The burden of mental health disorders is burgeoning and are a public health priority. These mental health disorders are characterised by one or more of: (1) abnormal thoughts, (2) maladaptive emotion regulation, (3) behavioural dysregulation and (4) strained relationships with others. Currently, to treat the psychosocial and behavioural problems associated with a mental health disorder, individuals are either prescribed psychotropic medication or transferred into psychotherapeutic treatment. However, demand continues to exceed available resources for psychotherapy and psychotropic medications come alongside a plethora of negative side effects which do not treat the root cause of the disorder. This presents a need to reorient focus towards the development of evidence-based early-intervention strategies to equip individuals to appropriately deal with adversity.
The global burden of mental health disorders also presents a significant problem in the workplace, where individuals often work whilst struggling. This is referred to as presenteeism, which harms workplace productivity and increases the number of sick days required by employees each year. However, the negative stigma associated with the disclosure of a mental health disorder to an employer remains a significant barrier to individuals seeking treatment. Stable employment is also classified as a wider determinant of health and wellbeing, with long-term unemployment being associated with a plethora of psychological ill-effects. Importantly, effects endure long-term and have permanent detrimental effects on life satisfaction. Also, the longer an individual is unemployed, the more complex their situation becomes, decreasing the likelihood of re-employment. Both of these come at significant economic cost to the UK Government, presenting a need to focus study on these populations.
Increasingly, public health initiatives place an emphasis on early-intervention approaches and the development of such interventions has captured public interest. Positive Psychology is one such approach. Specifically focusing on the development of light-touch evidence-based approaches to improve the wellbeing of the population. Positive Psychology Interventions (PPIs) have previously shown efficacy in the workplace and the unemployed. One example of a PPI is a reflective journaling intervention, where individuals document their experiences over the course of a week. Previously, both positive and negative written emotional disclosure have demonstrated effectiveness when aiming to improve wellbeing. One of the inaugural findings in the reflective journaling literature is the ‘3 Good Things’ intervention, which has demonstrated endured effects on wellbeing and depressive symptomology, in a large population sample.
Alongside a company sponsor (Rhyl City Strategy; see section 1.1), the primary aim of this body of work was to use reflective practice to improve intrinsic motivation, wellbeing and resilience in the long-term unemployed and employees. All diaries were first piloted in Higher Education Students before the successful interventions were implemented into an employed population. Specifically, Chapter 2, (Study 1) focused on reflection of basic psychological need satisfaction to improve intrinsic motivation and wellbeing. Chapter 3, (Study 2a) emphasised daily anxiety provoking events to improve resilience; Study 2b then reframed these anxieties into excitement. Study 2c then implemented the successful Excitement Diary into a small cohort of employees. Chapter 4, (Study 3) aimed to disentangle the mechanisms of the previously successful ‘3 Good Things’ diary and implement a novel Locus of Control (LOC) diary simultaneously. Finally, Chapter 5 (Study 4) established the effectiveness of a multicomponent 6-week PPI (BOOST!) in a population of long-term unemployed individuals who resided in four counties in North Wales. Chapter 6 discusses the practical implications of research, alongside its strengths and limitations.