Objective The goal of this paper was to elucidate the relationship between exposure to separate, multiple or repeated organizational change at both individual- and work-unit level and subsequent clinically relevant mental distress amongst employees two years after change had taken place. Methods A full panel, prospective design was utilized. Data were collected at two time-points two years apart, by self-administered, online questionnaires. Organizational change was measured by six items pertaining to separate types of change. Mental distress was measured using HSCL-10, with cut-off set to ≥1.85 to identify clinically relevant distress. Baseline sample consisted of 7985 respondents, of whom 5297 participated at follow-up. A multilevel analytic strategy was chosen as data were nested within work-units. Effects associated with exposure to organizational change at both individual- and work-unit level were estimated. Results Separate change: At the individual level, company reorganization [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.01‒1.65], downsizing (1.51, 95% CI 1.12‒2.03) and layoffs (OR 1.46, 95% CI 1.01‒2.12) were prospectively associated with mental distress. At work-unit level, company reorganization (OR 1.46, 95% CI 1.04-2.04) was associated with mental distress, but the statistically significant association diminished when adjusting for the work factors job control, job demands and support. Multiple changes: At the individual level, exposure to multiple organizational changes at baseline were associated with mental distress at follow-up (OR 1.75, 95% CI 1.28‒2.38). Repeated change: At the individual level, exposure to repeated organizational change was associated with mental distress at follow-up (OR 1.84, 95% CI 1.29‒2.63). Conclusions Exposure to organizational changes at the individual level indicated an elevated risk of subsequent clinically relevant mental distress following both separate, multiple and repeated organizational changes. These associations were also present at work-unit level, but diminished when adjusting for certain work factors, indicating a possible mediating effect. by Fløvik L, Knardahl S, Christensen JO. doi:10.5271/sjweh.3769
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