Help-seeking for mental health problems by employees in the Australian Mining Industry

Care navigation addresses issues of tele-mental health acceptability and uptake in rural and remote Australian communities

INTRODUCTION

People living in rural and remote areas face substantial barriers to accessing timely and appropriate mental health services. In the Bowen Basin region of Queensland, Australia, barriers include: limited local providers, long waiting lists, unreliable telecommunication, and reluctance to trial telehealth. Isaac Navicare is a new, community co-designed care navigation service which addresses these barriers by coupling care navigation with supported telehealth, and referrals to mental health providers and other supports. We aimed to understand the reach and effectiveness of Isaac Navicare in improving access to mental health services and address an evidence gap on strategies for improving telehealth acceptability.

METHODS

This mixed-methods implementation science evaluation used the RE-AIM Framework. It involved a client database review, survey and semi-structured interviews with service users during the 12-month pilot from November 2021.

RESULTS

197 clients (128 adults, 69 minors) were referred to Navicare during the pilot. Half of adult clients were unemployed, meaning referral options were limited to low-cost or bulk-billed services. Participants described Navicare as supportive and effective in helping to access timely and appropriate mental health supports. Most clients who expressed a treatment modality preference selected face-to-face (n = 111, 85.4%), however most referrals were for telehealth (n = 103, 66.0%) due to a lack of suitable alternatives. The rapport and trust developed with the care navigator was critical for increasing willingness to trial telehealth. Barriers to telehealth included privacy issues, technical difficulties, unreliable internet/phone, and perceived difficulties developing therapeutic rapport. The supported telehealth site was under-utilised. The majority (88.3%, n = 182) of referrals to Navicare were from local health or community service providers or schools.

DISCUSSION

Coupling supportive, individualised care navigation with tele-mental health provider options resulted in increased uptake and acceptance of telehealth. Many barriers could be addressed through better preparation of clients and improving promotion and uptake of the supported telehealth site.

CONCLUSION

Attitudes towards telehealth have changed during the COVID-19 pandemic, however although the need exists, barriers remain to uptake. Telehealth alone is not enough. Coupling telehealth with other supports such as care navigation improves acceptance and uptake.

A Narrative Review of Health Status and Healthcare Delivery in the Oil and Gas Industry: Impacts on Employees, Employers, and Local Communities

Workers in the oil and gas industry are exposed to numerous health risks, ranging from poor health behaviours to the possibility of life-threatening injuries. Determining the most appropriate models of healthcare for the oil and gas industry is difficult, as strategies must be acceptable to multiple stakeholders, including employees, employers, and local communities. The purpose of this review was to broadly explore the health status and needs of workers in the oil and gas industry and healthcare delivery models relating to primary care and emergency responses. Database searches of PubMed, EMBASE, CINAHL, PsycINFO, and Scopus were conducted, as well as grey literature searches of Google, Google Scholar, and the International Association of Oil and Gas Producers website. Resource-sector workers, particularly those in 'fly-in fly-out' roles, are susceptible to poor health behaviours and a higher prevalence of mental health concerns than the general population. Evidence is generally supportive of organisation-led behaviour change and mental health-related interventions. Deficiencies in primary care received while on-site may lead workers to inappropriately use local health services. For the provision of emergency medical care, telehealth and telemedicine lead to favourable outcomes by improving patient health status and satisfaction and reducing the frequency of medical evacuations.

In What Ways Does Health Related Stigma Affect Sustainable Employment and Well-Being at Work? A Systematic Review

PURPOSE

Studies are increasingly showing that health related stigma is a barrier to employment, but it is not known how. The aim of this systematic review is to identify, appraise and analyse studies that have directly or indirectly addressed ways in which stigma affects sustainable employment and well-being at work of people with disabilities.

METHODS

Using a multiphase screening process, this review is based on a comprehensive literature search (2000-2019) carried out in six electronic databases: Embase, Web of Science, Medline Ovid, Cochrane CENTRAL, PsycINFO and Google Scholar.

