MENTUPP was delivered in 4 phases: development phase (multilevel intervention and novel online platform (MENTUPP Hub) developed); first implementation phase (small scale SME Pilot study); the second (optimised) implementation phase (interventions enhanced and optimised based on Pilot evaluation); phase 3 (larger scale cRCT in 9 countries); and phase 4 (preparation for replication post-cRCT). In years 1-3, MENTUPP made significant progress on the first 3 phases, with the cRCT commencing in September 2022. In year 3, the cRCT concluded, the final optimisation in preparation for post-project implementation was completed, as was the evaluation of the trial.
The knowledge gained from the systematic reviews, expert consultation and guidance report informed the design of a comprehensive, multilevel intervention targeting both clinical and non-clinical mental health problems, and mental (ill-) health stigma.
Overall, 67 SMEs were recruited to participate in the cRCT and were randomised (33 intervention SMEs and 34 control SMEs). In RP3, 61 SMEs (31 intervention SMEs and 30 control SMEs) participated in both the 6- and 9-month follow-up data collection time points respectively.
cRCT Outcome Evaluation: suggest that the MENTUPP intervention is able to induce changes in employees in terms of wellbeing and mental health.
Interviews with the SME champions and the focus group with the research officers revealed that MENTUPP did not lead to any major tangible or specific changes in the participating organizations in the intervention group. However, organizational change was not the primary focus of MENTUPP.
cRCT Process Evaluation: In each of the SMEs allocated to the intervention condition (n=31), an information session had to be organised for employees and employers to inform them about the intervention and the data collection. However, this did not happen consistently in all SMEs: in 9 SMEs no such sessions were organised and in another 9 SMEs the sessions were given online. Participation in these sessions was also moderate: only 29% of employees attended them. Interviews with champions led to a better understanding of what factors hindered the implementation of MENTUPP during the trial. At the level of the organisation, support for MENTUPP generally decreased over time due to lower leadership involvement, organizational changes, a change in the champion responsible for engaging employees to actively participate in MENTUPP, and a high workload. At the individual level, the barriers were: a lack of time due to the high workload in the organisation, stigmatising attitudes, employees working in the field and thus rarely having face-to-face interactions with colleagues, and some employees having insufficient technological and/or mental health literacy to properly use the intervention.
Economic evaluation: The health benefits can be purchased by an employer at a relatively low cost. However, further research is needed because most cost estimates are based on data from only half of the participating SMEs. Due to this large amount of dropout, it was not possible to estimate the costs for each country separately.
MENTUPP actively disseminated its work through well-established social media channels, interactions with SMEs and key stakeholders, through press releases, conferences, meetings and academic papers. MENTUPP (at Dec 2023) has published 11 peer reviewed papers in leading journals, with more in the pipeline. Three MENTUPP Policy Briefs have also been published and the MENTUPP Final Online conference (12 Dec 2023) attracted 285 global registrations.
