About this presentation• These slides present interim findings from a review of the evidence undertaken in workshop conditions at Evidence Base Camp 2013/14.
• The findings from the review are not exhaustive. Due to time constraints not all available bibliographic databases have been searched, and books and longer reports were excluded from our synthesis sessions.
• The findings have not been peer reviewed or quality assuredin the same way as a formal research publication.
• The College of Policing Research Analysis and Information Unit (RAI) plans to turn this review of the evidence into a full Rapid Evidence Assessment Report in due course.
What interventions have been shown to be effective in
supporting mental well-being in the work place?Delegates:
Pippa Gregory - NCA
Clare Simkin – Hampshire Constabulary
Donna Holderness – College of Policing
Yvonne Burgess –College of Policing
Antony Evans –West Yorkshire Police
Dafydd Llywelyn – Dyfed-Powys Police
Sarah Crampton – Northamptonshire Police
Simon James – Wiltshire Police
Michelle Weller - NCA
Fiona Bohan – Devon and Cornwall Police
Sarah Knapper – Police Federation
College of Policing Facilitators:
Paul Quinton
Fiona Mclean
David Brown
Carol Heslop
Emily Powell
How did we answer the question?
• Using a Rapid Evidence Assessment (REA)
• REAs follow a systematic process to identify and appraise evidence…
• …but make compromises given available time and resources
• Pragmatic and transparent approach
• Ensure best possible coverage of literature in the time available
The process (in a nutshell)
1. Draft search terms
2. Draft sift criteria
3. Sift received abstracts
4. Request relevant papers
5. Read and ‘grade’ papers
6. Write it up (‘synthesis’)
Developing search terms
What interventions have been shown to be effective in supporting mental well-being in the work place?
Tier Area Synonyms include…
1 Wellbeing Wellbeing or “well being”; welfare; mind set; resilience; emotional or mental wellbeing; behavioural hardiness; stress; Pressure
2 Workplace Work place; workplace; place of work; office; employee; work environment; workforce
3 Interventions Intervention; tactic; strategy; initiative; procedure; approach
4 What Works Systematic review; rapid evidence assessment; trial; RCT; experiment; evaluation; effective; assessment; “what works”; impact; success.
Search outcomes
1600+ potentiallyrelevant studies
identified.
Wellbeing
InterventionWork place
What Works
Our search identifies studies that mention all
four of our areas: Wellbeing,
Intervention, Work place & ‘What
works’…
Searches find all potentially relevant studies…
AnonymousAnonymous THE WHIP NOTICE -WEEK OF 9/20/10,. (2010).
Abstract: Andrea Lawrence Designation Act (Sponsored by Rep. McKeon / Natural Resources Committee) 7 H.Con.Res. 294 - 75th Anniversary of the Blue Ridge Parkway (Sponsored by Rep. Perriello / Natural Resources Committee) 8 H.Res. 1503 - Expressing support for National Estuaries Day (Sponsored by Rep. Castor / Natural Resources Committee) 9 H.Res. 1508 - Celebrating the 200th Anniversary of John James Audubon (Sponsored by Rep. Whitfield / Natural Resources Committee) 10 Senate Amendment to H.R. 1454 - Multinational Species Conservation Funds Semipostal Stamp Act (Sponsored by Rep. Brown (SC) / Natural Resources Committee) 11 H.R. 3470 - Nationally Enhancing the Wellbeing of Babies through Outreach and Research Now Act (Sponsored by Rep. Cohen / Energy and Commerce Committee) 12 H.R. 5756 - Training and Research for Autism Improvements Nationwide Act (Sponsored by Rep. Doyle / Energy and Commerce Committee) 13 H.R. 2923 - Combat Methamphetamine Enhancement Act (Sponsored by Rep. Gordon / Energy and Commerce Committee) 14 H.R. 3199 - Emergency Medic Transition (EMT) Act (Sponsored by Rep. Harman / Energy and Commerce Committee) 15 H.R. 5809 - Safe Drug Disposal Act (Sponsored by Rep. Inslee / Energy and Commerce Committee) 16 H.R.
