Abstract
Purpose: Mental health at work has become a very important issue in Japan. The purpose of this study is to investigate the effectiveness of primary prevention (prevention of mental disorders and stress management in workplaces), secondary prevention (early detection and treatment) and tertiary prevention (support for workers with mental problems and rehabilitation). Method and results : In primary prevention, we developed a check list named MIRROR (Mental Health Improvement & Reinforcement/Research of Recognition) in 2004 and conducted interventional approaches for improvement of working conditions after we evaluated needs for improvement and job stress of 9.800 workers in 15 companies using this check list and Brief Job Stress Questionnaire (BJSQ) in 2005, then evaluated effects of the approaches on job stress and cost-benefit analysis. Job stress was reduced in the worksites when improvement of working conditions was successfully carried out. On cost-benefit analysis, 4 of 6 companies showed a decrease of total absent days due to mental problems, however only 2 companies showed benefit according to the method for analysis adopted in this study. In the other manufacturing company, we conducted mental health education and practice of active listening in order to improve of communication and reinforcement of supervisor support for 4 years. A marked reduction of workers with sick leaves for more than 1month due to mental problems was observed 2 years later of these approaches. In secondary and tertiary preventions, subjects were 162 consultation cases with mental problems visited health care center in 3 companies and 113 outpatients visited the mental health centers in a general hospitals. We compared the diagnosis, job stress, effectiveness of treatment and final outcome of both cases. Depressive cases (43.4%) were significantly much more in outpatient cases compared to consultation cases (25.3%). An arrangement of job stressors was done for 55.6% of consultation cases and effective in 90.0% of those, for 20% of outpatient cases and effective in 65.2% of those. Finery, 79.9% of 162 consultation cases were completely cure, 10.5% continued medical treatment, 1.9% steel on sick leave, 4.9% moved to other companies, 27.4% of 113 outpatients cases were cure, 31.0% continued, 19.5 % dropped out, 3.5% in sick leave, 17.5 % moved and 22.1% changed hospitals. Conclusion: 1) Interventional approaches such as improvement of working condition based on stress survey or educational approaches for supervisors seem to be effective for health outcome of workers, if it has done properly. 2) It seemed that final health outcome was better in consultation cases comparing to outpatient cases, because early detection & early treatment and arrangement for job stressors were easier in consultation groups in the companies.
