Elena Schwarz

Objective: More and more companies are offering specific training programmes aimed at supporting managers in dealing with the mental health of their employees. Nevertheless, little is known about the individual impact factors and their effects in everyday management. Methods: Using a qualitative research approach, 20 managers were asked about their experiences with a training programme after one and 12 months. Results: Analysis showed an overall great interest and open attitude among the participants. Still, ambivalences emerged when it came to implementing the training and actually dealing with mental health problems. Typifying the participants showed different stages to describe the managers’ individual attitudes concerning mental health at the workplace. Conclusion: The results could hold great potential for more targeted individualization of manager training courses in the field of mental health. However, further research is needed. Export

Background: Leadership in small and medium-sized enterprises (SMEs) is associated with a variety of challenges and stressors, which are reflected in their managers’ commonly experienced high stress levels. In this context, psychological strain can arise, but compared to large companies, SMEs face particular difficulties in implementing mental health promotion intervention. These difficulties partially originate in a profound lack of comprehensive research on the effectiveness and prospects of success of intervention strategies in SMEs. This study aims to close this gap by evaluating a stress management training for managers in SMEs (KMU-GO). Implementing established stress management strategies and making them more accessible within the SME context, the training aims to improve participants’ psychological and physiological well-being. Methods: We conducted a randomized controlled trial with an intervention and a waitlist control group in Germany. The intervention comprised 1.5 days of stress management training and two refresher sessions, focusing on short- and long-term coping strategies and self-reflection. Based on a sample of N = 155 managers, we conducted a multilevel analysis of covariance on psychological measures, namely stress reactivity, depression, and anxiety. Additionally, changes in physiological stress indices (i.e., hair cortisol concentration and salivary alpha-amylase activity) were examined. Results: Regarding the psychological measures, we found significant training effects six months after baseline. Twelve months after baseline, there were no significant differences between the intervention and control groups for either psychological or physiological variables. Conclusion: In conclusion, the present stress management training is effective in reducing psychological strain in SME managers. In order to achieve more sustainable effects, a continuation of the refresher sessions could be considered. Trial registration: Before including the first participant, the KMU-GO trial is registered at the German Clinical Trial Register (DRKS): DRKS00023457 (registered on 5 November 2020).

Background: Occupational health physicians are increasingly confronted with mental health issues at their workplace. Facing them, most of them feel insecure and not sufficiently trained. Employee’s mental well-being depends at the same time on individual and significantly on organizational variables. This complicates the physician’s position, since they have to serve many interests. The focus of the present study is to investigate what difficulties occupational health physicians face and how organizational culture and management influence their work. Methods: Interviews were conducted with N = 25 physicians as part of a training for basic mental health care. Interviews were interpreted using qualitative content analysis. Results: Working with mentally ill employees was difficult for the physicians interviewed. Many felt insecure managing and preventing mental health issues. A need for further education was observed. Environmental factors (organizational culture, management) have a strong impact on the work of an occupational health physician and highlight its systemic dimension. Even though many of our participants report a meanwhile more open attitude towards mental disorders at their workplace, on the level of direct contact to the management prevail descriptions of little acceptance and a high priority of economic outcomes. Conclusions: More education on topics of mental health is needed for occupational health physicians. Future trainings should consider the intertwined nature of their work and enable them in dealing consciously with other actors in the company. For enhancing employee’s mental well-being occupational health physicians could be granted a strengthened position in companies or be supported through more exchange with colleagues in other companies.

Background: Mental illnesses have received increasing attention in the work context in recent years, yet they are still often accompanied by stigma. One starting point for stigma reduction is interventions in the workplace. The present study evaluated a one-day workshop for managers in a large company. Method: Enrolled managers (n = 70) were randomly assigned to the intervention group and the waiting control group. The training included a theoretical section on mental and stress-related diseases as well as the interplay between work and health, group work on personal stress experience, theoretical input on dealing with mentally ill employees, and a group discussion on this topic along with case studies. Both groups completed the following questionnaires at baseline and three months after training: Effort–Reward Imbalance Questionnaire, Patient Health Questionnaire, Mental Health Knowledge Schedule, Social Distance Scale, and the Irritation Scale. Results: Compared to the waiting group, the intervention group showed a significant improvement in the Mental Health Knowledge Schedule (U = 417.00, p = 0.040) and an increase in the Irritation Scale (U = 371.50 p = 0.011). All other scales remained unchanged. Conclusion: The content and duration of the training were adequate to reduce cognitive stigma towards mental illness. However, the present approach was not sufficient for an improvement in the subjective stress level of the participating managers.

