Mental health needs in the workplace has been an evolving area of study and application and has been followed by the SafetyAtWorkBlog since its inception. Several recent statements and reports in Australia have shown that the subject continues to be discussed but not by those who can make the substantial social change, the Government, partly due to a lack of the type of evidence needed by Government to justify the change.
Mental Health is the core element of almost all the contemporary workplace hazards that are categorised as psychosocial. This includes stress, bullying, fatigue, suicide, work/life balance, and many more. Each of these categories are important but most reporting and a lot of the health promotion initiatives in the workplace focus on the manifestation of mental health instead of the source.
On February 21 2014 the chair of the Mental Health Council of Australia (MHCA), Jennifer Westacott, spoke about mental health and the workplace. Westacott is authoritative in her presentation but approaches workplace mental health from the same perspective as many others in this sector – the integration of mental health into the workplace rather than looking at the mental ill-health that workplaces can create. She quotes excellent research about workplace mental health but then says:
“This is affecting people with a mental illness and people without.”
She seems to miss that work practices and poor management can create mental ill health not only exacerbate existing mental health conditions. This is an important distinction when trying to engage businesses and CEOs in changing mental health status. A business executive is more likely to accept and deal with a mental health issue that his or her company has generated than recruit someone who already has a mental illness. One is a problem that the executive must own due to legislative obligations, the other is recruiting a person as a result of social obligation. Businesses work to compliance first and social responsibility later, if they have the time, the inclination, the financial resources and the maturity.
MHCA is strong on developing a collaborative approach on mental health and has created a Council of No-Government Organisation (CONGO) to help with this. In December 2012 CONGO (membership unknown) released a briefing paper on its goal and although the briefing paper is excellent it fails to address the work-created mental health issue. The paper does advocate greater collaboration with industry but, again, only in terms of mental health issues external to the workplace.
“The Commission will form a Taskforce, including industry, government and community leaders to actively promote effective employment support programs and workplace based programs that increase the participation in employment of people with mental health difficulties.
Employment support programs, initiatives and benefits must be more flexible.” (page 7)
The lack of attention to work-generated mental health hazards may not be a surprise if one notes that Jennifer Westacott is also the CEO of the Business Council of Australia (BCA). On 25 February Westacott spoke to ABC Radio about business productivity and Government budgetary programs which could introduce impediments to achieving mental health reform in workplaces. In fact Westacott’s positions and the increased audience granted by the Australian Government provides her with a maj0r opportunity to improve work-generated mental health and productivity should she wish to take on the challenge. As the Productivity Commission’s various investigations into business operations begin this year, the submissions from the BCA and the MHCA will be fascinating to compare given Westacott’s prominent position in both organisations.
In her speech Westacott moves to defining a mentally healthy workplace as having the following characteristics:
- “a place people want to be
- a place where people can realise their full potential
- a place that contributes to our sense of happiness”
She argues that such a workplace will have increased productivity. This is not so different from how many safety and human resources professionals describe a positive workplace culture. Westacott said that
“We need to remember that, at the most basic level, the poor management of stress will put employers at risk of claims. For employees, the poor management of stress will lead to poor productivity, poor cultures and low morale.”
And she emphasises that
“… a decent place to work is a mentally healthy workplace. A decent workplace is a creative and innovative one. So this is core business.”
In this she echoes actions in the past that have advocated dignity at work.
Westacott’s presentation last week was the strongest call for attention to mental health in workplaces for some time even though it misses the opportunity to hook businesses to the campaign by stating that poor management and work design generates as well as compounds mental ill-health. This hook could be occupational health and safety and how recent Australian OHS laws increase attention on due diligence and psychosocial obligations.
Around the time of Westacott’s presentation Suicide Prevention Australia (SPA) released a very good position paper on work and suicide prevention. It’s bibliography of research into the issues is terrific but the paper has a habit of collating bits of research data to provide the impression of evidence through significance. For instance in arguing a business case for suicide prevention, it opens with
“While no detailed and independent costing exists on the cost of suicide and suicidal behaviour to the Australian economy, every death does have a financial impact” (page 6)
It then lists economic estimates and costs, many that are familiar. Such estimates are dotted throughout health promotion literature and some OHS research and SPA hopes that this makes the business case. It does not, it lists estimates of cost. A business case should also include initiatives and changes that can improve the situation and business viability. The list of costs does not beat the statement that “no detailed and independent costing exists on the cost of suicide and suicidal behaviour to the Australian economy”. To get corporate buy-in on suicide prevention in the workplace it is exactly these independent and detailed costings that are required but SPA makes no recommendation on this.
The SPA report frequently mentions “work-related” suicides and suicidal behaviour but nowhere defines what it means by work or work-related. We know from the debates in the OHS sector for several years that what work and a workplace is can be contentious. The new OHS definition of workplace includes wherever work is undertaken. This is likely to have a substantial impact of work-related studies particularly mental health studies when a workplace can be anywhere including cafes, cars, or a worker’s home – places over which the employer has reduced control.
What seems to be missing from much of the research in health and mental health promotion in workplaces is the input of occupational health and safety professionals. The research and comments discussed in this article acknowledge OHS but fail to see how OHS can support and further their worthy campaigns.
It may come as a surprise that Australia does have a National Mental Health Policy and Plan but these are simply continuations of a strategy that has existed since 1992. Given the statement of Jennifer Westacott over twenty years after the initial mental health plan, such a strategy has not been a great success if it remains a struggle to have mental health accepted as a serious matter.
It is disappointing that as governments are trying to increase evidence-based policy making there is less evidence being created. There are lots of facts and these facts may seem to fit or support each other but that is not evidence.
Similarly an argument for a business case is not a list of business costs or estimates. Economic evidence is paramount with Australia’s current conservative Government and without evidence of the dollars that can be saved through mental health initiatives, it is difficult to see any substantial change in the mental health sector in this Government’s life.
Australian workplaces are much more than a place for companies to market their mental health promotion products and place a handful of brochures. Work is a dynamic process that allows for some social ills to be improved but also generates social ills. To try to promote mental health and wellbeing without acknowledging this dynamic is missing the opportunity to truly engage with the business and corporate sectors.