Do you fix the fish or the aquarium?

Guest post from Jason van Schie

We can all (hopefully!) agree that looking after workers makes sound business sense. Look after your workers, and they will look after you.

So what is the best way to care for employees? By responding to their symptoms of distress through provision of reactive services like EAP [Employee Assistance Program] and resilience apps (fixing the fish), or by improving the design, management and social interactions at work (the aquarium)?

Let’s park that question for a minute and consider two questions:
1) What happens when we fix the worker but not the work? and
2) If population health is the goal, which approach is more likely to achieve the desired result?

When providing services to the individual, they are likely to achieve a mental health benefit if the person uses the service correctly. For instance, a worker who goes through 3-6 sessions of CBT with a registered psychologist through a company-provided EAP service, and applies the homework in between sessions, may achieve a 20% improvement in their mental health.

However, if the reasons the person is distressed and accessing the EAP to begin with is because of crazy work demands, an unsupportive boss and no choice in how or when they do their work – as soon as they return to work, the symptoms are likely to re-emerge, and then they are back to square one.

Morally, I believe these services are the least an employer can do (read: least).

But – what if the point is population mental health? Let’s say you employ 10,000 workers, and 5% make use of the EAP (better than industry averages) and achieve an average 20% improvement in their mental health (optimistic). Across your worker population, you have increased the total mental health by a cumulative 1%. (Noting this improvement may be short lasting if it was actually work that was causing the mental ill-health symptoms to begin with).

Rather than trying to improve worker population mental health temporarily by 1% by focusing on the willing 5%, try a mental health intervention that benefits 100% of workers.

Work overload, low role clarity, low supervisor support, lack of job control, lack of organisational justice, poor change management are connected to mental health impacts. If any of these psychosocial hazards exist, improving these elements of work design can be considered a mental health intervention. Which to focus on? Well, ask workers through a psychosocial risk assessment consultation.

The best part about fixing the work is that all workers get the benefit – not just those willing few who will avail themselves of the intervention or are motivated enough to change their behaviour.

Improving 100% of worker’s mental health by an average of 5% gives – you guessed it – a 5% improvement across the population.

When it comes to designing impactful and sustainable work mental health interventions – businesses should focus first on fixing the aquarium. Your workers will then take care of business.

Jason van Schie
Psych Health, Safety and Wellbeing. Psychologist, Podcaster

Note: this article was originally published on LinkedIn and is reproduced with permission of the author.

Categories Burnout, change, Duty of Care, employers, ethics, health, mental-health, OHS, psychosocial, risk, safety, stress, Uncategorized, wellness

One thought on “Do you fix the fish or the aquarium?”

  1. What I liked particularly about Jason’s LinkedIn article was its clarity. Many are trying to develop analogies that illustrate the most effective way of preventing and managing psychosocial hazards at work – organisational change. Jason’s is the aquarium and fish. Dr Carlo Caponecchia applies the iced cake ( ). Caponecchia says that applying well-being programs (the icing) may make the cake look better, but if the cake is not of good quality, the icing will do little to improve the experience of eating the cake. To be crude, you cannot polish a turd.

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