Supporting the Mental Health of the Primary Care Workforce

Heather L Rogers, Jelka Zaletel, Pedro Pita Barros, Expert Panel On Effective Ways Of Investing In Health

Keywords: Mental health, primary care workforce, prevention, intervention

Background:

In 2021, the European Commission DG SANTE Expert Panel on Effective Ways of Investing in Health (EXPH) published an Opinion on ‘Supporting the Mental Health (MH) of the Health Workforce’ (see: https://ec.europa.eu/health/publications/supporting-mental-health-health-workforce-and-other-essential-workers-0_en).

Research questions:

The mandate asked the EXPH to address:
1. What are the specific determinants of MH of the health workforce?
2. What is known about MH interventions and their cost effectiveness?
3. What implementation conditions are necessary for successful delivery of MH interventions?
4. What evidence-based action points are recommended?

Method:

A literature review along with focus group discussions with EXPH members and invited experts were conducted.

Results:

1. Optimal mental health involves lack of mental illness AND high mental well-being.
2. There is a complex interplay of determinants - biological, psychological, and social & environmental (including both work-related, occupation-specific and non-occupational-specific characteristics) - influencing MH trajectories over time in the face of a given stressor.
3. Supporting the mental health of the primary care workforce requires inter-sectorial and multi-stage interventions (primary, secondary, and tertiary).
4. European Agency for Safety and Health at Work legislation exists, as well as international standards of the Occupational Health and Safety management system.
5. The Swiss cheese model of accident causation (Reason, 1990) is a helpful heuristic to illustrate this synergy among MH interventions enacted within and outside of the health sector.

Conclusions:

The main recommendation centers on the need for multiple interventions targeting multiple risk and protective factors occurring at multiple levels in order to ensure that all members of the primary care workforce benefit from them and no one individual is left behind. The priorities of different levels of interventions should begin with large scale interventions supporting the largest share of the health workforce, followed by interventions targeting organizational and team & job characteristics, and lastly targeting modifiable individual characteristics.

Points for discussion:

What interventions are available to support the mental health of the primary care workforce in your country?

At what level are these interventions implemented (e.g., policies outside the health sector, policies within the health sector, organizational-level policies, managerial interventions, center (group) interventions, individual interventions)?

What activities do you find most helpful to maintain your own mental health?

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