Evidence-based mental health promotion resource - health.vic.gov.au

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Evidence-based mental health promotion resource81Population group/settingAdults experiencing unemployment or underemployment for various reasons includethose with involuntary job loss and those who need to retrain and acquire neweducation and skills such as assertiveness (Health Education Authority 2001). Menfrom non-English speaking backgrounds are a priority group because they remaindisadvantaged in employment, even when all other factors are taken into account(Rahmani, Crosier & Pollack 2002). Other relevant groups include low income groupsand disadvantaged communities. Interventions settings include local employmentprograms.EffectivenessThe effectiveness of adult work programs is context dependent, but common impactsmeasured include job satisfaction, motivation, self-esteem, job seeking confidence andreduced depression (Health Education Authority 2001). The Winning Jobs Program hasbeen evaluated across the United States and Finland (the Työhön Job Search Program)with randomised control trials involving thousands of unemployed people and theirpartners. Short term results at a two-year follow-up showed improved re-employmentprospects and engagement with the labour market, and lower levels of distress (Jane-Llopis et al. 2005).Where people move from unemployment to low grade work, however, negative mentalhealth effects have been shown (Cave et al. 2001). Studies are needed of employmentstrategies that aim to improve work attributes to enhance mental health, includingsustained, long term changes to employment, especially in the jobs available to themost vulnerable groups of the population.Implementation issues• Program designers need to understand the local region/community and populationgroups of interest to effectively tailor programs.• Confidence in interview and job search skills, along with ongoing work support, isjust as important as literacy and numeracy skills.• Just moving unemployed people into ‘low grade’ work may not have positive healthimpacts (Cave et al. 2001). Income equity issues can be addressed at the local levelby working with local employment programs to ensure they are health promoting andnot health damaging.• Evaluations should measure impact and include a follow-up to assess outcomes overtime, including outcomes in terms of public policy and organisational practices.
82 Evidence-based mental health promotion resourceCommentEvaluations of adult work programs in terms of (at least) intermediate mental healthoutcomes (see the VicHealth Framework for the Promotion of Mental Health andWellbeing) would provide valuable complementary data to help build the case forhealth outcomes of employment. The appropriate role for measures to redress incomeinequality is contested, however, with public health benefits not always linked to incomeequity programs, and mental health outcomes almost never connected to equitymeasures. Income equity programs will remain a challenge for many years to come, butthe inclusion of mental health outcomes in evaluations will help to build the evidence onthe effects of income equity on health and wellbeing.The VicHealth (2004b) refugee relocation project indicates what other socialinfrastructure is necessary to safely and productively relocate refugees to rural areaswith employment vacancies.ReferencesBosma, H & Marmot, M 1997, ‘Low job control and risk of coronary heart disease inWhitehall (prospective cohort) study’, British Medical Journal, vol. 312, pp. 558–65.Cave, B, Curtis, S, Aviles, M & Coutts, A 2001, Health impact assessment forregeneration projects. Volume 11: selected evidence base, East London and the CityHealth Action Zone and Health Research Group, Queen Mary, University of London.Available at www.geog.qmul.ac.uk/health/.Friedlander, D & Burtless, G 1995, Five years after: the long-term effects of welfare-toworkprograms, Russell Sage Foundation, New York.Health Education Authority 2001, Making it happen: a guide to delivering mental healthpromotion, UK Department of Health, London. Available at www.nelf.nhs.uk/nsf/mentalhealth/makeithappen/ch3/3_0.htm.Rahmani, Z, Crosier, T & Pollack, S 2002, Evaluating the impact of the literacy andnumeracy training programme for job seekers, Australian Department of Education,Science and Training, Canberra.VicHealth 2004b, Mental health promotion in new arrival communities: learnings andpromising practices, Victorian Health Promotion Foundation, Melbourne.
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