Dear Researcher,
Emotional distress leading to physical symptoms accounts for as much
as 30 to 60 percent of all outpatient physicians visits. Depression is
one of the most frequent mental health problems in the United States
and costs more than $43 million annually, in lost earnings, treatment
costs, and workplace costs. Researchers estimate that primary care
physicians see about 150-250 patients a year with significant
symptoms.
Homicide is the second leading cause of death to workers in the United
States, accounting for 16 percent of worker fatalities in 1994. These
statistics do not include threats of physical violence. Assaults at
work cost an estimated 1 750 000 lost work days and $55 million in
lost wages annually. The mental anguish and emotional distress
stemming from incidents of harassment and threats add substantially to
those dollars.
Research has highlighted a number of work-related factors that can
negatively affect wellbeing:
- Lack of control over work, undervalued social position, low
decision-making influence
- Under-utilisation of skills
- Too high a workload, impossible deadlines
- Too low a workload, no or few challenges
- Low task variety, few learning, career or promotional
opportunities
- High uncertainty, competition, e.g. due to poorly defined roles
and responsibilities, lack of clear priorities and targets, job
insecurity
- Low pay
- Poor working conditions, e.g. noise, overcrowding, excessive
heat, inadequate breaks
- Low interpersonal support, social isolation, poor communication;
e.g. via inadequate or insensitive management, hostility from
colleagues
- Needlessly intimidating supervision rule by fear
- Bullying, discrimination, harassment
- Changes even those meant to humanize and improve conditions
being shunted around
- Ambiguous roles, blurred lines of authority
- Conflicts, not getting along with supervisors, workmates
- Lack of encouragement
Any of the following can provide clues that something is wrong and an
employer needs to take appropriate action to help.
Indicators of individual stress:
- Increase in unexplained absences or sick leave
- Poor performance
- Poor timekeeping
- Increased consumption of alcohol, tobacco or caffeine
- Frequent headaches or backaches
- Withdrawal from social contact
- Poor judgment/indecisiveness
- Constant tiredness or low energy
- Unusual displays of emotion e.g. frequent irritability or
tearfulness.
Indicators of group level stress:
- Disputes and disaffection
- Increased staff turnover
- Increased grievances and complaints.
Creating a Healthy Workplace
Any employer who wishes to create a healthy work environment for their
staff will need to develop policies and procedures to ensure that
their approach is systematic and thorough, and its results are
tangible. A specific policy relating to mental health at work is
advisable. Effective stress prevention and management require tackling
the problem at several levels simultaneously.
- Preventing problems by eliminating or minimising stress at
source
- Minimising the negative effects of stress via education and
management strategies
- Assisting individuals who are experiencing the effects of
stress.
Creating a Safe Workplace
Federal and state job safety laws require employers to make reasonable
efforts to provide a safe workplace. This duty may include steps to
reduce the risk of violence.
Employers also may be liable for negligence if they fail to exercise
ordinary care to avoid potential violence.Violence by employees can
create liability for negligent hiring, retention, supervision, or
training if their conduct was reasonably foreseeable. Federal and
state job discrimination laws compel employers to implement
anti-harassment policies and to take prompt action when harassment
occurs.
Preventing or Minimising the Causes of Stress
Eliminating or reducing sources of stress may be achieved by improving
physical working conditions, redesigning jobs, and/or
allowing more flexible working arrangements, such as job sharing, job
rotation, flexible working hours or the provision of
crèche facilities. Changes in personnel policies, e.g. to improve
communication, can also be helpful, as can strategic planning to
allow more decision-making and autonomy among staff 'on the ground',
e.g. by encouraging groups of workers to review and
recommend changes to system practices to reduce stress.
Since the sources of stress will vary between and even within
organisations, these must first be identified by some kind of
'stress audit'. In larger companies, this might take the form of a
self-report questionnaire administered to employees on an
organisation-wide or site- or department-specific basis. Smaller
companies may find it more appropriate to develop checklists,
which can be administered on a more informal basis, or to organize
discussion groups involving small numbers of staff. In either
case, the agenda should cover the following issues:
- Work content and scheduling
- Physical working conditions
- Terms of employment and expectations of different employees
within the organisation
- Working relationships
- Systems for communication and reporting
The results can be used as a lever for organizational change and a
guide to where resources need to be directed to achieve change in
preventing stress. Regular auditing can also provide a means of
monitoring stress levels and evaluating the effects of changes in
policies and practices at work.
