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      Development of MHFA-based 2-h educational program for early intervention in depression among office workers: A single-arm pilot trial

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          Abstract

          Objective

          In the workplace depression and suicide are serious mental health problems. A lack of knowledge and mental health skills along with the stigma toward mental health problems often results in delays in seeking professional help. Interventions targeting not only persons with mental health problems but also people around the individual are warranted in order to encourage supporting behavior within entire workplace. In the present study, we investigated the efficacy of our newly developed educational training program in the management with depression and suicidal risk in the workplace as a single-arm pilot trial.

          Methods

          The program is a two-hour (2-h) training course for employees based on the Mental Health First Aid (MHFA) program which aims to increase public mental health literacy. We conducted this program at a company workplace among 91 employees, and ultimately 83 participants completed the self-rated questionnaires. Changes in confidence and practical skills in early intervention of depression and suicide-prevention, and stigma toward mental health problems were evaluated using self-rated questionnaires at 3 time-points; pre-program, immediately post-program, and 1 month after the program.

          Results

          Confidence and practical skills were significantly improved even 1 month after the program, and stigma reduced just after the program.

          Conclusions

          Our pilot study suggests that the program has a positive impact on encouraging employees to support their co-workers with mental health problems, and is applicable for busy workers due to its short duration. A single-arm design, evaluation using self-rated questionnaire and short-term follow up period are the main limitations of the present study. Hence, future research is required to validate the effects of this program with control groups, and also to assess long-term effectiveness and objective changes such as absenteeism and sick leave.

          Trial registration

          UMIN Clinical Trials Registry (UMIN-CTR) R000023258

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          Most cited references31

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          Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: a meta-analysis.

          Mental Health First Aid (MHFA) is a standardized, psychoeducational programme developed to empower the public to approach, support and refer individuals in distress by improving course participants' knowledge, attitudes and behaviours related to mental ill-health. The present paper aims to synthesize published evaluations of the MHFA programme in a meta-analysis to estimate its effects and potential as a public mental health awareness-increasing strategy. Fifteen relevant papers were identified through a systematic literature search. Standardized effect sizes were calculated for three different outcome measures: change in knowledge, attitudes, and helping behaviours. The results of the meta-analysis for these outcomes yielded a mean effect size of Glass's Δ = 0.56 (95% CI = 0.38 - 0.74; p < 0.001), 0.28 (95% CI = 0.22 - 0.35; p < 0.001) and 0.25 (95% CI = 0.12 - 0.38; p < 0.001), respectively. Results were homogenous, and moderator analyses suggested no systematic bias or differences in results related to study design (with or without control group) or 'publication quality' (journal impact factor). The results demonstrate that MHFA increases participants' knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviours toward individuals with mental health problems. The MHFA programme appears recommendable for public health action.
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            Global patterns of workplace productivity for people with depression: absenteeism and presenteeism costs across eight diverse countries

            Purpose Depression is a leading cause of disability worldwide. Research suggests that by far, the greatest contributor to the overall economic impact of depression is loss in productivity; however, there is very little research on the costs of depression outside of Western high-income countries. Thus, this study examines the impact of depression on workplace productivity across eight diverse countries. Methods We estimated the extent and costs of depression-related absenteeism and presenteeism in the workplace across eight countries: Brazil, Canada, China, Japan, South Korea, Mexico, South Africa, and the USA. We also examined the individual, workplace, and societal factors associated with lower productivity. Results To the best of our knowledge, this is the first study to examine the impact of depression on workplace productivity across a diverse set of countries, in terms of both culture and GDP. Mean annual per person costs for absenteeism were lowest in South Korea at $181 and highest in Japan ($2674). Mean presenteeism costs per person were highest in the USA ($5524) and Brazil ($5788). Costs associated with presenteeism tended to be 5–10 times higher than those associated with absenteeism. Conclusions These findings suggest that the impact of depression in the workplace is considerable across all countries, both in absolute monetary terms and in relation to proportion of country GDP. Overall, depression is an issue deserving much greater attention, regardless of a country’s economic development, national income or culture.
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              The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review

