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Knowledge Exchange > Researchers > Research Initiatives > Centre for Research on Employment and Workplace Health (CREWH)


Centre for Addiction and Mental Health
455 Spadina Avenue, Suite 300
Toronto, ON M5S 2G8

Work and the workplace impact our quality of life, yet little is known about this complex relationship. Our goal is to transform our understanding of work and living using a trans-disciplinary approach to research. But it will take collaboration, and we are committed to exchanging information as we examine the impact of work on people with mental illness as well as work’s impact on mental health.

For more information about us, click here.

What Do Peer Support Workers Do? 

New Publication:  What do peer support workers do? - A job description
Biomed Central Health Services Research
 - August 2012 Release

CREWH researchers recently described the role of peer support workers at a psychiatric tertiary care facility.  Published in BMC Health Services Research, the study collected data through interviews, focus groups, and activity logs and were analyzed using a modified grounded theory approach.  Researchers found peers engage in direct work with clients and in indirect work that supports their work with clients.  The main types of direct work are advocacy, connecting to resources, experiential sharing, building community, relationship building, group facilitation, skill building/mentoring/goal setting, and socialization/self-esteem building.  The main types of indirect work are group planning and development, administration, team communication, supervision/training, receiving support, education/awareness building, and information gathering and verification.  These findings may contribute to a better understanding of the peer support worker position, the skills required, and the types of expectations that could define successful fulfillment of the role.

Jacobson, N.; Trojanowski, L.; Dewa, C.S..  What do peer support workers do?  A job description. BMC Health Services Research.  12:205, 2012.

Employment and First Episode Psychosis

New Publication:  Examining the Factors Associated with Paid Employment of Clients Enrolled in First Episode of Psychosis Programs
Schizophrenia Research and Treatment - April 2012 Release

A recent CREWH study published in Schizophrenia Research and Treatment looked at clients enrolled in first episode psychosis programs and psychosocial outcomes.  Specifically, the studied looked at the factors associated with paid employment among young adults who have experienced their first psychotic episodes.  Schizophrenia is one of the most debilitating mental disorders. For a significant portion of individuals who suffer from this disorder, onset occurs in young adulthood, arresting important social and educational development that is necessary for future successful labor force participation. Researchers found that in addition to treatment, socioeconomic factors such as receipt of public disability benefits and educational attainment are associated with employment status. These findings may help to inform future directions for the enhancement of psychosocial programs in FEP models to promote paid employment.

Dewa, C.S.; Trojanowski, L.; Cheng, C.; Loong, D.  Examining the Factors Associated with Paid Employment of Clients Enrolled in First Episode of Psychosis Programs. Schizophrenia Research and Treatment.  Volume 2012 (2012), doi:10.1155/2012/739616. 


Injury Severity and Psychiatric Co-morbidity Predict Working Status after Trauma in the Workplace

Publication: Factors Associated with Return to Work in Workers Assessed at a Specialized Worker's Compensation Board Psychological Trauma Program
American Journal of Industrial Medicine - July 2011 Release

A CREWH study published in the American Journal of Industrial Medicine, looked at the characteristics of workers referred to a specialized clinic for workers who are experiencing psychological impairment as a result of work-related trauma.  Focusing on workers who had their traumatic event in the past year, the researchers found that the majority were male and a significant proportion were born outside of Canada and worked in labour occupations.  At the time of assessment, 71% of workers were not working and were on medical or psychiatric disability.  Most commonly, the cause of the trauma was an accident and more than half suffered a permanent physical impairment as a result.  Post-traumatic Stress Disorder (PTSD) was the most common primary psychiatric diagnosis.  But, more than half of workers had more than one psychiatric diagnosis.   All other things being equal, workers who had a permanent physical impairment, a disrupted marriage and more than one psychiatric diagnosis were more likely not to be working when they came to the clinic.  These findings highlight areas for potential earlier screening and targeted intervention. 

This work was a collaboration between the Centre for Addiction and Mental Health’s Centre for Research on Employment and Workplace Health and the Psychological Trauma Program (PTP). 

Hensel, J.; Bender, A.; Bacchiochi, J.; Dewa, C.S.  Factors Associated with Return to Work in Workers Assessed at a Specialized Worker's Compensation Board Psychological Trauma Program. American Journal of Industrial Medicine.  54(7):552-9, 2011. 

Systematic Review - Interventions for Work-Related PTSD

Publication: Interventions to improve work outcomes in work-related PTSD: a systematic review
Biomed Central Public Health - October 31, 2011 Release

A systematic review by CREWH researchers has reviewed interventions for posttraumatic stress disorder (PTSD) that target workers traumatized in the workplace. PTSD is a debilitating illness that can follow a traumatic event.  Work-related PTSD can result in increased sick leave, reduced productivity, and even unemployment. Employees who experience work-related trauma often find it extremely difficult to return to their original place of employment.  Yet, those who do not return to work often face persisting PTSD symptoms.  Consequently, interventions focused on returning employees to the workplace are critical for breaking this vicious cycle of symptoms.  The results of the systematic review revealed a need for more research on effective interventions for work-related PTSD.  So far, the evidence indicates that promising interventions involve add-on treatments tailored to the workplace.

The systematic review was published in BioMed Central Public Health, and can be accessed here.

Stergiopoulos, E.; Cimo, A.; Cheng, C.; Bonato, S.; Dewa, C.S.  Interventions to improve work outcomes in work-related PTSD: a systematic review.  BMC Public Health.  11:838, 2011.