RESULTS

7.263 publications were identified; 96 studies were found eligible to be included in the review. 72% of the studies were conducted in North America or Europe. Few studies directly assessed how stigma affects the employment of people with disabilities. Most studies highlighted that attitudes and behaviour of employers formed a barrier to employment, as well as anticipated stigma and self-stigma in people with health problems. However, the findings also showed that the attitudes and behaviour of co-workers, health care professionals, reintegration professionals, customers, and family and friends could act as a barrier to employment although these influences are under-researched. Although many similarities were seen in the relevant findings of studies about both physical and mental disabilities, several nuances were found.

CONCLUSION

Stigma hampers sustainable employment and well-being in multiple ways. Whereas the number of publications on this topic is rapidly increasing, the roles of health care professionals, reintegration professionals, co-workers, customers, and family and friends particularly warrant more attention.

Worker and manager perceptions of the utility of work-related mental health literacy programmes delivered by community organisations: a qualitative study based on the theory of planned behaviour

OBJECTIVES

Reluctance to seek help is a leading contributor to escalating mental injury rates in Australian workplaces. We explored the benefit of using community organisations to deliver mental health literacy programmes to overcome workplace barriers to help-seeking behaviours.

DESIGN

This study used a qualitative application of the theory of planned behaviour to examine underlying beliefs that may influence worker's intentions to participate in mental health literacy programmes delivered by community organisations and manager support for them.

SETTING

This study took place within three large white-collar organisations in the Australian state of Victoria.

PARTICIPANTS

Eighteen workers and 11 managers (n=29) were interviewed to explore perspectives of the benefits of such an approach.

RESULTS

Community organisations have six attributes that make them suitable as an alternative mental health literacy programme provider including empathy, safety, relatability, trustworthiness, social support and inclusivity. Behavioural beliefs included accessibility, understanding and objectivity. The lack of suitability and legitimacy due to poor governance and leadership was disadvantages. Normative beliefs were that family and friends would most likely approve, while line managers and colleagues were viewed as most likely to disapprove. Control beliefs indicated that endorsements from relevant bodies were facilitators of participation. Distance/time constraints and the lack of skills, training and lived experiences of coordinators/facilitators were seen as barriers.

CONCLUSIONS

Identifying workers' beliefs and perceptions of community organisations has significant implication for the development of effective community-based strategies to improve worker mental health literacy and help seeking. Organisations with formal governance structures, allied with government, peak bodies and work-related mental health organisations would be most suitable. Approaches should focus on lived experience and be delivered by qualified facilitators. Promoting supervisor and colleague support could improve participation. Models to guide cross-sector collaborations to equip community organisations to deliver work-related mental health literacy programmes need to be explored.

Mental health and workplace factors: comparison of the Ghanaian and Australian mining industry

Background

Mining is a global industry and contributes significantly to international economies. This study seeks to compare the patterns of psychological distress, job demand-control, and associated characteristics between two countries (Australia/Ghana) to increase understanding of cross-cultural factors relevant to mental health in this industry.

Method

A cross-sectional study design was used. Eight coal mines in Australia and five gold mines in Ghana. A total of 2622 mineworkers participated in this study. Kessler Psychological Distress Scale (K10), Job Content Questionnaire (JCQ), Alcohol Use Disorders Identification Test (AUDIT), the Berkman-Syme Social Network Index (SNI) and help-seeking questionnaire.

Results

Ghanaian mineworkers reported increased psychological distress compared to Australian mineworkers; Job demands outweighed control among Ghanaian mineworkers but was associated with lower risk of psychological distress compared to Australian mineworkers; Ghanaian mineworkers were significantly less likely to drink alcohol at risky levels but this was associated with higher psychological distress; Increased social network was associated with decreased psychological distress for both countries.

