Randomized controlled trials (RCTs) are possible when studying depression in the workplace.
This is one of the key findings of a systematic review completed by the Institute for Work & Health (IWH) in February. The review, led by IWH Associate Scientist Andrea Furlan, looked at the effectiveness of programs to address workplace depression.
The RCT finding is important because RCTs are considered the gold standard for determining the effectiveness of health, safety and disability prevention interventions, says Furlan.
Depression in the workplace is widespread. Not surprisingly, employers are increasingly concerned about the effects of depression on their employees and their workplaces. Yet, workplace-sponsored programs that target depression remain uncommon.
This systematic review was conducted to determine the range of possible evidence-based programs that could be implemented in workplaces to improve workers’ depression and reduce associated productivity losses. In the end, however, the review team could recommend no intervention as being effective because the evidence from the studies reviewed was considered to be of very low quality.
Some interventions feasible
However, the review did solidify the questions the stakeholders want answered by future research: What programs work? When is the best time to intervene? Why do some interventions work in the short-term, but not the long-term? It also confirmed that RCTs can be used to help answer these questions.
And it did find that some intervention approaches are feasible and, therefore, could be further evaluated in future studies. These included enhanced primary care, enhanced psychiatric care, enhanced role for occupational health physicians, psychological interventions, work stress reduction and integrated care.
Perhaps the solution lies in layered approaches that aim to break down both individual and organizational barriers in order to prevent the occurrence and reoccurrence of disability and absence due to depression, says Furlan.
Both a full and summary report are available at: www.iwh.on.ca/sys-reviews/workplace-depression-interventions.