Social Return on Investment of Coming to Our Senses: A Mindfulness-Based Intervention for Improving Mental Health and Wellbeing of NHS Healthcare Workers in Wales

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review your manuscript. This study is very interesting, well written and adds value to the current evidence around the impact of mental health for healthcare workers. The abstract describes the study well. The introduction is generally well written and includes good background with relevant and appropriate references, although more citations would be recommended. The methods a re well described and provide good definitions of the tools used in the study.  Some further detail around the data analysis (qualitative data) would be beneficial. The results are generally clearly presented, with the tables well supported by text. They align with the aims of the study and flow nicely from the methods section. The discussion is mostly high level with good application of your findings to the "real world" demonstrating the impact of programmes such as this. The conclusion could bs stronger.  I have added some specific points below. 

Line 37 and 55: Referencing error (you don't need the initial before Taylor as the dates are different. 

Line 67 - needs a reference for the pilot study. 

Line 71 - needs a reference for the evaluation of the pilot study. 

Line 72 - you do not need to have the survey in this sentence (this should be in the methods section only). 

The final paragraph of the introduction is probably better placed in the context section of the methods. Some of it is already repeated anyway. You will need to reframe your aim to be more broad and allude to Phase 2 in the methods section.  

Line 200 - needs a reference for "previously published statistics"

Line 222 - Is there a reason why you have described the number of participants as "four in five" rather than just stating the number? 

Line 318 - an extra bracket, can be removed. 

The two sentences in the conclusion are almost a repeat of each other. I would consider rewsording this. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The topic and subject of research are very important and current. The manuscript is well structured and written. The abstract is informative and concise, and the keywords are well selected and defined. Despite the many advantages, there are certain elements that can be improved.

1. The Introduction section is generally well written and contains relevant references. At the end of the section, there is an initial introduction to the "Coming to Our Senses" program, however, in that presentation, a connection must be made between the mentioned program and the corresponding theory (or theories). In this way, the opportunity to strengthen the theoretical contribution of the research opens up.

Also, at the end of the Introduction section, it is necessary to clearly define the goal and purpose of the research. Previously, it is necessary to research and list similar programs that have been implemented around the world and define the motivation and research gap. It is advisable to end this section with research questions. Defining the research questions would strengthen the purpose and originality of the manuscript.

2. The Materials and Methods section is well written, structured and sufficiently informative. Subsection 2.3 Sample contains basic information and should be supplemented. How are the participants in the program selected? How were they accessed? Were there any criteria for inclusion or exclusion from the sample? These and similar issues need to be addressed.

3. The Discussion section is very well developed and objectively presents and treats the results, especially in the part related to limitations. On the other hand, the impression is that this section lacks two important elements: theoretical implications and practical implications. Without these elements, the study and the manuscript have no purpose, and therefore it is recommended to the authors to focus their attention on the construction of these parts.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Thank you for submitting your paper. It examines the social value of a workplace mental health intervention using an SROI framework, a timely and policy-relevant topic. Strengths include the use of HACT valuation tools and alignment with HM Treasury’s Green Book.

Please see the comments and suggestions below to improve your manuscript.

 

1. Introduction

The manuscript effectively highlights the importance of workplace mental health and the value of evaluating interventions using economic and social frameworks. The use of SROI, along with HACT tools and alignment with HM Treasury’s Green Book, adds methodological rigor and policy relevance.

Suggestions for Improvement:

• Emphasize the research gap and the study’s unique contribution more clearly.
• Highlight the objective of estimating the SROI of Phase 2 prominently and link it to how it extends or differs from previous SROI or wellbeing studies.
• Strengthen the literature review by referencing and comparing 2–3 relevant empirical studies.

2. Materials and Methods

The manuscript adopts an appropriate methodological approach using SROI with wellbeing valuation. The use of HACT Social Value and Mental Health Social Value Calculators aligns with UK policy standards, and the key cost and benefit categories are conceptually relevant.

 Points to Consider / Suggestions:

• Clearly specify the study design (e.g., pre–post intervention, observational).
• Resolve confusion regarding sample size: Abstract refers to “39/84,” while Methods mention 84.
• Describe participant recruitment, inclusion/exclusion criteria, and response rates; consider adding a participant flow table or figure.
• Address attrition and missing data.
• Explicitly state key assumptions underlying SROI calculations (e.g., attribution, deadweight, time horizon).
• Provide a more detailed description of the analytical process to ensure reproducibility.
• Include a brief sensitivity or robustness analysis and discuss uncertainty around SROI estimates.

3. Results

The results generally align with the study’s objectives, with SROI estimates reported clearly and cost and benefit categories logically structured.

Suggestions for Improvement:

• Present results descriptively, separating them from interpretation.
• Communicate uncertainty or variability in estimates (e.g., ranges or alternative assumptions).
• Include summary tables showing:
• Costs
• Monetized benefits
• SROI ratios

4. Discussion

The Discussion links findings to wellbeing, productivity, and policy relevance, while acknowledging practical implications.

Suggestions for Improvement:

• Critically interpret results rather than repeating them, comparing with previous SROI or wellbeing studies.
• Engage more with existing SROI and mental health valuation literature.
• Discuss why the estimated SROI is higher or lower than expected.
• Explicitly acknowledge limitations related to sample size, attrition, and study design.
• Strengthen discussion of policy and practice implications.

5. Conclusions

The conclusions align broadly with the results and reinforce the importance of evaluating wellbeing interventions.

 Suggestions for Improvement:

• Provide a concise summary of key limitations.
• Avoid overgeneralizing beyond the data.
• Clearly outline specific avenues for future research, such as replication in other settings or improved study designs.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

Thank you for your hard work in addressing the comments and suggestions. The manuscript has improved significantly and now offers much greater value for publication.