Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework.

BACKGROUND: Despite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development. METHODS: We searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles. RESULTS: Of 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients' intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health. CONCLUSION: It is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems. PROTOCOL REGISTRATION: The protocol is registered on PROSPERO, CRD42021276838.

High performance work system and transformational leadership: Revisiting and questioning their implications for health-related wellbeing.

Employee wellbeing represents a profound management challenge for both leaders and HR professionals, and both transformational leadership (TL) and high performance work system (HPWS) are assumed to play important roles in tackling this challenge. However, we know little about their unique and relative importance in promoting wellbeing. To shed light on this methodologically, theoretically and practically important issue, we draw mainly on leadership substitutes theory. Based on a comprehensive mediation model we examine whether HPWS substitutes the assumed relationships between TL and employee emotional exhaustion. Our study answers to three important calls for research: to examine the joint effects of leadership and HPWS, to examine their health-related impact, and to pursue more theory contesting research in management studies. Based on data from 308 white collar employees working under 76 middle-managers in five Finnish organizations our study points to the incompleteness of previous siloed research on both TL and HPWS, sheds new light on their relationships with wellbeing, and suggests ways to develop both TL and HPWS theory, thus providing important guidance for future research on their effects.

Western and non-western leadership styles and employee wellbeing: a case of a high-power distance context.

The study combines an emic and etic perspective to test the relationships between three different (Western and non-Western) leadership styles, that is, transformational, authoritarian, and benevolent paternalistic, and follower emotional exhaustion in a high-power distance context of Russia. It employs hierarchical linear modeling (HLM) to analyse a sample of 403 followers to middle-level managers in Russian organizations. The analysis finds only transformational leadership to be generally negatively associated with emotional exhaustion. However, under conditions of high individual-level power distance orientation among followers, this association diminishes whereas that of authoritarian leadership and exhaustion increases. Benevolent paternalistic leadership is unrelated to emotional exhaustion. The study extends research on the relative importance of Western and non-Western leadership behaviors for employee wellbeing in high-power distance contexts and on how this importance differs across followers, thus highlighting the role of follower expectations in determining the effectiveness of leadership. It points toward the need for future research to simultaneously test the contingencies and relative importance of paternalistic, authoritarian, transformational, as well as other leadership styles in various cultures as well as to continue exploring the moderating influence of various cultural value orientations on these leadership styles' follower effects.

Expatriates on the run: The psychological effects of the COVID-19 pandemic on expatriates' host country withdrawal intentions.

Extant research on expatriation in high-stress environments where stress is caused by ongoing and unexpected natural crises remains limited. Drawing on stress theory, in this study, we develop a model to examine the stress-inducing effects of intra-family concerns and workplace discrimination on the intentions to leave the host country among expatriates in the high-stress environment of the ongoing COVID-19 pandemic. We also explore whether gender and the level of work adjustment moderate the propensity of intra-family health concerns and workplace discrimination to induce psychological stress. Based on our analysis of 381 expatriates living and working in the United Arab Emirates, we find the model to be generally supported. We also reveal an intriguing moderating effect of work adjustment on the relationship between intra-family health concerns and psychological stress. Overall, the analysis is among the first ones to shed light on the role of natural crises' stressors in defining expatriate outcomes.

A vicious cycle of health (in)equity: Migrant inclusion in light of COVID-19.

Objectives: Whilst mass vaccination is suggested as an important means to contain COVID-19 pandemic, vaccination policies across many countries have systematically excluded some groups of population, especially migrants. This study aims to document the impact of diversified vaccination strategies as a preventative and control measure for the health and safety of the wider population within a country. Methods: We selected five countries that have experienced the changes in migrant inflows to the most extreme among OECD countries in 2020: The United States, Australia, Canada, Japan, and South Korea. We conducted an extensive qualitative documentary analysis focused on policies and interventions implemented in these countries since January 2020 till the end of September 2021. We also analyzed publicly available epidemiological data (released by the governments and other international organizations). Results: We find that achieving migrants' health and vaccination equity is not without challenges, and a failure to address those multiplicity of concerns may result in a vicious cycle for the vulnerable population at the fringes of our economy. Migrants continue to face extenuating circumstances with higher risks to their health and safety, when they are excluded or disadvantaged in vaccination policies. The more inclusive and proactive the governments are in consideration of diversity of migrant populations, the better they can manage the pandemic, which leads to overall societal benefit of ensuring public health. Conclusions: Equity-based policies can mitigate disparities in access to vaccination and healthcare, thereby reducing the spread of COVID-19 in the community.

The nonlinear relationship between atypical applicant experience and hiring: The red flags perspective.

Hiring managers regularly encounter job applicants with atypical levels of experience across several common domains-For example, occupational experience, general work experience, educational experience, and life experience. Surprisingly, few large-scale studies have investigated how hiring managers respond to applicants with atypical experience for the job, leaving a substantial lacuna in our knowledge. The primary goal of the present study is to examine the association between relative under- and over-experience in the aforementioned domains and the likelihood of applicants being subsequently interviewed and eventually hired. We draw on insights from attribution theory to introduce the concept of red flags in the judgment of applicant experience. In doing so, we propose that hiring managers may avoid interviewing and hiring applicants with atypical experience relative to the applicant pool (i.e., relative over- or underexperience). Overall, our red flags perspective posits that job applicants with typical amounts of experience will be favored by hiring managers, which may be a useful lens for explaining why highly experienced applicants are not always considered. We test these predictions on a unique dataset parsed from 53,194 résumés and the corresponding application forms from 42 different organizations. Our results are broadly consistent with the red flags perspective, notably uncovering some intricate nonlinear effects. Implications for theory and practice are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).