"Background
Information is lacking on the effects of organisational changes on mental health and on the underlying mechanisms. The objectives of this prospective study were to explore the associations between organisational changes, psychosocial work factors and the incidence of poor psychological well-being among the national French working population.
Methods
The study sample included 15,185 employees of both genders, with good well-being at baseline, and followed up in 2013, 2016 and 2019 (National French working conditions survey). Organisational changes included seven types of changes, and psychosocial work factors included sixteen factors. Psychological well-being was assessed using WHO-5. Weighted robust Poisson regression models and the Karlson, Holm and Breen (KHB) method were used. Covariates were taken into account in the models.
Results
The exposure to any organisational change was associated with the incidence of poor well-being (incidence rate ratio = 1.36, 95% CI: 1.19 ; 1.56). The following changes were associated with the incidence of poor well-being: technological change, change in work organisation, and buyout/change in the management team. There was a dose-response association between the number of changes and the incidence of poor well-being, although this association was not straightforward. A negative feeling about changes, and the lack of information, consultation, and influence increased the incidence of poor well-being still further. The mediating role of all psychosocial work factors together in the associations between organisational changes and the incidence of poor well-being was estimated to be 33.9–44.5% according to the studied type of organisational change. Among these factors, job insecurity and quantitative demands were mediators for the associations between all types of organisational changes and the incidence of poor well-being.
Conclusions
Preventive measures focusing on organisational changes may contribute to improve the psychosocial work environment and mental health at work."

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