Stress prevention strategies should also involve the development of a
supportive work ethos and climate, in which staff can feel free to be
open about stress they are experiencing, in the knowledge that they
will be helped and supported to deal with their issues. This may
require setting up more open communication channels within an
organisation, and actively discouraging behaviours that contribute to
stress, such as routine late working, taking work home at weekends and
competitive behaviour.
Monitoring Conduct at Work
Employers have a right to control the workplace. They can regulate
access to the jobsite with security guards, physical barriers,
identification requirements, and high-tech surveillance techniques.
They also have broad discretion to search work areas in response to
suspected employee misconduct and to monitor workers' telephone and
email communications.
Helping People Cope with Unavoidable Stress
A number of interventions can help individuals to deal with sources of
stress that cannot be changed, and thus avoid their negative effects.
Such initiatives generally involve skills training and education.
- Stress education and stress management courses can help people to
recognize signs of stress and develop their coping skills and
resilience.
- There are a wide variety of skills training options under the stress
management umbrella, including assertiveness training, leadership
skills training, time management skills, interpersonal skills
training and relaxation techniques. These types of courses can be
particularly valuable in training managers to recognize the early
warning signs of stress in their staff and review their management
style and its impact on the people they manage.
Another approach is the direct promotion of positive health behaviours
which aim to keep staff fit to cope with the pressures of work. These
may include provision of exercise and keep-fit programmes, and the
introduction of healthy lifestyle management initiatives, such as
health screening programmes, smoking and alcohol cessation programmes
and dietary advice.
Early Intervention and Support
Early recognition of the signs of stress, anxiety and depression is
the crucial first step in dealing with such problems and preventing
them from becoming more serious. Most people make a full recovery,
often without needing to take any time off work. However, individuals
should be encouraged to seek help as soon as possible, via their
physician if no workplace programme or occupational health service is
in place.
Attention should be given to removing or reducing further sources of
stress at work and supporting the individual through any short-term
crisis.
Appropriate counselling can ferret out sources of stress and help to
relieve it. It is crucial, notes one psychotherapist, to emphasize the
normalcy and frequency of emotional and psychological problems, which
afflict over half the workforce at some time. Even brief counselling
by a professional can do wonders and markedly diminish stress, perhaps
short-circuiting illness
behaviour and getting workers back to work.
Access to professional counselling services can be an invaluable help
in assisting the recovery and rehabilitation of stressed employees,
and the number of organisations providing such services is currently
increasing. Such services are ideally provided either by an
independent outside agency, or form part of a broader employee
assistance programme (EAP), which may sometimes be sourced in-house.
EAPs provide information and referral to appropriate support services,
including counselling support for employees and sometimes their family
members. Many programs are run off-site, and are available at no cost
to employees and their families. Some have a 1-800 number and may
include a 24-hour telephone counselling/help line for staff support.
A particular advantage of EAPs is that they can be used to provide
feedback to employers, on a confidential basis, about recurring
problems within an organisation, thus helping to identify sources of
stress and areas of intervention for stress management and prevention
programmes.
The National Mental Health Association (NMHA) has resources available
on coping with loss, post-traumatic stress disorder and other topics
through its Web site (www.nmha.org) and toll-free number
(800-969-NMHA).
Conducting Background Checks with Restrictions
Conducting background checks on job applicants is one weapon in the
employer's anti-violence arsenal. A thorough check may weed out
someone with a history of violence or behaviors often associated with
a heightened potential for violence. Criminal background checks often
are required for specific jobs that involve working with children or
caring for others. Background checks and preemployment tests also
involve balancing an employer's need to know with individuals'
protection from defamation or intrusions into their privacy.
Creating a Battle Plan
Employers should have a comprehensive plan to reduce the potential for
violence. Create a threat assessment team to analyze the risks present
at the work site and then to develop and implement a program to
respond to those risks. In addition to physical modifications to
facilities and administrative controls, training of supervisors and
employees on violence-related issues is essential. A crisis management
team also should be in place to respond effectively when an incident
does occur.
