Attribution 4.0 International (CC BY 4.0)2022-06-232022-06-232017-09-29Andreeva, E., Brenner, M.H., Theorell, T. et al. Risk of psychological ill health and methods of organisational downsizing: a cross-sectional survey in four European countries. BMC Public Health 17, 758 (2017). https://doi.org/10.1186/s12889-017-4789-31471-2458https://hdl.handle.net/20.500.12503/31176The manner in which organizational downsizing is implemented can make a substantial difference as to whether the exposed workers will suffer from psychological ill health. Surprisingly, little research has directly investigated this issue. We examined the likelihood of psychological ill health associated with strategic and reactive downsizing.|A cross-sectional survey included 1456 respondents from France, Sweden, Hungary and the United Kingdom: 681 employees in stable workplaces (reference group) and 775 workers from downsized companies. Reactive downsizing was exemplified by the exposures to compulsory redundancies of medium to large scale resulting in job loss or surviving a layoff while staying employed in downsized organizations. The workforce exposed to strategic downsizing was represented by surplus employees who were internally redeployed and supported through their career change process within a policy context of "no compulsory redundancy". Symptoms of anxiety, depression and emotional exhaustion were assessed in telephone interviews with brief subscales from Hospital Anxiety Scale (HADS-A), Hopkins Symptom Checklist (SCL-CD|We observed no increased risk of psychological ill health in the case of strategic downsizing. The number of significant associations with psychological ill health was the largest for the large-scale reactive downsizing: surviving a layoff was consistently associated with all three outcome measures; returning to work after the job loss experience was related to anxiety and depression, while persons still unemployed at interview had elevated odds of anxiety. After reactive medium-scale downsizing, unemployment at interview was the only exposure associated with anxiety and depression.|The manner in which organizational downsizing is implemented can be important for the psychological wellbeing of workers. If downsizing is unavoidable, it should be achieved strategically. Greater attention is needed to employment and health policies supporting the workers after reactive downsizing.Copyright © The Author(s). 2017http://creativecommons.org/licenses/by/4.0/cross-sectional surveyEuropean countriespsychological ill healthreactive downsizingreturning to workstrategic downsizingsurviving a layoffAdolescentAdultAgedAnxietyCross-Sectional StudiesDepressionEmploymentEuropeFemaleHumansMaleMiddle AgedOrganizationsPersonnel DownsizingRiskUnemploymentYoung AdultArticle© The Author(s). 2017171