Die mental health has developed from a desirable addition to a critical foundation for the success of modern companies. In view of the increasing shortage of skilled workers, the spread of hybrid working models and constantly growing pressure to change, the mental stability of employees is inevitably moving to the center of corporate resilience. While many organizations recognize the urgency of this issue and strive to implement measures, there is often a lack of comprehensive, systemic understanding. The result is often fragmented individual initiatives, unclear responsibilities and a lasting effect that is difficult to measure or do not exist.
Companies often invest in isolated interventions — from stress prevention programs to carrying out a psychological risk assessment (GBU Psyche) — without embedding them into an overarching strategic framework. There is a lack of the necessary connection between the individual measures, which significantly limits their potential to have a lasting impact. It is precisely at this crucial point that the innovative approach of a integrated health strategy on. It aims to link prevention, intervention and organizational development measures in a coherent way, namely across all levels of the company — from individual employees to top management levels.
A core element of this integrated strategy is the so-called multi-level approach. In a differentiated way, this takes into account both individual needs and influencing factors as well as the organizational framework that significantly shape the mental health of the workforce. This article sheds light on why this comprehensive approach in particular is the key to sustainable occupational health. It presents the scientific evidence that underpins the effectiveness of this model and also provides concrete insights and practical guidance on how companies can successfully implement this pioneering approach in their organization.
The term “multi-level approach” refers to an intervention model that is targeted at several systemic levels starts at the same time. In an operational context, this includes:
Studies show that isolated interventions, such as just resilience training or a unique GBU psyche, can show positive effects in the short term — but are not sustainableif they are not embedded in a comprehensive system. A GBU alone can reveal, for example, that employees feel a high level of mental stress — but without follow-up measures at structural and management level, the effect fizzles out.
A multi-level approach ensures that findings are not only documented, but also translated into change become. At the same time, it promotes individual well-being, collective team dynamics and structural clarity. This is the only way to create a culture of mental health that does not react selectively but acts preventively.
2. Basics: What does a multi-level approach mean in workplace health promotion?
The term “multi-level approach” is increasingly establishing itself as an indispensable framework in modern workplace health promotion. It describes a comprehensive intervention model whose primary aim is to simultaneously several interdependent systemic levels to be effective within an organization. This simultaneous processing of different levels is the decisive difference from traditional measures, which are often considered in isolation. In the specific context of occupational health management, this multi-level approach typically comprises three central levels, which in their entirety reflect the complexity of mental health in the work environment and must be addressed:
Why is that relevant?
The relevance of a multi-level approach to workplace health promotion results from the recognition that isolated interventions, which focus only on one of the above levels, can achieve positive effects in the short term, but usually have an effect not permanent is when they are not embedded in a comprehensive and integrated system. A striking example of this is the implementation of a psychological risk assessment (GBU Psyche). Such an assessment can undoubtedly reveal that employees feel a high level of mental stress in certain areas or due to specific factors. However, if these findings remain without adequate follow-up measures at the structural and management level, for example in the form of adjustments to work organization or training managers in dealing with psychological stress, the potential positive effect of GBU fizzles out. The burdens persist and employees may not feel that their concerns are being taken seriously.
A multi-level approach, on the other hand, ensures that the insights gained from analyses are not only documented and stored, but also consistently translated into concrete changes become. By simultaneously considering and processing individual, team and organizational levels, a synergetic effect is achieved. This comprehensive approach therefore not only promotes the individual well-being and mental health of individual employees, but also strengthens the collective dynamics within the teams and creates greater structural clarity and a health-promoting working environment throughout the organization. This is the only way to create a sustainable mental health culture that not only reacts reactively to acute problems, but is rather proactively and preventively designed to minimize future burdens and strengthen employee resources in the long term.
The added value of a multi-level approach to workplace health promotion is not only theoretically understandable — it is empirically proven. One of the most well-founded studies on this right now is the one in the scientific journal Trials published MENTUPP study (2023). This is a large-scale, cluster-randomized intervention study by the international research network of the same name, which shows what effect a coordinated multi-level strategy can have in various organizations.
The aim of the MENTUPP study was to promote mental health in small and medium-sized companies through a comprehensive prevention program — with interventions at individual, team-related and organizational levels. The results are clear: Companies that implemented a multi-level approach saw a significant reduction of Anxiety symptoms, stress levels, and burnout rates within their workforce. At the same time, indicators such as team climate, subjective well-being and perceived leadership quality improved.