              Background The majority of people experiencing mental-health problems do not seek help, and the stigma of mental illness is considered a major barrier to seeking appropriate treatment. More targeted interventions (e.g. at the workplace) seem to be a promising and necessary supplement to public campaigns, but little is known about their effectiveness. The aim of this systematic review is to provide an overview of the evidence on the effectiveness of interventions targeting the stigma of mental illness at the workplace. Methods Sixteen studies were included after the literature review. The effectiveness of anti-stigma interventions at the workplace was assessed by examining changes in: (1) knowledge of mental disorders and their treatment and recognition of signs/symptoms of mental illness, (2) attitudes towards people with mental-health problems, and (3) supportive behavior. Results The results indicate that anti-stigma interventions at the workplace can lead to improved employee knowledge and supportive behavior towards people with mental-health problems. The effects of interventions on employees’ attitudes were mixed, but generally positive. The quality of evidence varied across studies. Conclusions This highlights the need for more rigorous, higher-quality evaluations conducted with more diverse samples of the working population. Future research should explore to what extent changes in employees’ knowledge, attitudes, and supportive behavior lead to affected individuals seeking help earlier. Such investigations are likely to inform important stakeholders about the potential benefits of current workplace anti-stigma interventions and provide guidance for the development and implementation of effective future interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12888-015-0706-4) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: InvestigationRole: Methodology
                Role: Formal analysis
                Role: InvestigationRole: Resources
                Role: InvestigationRole: Resources
                Role: SoftwareRole: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Funding acquisitionRole: SoftwareRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                7 December 2018
                2018
                : 13
                : 12
                : e0208114
                Affiliations
                [1 ] Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
                [2 ] TOTO Ltd., Kitakyushu, Fukuoka, Japan
                [3 ] Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
                [4 ] Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
                [5 ] Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
                [6 ] Shimane Prefectural Counseling Center for Physical and Mental Health, Matsue, Shimane, Japan
                [7 ] Mie Prefectural Mental Medical Center, Tsu, Mie, Japan
                [8 ] Kitakyushu Mental Health Center, Kitakyushu, Fukuoka, Japan
                [9 ] Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
                Chiba Daigaku, JAPAN
                Author notes

                Competing Interests: Miyako Hirashima and Shion Ueno are employed by TOTO Ltd. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

                Author information
                http://orcid.org/0000-0001-5169-2930
                Article
                PONE-D-18-10200
                10.1371/journal.pone.0208114
                6285460
                30532174
                3a0eb97a-4399-4d0c-b21a-5b40e63b8984
                © 2018 Kubo et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 May 2018
                : 7 November 2018
                Page count
                Figures: 1, Tables: 5, Pages: 12
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100009619, Japan Agency for Medical Research and Development;
                Award ID: JP16dk0307028
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100009619, Japan Agency for Medical Research and Development;
                Award ID: JP17dk0307073
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: JP25461781
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: JP16H06403
                Award Recipient :
                This work was supported by a Grant-in-Aid for Scientific Research on (1) The Japan Agency for Medical Research and Development (AMED) ( https://www.amed.go.jp/) (JP16dk0307028 & JP17dk0307073 to TAK), and (2) KAKENHI - the Japan Society for the Promotion of Science ( https://www.jsps.go.jp/j-grantsinaid/index.html) (JP16H06403 to TAK & JP25461781 to KO). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. TOTO Ltd. provided support in the form of salaries for authors [MH & SU], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the 'author contributions' section.
                Categories
                Research Article
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Suicide
                Social Sciences
                Economics
                Labor Economics
                Employment
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Research and Analysis Methods
                Research Design
                Pilot Studies
                Social Sciences
                Sociology
                Education
                Lectures
                Custom metadata
                In the present study, the participants are employees of a company. Some data potentially identifies participants, therefore, Kyushu University IRB has set restrictions on sharing data publicly. In the present stage, data access is restricted to a limited number of researchers. If researchers outside of the present study desire to access this data, a procedure must be followed to obtain permission from Kyushu University IRB. We also provide contact information: Kyushu University Institutional Review Board (IRB), E-mail: ijkseimei@ 123456jimu.kyushu-u.ac.jp .

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