Table 2 Purpose and output of the MENTUPP ToC process stages

1. Exploitation of the evidence base collected through multiple reviews and an expert consultation

The knowledge derived was utilized to define the MENTUPP ToC outcomes

Through the reviews findings on: 1) mental health interventions in the construction industry, 2) mental health interventions in the ICT sector and 3) mental health interventions in the health sector, 4) interventions to detect and treat depression and anxiety in SMEs, 5) interventions to reduce stigma towards mental illness in the workplace, and 6) the implementation of mental health interventions in the workplace were collected

Through the expert consultation findings on the insights and assessments of stakeholders from 8 European countries and Australia on: 1) the promotion of employee wellbeing, 2) the mental health needs of employees and employers in addition to identifying any gaps, 3) the level of stigma and gaps in anti-stigma programs in the workplace, 4) gender-specific needs, 5) the impact of the COVID-19 pandemic, and acceptability of interventions were collected. All the findings were merged and thematically analyzed and synthesized resulting to:1) a list of outcomes which MENTUPP aims to achieve, 2) a list of intervention components that are required for the outcomes to be achieved, 3) formulation of recommendations concerning implementation

2.Introductory ToC meeting March 1st 2021 (n = 9)

To introduce ToC, to achieve consensus on its selection as an appropriate theoretical framework for the development approach. To discuss a first proposal of key components

Through this online meeting we achieved: 1) the approval of the ToC and development approach, 2) a deeper understanding of its terms and defitnions, and 3) the exchange of ideas about MENTUPP key components (impact, ceiling of accountability, long-term and intermediate outcomes, rationales, assumptions)

3.First ToC workshop March 23rd 2021 (n = 24)

To further familiarize with the ToC approach and discuss a second proposal on the MENTUPP key components

Through this online workshop we achieved: 1) consensus on impact, ceiling of accountability and long-term outcomes, and 2) the further elaboration of the intervention components and their expected outcomes by the developers

4.Second ToC workshop May 20th 2021 (n = 20)

To create a first draft of the MENTUPP ToC map

Through this online workshop we achieved: 1) the classification of the intervention components and the outcomes in broader thematic clusters to reflect better the expected level of change, 2) the link between the outcomes and three levels of change: a) the leader, b) the employee and c) the SME level, 3) the optimization of the rationales and the assumptions, and 4) the reformulation of the ToC map

5.Third ToC workshop July 1st 2021 (n = 19)

To discuss the second draft of the ToC map including the expected causal pathways, the clustering of the intervention components and a first proposal of indicators

Through this online workshop we achieved: 1) the categorization of the outcomes in long-term/distal, intermediate and proximate highlighting the causal mechanisms within MENTUPP, 2) the link between the outcomes to a fourth level of change: the team level, and 3) the inclusion of outcomes related to implementation requirements in the ToC map, 4) the selection of outcome indicators to describe the main changes expected to occur due to MENTUPP, and 5) a first proposal of assumptions indicators

6.Fourth ToC workshop September 24th 2021 (n = 17)

To discuss and finalize the third draft of the ToC map including expected backwards interactions. To discuss the second proposal of the outcomes indicators. To discuss the assumptions indicators

Through this online workshop we achieved: 1) the finalization of the ToC map and the ToC key components, 2) the finalization of the long-term, proximate, intermediate outcomes indicators as well as of the assumptions indicators, and 3) the writing of the ToC narrative