These results also confirm previous studies. Biron & Karanika-Murray (2014) found that mental health interventions in the workplace are only effective in the long term if they do not only target the individual but incorporate structural and social factors in the work environment. The large-scale meta-analysis by Montano et al. (2017) paints a similar picture, which shows that combined measures — i.e. packages of measures that simultaneously affect leadership, communication and individual resilience — go well beyond individual measures in terms of their impact.
Especially in times of accelerating work demands, hybrid teams and growing psychological stress, this is no coincidence. Because mental health is created working together: from requirements, resources, social support and organizational sense. A multi-level approach structurally represents exactly this interplay.
MENTUPP goes one step further: It combines classic training with digital tools and continuous accompanying research — a blueprint for modern, evidence-based health promotion, as also sought in digital solutions such as mentalport.
Despite increasing attention to mental health, many organizations still have a fundamental misunderstanding: Load is primarily measured — but not designed. In practice, this means that companies carry out a risk assessment of psychological stress (GBU Psyche), collect data, analyse results — but this often remains the case. The implementation of specific measures that could have an effect on a structural level is omitted or is fizzling out.
This view ignores the core of corporate health strategy. Psychological stress is not a static state that needs to be recorded once, but a dynamic, systemically embedded process. It is created through the interplay of work tasks, leadership, social interaction and organizational culture — and that is exactly where we need to start.
Integrated health strategies take up this understanding: They do not regard psychological distress as a diagnostic issue, but as strategic control parameter. Just as financial data or production figures are regularly monitored and translated into decisions, psychological indicators — such as mental energy balance, collective exhaustion tendencies or management tensions — should also be used as continuous management data.
This requires:
When mental load is understood not only as a risk factor but as an expression of organizational development, the view of leadership, structure and culture also changes. Health is then no longer “managed” but actively designed — across all levels.
In many companies exist health management (BGM) and Occupational safety measures (ASM) largely separated from each other — both organizationally and in terms of content. While BGM is under the responsibility of HR or occupational health managers, occupational safety is often coordinated by occupational safety specialists, company doctors or external agents. This division has grown historically — but today it is increasingly a hindrance.
Why Because mental health cannot be divided between BGM and ASM. The causes of psychological stress always affect both spheres: workplace design as well as individual coping skills. If measures only work on one side, they often remain ineffective or fizzle out in everyday operational life. What is missing is strategic and functional integration.
Occupational safety — particularly within the framework of GBU Psyche — focuses on legal requirements: What are the risks in the workplace? Which protective measures must be implemented? The language is often technical, the goal is minimization.
BGM, on the other hand, works with a promotion-oriented understanding: How can resources be strengthened, behavior changed and health-promoting structures created? The focus here is on motivation, culture and learning.
Both perspectives are important — but it is only when they are interlinked that an effective, holistic health strategy can be created. This connection must be actively organized:
It is crucial that this interlocking not just operational, but also strategically anchored will. This means that management must take health goals just as seriously as sales or innovation figures. Managers must not only carry out safety briefings, but also promote psychological safety within the team. HR must not only write personnel development plans, but also monitor workload indicators.
This integration is not an end in itself — it pays off. Studies show that companies that regard health as part of their management processes are significantly more resilient: They react faster to stress signals, are more adaptive in change processes and have more stable employee retention.
One example of this type of management integration is the concept of “Health Governance”, which is finding its way into more and more large companies. Health management is located at board level, supervised by a cross-divisional committee and translated into operational management with clear responsibilities. The aim is to integrate health as a cross-cutting issue into all management processes.
Conclusion: Only when mental health is no longer regarded as a special loop, but is integrated into the normal process of corporate management, can it have a lasting effect. BGM and ASM do not form two worlds — but two approaches to the same goal.
What do integrated health strategies with a multi-level approach look like in practice? An example from industry shows how such an approach can have a concrete effect — and which success factors are decisive.
A medium-sized manufacturing company with around 480 employees had to deal with remarkably high absences due to mental illness over the years. The HR department found that stress-related illnesses (burnout, adjustment disorders, depressive episodes) in particular increased sharply. In parallel, employee surveys revealed an increased level of emotional exhaustion and declining identification with the company.
Against this background, the management, together with HR management and the occupational safety officer, decided to fundamentally change course. Instead of relying on isolated health campaigns — such as back courses, mindfulness training or health days — as before, a comprehensive, systemically anchored health approach should be established. The motto was: Avoid burnout before it happens — through systemic understanding and creative action.
In collaboration with external consultants and digital tools (including a platform for health analyses and action planning), the company then implemented a multi-level approach, consisting of:
The results were clear — both quantitatively and qualitatively:
An internal ROI report estimated the economic benefits of the program (including savings through reduced lost days, reduced turnover and lower recruiting costs) at around 2.6 times the investment.
