The importance of manager support for the mental health and well-being of ambulance personnel

Katherine Petrie, Aimée Gayed, Bridget T Bryan, Mark Deady, Ira Madan, Anita Savic, Zoe Wooldridge, Isabelle Counson, Rafael A Calvo, Nicholas Glozier, Samuel B Harvey, Katherine Petrie, Aimée Gayed, Bridget T Bryan, Mark Deady, Ira Madan, Anita Savic, Zoe Wooldridge, Isabelle Counson, Rafael A Calvo, Nicholas Glozier, Samuel B Harvey

Abstract

Interventions to enhance mental health and well-being within high risk industries such as the emergency services have typically focused on individual-level factors, though there is increasing interest in the role of organisational-level interventions. The aim of this study was to examine the importance of different aspects of manager support in determining the mental health of ambulance personnel. A cross-sectional survey was completed by ambulance personnel across two Australian states (N = 1,622). Demographics, manager support and mental health measures were assessed. Hierarchical multiple linear regressions were conducted to determine the explanatory influence of the employee's perception of the priority management places upon mental health issues (manager psychosocial safety climate) and managers' observed behaviours (manager behaviour) on employee common mental disorder and well-being within ambulance personnel. Of the 1,622 participants, 123 (7.6%) were found to be suffering from a likely mental disorder. Manager psychosocial safety climate accounted for a significant amount of the variance in levels of employee common mental health disorder symptoms (13%, p<0.01) and well-being (13%, p<0.01). Manager behaviour had a lesser, but still statistically significant influence upon symptoms of common mental disorder (7% of variance, p<0.01) and well-being (10% of variance, p<0.05). The perceived importance management places on mental health and managers' actual behaviour are related but distinct concepts, and each appears to impact employee mental health. While the overall variance explained by each factor was limited, the fact that each is potentially modifiable makes this finding important and highlights the significance of organisational and team-level interventions to promote employee well-being within emergency services and other high-risk occupations.

Conflict of interest statement

AS is employed by and a representative of Ambulance Victoria and ZW is employed by and a representative of NSW Ambulance. SBH is employed by the Black Dog Institute, who provides manager training to workplaces. All other authors have no other competing interests to report in relation to the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Association between reported level of…
Fig 1. Association between reported level of manager support (manager behaviour and manager psychosocial safety climate) and symptoms of common mental disorder (measured by the total Kessler K6 score).
Both MB and MPSC scores have been grouped into quintiles.
Fig 2. Association between reported level of…
Fig 2. Association between reported level of manager support (manager behaviour and manager psychosocial safety climate) and mental well-being amongst ambulance personnel (Short Warwick-Edinburgh Mental Well-being Scale; SWEMWBS).
Both MB and MPSC scores have been grouped into quintiles.

