title: Worksite mental health interventions: a systematic review of economic evaluations.
abstract: 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.
authors.affiliation: Centre for Public Health Forecasting, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands. heleen.hamberg@rivm.nl
authors.forename: Heleen H
authors.initials: HH
authors.lastname: Hamberg-van Reenen
authors.forename: Karin I
authors.initials: KI
authors.lastname: Proper
authors.forename: Matthijs
authors.initials: M
authors.lastname: van den Berg
mesh_terms: D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D005069:Evaluation Studies as Topic; D006801:Humans; D001523:Mental Disorders / Q000191:economics* / Q000517:prevention & control / Q000628:therapy; D008603:Mental Health / Q000191:economics*; D008605:Mental Health Services / Q000191:economics*; D009786:Occupational Health Services / Q000191:economics*; D017132:Workplace