Mental support research

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In SafetyAtWorkBlog in 2008 there have been several posts concerning suicide.  There is a growing research base on the matter and The Lancet adds to this through an article published in December 2008.

Researchers have found that the type of mental health services provided to the community can affect the rate of suicide.  This is important research even though SafetyAtWorkBlog regularly questions the applicability of research undertaken in Scandinavian countries to the rest of the world.  Bearing the cultural differences in mind, the research will stir debate and, hopefully, localised research along the same lines.

Below is the text of the press release about the research:

WELL-DEVELOPED COMMUNITY MENTAL-HEALTH SERVICES ARE ASSOCIATED WITH LOWER SUICIDE RATES

Well-developed community mental-health services are associated with lower suicide rates than are services oriented towards inpatient treatment provision in hospitals. Thus population mental health can be improved by the use of multi-faceted, community-based, specialised mental-health services. These are the conclusions of authors of an Article published Online first and in an upcoming edition of The Lancet, written by Dr Sami Pirkola, Department of Psychiatry, Helsinki University, Finland, and colleagues.

Worldwide, the organisation of mental-health services varies considerably, only partly because of available resources. In most developed countries, mental-health services have been transformed from hospital-centred to integrated community-based services. However, there is no decisive evidence either way to support or challenge this change.

The authors did a nationwide comprehensive survey of Finnish adult mental-health service units between September 2004 and March 2005. From health-care or social-care officers of 428 regions, information was obtained about adult mental-health services, and for each of the regions the authors measured age-adjusted and sex-adjusted suicide risk, pooled between 2000 and 2004 – and then adjusted for socioeconomic factors.

They found that, in Finland, the widest variety of outpatient services and the highest outpatient to inpatient service ratio were associated with a significantly reduced risk of death by suicide compared to the national average. Emergency services operating 24 hours were associated with a risk reduction of 16%. After adjustment for socioeconomic factors, the prominence of outpatient mental-health services was still associated with a generally lower suicide rate.

The authors conclude: “We have shown that different types of mental-health services are associated with variation in population mental health, even when adjusting for local socioeconomic and demographic factors. We propose that the provision of multifaceted community-based services is important to develop modern, effective mental-health services.”

In an accompanying Comment, Dr Keith Hawton and Dr Kate Saunders, University of Oxford Department of Psychiatry, UK, say: “The message to take from these findings must be that while well thought out and carefully planned new developments that increase access to secondary care services for mental-health patients are to be encouraged, measured progress towards flexible community care, not rapid ongoing change, should be the order of the day.”

 

Passport to Safety in Australia

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Around the turn of the century a father told me this

“My son was 19 years old and he was killed in an accident in a small warehouse in a suburb of Toronto. In this little shop, it was a small business with only 4 or 5 people there. He got the job through a friend whose Father ran the business. It was the second or third day on the job and he was asked to go back and decant some fluid from a large drum to some small vessels. The action violated every OHS regulation in the book. There were multiple ignition sources, there was no grounding. A spark went off and lit up the fumes that went back in the drum and it exploded over my son. He died 24 hours later.”

That father was Canadian, Paul Kells, and this traumatic event set him on a journey to improve safety for young workers.  Paul established the Safe Communities Foundation.

Paul has travelled to Australia several times and he has been granted audiences with many OHS regulators but it seems that government of South Australia is the most ardent supporter of Paul’s Passport to Safety program.

Over 5000 students in South Australia have completed the program since 2005 and the government is trying to reach the target of 20,000 teenage students.  A sponsorship form is available for download.

SafetyAtWorkBlog supports Paul’s work and the sponsorship initiative of the South Australian government.

This is what the workplace safety ads in Australia are missing, a passionate advocate who speaks about the reality of workplace death and personal loss – someone who has turned grief into a social entrepreneurship.  If only this type of inspiration could happen without the cost of a life.

My 2000 interview with Paul is available by clicking on this link kell-interview.  It was originally published in SafetyAtWork magazine in February 2001.

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Bullying, duty of care and compensation

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The growth of attention to psychosocial hazards in Australia received a considerable boost from a stress survey undertaken by the ACTU some years ago.  During the survey of union-members, it became clear that bullying was a major generator and perpetrator of workplace stress.  The unions went to town on this data and set the agenda for some time in OHS.  Their success was echoed and mirrored in the United Kingdom and Europe. (In fact, Europe seems to be the jurisdiction that has kept the momentum)

The survey and campaign got the attention of regulators and OHS professionals to the presence of, perhaps, the next generation of occupational health and safety activity.

Since that time psychosocial hazards have splintered into sub-groups of stress, occupational violence, workload, fatigue management, shift work, dignity at work and a range of other matters. However bullying persists as the front runner.

As with many elements of OHS, risk management and cultural studies the defence forces provide signposts to future civilian issues. Yesterday the Australian Defence Force agreed to pay ex-gratia payments to family members of defence personnel who had committed suicide as a result of bullying suffered at the hands of their colleagues.  There are many significant signposts from these incidents but one of particular note was that the payments were not made to dependents but to other family members.

According to the ABC radio report by Karen Barlow:

“The suicides date back up to 12 years, when Lance-Corporal Nicholas Shiels killed himself after accidentally shooting his best friend dead during Army training.

Private John Satatas hanged himself at Holsworthy Barracks, in western Sydney, five years ago after being bullied and racially taunted.

Private David Hayward committed suicide four years ago after he was injured and had gone AWOL.” 

The Defence Minister, Joel Fitzgibbon, was interviewed on this issue, and others, on Radio National on 23 October 2008 and  has referred the matter to a general review of the defence forces. Fitzgibbon acknowledged that “shortcomings in the defence force system” contributed to the situation and could have been better handled after the event.

The day before the media attention the Australian Defence Force released the findings of its annual attitudinal survey of personnel.  The 2007 survey found, according to a media statement:

“… a marked improvement in knowledge of mental health issues as well as members’ assessments of their own mental health. Since 1999, the data also shows an increasing proportion of personnel who believe that unacceptable behaviour is well managed.”

As Australia moves to a national OHS and workers compensation system, or at least a harmonised system, more attention should be given to some of the responses and OHS initiatives in Commonwealth departments as these will be just as influential on OHS law and management as any State initiative.

Getting back on the horse

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Several weeks ago a long-lost warship, the HMAS Sydney, was discovered off the coast of Western Australia. The Sydney disappeared with over 600 crew. There are many interesting stories that are appearing about the discovery but one resonated with me at the Workers’ Memorial ceremony at the Victorian Trades Hall this morning.

Last Friday was ANZAC Day in Australia, a day when we remember the fallen, particularly, in World War 1. At the dawn service at Geraldton, the closest town to where the HMAS Sydney was found, there was a record number of people, many there because of the Sydney. Some of the Sydney’s sailors’ family have travelled to the site of the wreckage to remember and to say goodbye.
At the Workers’ Memorial today, I met a woman who had been permitted to visit the site of her son’s workplace death. He died almost 10 years ago and she told me that for many years she would not have dreamt of going there but how glad she was that she finally did.
People have an odd need to visit the sites of dead relatives. It is perhaps the last tenuous link we have to our friend’s last conscious memories. As I grow older, I might better understand this need but at the moment those sites remind me of pain, trauma and sadness – emotions that should have no place at work.