About this presentation These slides present interim findings from a review of the evidence undertaken in workshop conditions at Evidence Base Camp 2013/14. The findings from the review are not exhaustive. Due to time constraints not all available bibliographic databases have been searched, and books and longer reports were excluded from our synthesis sessions. The findings have not been peer reviewed or quality assured in the same way as a formal research publication. The College of Policing Research Analysis and Information Unit (RAI) plans to turn this review of the evidence into a full Rapid Evidence Assessment Report in due course.

What interventions have been shown to be effective in supporting mental well-being in the work place? Delegates: Pippa Gregory - NCA Clare Simkin – Hampshire Constabulary Donna Holderness – College of Policing Yvonne Burgess –College of Policing Antony Evans –West Yorkshire Police Dafydd Llywelyn – Dyfed-Powys Police Sarah Crampton – Northamptonshire Police Simon James – Wiltshire Police Michelle Weller - NCA Fiona Bohan – Devon and Cornwall Police Sarah Knapper – Police Federation College of Policing Facilitators: Paul Quinton Fiona Mclean David Brown Carol Heslop Emily Powell

How did we answer the question? Using a Rapid Evidence Assessment (REA) REAs follow a systematic process to identify and appraise evidence… …but make compromises given available time and resources Pragmatic and transparent approach Ensure best possible coverage of literature in the time available

The process (in a nutshell) 1.Draft search terms 2.Draft sift criteria 3.Sift received abstracts 4.Request relevant papers 5.Read and ‘grade’ papers 6.Write it up (‘synthesis’)

Developing search terms What interventions have been shown to be effective in supporting mental well-being in the work place? TierAreaSynonyms include… 1WellbeingWellbeing or “well being”; welfare; mind set; resilience; emotional or mental wellbeing; behavioural hardiness; stress; Pressure 2WorkplaceWork place; workplace; place of work; office; employee; work environment; workforce 3InterventionsIntervention; tactic; strategy; initiative; procedure; approach 4What WorksSystematic review; rapid evidence assessment; trial; RCT; experiment; evaluation; effective; assessment; “what works”; impact; success.

Search outcomes potentially relevant studies identified. Wellbeing Intervention Work place What Works Our search identifies studies that mention all four of our areas: Wellbeing, Intervention, Work place & ‘What works’…

Searches find all potentially relevant studies… AnonymousAnonymous THE WHIP NOTICE - WEEK OF 9/20/10,. (2010). Abstract: Andrea Lawrence Designation Act (Sponsored by Rep. McKeon / Natural Resources Committee) 7 H.Con.Res th Anniversary of the Blue Ridge Parkway (Sponsored by Rep. Perriello / Natural Resources Committee) 8 H.Res Expressing support for National Estuaries Day (Sponsored by Rep. Castor / Natural Resources Committee) 9 H.Res Celebrating the 200th Anniversary of John James Audubon (Sponsored by Rep. Whitfield / Natural Resources Committee) 10 Senate Amendment to H.R Multinational Species Conservation Funds Semipostal Stamp Act (Sponsored by Rep. Brown (SC) / Natural Resources Committee) 11 H.R Nationally Enhancing the Wellbeing of Babies through Outreach and Research Now Act (Sponsored by Rep. Cohen / Energy and Commerce Committee) 12 H.R Training and Research for Autism Improvements Nationwide Act (Sponsored by Rep. Doyle / Energy and Commerce Committee) 13 H.R Combat Methamphetamine Enhancement Act (Sponsored by Rep. Gordon / Energy and Commerce Committee) 14 H.R Emergency Medic Transition (EMT) Act (Sponsored by Rep. Harman / Energy and Commerce Committee) 15 H.R Safe Drug Disposal Act (Sponsored by Rep. Inslee / Energy and Commerce Committee) 16 H.R. Sifting our abstracts identifies the truly relevant literature. Sift criteria is used so that we are consistent and transparent in our sifting. Returned by the wellbeing search…

Our Inclusion Criteria QuestionAnswerAction Q1. Is the key topic of the paper mental well-being in the workplace? YesGo to 2 NoRed Q2. Is the paper looking at the effectiveness of interventions or causal factors in mental wellbeing? YesGo to 3 NoRed Causal FactorsAmber Q3. Does the paper include empirical research? YesInclude NoRed UnsureAmber

Sifting – flow of papers Searches of online databases and library catalogue N=1,229 Papers sifted out: N=1,157 Example reasons for exclusion: Language (not English) n=1 Publication not available n=14 Duplicatesn=7 Papers excluded: Total N=31/72 Reasons for exclusion: Did not meet sift criteria n=31 Reports meeting inclusion criteria & mapped N=41 Abstrac t and title screene d N=1,22 9 Full text screene d N=72 Our initial search identified 1,229 papers, but only 41 (3%) were actually relevant to our research question. Our findings are drawn from these 41 studies that we have reviewed over the last two days. We searched the main databases available to the National Police Library Due to time restrictions, we have not included books and reports in our synthesis Some longer studies could not be included due to time restrictions.

Synthesis – Mapping the evidence

What does ‘good’ or ‘robust’ evidence look like? Systematic Reviews (Based on level 3-5 studies) 5 Randomised controlled trials 4 Before/after measures Multiple site comparisons 3 Before/after measures Two site comparisons 2 Before/after measures No comparison site 1 One-off measure No comparison site Study designs increasingly rule out potential alternative causes Statements about ‘what works’ Statements about ‘what’s promising’ Study designs cannot rule out potential alternative causes Statements about possible impact

Synthesis – Quality of evidence

Synthesis What Works (systematic reviews) A range of interventions have been shown to ‘work’ in non-policing settings including those targeted at the following levels: - Individual – humour ; exercise; talking to non-colleagues; education focused on skills & competency; short term and targeted crisis / psycho- social support techniques (e.g. counselling, stress support) - Organisational – people friendly operating model (e.g. work space, procedures, or flexible working,); a range of health promotion strategies; fostering of professional networks What’s Promising (RCTs) A range of interventions have been shown to be effective in improving mental well being, and helping staff to manage stress and be more resilient in non-policing organisations. These interventions included: strategies to empower staff and improve their control over their work environment; techniques to allow staff to manage stress better (e.g. yoga, gentle exercise, psychological tools and methods); and coaching and targeted support. What’s Unknown It is not clear: whether these interventions would work in a police setting; when these interventions would work best (e.g. do they require transformational leadership?); and how much dosage is required and how sustainable is the effect What’s Harmful (systematic reviews) Nothing was found from systematic review evidence to suggest any intervention had a detrimental effect

Key messages Most studies were published in the last 14 years and undertaken predominantly in North America, though some were carried out in the UK Very few studies were found that were conducted in a policing setting; most were from a range of professions including healthcare The overall quality of evidence was high, though the studies were very targeted on specific aspects of wellbeing Therefore, there may be an issue about how transferable the findings are to policing & the UK There were a wide range of interventions - targeted at individuals and whole organisations - that were found to be effective A common theme to the effective interventions seemed to be employee empowerment More research is needed and could focus on longer term sustainability, cost-effectiveness and whether these interventions also work in UK policing in order to refine our knowledge What interventions have been shown to be effective in supporting mental wellbeing in the workplace?