title: Protecting and promoting mental health of nurses in the hospital setting: Is it cost-effective from an employer's perspective?
abstract: OBJECTIVE
  Nurses are at elevated risk of burnout, anxiety and depressive disorders, and may then become less productive. This begs the question if a preventive intervention in the work setting might be cost-saving from a business perspective.
  
  
  METHODS
  A cost-benefit analysis was conducted to evaluate the balance between the costs of a preventive intervention among nurses at elevated risk of mental health complaints and the cost offsets stemming from improved productivity. This evaluation was conducted alongside a cluster-randomized trial in a Dutch academic hospital. The control condition consisted of screening without feedback and unrestricted access to usual care (N = 206). In the experimental condition screen-positive nurses received personalized feedback and referral to the occupational physician (N = 207).
  
  
  RESULTS
  Subtracting intervention costs from the cost offsets due to reduced absenteeism and presenteeism resulted in net-savings of 244 euros per nurse when only absenteeism is regarded, and 651 euros when presenteeism is also taken into account. This corresponds to a return-on-investment of 5 euros up to 11 euros for every euro invested.
  
  
  CONCLUSIONS
  Within half a year, the cost of offering the preventive intervention was more than recouped. Offering the preventive intervention represents a favorable business case as seen from the employer's perspective.
authors.affiliation: Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands (Department of Public Mental Health). c.noben@maastrichtuniversity.nl.
authors.forename: Cindy
authors.initials: C
authors.lastname: Noben
authors.affiliation: Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands (Department of Public Mental Health). s.evers@maastrichtuniversity.nl.
authors.forename: Silvia
authors.initials: S
authors.lastname: Evers
authors.affiliation: Academic Medical Center, Amsterdam, the Netherlands (Coronel Institute of Occupational Health). k.nieuwenhuijsen@amc.uva.nl.
authors.forename: Karen
authors.initials: K
authors.lastname: Nieuwenhuijsen
authors.affiliation: Academic Medical Center, Amsterdam, the Netherlands (Coronel Institute of Occupational Health). s.m.ketelaar@amc.uva.nl.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ketelaar
authors.affiliation: Academic Medical Center, Amsterdam, the Netherlands (Coronel Institute of Occupational Health). f.r.gartner@lumc.nl.
authors.forename: Fania
authors.initials: F
authors.lastname: Gärtner
authors.affiliation: Academic Medical Center, Amsterdam, the Netherlands (Coronel Institute of Occupational Health). j.sluiter@amc.uva.nl.
authors.forename: Judith
authors.initials: J
authors.lastname: Sluiter
authors.affiliation: Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands (Department of Public Mental Health). fsmit@trimbos.nl.
authors.forename: Filip
authors.initials: F
authors.lastname: Smit
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000523:psychology; D008603:Mental Health / Q000191:economics*; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D017132:Workplace; D055815:Young Adult
keywords: cost benefit; mental disorders; nurses; occupational health; prevention; work functioning