Background: Leaders in small and medium-sized enterprises (SMEs) are exposed to increased stress as a result of a range of challenges. Moreover, they rarely have the opportunity to participate in stress management trainings. Therefore, KMU-GO (ger: Kleine und mittlere Unternehmen – Gesundheitsoffensive; en: small and medium-sized enterprises – health campaign) aims at conducting and evaluating such a stress management training. The focus of evaluation does not only lie on the effects on leaders participating but also on their employees. Methods: The study is planned as a 2 × 3 mixed design with two groups (intervention and waiting control group) as a between factor and point in time (at baseline, 6 and 12 months later) as a within factor. We aim at collecting data from N = 200 leaders. Based on the results of a preceding assessment, an already successfully implemented stress management training was adapted to SME needs and now serves as the framework of this intervention. The stress management training comprises one and a half days and is followed by two booster sessions (each 180 min) about 3 and 6 months after the training. The main focus of this intervention lies on specifying leaders stress reactivity while at the same time investigating its effects on employees’ mental health. Further dependent variables are leaders´ depression and anxiety scores, effort-reward imbalance, sick days and psychophysiological measures of heart rate variability, hair cortisol, and salivary alpha-amylase. Cost-effectiveness analyses will be conducted from a societal and employers’ point of view. Discussion: Stress management is a highly relevant issue for leaders in SMEs. By providing an adequate occupational stress management training, we expect to improve leaders´ and also employees` mental health, thereby preventing economic losses for SMEs and the national economy. However, collecting data from employees about the success of a stress management training of their leader is a highly sensitive topic. It requires a carefully planned proceeding ensuring for example a high degree of transparency, anonymity, and providing team incentives. Trial registration: The KMU-GO trial is registered at the German Clinical Trial Register (DRKS): DRKS00023457 (05.11.2020)

Mental health problems have become one of the most common causes of incapacity for work, and engender high costs to society. Especially managerial behavior was found to have a great impact on employees’ well-being. In order to support those in leading positions in dealing with their own, as well as their employees’, psychological stress factors, we conducted a specific manager training. At the same time, we wanted to find out about the training’s short- and long-term effects. Participants were asked to give information about their knowledge and attitudes concerning mental health (Mental Health Knowledge Schedule, Social Distance Scale), as well as to comment on their own health condition (12-Item Short Form Health Survey, Patient Health Questionnaire) and working situation (Effort–Reward Inventory, Irritation Scale). Data were collected at baseline, as well as 3 and 12 months after the training. Results show long-term improvements in knowledge and attitudes measured by the Mental Health Knowledge Schedule (MAKS: M_t1 = 22.88, Mt2 = 23.79, Mt3 = 23.79, p = 0.005) but not in the Social Distance Scale (SoDi: M_t1 = 0.96, Mt2 = 0.85, Mt3 = 0.84, p = 0.165). Over the period of time observed, no changes were found regarding health- or work-related instruments. Due to the uncontrolled design of the study, further research is needed to determine the exact effectiveness.

Psychische Erkrankungen gelten in Deutschland als zweithäufigster Grund für Arbeitsunfähigkeit. Dabei kann die Arbeit selbst sowohl Belastung als auch Ressource für die Mitarbeiter sein. Positiven Einfluss auf den Krankheitsverlauf hat vor allem die frühe Erkennung und somit auch frühe Behandlung der Erkrankungen. Die Psychosomatische Sprechstunde im Betrieb (PSIB) ist ein vom Betrieb initiiertes Angebot für Mitarbeiter mit psychischen Beschwerden. Sie wird von externen Experten für seelische Gesundheit durchgeführt, gehört aber zum betrieblichen Versorgungsnetzwerk. Das so entstehende, niedrigschwellige Angebot soll Mitarbeitern den Zugang zu adäquater Behandlung erleichtern. Die enge Anbindung der Behandler an den Betrieb soll weiter die individuelle Integration von Arbeitsthemen in die Behandlung ermöglichen. Die Rahmenbedingungen der Sprechstunde, wie z. B. der Ort und die Dauer des Kontaktes, werden im Vorlauf mit dem jeweiligen Unternehmen abgestimmt. Der Fokus der Begegnung liegt auf der Vermittlung von Kontrolle und Orientierung an den Mitarbeiter. Zentrale Elemente der PSIB sind dabei zunächst die Beziehungsherstellung zwischen Behandler und Mitarbeiter sowie eine erste Diagnostik und Situationsbeschreibung. Weitere Elemente sind Wissensvermittlung und Befähigung des Mitarbeiters sowie abschließend die Planung und Begleitung nächster Schritte. Insgesamt 174 Mitarbeiter dreier Unternehmen wurden mit 194 Nutzern psychotherapeutischer Ambulanzen verglichen. Es zeigte sich eine signifikant höhere Nutzerzufriedenheit der Sprechstundenteilnehmer zu denen der Regelversorgung. Mental disorders are considered to be the second leading cause for sick leave in Germany. However, work itself can function both as a burden as well as a power resource for employees. Early detection, followed by an early intervention, in particular, have a positive influence on the progress of the disease. The Psychosomatic Consultation in the Workplace (PSIW) is an offer, initiated by the company, for employees with mental health problems. It is conducted by external experts for mental health even though being offered by the company itself. This low-threshold offer is meant to facilitate the access to adequate treatment for the employees. Furthermore, the close proximity of the practitioner to the company allows to consider individual workplace conditions during treatment. The general framework, such as location and duration of the consultation, is set out with each company in advance. The main focus of the consultations is put on transferring control and orientation to the employee. Central elements of the PSIW are fostering a trustful relationship between the practitioner and the employee in line with a first diagnostic assessment and description of the situation. Further effects are the transfer of knowledge and the empowerment of employees, as well as providing support in the planning of further steps. A total of 174 employees of three different companies have been compared to 194 users of psychotherapeutic ambulances. Results showed a significantly higher satisfaction of PSIW-users compared to users of standard treatment.