Developing a Mental Health Policy
A mental health policy should be an integral part of any
organisation's health and safety policy. Analysis of such model
policies has defined certain key elements of good practice in relation
to promoting mental wellbeing at work. As a first step, it seems that
organisations need to recognize and accept that mental health is an
important issue. Introduction of a mental health policy embodies such
an organisational commitment to mental health.
There are three key stages in establishing a mental health policy:
1. Audit
To provide information on existing levels of stress and mental illness
within an organization and in what ways organizational structure and
function may be contributing to these, or otherwise. The process will
identify areas for intervention via a mental health policy.
2. Development
To produce a mental health policy tailored to the needs of an
organization. The policy document may include:
- An introduction, outlining the negative effects of mental illness on
sickness absence and work performance, and defining the aims and
objectives of the policy. Core aims might be to promote mental
wellbeing, reduce the stigma associated with mental illness and
provide assistance to employees suffering from stress or more serious
mental health problems.
- Health, safety and welfare policy of the organisation.
- Human resource policies e.g. on mental health and recruitment,
sickness absence and rehabilitation, alcohol abuse.
- Organisational philosophy on health promotion and mental illness
prevention.
- Draft strategies for stress prevention and management, based on
identification of mental health needs via the process of audit.
- Details of staff training programmes, including management training
and stress management courses, specific training for personnel
managers on mental health, and health education of the workforce, e.g.
mental health education within induction training programmes for new
employees.
- Descriptions of the roles and responsibilities of employees at all
levels of the organisation in respect of promoting mental health,
including senior managers, line managers, personnel managers,
occupational health services, staff associations and trades unions and
employees (for themselves and their colleagues).
- Details of the processes of auditing, monitoring and evaluation.
- Estimated costs and time schedule for implementation.
Crucial to the success of a mental health policy is that it should be
developed by a working group that includes representatives from all
levels and sections of the organisation, including personnel/human
resource managers, health professionals such as occupational health
nurses, physicians or psychologists, senior management, and employee
representatives. It should also be applicable to all staff, regardless
of age, sex, ethnic origin or grade.
3. Implementation
To convert the policy into practice throughout the organisation. This
relies on the commitment and co-operation of all employees, headed by
management at the most senior level. Any mental health policy should
be reinforced by regular monitoring and evaluation against performance
indicators, such as reductions in sickness absence and improvements in
staff satisfaction as demonstrated by regular auditing. Revision of
the policy in line with review findings should permit its continual
improvement, alongside a parallel improvement in the mental wellbeing
of staff.
Some bibliographic references for further study on this problem:
- Developing Programmes to Achieve a Healthy Society: Creating Healthy
Workplaces in Northern Ireland; Occupational Medicine; Ken Addley;
1999. (Oxford), 49(5), 325-30.
- Emotion at Work: A Special Issue of the European Journal of Work and
Organizational Psychology; Rob B. Briner; Behavioral Science; 1999
- Johnson, J.V. and Hall, E.M. (1988). Job strain, work place social
support, and cardiovascular disease: a cross-sectional study of a
random sample of the Swedish working population. American Journal of
Public Health, 78, 1336-1342.
- Handbook of Organizational Health Psychology: Programs to Make the
Workplace Healthier by Sam Klarreich (Editor); Psychosocial Press;1998
- The Incestuous Workplace: Stress and Distress in the Organizational
Family; William L. White; Chestnut Health Systems; 2nd edition; 1997
- http://www.apex.gc.ca/interest/synopsis_e.html
- http://www.convoke.com/markjr/toxic.html
- http://www.apa.org/ppo/issues/ebsinterdisp.html
- http://www.macses.ucsf.edu/Research/Social%20Environment/notebook/worksoc.html
- http://www.hrhero.com/sample/trialWorkplaceViolence.pdf
- http://www.uwci.org/work_helpful_tips.htm
- http://www.mentalhealth.org.uk/html/content/bkworkplace.cfm
- http://www.apex.gc.ca/interest/synopsis_e.html
- http://joh.med.uoeh-u.ac.jp/pdf/E45/E45_1_01.pdf
- http://www.mentalhealth.org.nz/mhatwork.asp |
Clarification of Answer by
aresearcher-ga
on
02 Sep 2003 23:25 PDT
Changes in personnel policies should be implemented, especially those
to improve communication. This would ensure that dissatisfaction or
anger among employees is not pent up, which would decrease
productivity.
