Economic modelling for interventions to prevent poor, promote positive and improve mental wellbeing: Mental wellbeing at work

Excerpt

Background: The National Institute for Health and Care Excellence (NICE) worked with Public Health England to develop a guideline scope. The guideline will update and replace the NICE guideline PH22: mental wellbeing at work [1]. It may also be used to update the NICE quality standard for healthy workplaces: improving employee mental and physical health and wellbeing.

As stated in the final scope, the proportion of UK employees who are part-time, temporary, agency staff, on zero hours contracts or self-employed has increased since PH22 was published in 2009. In 2017, there was an independent review into how employers can better support the mental health of employees [2]. The review estimates that 15% of UK workers have an existing mental health condition and concludes that the UK faces significant mental health challenges at work. Better mental wellbeing and job satisfaction are associated with increased workplace performance and productivity [3]. However, many employers know the value of positive mental wellbeing but do not know how to promote it. In some cases, interventions aimed at increasing productivity might have harmful effects on an employee’s wellbeing and, as such, these consequences can also be important for decision making.

NICE commissioned York Health Economics Consortium (YHEC) to carry out a systematic cost-effectiveness review and conduct an economic evaluation. This document outlines the objectives, methods and results of the economic evaluation.

Objectives: The Public Health Advisory Committee (PHAC) prioritised questions in the NICE scope for further economic analysis. Research questions were not prioritised if there was sufficient cost-effectiveness evidence available in the published literature. Where cost-effectiveness evidence was insufficient, research questions were prioritised if there was updated and available effectiveness evidence since the publication of the previous guidelines or if economic modelling had previously not been conducted. The aim of this analysis was to conduct economic modelling and provide data on costs and benefits to employers who are considering implementing an intervention at work in order to prevent poor wellbeing, promote positive wellbeing and improve mental wellbeing. Additionally, cost-consequences analysis was used to assess any changes in employee outcomes. Outcomes from the economic model will help to inform the committee’s guidance decisions for questions prioritised in the NICE scope and provide an interactive online calculator to help inform employers implementing mental wellbeing interventions in the workplace.

All research questions with an economic element from the NICE scope were prioritised for modelling. These are:

1. What universal, organisational-level interventions, programmes, policies or strategies are effective and cost-effective at:

   1. –

      Preventing poor mental wellbeing?

   2. –

      Promoting positive mental wellbeing?

   3. –

      Improving mental wellbeing?

2. What interventions or strategies effectively and cost-effectively help employers and peers to recognise and engage employees who may require support for their mental wellbeing, or to identify periods of high risk within an organisation?

3. What approaches to help managers to understand, promote and support mental wellbeing are effective and cost-effective?

4. What approaches are effective and cost-effective to help managers to improve their knowledge and skills in recognising employees who experience or are at risk of poor mental wellbeing?

5. What approaches are effective and cost-effective to help managers to improve their knowledge and skills in responding to mental wellbeing issues?

6. What organisational-level approaches, programmes, strategies or policies targeted to employees who experience or who are identified as being at risk of experiencing poor mental wellbeing at work are effective and cost-effective at:

   1. –

      Preventing poor mental wellbeing?

   2. –

      Promoting positive mental wellbeing?

   3. –

      Improving mental wellbeing?

7. What universal, individual-level interventions or programmes are effective and cost-effective at:

   1. –

      Preventing poor mental wellbeing?

   2. –

      Promoting positive mental wellbeing?

   3. –

      Improving mental wellbeing?

8. What individual-level interventions targeted to employees who experience or are identified as being at risk of poor mental wellbeing at work are cost effective and:

   1. –

      Preventing poor mental wellbeing?

   2. –

      Promoting positive mental wellbeing?

   3. –

      Improving mental wellbeing?