Conclusions

These findings identify cultural and geographical differences in the socio-demographics, workplace factors, psychological distress, and alcohol use in both countries. Cross-cultural occupational workplace factors and mental health issues are highlighted. Potential workplace interventions applicable in comparable settings are recommended.

Gender-Oriented Mental Health Prevention: A Reappraisal

Many studies have investigated the impact of gender on mental health, but only a few have addressed gender differences in mental health risk and prevention. We conducted a narrative review to assess the current state of knowledge on gender-specific mental health preventive interventions, along with an analysis of gender-based risk factors and available screening strategies. Out of 1598 articles screened using a comprehensive electronic search of the PubMed, Web-of-Science, Scopus, and Cochrane databases, 53 were included for review. Among risk factors for mental health problems, there are individual, familiar, social, and healthcare factors. Individual factors include childhood adversities, which show gender differences in distribution rates. However, current childhood abuse prevention programs are not gender-specific. Familiar factors for mental health problems include maternity issues and intimate partner violence, and for both, some gender-specific preventive interventions are available. Social risk factors for mental health problems are related to education, employment, discrimination, and relationships. They all display gender differences, but these differences are rarely taken into account in mental health prevention programs. Lastly, despite gender differences in mental health service use being widely known, mental health services appear to be slow in developing strategies that guarantee equal access to care for all individuals.

The characteristics of accepted work-related injuries and diseases claims in the Australian coal mining industry

Background

Coal mining is a hazardous industry. The purpose of the study is to identify the nature of occupational injuries and diseases among coal miners and to determine the factors that affect the rate of injury and duration of time loss from work.

Methods

A retrospective cohort study was conducted using accepted workers' compensation claims data of 30,390 Australian coal miners between July 2003 and June 2017.

Results

Musculoskeletal and fracture conditions accounted for approximately 60% of claims in all occupational groups. Cox regression analysis showed that older age and female gender were significant predictors of longer time off work. Injury types and occupations were associated with work time loss: mental health conditions, and machine operators and drivers had significantly longer durations of time off work.

Conclusion

Future research can further address how these factors led to longer time off work so that coal industry regulators, employers, and healthcare providers can target interventions more effectively to these at-risk workers.

WITHDRAWN: The influence of employee pressure on the management cost of enterprise technological innovation using mental health education

Ahead of Print article withdrawn by publisher.

Predictors of Psychological Distress and Mental Health Resource Utilization among Employees in Malaysia

We sought to examine predictors of psychological distress among employees as well as the level of awareness and usage of available mental health resources by employees through their own organizations. The Malaysian Healthiest Workplace survey cross-sectional dataset was used to explore the association between psychological distress, a range of health conditions, as well as mental health resource awareness and usage in a sample of 11,356 working Malaysian adults. A multivariate logistic regression was conducted to determine predictors of high psychological distress. Comorbid illnesses that were associated with psychological distress were mental illness (OR 6.7, 95% CI 4.39-10.14, p = 0.001), heart conditions (OR 2.17, 95% CI 1.18-3.99, p = 0.012), migraines (OR 1.59, 95% CI 1.33-1.90, p = 0.001), bronchial asthma (OR 1.43, 95% CI 1.11-1.85, p = 0.006), and hypertension (OR 1.42, 95% CI 1.07-1.88, p = 0.016) compared to individuals with no comorbid conditions. A total of 14 out of 17 comorbid medical illnesses were associated with elevated levels of psychological distress among employees. Awareness and usage of support services and resources for mental health were associated with lower psychological distress. These findings extend the literature by providing further evidence on the link between chronic illness, occupational type, as well as awareness and use of mental health resources by psychological distress status.

Does Help Seeking Behavior Change Over Time Following a Workplace Mental Health Intervention in the Coal Mining Industry?

OBJECTIVES

To investigate help seeking behavior and attitudes to mental health in mining employees.