Healthcare Papers Vol.11 Special Issue

Mental health in the workplace - June 1, 2011 Release

This month saw the release of a special issue of Healthcare Papers, an international journal on new models for healthcare. The issue takes a multidisciplinary look at mental health in the workplace, in an effort to create a forum for researchers, employers, labour unions, and policy makers to incite the much-needed change in workplace mental health promotion.

As Guest Editor Dr. Carolyn Dewa explains, “for change to occur, all stakeholder groups need to be present.” Dr. Dewa is a senior research scientist at CAMH, where she heads the Centre for Research on Employment and Workplace Health.

The special issue emerged from the Fourth Annual Canadian Research Congress on Mental Health and Addictions in the Workplace, held in Toronto in 2009. Research articles range from the biological and psychological markers of workplace stress, to a discussion of methods for assessing workplace change and its effect on workers.

From the stakeholder perspective, a number of articles outline the contributions that policy makers and businesses can offer to improve mental health in the workplace. Finally, a personal essay by Rick Green delves into the experience of living with attention deficit hyperactivity disorder.

The issue takes a many-sided perspective on the emerging dialogue between researchers and stakeholders, that promises to bring about new strategies for promoting mental health in the workplace. The journal is available for download here. 

Report:  The little-known lives of staff who support those with developmental disabilities

CAMH researchers investigate the emotional impact of working with people with developmental disabilities and the associated risk for job burnout 

We know surprisingly little about the experiences of the direct support staff in Canada who work with individuals who have developmental disabilities.  A project undertaken by scientists from CAMH’s Dual Diagnosis Program and the Centre for Research on Employment and Workplace Health seeks to examine exactly this.  A series of studies involving different groups of support staff have been carried out to look at the emotional well-being of staff, particularly as it pertains to their experience of client aggression.  The presence of aggressive behaviour among people with developmental disabilities has been well documented and the study authors were interested in understanding how this exposure affects staff members’ well-being in and out of the workplace.

This project utilized a survey which assessed several major areas, including staff exposure to client aggression, the impact it has on their work, levels of job burnout, confidence in dealing with challenging client behaviours and the availability of policies and resources for support.  The largest study included over 900 of Ontario’s community direct support staff who work with adults with developmental disabilities.  Other groups sampled include community staff who support youth, summer camp staff and hospital in-patient staff. 

Quick Facts

·        Nearly all staff from all settings reported experiencing some form of client aggression. A significant proportion reported it to be a near daily occurrence. 

·        Depending on work setting, between 6 and 14% of staff had missed time from work due to a physical injury which was the result of client aggression.

·        Regardless of how frequently they were exposed to aggression, staff in all settings rated themselves highly in terms of their perceived ability to manage aggressive behaviour and they reported that their work provided some positive benefit to their lives.

·        Approximately half of all staff reported experiencing what they felt were emotional problems related to dealing with client aggression.   

·        Most staff were not experiencing job burnout, however a third or more may be at high risk.  Symptoms of job burnout were associated with more frequent and more severe aggression among community and camp staff, but not hospital in-patient staff.

·        Most staff reported having access to resources through their workplace to deal with emotional stress resulting from client aggression.  However, only a limited number of staff had actually utilized them.

·        Across all settings, there were a small proportion of staff who were not aware of policy relating to violence and aggressive behaviour in the workplace.  Furthermore, policy was not always followed because staff felt it was too much work or would not be helpful.

Research has shown that stress in the workplace can lead to decreased productivity and burnout, which in turn results in increased labour and healthcare costs, higher job turnover, increased rates of staff disability and decreased stability for clients receiving care.  These reports were prepared in hopes of reaching stakeholders and promoting discussion of these issues.  We are very interested in opportunities to receive feedback and/or stimulate discussion around our findings with an ultimate goal of improving the well-being of these important care providers and the clients they support.

We Can Do It: Evidence and Interventions for Transforming Mental Health in the Workplace

October 28, 29, and 30, 2009 in Toronto

In 2009, the 4th Annual Canadian Congress for Research on Mental Health and Addiction in the Workplace was held in Toronto on October 28-30, hosted by CAMH’s Work and Well-being Research and Evaluation program.  This Congress is the leading Canadian forum of its kind dedicated to improving the workplace and the mental health of employees, and it is also becoming a forum for exchange between Canadian and international researchers. 

This year’s Congress had five goals:

·         Foster knowledge exchange

·         Ensure the program reflected the diversity of stakeholder perspectives and demonstrated how each contributes to promoting mental health in the workplace

·         Introduce a broader public health perspective to research in this area.

·         Create a forum that fostered exchange and networking among delegates

·         Use the knowledge exchanged at the Congress to create resources that can continue to be used and accessed after the Congress

And it was a success. Overall, delegates were very impressed with the quality of the research presented at the Congress with 96% of attendees reporting the Congress topics covered were informative and 87% that the topics were useful. More than 90% of delegates indicated their new knowledge could be applied to their own workplace or research.

Other Resources

Watch short videos on expectations and feedback on the Canadian Congress on Mental Health and Addiction in the Workplace. Due to popular demand, presentations from the 2009 Congress were posted and can be found here. A copy of the final program (PDF) is also available.


Congress final report

Congress impact report

 Congress delegates at one of many plenary sessions at the Congress

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