Open Access Research article

A qualitative study of the interactions among the psychosocial work environment and family, community and services for workers with low mental health

Catherine R Mackenzie1*, Dominic Keuskamp1, Anna M Ziersch1, Fran E Baum1 and Jennie Popay2

Author Affiliations

1 Southgate Institute for Health, Society & Equity, Flinders University, Adelaide, Australia

2 Division of Health Research, Lancaster University, Lancaster, UK

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BMC Public Health 2013, 13:796  doi:10.1186/1471-2458-13-796

Published: 3 September 2013

Abstract

Background

The psychosocial work environment can benefit and harm mental health. Poor psychosocial work environments and high level work-family conflict are both associated with poor mental health, yet little is known about how people with poor mental health manage the interactions among multiple life domains. This study explores the interfaces among paid work, family, community and support services and their combined effects on mental health.

Methods

We conducted 21 in-depth semi-structured interviews with people identified as having poor mental health to examine their experiences of paid employment and mental health and wellbeing in the context of their daily lives.

Results

The employment-related psychosocial work environment, particularly workplace relationships, employment security and degree of control over hours, strongly affected participants’ mental health. The interfaces among the life domains of family, community and access to support services suggest that effects on mental health differ according to: time spent in each domain, the social, psychological and physical spaces where domain activities take place, life stage and the power available to participants in their multiple domains. This paper is based on a framework analysis of all the interviews, and vignettes of four cases. Cases were selected to represent different types of relationships among the domains and how interactions among them either mitigated and/or exacerbated mental health effects of psychosocial work environments.

Conclusions

Examining domain interactions provides greater explanatory capacity for understanding how people with low mental health manage their lives than restricting the research to the separate impacts of the psychosocial work environment or work-family conflict. The extent to which people can change the conditions under which they engage in paid work and participate in family and social life is significantly affected by the extent to which their employment position affords them latitude. Policies that provide psychosocial protections to workers that enable them to make changes or complaints without detrimental repercussions (such as vilification or job loss) and increase access to welfare benefits and support services could improve mental health among people with paid work. These policies would have particularly important effects for those in lower socioeconomic status positions.

Keywords:
Psychosocial work environment; Life domains; Work-family; Socio-ecological model; Mental health