METHODS

A pre-post survey study of employees from two Australian coal mines. Data were collected prior to, at baseline, at 6 and 18 months following delivery of the MATES in mining (MIM) peer support mental health intervention.

RESULTS

Help seeking behaviors increased, with participants' sex, age, relationship status, shift type, and psychological distress significantly associated with likelihood of seeking help (P <0.05). In relation to stigma, significantly more participants' disagreed that they would be treated differently by friends or colleagues following disclosure of mental illness (P < 0.01).

CONCLUSIONS

Results provide an understanding of help seeking behaviors of mining employees; support the MATES in Mining peer support program in the men dominated industry and provide information to guide mental health workplace program development more broadly.

Factors associated with patterns of psychological distress, alcohol use and social network among Australian mineworkers

OBJECTIVE

To investigate the convergence of individual findings relating to psychological distress, alcohol use and social network (SN) to identify their associated clusters within Australian mineworkers.

METHODS

This study used cross-sectional survey data from 3,056 participants across 12 Australian mines. Latent class analysis used the scores of Kessler Psychological Distress Scale, Alcohol Use Disorders Identification Test (AUDIT) and Social Network Index.

RESULTS

Class 1 (moderate to very high psychological distress, low SN score and low to moderate AUDIT) included 39% (n=1,178) participants and class 2 (low to moderate psychological distress and AUDIT and very high SN) composed of 61% (n=1,873) participants. Class 1 was associated with younger age (OR=0.65, 95%CI=0.53-0.81), being a current smoker (OR=1.45, 95%CI=1.18-1.79), and reporting a history of anxiety (OR=3.00, 95%CI=2.23-4.05) and/or depression (OR=2.18, 95%CI=1.65-2.90).

CONCLUSIONS

These findings highlight the challenges the mining sector faces regarding the welfare of its employees. Implications for public health: Modifiable work factors associated with lower social networks and higher psychological distress need addressing at an individual and industry level through targeted and specifically tailored multi-component interventions.

The status of job burnout and its influence on the working ability of copper-nickel miners in Xinjiang, China

BACKGROUND

Job burnout is increasingly common among occupational groups, and it is evolving into a new occupationally harmful phenomenon. The purpose of this study was to investigate the status of job burnout and its influence on the working ability of copper-nickel miners in Xinjiang, China, and to provide a theoretical basis for alleviating job burnout and improving the working ability of copper and nickel miners.

METHODS

A cross-sectional survey was carried out in June 2017 to September 2018 in Hami City, Xinjiang Autonomous Uygur Region, China. According to the main production process stratification of copper-nickel ore (mining unit, beneficiation unit, smelting unit), a self-administered questionnaire survey on the general situation of miners was conducted on the basis of the Chinese Maslach Burnout Inventory and Work Ability Index Questionnaire among 1400 miners registered in the human resources department of copper and nickel mines by stratified cluster sampling.

RESULTS

There were 1014 miners with different degrees of burnout, accounting for 80.86% of the total: 432 people reported mild burnout (34.45%), 516 reported moderate burnout (41.15%), and 66 reported high burnout (5.26%). There were significant differences in the degree of burnout according to sex, age, education level, monthly income, and work unit (p < 0.05). The level of male burnout was higher than that of females. Miners aged 35-40 years, with a high-school education, a monthly income of less than 2500 yuan, and who belonged to the smelting unit had the highest job burnout.There were significant differences in working ability among miners with different burnout level (p < 0.01). Partial correlation analysis showed that work ability was negatively correlated with emotional exhaustion, reduced sense of achievement, and total burnout score (p < 0.001). Multinomial logistic regression analyses showed that the education level, professional title,work units and job burnout level had a pronounced impact on the working ability of miners (p < 0.001); The reduced level of education, primary title, smelting unit, and the increase in job burnout are risk factors for the reduction of working ability.

CONCLUSIONS

Our results indicate that job burnout is common among copper and nickel miners. Furthermore, working ability decreases with an increase in job burnout, and reducing job burnout can improve the working ability of copper and nickel miners.