Sifting our abstracts identifies the truly relevantliterature. Sift criteria is used so that we are consistent and transparent in our sifting.
Returned by the wellbeing search…
Our Inclusion CriteriaQuestion Answer Action
Q1. Is the key topic of the paper mental well-being in the workplace?
Yes Go to 2
No Red
Q2. Is the paper looking at the effectiveness of interventions or causal factors in mental wellbeing?
Yes Go to 3
No Red
Causal Factors Amber
Q3. Does the paper include empirical research?
Yes Include
No Red
Unsure Amber
Sifting – flow of papers
Searches of online databases and
library catalogueN=1,229
Papers sifted out: N=1,157
Example reasons for exclusion:Language (not English) n=1Publication not available n=14Duplicates n=7
Papers excluded: Total N=31/72
Reasons for exclusion:• Did not meet sift criteria n=31
Reports meeting inclusion criteria &
mappedN=41
Abstract and title
screened
N=1,229
Full text
screened
N=72
Our initial search identified 1,229 papers, but only 41 (3%) were actually relevant to our research question. Our findings are drawn from these 41 studies that we have reviewed over the last two days.
• We searched the main databases available to the National Police Library• Due to time restrictions, we have not included books and reports in our synthesis• Some longer studies could not be included due to time restrictions.
Synthesis – Mapping the evidence
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1980-1989 1990-1999 2000-2009 2010+
Publication Date
Synthesis – Mapping the evidence
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UK North
America
Australia Other
European
International
Country of focus
Synthesis – Mapping the evidence
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Intervention Type
Synthesis – Mapping the evidence
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Policing Healthcare Education Other / multiple
Study Context
What does ‘good’ or ‘robust’ evidence look like?
Systematic Reviews(Based on level 3-5 studies)
5 Randomised controlled trials
4Before/after measures
Multiple site comparisons
3Before/after measuresTwo site comparisons
2Before/after measures
No comparison site
1One-off measure
No comparison site
Study designs increasingly rule out potential alternative causes
Statements about ‘what works’
Statements about ‘what’s promising’
Study designs cannot rule out potential alternative causes
Statements about possible impact
Synthesis – Quality of evidence
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Level 1 Level 2 Level 3 Level 4 Level 5 Systematic
review
Number of studies
SynthesisWhat Works(systematic reviews)
A range of interventions have been shown to ‘work’ in non-policing settings including those targeted at the following levels:- Individual – humour ; exercise; talking to non-colleagues; education focused on skills & competency; short term and targeted crisis / psycho-social support techniques (e.g. counselling, stress support)- Organisational – people friendly operating model (e.g. work space, procedures, or flexible working,); a range of health promotion strategies; fostering of professional networks
What’s Promising(RCTs)
A range of interventions have been shown to be effective in improving mental well being, and helping staff to manage stress and be more resilient in non-policing organisations.These interventions included: strategies to empower staff and improve their control over their work environment; techniques to allow staff to manage stress better (e.g. yoga, gentle exercise, psychological tools and methods); and coaching and targeted support.
What’s Unknown It is not clear: whether these interventions would work in a police setting; when these interventions would work best (e.g. do they require transformational leadership?); and how much dosage is required and how sustainable is the effect
What’s Harmful(systematic reviews)
Nothing was found from systematic review evidence to suggest any intervention had a detrimental effect
Key messages
• Most studies were published in the last 14 years and undertaken predominantly in North America, though some were carried out in the UK
• Very few studies were found that were conducted in a policing setting; most were from a range of professions including healthcare
• The overall quality of evidence was high, though the studies were very targeted on specific aspects of wellbeing
• Therefore, there may be an issue about how transferable the findings are to policing & the UK
• There were a wide range of interventions - targeted at individuals and whole organisations - that were found to be effective
• A common theme to the effective interventions seemed to be employee empowerment
• More research is needed and could focus on longer term sustainability, cost-effectiveness and whether these interventions also work in UK policing in order to refine our knowledge
What interventions have been shown to be effective in supporting mental wellbeing in the workplace?