Psychological stress is not an individual deficit — but an expression of systemic friction, lack of clarity, overwhelming or cultural dysfunction. When companies are ready to address these aspects structurally to address, new scope for action is created: for healthy leadership, resilient teams and long-term commitment. Multi-level health management is not a luxury — but an investment in the organization's ability to act.
Infrastructure — particularly digital — is a key success factor for implementing integrated health strategies. Because even the best concepts for multi-level health promotion only have an effect if they can be implemented in everyday life, are scalable and can be continuously controlled. This is exactly where digital platform solutions come into play.
In an increasingly complex working world with hybrid teams, decentralized structures and dynamic requirements, health measures must meet three central criteria today:
Digital platforms such as Mentalport create a central interface for this — and go even further. mentalport was developed explicitly to bridge the gap between psychological diagnostics, organizational management and concrete behavioral change. The platform enables:
mentalport follows a consistent multi-level approach:
mentalport is also designed in such a way that Not a parallel world but can be integrated into existing organizational structures. This applies to both technical interfaces (e.g. HRIS or learning management systems) and organizational processes. All results are data protection-compliant, pseudonymized and can be documented in an audit-proof manner.
Digital solutions such as mentalport are not just tools, but an expression of a systemic understanding of health. Anyone who invests in such a tool as an organization is signaling that we take mental health seriously — not as a short-term trend, but as an integral part of our management logic.
In addition, mentalport makes it easier Integration of ASM and BGM (see part 5) by combining health data, action planning and documentation in one system. For example, a GBU module becomes a tailor-made measure with progress monitoring and reporting — instead of the implementation being silted up in paper files or mail loops.
Conclusion: Without digital support, multi-level health management quickly becomes an organizational burden. With the right platform — such as mentalport — it becomes a strategic opportunity: for better decisions, healthier processes and resilient organizations.
As convincing as the multi-level approach appears on paper, its implementation in practice is complex. Many organizations underestimate the effort involved in truly integrating health, leadership, and structure. At the same time, experience shows that it's worth it. But how do you make the step from analysis to effective implementation?
In many companies, health is organized in silos: HR is responsible for BGM, the occupational safety specialist is responsible for occupational safety, managers care about performance — and no one really feels responsible for mental health. This separation prevents holistic strategies.
Solution approach: The introduction of a joint governance structure — e.g. in the form of a comprehensive health board — that links ASM, BGM, HR and leadership. A C-level sponsor for mental wellbeing can also be decisive in creating priority.
Mental health is still too rarely seen as a management task. As long as mental stress is regarded as a private problem or HR issue, there is no strength to implement systemic solutions.
Solution approach: Health indicators must be included in the management dashboard. This works best when the platform issues specific KPIs for collecting, evaluating and documenting measures, such as those offered by mentalport. Leadership must understand that health is a factor of productivity and the future.
Particularly in traditional structures or when psychological security is low, there is skepticism about psychological diagnostics: What happens with the data? Is there a threat of control or reprisal?
Solution approach: Clear communication, pseudonymization and legally compliant data protection processes create trust. Platforms such as mentalport ensure that no conclusions can be drawn about individual persons — and make it transparent which data is used for which purpose.
Many companies collect data on mental health — as part of the GBU Psyche, for example — but they do too little with the results. The transfer to sustainable measures is not successful.
Solution approach: The key is automating and standardizing recommendations. When, as with mentalport, action-oriented suggestions are automatically derived from every analysis — and management or HR can actively implement them — there is a real impulse for change.
Time, personnel, budget — health strategies compete with many other issues. It often fails not because of will, but because of ability.
Solution approach: The added value must be tangible: short micro-interventions, scalable offers, low effort. Digital solutions make it possible to integrate measures into day-to-day business without major project costs. Particularly effective: Piloting with strained teams for rapid impact experience.
The shift towards an integrated health strategy with a multi-level approach is not a short-term project — it is a process of transformation. But it is feasible. And above all: It is necessary. Companies that think of mental health strategically, data-based and multi-dimensionally secure a real advantage for the future — in terms of resilience, skill retention, productivity and innovative strength.
If you want to successfully implement integrated health strategies, you need a clear commitment at the highest level, a platform that enables implementability — and the patience to think systemically.
The key recommendations for action are:
Integrated strategies are the logical consequence of the challenges of today's working world. They enable companies not only to react, but also to shape. The time is right.
Note: This article is based on scientifically based findings and practical experience with the mentalport platform. More information: www.mentalport.health
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