Such policies should exist to preserve the relationship between all
employees regardless of their positions or kinds of work they perform,
and ensure that all employees receive fair and equitable treatment
from anyone who is in a position of authority at all times.
When all parties are willing to discuss in a rational manner any
problems that may arise, a sound working relationship can be developed
between the employee and supervisor. An example policy would be the
'grievance and appeal procedure' which may be provided between the
employee and the supervisor, as a formal means of communication for
solving problems in a prompt, orderly and fair manner.
This procedure provides the employee with the right to present a
problem or appeal free from interference, restraint, coercion or
reprisal, if fair treatment has not been received or other employment
problems have developed for which a solution is needed.
In addition, corporations could incorporate seminars/courses/workshops
into their work schedule, to increase teamwork and reduce stress and
conflict. (These should be sponsored by the organization, and
attendance made compulsory.) Among these are:
· Interpersonal Dynamics Skills Training Program for Businesses and
Organizations (Team-Building Workshop)
- aims to foster a spirit of trust, creativity, enthusiasm and
team-cooperation by teaching a set of practical interpersonal skills
that can be applied to improve communication and to ensure cooperative
problem-solving. These skills can also be
used unilaterally to improve working relationships with colleagues
outside one's work team, or with external customers or clients.
offered by the National Institute of Relationship Enhancement.
For further information, or to schedule a workshop for your work
group, team, department or organization, please contact Rob Scuka,
Ph.D., M.S.W., L.C.S.W.-C., at 301-986-1479, or by email at
niremd@nire.org.
Phone:
1-800-4-FAMILIES
301-986-1479
Fax:
301-680-3756
Postal:
4400 East-West Hwy., Suite 28, Bethesda, MD 20814-4501
Email: info@nire.org
· Harassment Policy Development
· Human Rights Investigations
· Harassment Seminars for Managers, Supervisors, Employees, Youth
· Conflict resolution
· Harassment Awareness Pamphlets for Employees
· Anger Management
· Mediation Services
· Volunteer Screening Policy Development
offered by Arbourwood Consulting Inc.
For more information, contact:
Phone: 613-841-4942
Fax: 613-841-4943
Email: redjoy@travel-net.com
Postal:
6233 Arbourwood Drive
Ottawa, Ontario, Canada
K1C 7L6
Web: http://www.arbourwood.com/
· The Corporate Fast-Track Anger Management Program
- designed as a resource for supervisors, managers, executives and
busy professionals who want results - fast, without having to attend
the usual 8 to 10 week anger management programs. Participants attend
private, two 4-hour classes separated by one-two weeks during which
time they are given 'homework'- activities designed to utilize the
learned materials and concepts. Classes consist of readings, lecture
material, videos, and application of learned principles to individual
anger management issues and situations. Specific subjects covered
include anger management, stress management techniques, increasing
'emotional intelligence', and ways to improve communciation with
others.
offered by Dr. Fiore and Associates, LLC.
Contact: 1-800-984-4414
to schedule your private corporate fast-track class
Classes are conducted in Long Beach, Orange County, San Bernardino and
Riverside, California.
Web: http://www.angercoach.com/
· Nonviolent communications (NVC), conflict resolution, relationships,
and anger management skill training for business;
offered by Compassionate Communications.
Contact:
Rodger Sorrow
1734 Bath Street, Santa Barbara, CA 93101
Phone 805-687-8831 or Email rodgersorrow@aol.com
or
Kathi Aichner
2641 Samarkand Drive, Santa Barbara, Ca 93105
Phone 805-682-5618 or email irishlassi@aol.com
Web: http://www.communicationfromtheheart.com/
· The Psychology of Persuasion Seminar
- to create environments where others are comfortable sharing
information. This seminar also encourages people to present ideas in
the most powerful and influential language based on what really
motivates each person. Increases teamwork; reduces stress and
conflict. Workshops for Team Building, Performance Management and
Coaching skills for managers.
offered by:
Innergize Training & Coaching
Toronto, Canada
Contact:
Tel: (416) 492-3200
Fax: (416) 492-9102
E-mail: innergizetraining.msn@attcanada.net
Web: http://www.innergizetraining.com
References:
http://www.trainingreport.ca/dir2000/listings.cfm?CategoryID=26
http://www.nire.org/team_building_workshop.html
http://www.angercoach.com/
www.unm.edu/~askdrc/FAQ.html
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