Worksite mental health interventions: a systematic review of economic evaluations.

OBJECTIVE To give an overview of the evidence on the cost-effectiveness (CE) and financial return of worksite mental health interventions. METHODS A systematic search was conducted in relevant databases. Included economic evaluations were classified into two groups based on type of intervention: (1) aimed at prevention or treatment of mental health problems among workers or (2) aimed at return to work (RTW) for workers sick-listed from mental health problems. The quality of the included economic evaluations was assessed using the Consensus Health Economic Criteria list (CHEC-list). RESULTS Ten economic evaluations were included in this systematic review. All four economic evaluations on the prevention or treatment of mental health problems found a positive cost-benefit ratio, although three of these studies had low to moderate methodological quality. In five out of six economic evaluation studies on RTW interventions, no favourable CE or cost-benefit balance was found. One study of moderate methodological quality reported on a positive CE balance. CONCLUSIONS Due to a limited number of economic evaluations on worksite mental health interventions of which a majority was lacking methodological quality or lacking evidence, only a tentative conclusion can be drawn from the results of this systematic review. Worksite interventions to prevent or treat mental health problems might be cost-effective, while those RTW interventions that included a full economic evaluation aimed at depressed employees do not seem to be cost-beneficial. More high-quality economic evaluation studies of effective worksite mental health interventions are needed to get more insight into the economic impact of worksite mental health interventions.