Occupation-related antecedents, job-related outcomes, and intervening factors of mental health disorders among food handlers: A scoping review protocol

Introduction

The prevalence of mental health disorders is high worldwide. The World Health Organization (WHO) report on Global Mental Health 2022 indicates that one in eight individuals in the world is living with mental disorders (World Health Organisation, 2022). The WHO defines mental health as “A state of mental well-being that enables people to cope with the stresses of life, to realize their abilities, to learn well and work well, and to contribute to their communities. Mental health is an integral component of health and well-being and is more than the absence of mental disorder.” The WHO emphasizes that mental health is a basic human right and an integral element of our general health and well-being (World Health Organisation, 2022). The prevalence of mental health conditions and their socioeconomic consequences is enormous. A health condition is a broad term that generally covers mental and psychological disorders.

The cost of mental condition to the world economy, which stood at approximately US$ 2.5 trillion in 2010, is expected to reach US$ 6 trillion by 2030, alongside an increase in social cost. Low- and middle-income countries (LMIC) alone need to bear 35 per cent of the total cost of healthcare for mental health conditions. In addition to the direct costs involved in the treatment of mental health conditions, countries also face indirect costs, such as reduced economic productivity, unemployment, societal inequality, suicides, and substance use. In most societies, mental health is neglected and fails to provide care and support to people (World Health Organisation, 2022). Although mental health conditions are common across the globe, millions of individuals suffer from silence, which has a significant negative impact on their daily lives. The World Mental Health Report published by the WHO in 2022 indicates that even after publishing its landmark health report in 2001, the recommendations remain valid today (World Health Organisation, 2022).

Mental health and work are also highly interlinked. Employees’ mental health is a ubiquitous concern in the workplace. While most employees report at least one symptom of poor mental health, approximately 20 per cent of employees have mental illness (Rosado-Solomon et al., 2023). Employees’ mental health has a huge impact on organizations and, subsequently, on global society. A collective policy brief on mental health by the WHO and the International Labour Organization (ILO) indicates that 12 billion working days are lost every year due to anxiety and depression (World Health Organisation & International Labour Organisation, 2022). Poor mental health can influence an individual employee’s physical health, which further increases the risk of accidents, poor quality of work, and higher levels of absenteeism. Good mental health among employees enables them to be more productive, and vice versa, in unhealthy work environments. Individuals are able to function, cope, connect, and thrive better because of their good mental health (World Health Organisation & International Labour Organisation, 2022).

Food handlers can be anyone who directly or indirectly handles unpackaged and packaged food, food equipment, and utensils used to serve or prepare food (Food and Agriculture Organization of the United Nations, 2017). Food handling is the most common occupation and is exposed to many stress factors. The management expectation of dedication and commitment, which ultimately leads to a long working hours culture, makes food service employees have a higher average risk of exposure to depression, stress, anxiety, and chronic pain (Cerasa et al., 2020). Moreover, studies have shown that verbal aggression, bullying, physical aggression, screams, and threats are common in the food service workplace (Cristina et al., 2021). The existing literature on mental health-related challenges among food handlers provides a diverse set of factors that are associated with mental health. Researchers have also highlighted that events such as global health emergencies like the COVID-19 pandemic have fuelled mental health challenges among food handlers. For example, perceived stress has been found to increase owing to occupation-related stressors among food service employees during the pandemic (Wilkesmann & Wilkesmann, 2021).

Research studies that attempt to identify the factors that are critical for mental health among food handlers are multifactor: job-related factors (Eburne & Eburne, 2010; Ishaque et al., 2021) person- or employee-related factors (Chuang et al., 2011; Harris & Giuffre, 2010; Hinterstoisser, 2011), organization-related factors (Chen & Wang, 2019; Chuang et al., 2011; Ishaque et al., 2021), contextual factors (Cerasa et al., 2020; Cristina et al., 2021; Harris & Giuffre, 2010; Hinterstoisser, 2011; Kohli & Mehta, 2022) and external environment-related factors (Chen & Wang, 2019; Wilkesmann & Wilkesmann, 2021). However, there is no synthesized evidence on the antecedents of mental health conditions among foodservice employees. In a similar manner, outcomes of mental health conditions also described in the literature. It is also multidimensional, as the mental health of food handlers has significant effects on individuals, organizations, family members, and society at a large (Cerasa et al., 2020; Chen & Wang, 2019; Chuang et al., 2011; Cristina et al., 2021; Harris & Giuffre, 2010; Hinterstoisser, 2011; Ishaque et al., 2021; Kohli & Mehta, 2022; Pidd et al., 2015). The most common outcome frequently highlighted in literature is employee turnover. The most common antecedents, outcomes, and contextual factors are presented in Figure 1.

Figure 1. Food Handler’s mental health conditions.

While employee mental health and well-being are crucial, there remains a dearth of research in this area, particularly among foodservice handlers (Cristina et al., 2021; Ishaque et al., 2021; Kohli & Mehta, 2022). Our objective was to fill this gap by conducting a thorough scoping review that delves into the antecedents, outcomes, and intervening factors associated with mental health disorders among food handlers, as detailed in this protocol.

2. Methods

The researchers in the proposed scoping review will adopt the updated methodological guidelines of the JBI for the scoping review protocol (Peters et al., 2020). A preliminary search of PROSPERO, MEDLINE, JBI Evidence Synthesis, and Cochrane Database of Systematic Reviews was conducted to confirm that no current or scoping reviews or systematic reviews were underway.

This review aims to examine the factors that contribute to mental health conditions among food handlers worldwide. We will identify the factors associated with mental health conditions, including stress, depression, anxiety, and burnout, among food handlers. These factors are classified as individual- or person-related, occupation- or work-related, organizational-, and environment-related. We will also explore the outcomes of mental health conditions among food handlers in individuals, organizations, and society. We will look at potential mediators and moderators that may influence the complex relationship between the factors that influence foodservice employees’ mental well-being. Through a comprehensive review of the literature, we hope to highlight gaps, synthesize insights, and inform future research, practices, and policies to effectively address mental health concerns among food handlers, who are an overlooked occupational group. The research questions of the proposed scoping review were developed based on Population, Concept and Context (PCC framework). The framework is presented in Table 1.

With the above PCC framework, we aimed to address the following research questions: (1) What are the occupation-related factors that cause mental health conditions in food handlers? (2) What are the outcomes of food handlers’ mental health conditions for individuals, organizations, and society? (3) Do any intervening factors moderate or mediate the relationship between antecedents and outcomes of food handlers’ mental health? (4) What strategies have been adopted to address mental health conditions among food handlers?

3. Discussion

We plan to conduct the first scoping review that focuses on consolidating evidence across the intersecting issues of mental health conditions among food handlers, a vulnerable occupational population. This review aimed to provide a broad map of the available research landscape related to mental health status, associated factors, and relevant interventions among food handlers across diverse contexts. We will analyze the coverage, insights, and remaining knowledge gaps to guide future studies and organizational efforts to address this topic. We will use a systematic strategy to capture published and grey literature across several databases and search for citations. However, there are some limitations regarding the language (only English) and databases screened due to logistical constraints. We should note that scoping reviews do not assess the methodological quality or risk of bias in the included studies, and we will not do so either. Despite its limitations, this scoping review represents a crucial step in consolidating the current fragmented evidence on mental health among food handlers. By synthesizing available research across diverse contexts, this review will provide a comprehensive overview of the current state of knowledge, facilitating the identification of gaps and priorities for future investigations. These findings can inform the development of targeted interventions, workplace policies, and training programs tailored to the unique needs and challenges faced by food handlers, ultimately promoting their mental well-being and overall occupational health.