Should We Be Screening for Mental Ill Health in High-Risk Workforces? Results of a Cluster Randomised Control Trial
Tracks
Diamond Ballroom I: In-Person & Virtual via OnAIR
| Thursday, June 5, 2025 |
| 12:15 PM - 12:45 PM |
Overview
Prof Samuel Harvey, UNSW Sydney & Black Dog Institute
Presenter
Prof Sam Harvey
Professor of Psychiatry, UNSW Sydney & Executive Director and Chief Scientist, Black Dog Institute
UNSW Sydney & Black Dog Institute
Should We Be Screening for Mental Ill Health in High-Risk Workforces? Results of a Cluster Randomised Control Trial
Abstract
Background Mental health screening is increasingly being implemented within high-risk industries such as emergency service workers, despite a recent WHO-endorsed review finding a lack of good quality research into the effectiveness of workplace mental health screening.
Methods A cluster randomised controlled trial was conducted comparing help-seeking behaviour and levels of psychological distress of firefighters who received tailored feedback following completion of a 13-item mental health screening (n=228) to a control group who received generic feedback (n=262). Three-month follow-up data was collected (n=380; 77.55%).
Outcomes Of the firefighters who completed baseline (n=490), 149 (30.41%) scored moderate to severe levels of psychological distress at baseline as measured by the K6. For those in the intervention group (n=65; 43.62%) no differences were detected at 3-months in help-seeking compared to the control group (n=84; 56.38%). However, the intervention group had significantly higher levels of psychological distress at 3-month follow-up compared to the control (t (147) =2.0, p <.05).
Interpretation Our findings suggest that mental health screening paired with tailored feedback does not increase help-seeking or reduce psychological distress at 3-month follow-up, and has the potential to be harmful for individuals, particularly those experiencing moderate levels of psychological distress. As such, mental health screening should not be implemented within workplaces.
Funding The trial funded by the iCare foundation and a NHMRC Investigator Grant.
Clinical trials registry: ACTRN12621001457831
Prof Samuel B Harvey 1
Dr Aimee Gayed 1
Karen Krakue 1
Jessica Strudwick 1
Daniel Collins 1
Dr Mark Deady 1
Prof Richard Bryant 1, 2
1. Black Dog Institute, University of New South Wales, Sydney, Australia
2. School of Psychology, University of New South Wales, Sydney, Australia
Three Key Learnings:
1. Certain occupational groups, such as first responders and healthcare workers, are at increased risk of mental disorder and suicide.
2. Even amongst such high-risk workers, mental health screening is not an effective way to increase help seeking or improve mental health outcomes
3. There are potential risks with any mental health intervention. The results of this study show the dangers, and potential harmful effects, of pathologizing milder mental health symptoms.
Methods A cluster randomised controlled trial was conducted comparing help-seeking behaviour and levels of psychological distress of firefighters who received tailored feedback following completion of a 13-item mental health screening (n=228) to a control group who received generic feedback (n=262). Three-month follow-up data was collected (n=380; 77.55%).
Outcomes Of the firefighters who completed baseline (n=490), 149 (30.41%) scored moderate to severe levels of psychological distress at baseline as measured by the K6. For those in the intervention group (n=65; 43.62%) no differences were detected at 3-months in help-seeking compared to the control group (n=84; 56.38%). However, the intervention group had significantly higher levels of psychological distress at 3-month follow-up compared to the control (t (147) =2.0, p <.05).
Interpretation Our findings suggest that mental health screening paired with tailored feedback does not increase help-seeking or reduce psychological distress at 3-month follow-up, and has the potential to be harmful for individuals, particularly those experiencing moderate levels of psychological distress. As such, mental health screening should not be implemented within workplaces.
Funding The trial funded by the iCare foundation and a NHMRC Investigator Grant.
Clinical trials registry: ACTRN12621001457831
Prof Samuel B Harvey 1
Dr Aimee Gayed 1
Karen Krakue 1
Jessica Strudwick 1
Daniel Collins 1
Dr Mark Deady 1
Prof Richard Bryant 1, 2
1. Black Dog Institute, University of New South Wales, Sydney, Australia
2. School of Psychology, University of New South Wales, Sydney, Australia
Three Key Learnings:
1. Certain occupational groups, such as first responders and healthcare workers, are at increased risk of mental disorder and suicide.
2. Even amongst such high-risk workers, mental health screening is not an effective way to increase help seeking or improve mental health outcomes
3. There are potential risks with any mental health intervention. The results of this study show the dangers, and potential harmful effects, of pathologizing milder mental health symptoms.
Biography
Prof Harvey is a Professor of Psychiatry at UNSW Sydney and the Executive Director and Chief Scientist at the Black Dog Institute. He has published more than 220 research publications and been awarded over $40 million in grant income. Prof Harvey is internationally recognised for his program of research focused on creating more mentally healthy workplaces. He has advised the World Health Organisation and various governments on this and other mental health reform topics.
