How adverse working conditions increase the risk of depression

By Dr. Chinta SidharthanReviewed by Benedette Cuffari, M.Sc.Oct 17 2023

In a recent study published in The Lancet, researchers examine the association between working conditions and the prevalence of mental health disorders, as well as the efforts to promote and safeguard mental health in the workplace.

Study: Work-related causes of mental health conditions and interventions for their improvement in workplaces. Image Credit: PeopleImages.com - Yuri A / Shutterstock.com

Background

Increasing evidence suggests that adverse working conditions are intricately linked to mental health disorders, which impact not only the affected individuals but also their coworkers, employers, families, and society. The World Health Organization (WHO) defines mental health as an individual's state of well-being that allows them to realize their abilities, work productively, and cope with the stressors of life while contributing to their community.

The three important aspects of mental health include mental well-being, mental health problems, and mental disorders. The distinctions between these three aspects are essential, as their implications vary significantly from protection to compensation.

Mental health disorders such as anxiety, depression, and substance abuse are common in the workplace. The recent coronavirus disease 2019 (COVID-19) is believed to have exacerbated these problems.

About the study

In the present study, researchers first defined key terms associated with work and mental health and examined why mental health and work are both important areas of research. A review and synthesis of the current state of knowledge on the causal role of the environment in workplaces in the initiation or development of mental health disorders was subsequently performed. The researchers also examined the options and avenues available to promote and protect mental health at work.

The study included various systematic reviews with meta-analyses of studies published between December 2011 and January 2017 involving prospective cohorts. The review focused on individuals of working age throughout the world exposed to specific chemical, physical, psychosocial, and ergonomic working conditions.

Although the impact of the psychosocial work environment on the mental health of workers gained much attention between the 1960s and 1970s, it was not until the beginning of the 20^th century that this association was explored on a large, epidemiological scale. However, with the subsequent rapid increase in prospective studies examining the incidence of depressive disorders linked to working conditions, there have been a plethora of systematic reviews with meta-analyses.

Given the numerous systematic reviews on the subject, the current study's researchers conducted a meta-review or umbrella review. Herein, they reviewed other systematic reviews to synthesize the findings and gain an understanding of the current evidence on the impact of the working environment on mental health.

Individuals who were not exposed to these working conditions were used as the comparators. The examined outcomes included the onset of mental health disorders as defined by the International Statistical Classification of Diseases Tenth Revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Study findings

Three primary models of psychosocial work stress exposure were identified and associated with absence from work due to issues related to mental health and the onset of depressive disorders. These models addressed job strain, which was related to jobs that involved high demand but low control, the imbalance in effort and reward, and organizational justice, which addressed perceptions of fairness felt by an employee in the workplace.

Workplace bullying was linked to a 2.58-fold increase in the risk of depressive disorders and was the strongest factor influencing mental health in the workplace. Other components of psychosocial work stress that were associated with adverse mental health outcomes included job insecurity, increased job and emotional demands in the workplace, and low social support.

Although the evidence from prospective cohort studies strongly suggests an association between adverse factors in the working environment and an increased risk of depressive disorders, the research on the association between working conditions and other mental health disorders is insufficient.

To improve our understanding of the correlation between adverse working conditions and the incidence of mental health disorders, the researchers suggested a need for an improved theoretical framework to understand the link between workplace stress and psychiatric disorders. The methods for assessing exposures such as working conditions also need to be reexamined, as current methods depend largely on self-reports and, as a result, are subject to bias.

Current efforts to promote and protect mental health were disproportionately focused on individual illnesses rather than an effort to enhance mental health and improve working conditions. There was also a discrepancy between high and low socioeconomic groups in the focus on workers.

The researchers highlighted the need to translate these findings on mental health in the workplace into practice and policies that can be implemented through interventional guidelines, national policies, and programs based on need.

Conclusions

Evidence from numerous studies indicates a strong association between adverse work environments and the incidence of depressive disorders. Nevertheless, there remains a need for improved theoretical frameworks and assessment methods to understand the link between working conditions and other mental health problems. The findings on the importance of a healthy workplace environment on mental health must also be translated into implementable policies.