References

    1. Harvey SB, Deady M, Wang MJ, Mykletun A, Butterworth P, Christensen H, et al. Is the prevalence of mental illness increasing in Australia? Evidence from national health surveys and administrative data, 2001–2014. Med J Aust. 2017;206(11):490–3.
    1. Harvey SB, Henderson M. Occupational psychiatry. Psychiatry. 2009;8(5):174–8.
    1. Harvey SB, Henderson M, Lelliott P, Hotopf M. Mental health and employment: much work still to be done. Br J Psychiatry. 2009;194(3):201–3. doi:
    1. McFarlane AC, Bryant RA. Post-traumatic stress disorder in occupational settings: anticipating and managing the risk. Occupational Medicine. 2007;57(6):404–10. doi:
    1. Mitchell JT, Everly GS Jr. Critical incident stress debriefing (CISD) and the prevention of work-related traumatic stress among high risk occupational groups Psychotraumatology: Springer; 1995. p. 267–80.
    1. Mitchell JT. Crisis intervention & CISM: A research summary. Retrieved August. 2003;12:2004.
    1. Joyce S, Modini M, Christensen H, Mykletun A, Bryant R, Mitchell PB, et al. Workplace interventions for common mental disorders: a systematic meta-review. Psychol Med. 2016;46(4):683–97. doi:
    1. Petrie K, Joyce S, Tan L, Henderson M, Johnson A, Nguyen H, et al. A framework to create more mentally healthy workplaces: A viewpoint. Aust N Z J Psychiatry. 2017:4867417726174.
    1. Harvey SB, Modini M, Joyce S, Milligan-Saville JS, Tan L, Mykletun A, et al. Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems. Occup Environ Med. 2017;74(4):301–10. doi:
    1. Modini M, Joyce S, Mykletun A, Christensen H, Bryant RA, Mitchell PB, et al. The mental health benefits of employment: Results of a systematic meta-review. Australas Psychiatry. 2016.
    1. Dollard MF, Bakker AB. Psychosocial safety climate as a precursor to conducive work environments, psychological health problems, and employee engagement. Journal of Occupational and Organizational Psychology. 2010;83(3):579–99.
    1. Hall GB, Dollard MF, Coward J. Psychosocial safety climate: Development of the PSC-12. International Journal of Stress Management. 2010;17(4):353.
    1. Idris MA, Dollard MF, Coward J, Dormann C. Psychosocial safety climate: Conceptual distinctiveness and effect on job demands and worker psychological health. Safety Science. 2012;50(1):19–28.
    1. LaMontagne AD, Keegel T, Shann C, D'Souza R. An integrated approach to workplace mental health: an Australian feasibility study. International Journal of Mental Health Promotion. 2014;16(4):205–15.
    1. Harvey SB, Milligan-Saville JS, Paterson HM, Harkness EL, Marsh AM, Dobson M, et al. The mental health of fire-fighters: An examination of the impact of repeated trauma exposure. Aust N Z J Psychiatry. 2015.
    1. Du Preez J, Sundin J, Wessely S, Fear N. Unit cohesion and mental health in the UK armed forces. Occupational medicine. 2011;62(1):47–53. doi:
    1. Jones N, Seddon R, Fear NT, McAllister P, Wessely S, Greenberg N. Leadership, cohesion, morale, and the mental health of UK Armed Forces in Afghanistan. Psychiatry: Interpersonal & Biological Processes. 2012;75(1):49–59.
    1. Jones N, Campion B, Keeling M, Greenberg N. Cohesion, leadership, mental health stigmatisation and perceived barriers to care in UK military personnel. Journal of Mental Health. 2016:1–9.
    1. Armistead-Jehle P, Buican B. Evaluation context and Symptom Validity Test performances in a US Military sample. Archives of Clinical Neuropsychology. 2012;27(8):828–39. doi:
    1. Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Rivers AJ, Morgan CA, et al. Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: the role of resilience, unit support, and postdeployment social support. Journal of affective disorders. 2010;120(1):188–92.
    1. Bartone PT. Resilience under military operational stress: Can leaders influence hardiness? Military psychology. 2006;18(S):S131.
    1. Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults American Psychological Association; 2000.
    1. Harvey SB, Milligan-Saville JS, Paterson HM, Harkness EL, Marsh AM, Dobson M, et al. The mental health of fire-fighters: An examination of the impact of repeated trauma exposure. Australian & New Zealand Journal of Psychiatry. 2016;50(7):649–58.
    1. Milligan‐Saville JS, Paterson HM, Harkness EL, Marsh AM, Dobson M, Kemp RI, et al. The Amplification of Common Somatic Symptoms by Posttraumatic Stress Disorder in Firefighters. Journal of Traumatic Stress. 2017;30(2):142–8. doi:
    1. Bennett P, Williams Y, Page N, Hood K, Woollard M. Levels of mental health problems among UK emergency ambulance workers. Emerg Med J. 2004;21(2):235–6. doi:
    1. Berger W, Coutinho ES, Figueira I, Marques-Portella C, Luz MP, Neylan TC, et al. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):1001–11. doi:
    1. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand S-L, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological medicine. 2002;32(6):959–76.
    1. Furukawa TA, Kawakami N, Saitoh M, Ono Y, Nakane Y, Nakamura Y, et al. The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan. International journal of methods in psychiatric research. 2008;17(3):152–8. doi:
    1. Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Archives of general psychiatry. 2003;60(2):184–9.
    1. Veldhuizen S, Cairney J, Kurdyak P, Streiner DL. The sensitivity of the K6 as a screen for any disorder in community mental health surveys: a cautionary note. The Canadian Journal of Psychiatry. 2007;52(4):256–9. doi:
    1. Kessler RC, Berglund PA, Zhao S, Leaf PJ, Kouzis AC, Bruce ML, et al. The 12-month prevalence and correlates of serious mental illness (SMI). Mental Health, United States. 1996;5600.
    1. Stewart-Brown S, Tennant A, Tennant R, Platt S, Parkinson J, Weich S. Internal construct validity of the Warwick-Edinburgh mental well-being scale (WEMWBS): a Rasch analysis using data from the Scottish health education population survey. Health and quality of life outcomes. 2009;7(1):15.
    1. Paramedics Australasia. Paramedics in the 2011 Census. Supplement to Paramedics Australasia's response to the Australian Health Ministers' Advisory Council Consultation Paper. Victoria, Australia; 2012 November 2012.
    1. Hall GB, Dollard MF, Winefield AH, Dormann C, Bakker AB. Psychosocial safety climate buffers effects of job demands on depression and positive organizational behaviors. Anxiety, Stress & Coping. 2013;26(4):355–77.
    1. Sterud T, Hem E, Ekeberg O, Lau B. Health problems and help-seeking in a nationwide sample of operational Norwegian ambulance personnel. BMC Public Health. 2008;8 (no pagination)(3).
    1. Sterud T, Hem E, Lau B, Ekeberg O. A comparison of general and ambulance specific stressors: Predictors of job satisfaction and health problems in a nationwide one-year follow-up study of Norwegian ambulance personnel. Journal of Occupational Medicine and Toxicology. 2011;6 (1) (no pagination)(10). doi:
    1. Neal A, Griffin MA. A study of the lagged relationships among safety climate, safety motivation, safety behavior, and accidents at the individual and group levels. Journal of applied psychology. 2006;91(4):946 doi:
    1. Carr JZ, Schmidt AM, Ford JK, DeShon RP. Climate perceptions matter: a meta-analytic path analysis relating molar climate, cognitive and affective states, and individual level work outcomes. The Journal of applied psychology. 2003;88(4):605–19.
    1. Kendler KS, Gatz M, Gardner CO, Pedersen NL. A Swedish national twin study of lifetime major depression. American Journal of Psychiatry. 2006;163(1):109–14. doi:
    1. Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. American Journal of Psychiatry. 2000;157(10):1552–62. doi:
    1. Fanous AH, Neale MC, Aggen SH, Kendler KS. A longitudinal study of personality and major depression in a population-based sample of male twins. Psychological medicine. 2007;37(8):1163–72. doi:
    1. Kendler KS, Karkowski LM, Prescott CA. Causal relationship between stressful life events and the onset of major depression. American Journal of Psychiatry. 1999;156(6):837–41. doi:
    1. Kendler KS, Thornton LM, Gardner CO. Genetic risk, number of previous depressive episodes, and stressful life events in predicting onset of major depression. American Journal of Psychiatry. 2001;158(4):582–6. doi:
    1. Moffitt J, Bostock J, Cave A. Promoting well-being and reducing stigma about mental health in the fire service. Journal of Public Mental Health. 2014;13(2):103–13.
    1. Nishiuchi K, Tsutsumi A, Takao S, Mineyama S, Kawakami N. Effects of an education program for stress reduction on supervisor knowledge, attitudes, and behavior in the workplace: a randomized controlled trial. Journal of occupational health. 2007;49(3):190–8.
    1. Dimoff JK, Kelloway EK, Burnstein MD. Mental health awareness training (MHAT): The development and evaluation of an intervention for workplace leaders. International Journal of Stress Management. 2016;23(2):167.
    1. Milligan-Saville JS, Tan L, Gayed A, Barnes C, Madan I, Dobson Mea. Workplace mental health training for managers: Results of a cluster randomized controlled trial. Lancet Psychiatry. In press(In press).
    1. Netterstrøm B, Conrad N, Bech P, Fink P, Olsen O, Rugulies R, et al. The relation between work-related psychosocial factors and the development of depression. Epidemiologic reviews. 2008;30(1):118–32.
    1. De Lange AH, Taris TW, Kompier MA, Houtman IL, Bongers PM. The relationships between work characteristics and mental health: Examining normal, reversed and reciprocal relationships in a 4-wave study. Work & Stress. 2004;18(2):149–66.

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