Treatment-seeking differences for mental health problems in male- and non-male-dominated occupations: evidence from the HILDA cohort

BACKGROUND

There is a well-established gender divide among people who do and do not seek professional help from mental health professionals. Females are typically more likely to report, and seek help for, mental health problems. The current paper sought to examine the role of employment context on help-seeking for mental health issues. We hypothesised that men and women in male-dominated occupations would be less likely to seek help than those in non-male-dominated occupations.

METHODS

Data from the Household, Income and Labour Dynamics in Australia survey were used. Help-seeking, measured in 2013, was defined as whether a person reported attending a mental health professional in the 12 months prior to the survey. The exposure, male- and non-male-dominated occupations (measured in 2012), was defined using census data based on self-reported occupation. Analyses were stratified by gender and controlled for relevant confounders (measured in 2012), including mental health and prior help-seeking. We conducted multivariate logistic and propensity score analyses to improve exchangeability of those exposed and unexposed.

RESULTS

For males, being in a male-dominated occupation was independently associated with reduced likelihood of help-seeking (OR 0.66, 95% CI 0.46-0.95) in the adjusted model, although this result fell just out of significance in the propensity score analysis. There was no independent effect of being in a male-/non-male-dominated occupation for help-seeking among women.

CONCLUSIONS

Results suggest that male-dominated occupations may negatively influence help-seeking among males. There is a need for more research to understand this relationship and for workplace-based prevention initiatives.

Employee Stress, Reduced Productivity, and Interest in a Workplace Health Program: A Case Study from the Australian Mining Industry

The Australian mining sector has an elevated industry prevalence of stress and high stress related productivity impairment costs. This study surveyed 897 employees from an Australian mining company to identify characteristics associated with: (a) high stress related productivity impairment costs; and (b) likelihood of stressed employees wanting stress management assistance at work. Groups associated with average annual productivity impairment costs in excess of $50,000 per employee included: permanent day shift employees; employees who reported being stressed at work most of the time; employees who reported being stress at work all of the time; and employees who were contemplating better managing their stress in the next 6 months. Overall, 52% of employees who identified as being in the contemplation stage of change for stress management and 52% of employees who experienced stress most of the time reported wanting stress assistance with stress. However, only 33% of stressed permanent day shift employees and 36% of employees who experienced stress all the time reported wanting stress assistance. To achieve a high return on investment when implementing workplace stress management programs in the mining industry, practitioners need to strategically target health promotion to engage stressed employees with high productivity impairment costs and low desire for stress management assistance.

Feasibility and acceptability of strategies to address mental health and mental ill-health in the Australian coal mining industry

Background

To evaluate the feasibility, acceptability and effectiveness of implementing a peer-based, multi-component mental health program in the Australian coal mining industry.

Methods

The multicomponent program included MATES in mining (a peer-based mental health and suicide prevention program) and supervisor training. Eight Australian coal mines participated in the research, with four mines receiving the mental health program. Primary outcome variables including mental health stigma, help-seeking behaviour and perception of the workplace commitment to mental health were measured prior to program implementation, and then again 10 months following using a paper based survey. Process evaluation of the mental health program was measured using a pre-test/post-test survey.

Results

MATES in mining 1275 miners participated in the MATES general awareness and connector training. Participants were more confident that they could identify a workmate experiencing mental ill-health; help a workmate, family member or themselves identify where to get support and were more willing to start a conversation with a workmate about their mental health. Supervisor training 117 supervisors completed the supervisor training and were subsequently more confident that they could: identify someone experiencing mental ill-health in the workplace; identify and recommend support services to a person experiencing mental ill-health; and have an effective conversation about performance issues that may be due to mental ill-health.

Conclusions

Our findings show evidence to support the use of peer-based mental health programs in the mining industry, and for male-dominated industry more broadly.