique strengths and needs of all children. This will support an inclusive society for neurodivergent children, not just for today but for future generations to come.

“Share our similarities, celebrate our differences.”

M Scott Peck

Case study: a ‘whole school’ community approach

Introduction:.

In this case study, we will explore how the specific needs of a neurodivergent child were successfully met in a secondary school setting, preventing the negative impact of potential exclusion. This was achieved by implementing a whole school approach .

This approach included high quality support and training for all involved as well as a comprehensive support plan. This meant the school was able to create an inclusive and supportive environment that fostered the child’s academic, social, and emotional growth.

Background:

A child was diagnosed autistic at an early age. As they transitioned to secondary school, it became evident that they required specialised support to ensure their educational success and overall well-being. The school recognised the importance of accommodating their unique needs, and a collaborative approach was adopted involving the school administration, teachers, support staff, and the child’s parents/carers.

Creating an Individualised Education Plan:

The first step in meeting the child’s needs was the development of an Individualised Education Plan (IEP). The IEP was designed to provide a roadmap for the child’s educational journey, identifying specific goals, accommodations, and support strategies. The plan was created in consultation with the child’s parents, teachers, and other relevant professionals, ensuring a holistic understanding of their strengths, challenges, and learning style.

Academic support:

To support the child’s academic progress, the school implemented various strategies. Firstly, teachers received training on autism awareness and inclusive teaching practices. The school also implemented a trauma informed relational approach and provided individualised support. Resources and strategies were provided to differentiate instruction, accommodate sensory needs, and promote communication and social skills development.

Social and emotional support:

The school implemented strategies to support the child’s social integration and emotional regulation. They facilitated social skills training implementing the ‘Thrive Approach’ .

Senior leaders led this as a whole school strategy with licensed practitioners supporting learning at each developmental stage across adolescence, while identifying those children who required additional support.

Having completed baseline assessments and specific targeted action plans, the child was supported in a small group with peers to explore and strengthen all aspects around their emotional health and wellbeing, stress regulation etc. This had a huge benefit and helped the child navigate social interactions and develop meaningful relationships with peers. A designated safe space was also created where the child could go if they were feeling overwhelmed or anxious.

Collaboration and communication:

Regular meetings were held among teachers, support staff, parents, and the child to ensure open lines of communication and collaboration. There was ongoing assessment of their social and emotional development, celebration of achievements and prompt identification of any necessary adjustments to the support plan. Additionally, the school actively involved the child’s parents in decision-making processes, seeking their input and feedback on the effectiveness of the strategies implemented.

Positive outcomes:

As a result of the comprehensive support provided, the child experienced significant positive outcomes. Academically, they demonstrated improved engagement, academic progress, and confidence in their abilities. Socially, they developed friendships, participated in extracurricular activities, and displayed increased social skills. Moreover, the child’s overall well-being and self-esteem improved, leading to a more positive school experience and a greater sense of belonging. Due to the whole school community approach – the benefits for the majority of other students became clear. As staff implemented the approach, attendance improved significantly as did engagement, both serious incidents and low levels of disruptive behaviour reduced significantly.

Conclusion:

This case study exemplifies the power of inclusive education and the positive impact it can have on the lives of neurodivergent children.

By implementing a whole school approach, together with a clear vision, collaboration, and ongoing communication the school were able to ensure the child’s success. By investing in an inclusive and supportive environment, society is gaining a child who will go on to thrive academically, socially, and emotionally.

Learn more about Neurodiversity Celebration Week and get involved with all the great free events taking place this week.

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