The distal and proximal causes of depression and common mental health problems are poorly understood. There is limited success in preventing the onset of depression with individual, or group structured psychological support, such as cognitive behaviour and counselling approaches, offered to adults with subthreshold (fewer than 4) symptoms of depression (Van Zoonen, 2014).

Many studies (Leka & Jain, 2017) suggest that employees who report high levels of work stress are at a greater risk of developing a range of mental and physical health conditions such as depression (ILO, 2016). Well-being at work is defined as individuals’ ability to work productively and creatively, to engage in strong and positive relationships, fulfilment of personal and social goals, contribution to community, and a sense of purpose.

Addressing mental health in its totality recognises the complex interrelationships among risks to mental health, including? sub-threshold conditions of poor psychological health that may not have yet resulted in diagnosed mental ill health problems.

Policies and practices that tackle a wider range of risk factors could improve mental health through appropriate interventions in the work environment. They could promote positive and supportive organisational cultures and organisational justice, increase employee control and participation, introduce teamwork (where appropriate) in combination with interventions at the individual level (selected and targeted prevention, for example, coaching, cognitive-behavioural therapy, physical activity and problem- focused return-to-work programmes). There is a notable dearth of knowledge on the effects of the structural environment (sound, light, air quality) on mental health at work.

Women make up 45% of the labour force. Pregnancy, childbirth and the transition to motherhood are profoundly transformative experiences for women in physical, psychological, social and even organisational terms (Millward, 20065; Smith, 1999). Such transition points broadly relate to the personal experiences and organisational procedures surrounding maternity leave: pre-leave, maternity leave, and (for many) return to work.

Each one of these stages can yield important opportunities for psychological growth and emotional fulfilment; but, conversely, can pose mental and physical challenges and strains for mothers, also an equality issue.

Most adults avoid or fail to access free depression prevention services [Cuijpers Ref] and under use treatment services globally [WHO]. The public tell us they do not feel able to be open about mental health with occupational health or counselling services provided through their employer. Presenteeism (being mentally ill at work: cost to UK employers £16.8bn–£26.4bn) costs more than absenteeism (£7.9bn) (Deloitte, 2017).

The Workplace Maternal Depression Prevention Network (WMDPN) will join together expertise in discovering social, psychological and physical determinants of depression, in interventional practice skills, and in complex population and intervention outcome designs. It will create fundable proposals for research on maternal mental health (selected prevention) and subsequently on universal workplace prevention. Proposals will address the fundamental problem that access to such interventions is difficult, most adults avoid or fail to access services that can prevent depression or treat it early and employers also resist change in their management practices.

A UK based network is needed with expertise in the psychological and structural environment, public health and epidemiology, mathematical modelling (of complex systems and outcomes), intervention development and complex evaluation designs (see 4.3).

Surprisingly little attention has been devoted to mental health prevention research in the UK. We lack interdisciplinary work bringing together researchers interested in the determinants of poor mental health and in intervention and behaviour change. Our network would create new relationships and commitments to developing research proposals, co-designed by such researchers, together with the public and with employers, for whom the economic returns on investment are substantial. We also bring to the table achievements and expertise from outside the UK, demonstrating those successes necessary encourage change in the UK research and employment cultures.

We propose to site research in the employment sector to address three important change targets: the psychological and organisational work environment; the perceptions and behaviour of managers and of employees; and incentives and barriers to behaviour change.
The wellbeing and mental health of women in work is crucial to maintaining the future adult workforce and raises key gender and equality issues. Our initial proposed membership includes expertise in changing group and management practice and individual psychological change. An 'early win' could grow out of previous work by two of us (TB, PS). We have identified potentially promising approaches to prevention of maternal depression, developed by altering routine NHS maternity professional training and care (Psychol Med. 2011;41:739-748). This could be adapted to the work place by redesigning employee support practices by adapting mentoring and coaching to address psychological needs. Successful adaptions like this could eventually be scaled up as (universal) mental health prevention practices across the wider workforce.