depression – Page 34 – SafetyAtWorkBlog

Mental Illness and Workplace Safety

Reports in the Australian media this week indicated that “nearly half the population has a common mental health problem at some point during their lives”. Safety professionals and HR practitioners should take note of these statistics and hope that it does not manifest in their shift, even though it is likely.

The difficulty with trying to manage or anticipate mental health issues is that they seem to have evolved over time and multiplied. There is the common phrase of “trying to herd cats” and it seems that mental health issues are the cats. One could apply lateral thinking and propose the solution is to get a dog but will the dog herd a cat that doesn’t look like a cat, smell like a cat, or worst scenario of all, a cat that resembles a dog!

Because of the fluctuating psychiatric states of everyone everyday how does one recognise when a mood swing becomes a mental health issue. Does one take everything as a mental health issue and waste time on frivolous matters? Or is there no such thing as a frivolous matter?

In the one article there are these confusing and inconsistent terms for mental health:

“common mental health problem”

“mental condition”

“non psychotic psychiatric problems”

“mood disorder”

“anxiety disorder”

“mental health disorder”

“substance abuse or dependency”

“mental disorder”

“mental illness”

“psychiatric condition”

In this report it is unlikely that the synonyms have been generated by the journalist as the data quoted is from the Australian Bureau of Statistics, but it indicates the confusion that safety professionals can feel when they need to accommodate more recent workplace hazards – the psychosocial hazards.

The list above does not include the “established” hazards of bullying, occupational violence or stress. The fact that there may be a clear differentiation between mental health symptoms and mental disorders but that needs to be clearly communicated to those who manage workplaces so that control resources can be allocated where best needed.

The article referred to above provides interesting statistics and there are gems of useful information in the ABS report but the article provides me with no clues about how to begin a coordinated program to address the mental health issues in the workplace. It is an article without hope, without clues, without pathways on which the professional can act.

There is no doubt the psychosocial hazards at work are real but the advocates of intervention need to clarify the message.

Kevin Jones

(This blog posting does not discuss the recent changes to compensation for defence personnel and soldiers for mental health from combat, but mental health in that “industry” is a fascinating comparison to what occurs in the private sector.)

Happiness is a warm million

The Australian newspapers in late-February shared the “outrage” of politicians and then the community over training that was provided to public servants by the American “happiness guru” Professor Martin Seligman.

The cost to the taxpayer seems exorbitant but the psychologist was from the US and was training delegates for many days. It is not unusual for US experts to charge over $US600 per hour plus travel and accomm0dation.

The Community & Public Sector Union‘s Assistant National Secretary Paul Gepp noted in a media statement that news of the expensive conference, which paid an American psychologist’s team more than $440,000, came with news of more layoffs of public servants, as 100 lost their jobs in the Crime Commission.

“Public servants are working hard to keep essential services going, keep our communities safe and make the stimulus package work,” said Mr Gepp. “Million-dollar, feel-good conferences don’t help get these jobs done. If the Government is looking to cut, we suggest it starts with junkets like this.”

The OHS context of this furore comes from the reasons for the training and whether the same benefits could have been obtained at a reduced price.

Media reports say that in parliament on 26 February 2009

“[Deputy Prime Minister, Ms Julia] Gillard attacked Liberal frontbencher Andrew Southcott for attempting to “parody” Professor Seligman, who she described as a “noted educationalist”.
“He is the leader in the development of (a) resiliency program that has been shown to make a difference to mental health issues amongst young people, including issues like anorexia and depression. That is actually serious and ought not to be cat-called about.”

SafetyAtWorkBlog has written previously about the workloads of the public sector under the Rudd government and how the government has chosen not to set reasonable production targets. The Seligman seminars are an example of trying to treat the symptoms and not the cause. Seligman’s programs are not the issue here as the results claimed may be absolutely justified.

Part of the problem for the government is timing, and in this, it shares a lot with behavioural-based safety programs. Whenever a company introduces a wellbeing program, or a happiness seminar, or resilience training, or a team-building extreme sports excursion, it indicates to me that either the company is one that has already tried the traditional approaches to controlling workplace hazards, hasn’t the faintest ides what to do to improve the safety in their workplace , or has too much money in its human resources budget and needs to spend it by the end of the financial year.

Regrettably, the money spent on public service mental health has been poorly targeted and papers over the cracks whilst ignoring the structural instability of how it manages its people.

Kevin Jones

Chronic disease report

The Australian Institute of Health and Welfare has released a report on the labour force effects of chronic illnesses. The report, Chronic disease and participation in work,

shows that chronic diseases are associated with more days off work and/or being out of the workforce, and some of the biggest culprits are depression, arthritis and asthma.

The report focuses on chronic illnesses rather the workplace impacts of the illnesses themselves but there is information that is relevant to how we manage our employees and psychosocial hazards. For instance the report says

Arthritis, asthma and depression were associated with 76% of the total loss due to days away from work (29% associated with depression, 24% with arthritis and 23% with asthma).

For people participating full-time in the labour force, there was a loss of approximately 367,000 person-years associated with chronic disease, approximately 57,000 person-years in absenteeism associated with chronic disease and 113,000 person-years were lost due to death from chronic disease.

The report acknowledges that any estimates of loss are underestimated and also provides very useful data on chronic diseases and absenteeism

Loss due to absenteeism from full-time and part-time employment was calculated as the difference between the number of days off work for people with chronic disease, and the number expected if age and sex-specific rates of absenteeism among people without chronic disease applied.

The loss from absenteeism associated with chronic disease was approximately 500,000 days per fortnight. This was equivalent to approximately 13.2 million days per year or 57,000 person-years of full-time participation (assuming 48 working weeks of 5 days duration with 10 public holidays per year).

About two-thirds of this cost was carried by males, and people aged 35-44 and 45-54 years accounted for the majority (75%) of lost days.

Analysis of absenteeism by specific chronic disease showed that depression, arthritis and asthma were associated with around 76% of days away from work.

A sort-of resolution for Paula Wriedt

Paula Wriedt, a Tasmanian Member of Parliament who attempted suicide in August 2008, resigned on 18 January 2009. According to her media statement

“I have made a significant recovery since my hospitalisation in August, but I believe it is in my best interests, and the interests of my family, to concentrate on improving my health away from the daily pressures of being a member of Parliament.

“This illness has had a significant impact on my life.

“The many demands I faced last year, on both a professional and personal level, meant I neglected to take stock of my health until it was too late.

“During this time, I made a mistake by forming an inappropriate relationship with a member of my staff. This had significant implications for the families involved, and I am not proud of my actions.

“I deeply regret the hurt that has been caused by this.”

She goes on to speak positively of undertaking meaningful work outside of politics. It is hoped that Paula does not feel obliged to follow other politicians into promoting depression support services. For most Australians Paula Wriedt will be associated with her affair and suicide attempt. Tasmanians should remember her as a good parliamentarian, as mentioned by the current Premier David Bartlett (who is only slightly older than Paula at 41), and for her achievements in the education portfolio.

Kevin Jones

Other post concerning Paula’s situation are available by searching for “Wriedt” in the field below.

Mental support research

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.”

Sexual harassment and occupational health and safety

Some old-time safety professionals are struggling with the inclusion of psychosocial hazards in their safety management programs. Some deny the relevance of sexual harassment to their duties and hope that the issue can be contained within the human resources department, the “dark arts” of workplace safety.

Many of these same safety professionals are calling for more evidence-based decisions on workplace safety.

Evidence is now in on the social and work impact of sexual harassment. Australia’s Human Rights Commission has issued Effectively preventing and responding to sexual harassment: A Code of Practice for employers‘ which states on page 48

Employers have a common law duty to take reasonable care for the health and safety of their employees. This common law duty is reinforced by occupational health and safety legislation in all Australian jurisdictions.

An employer can be liable for foreseeable injuries which could have been prevented by taking the necessary precautions. As there is considerable evidence documenting the extent and effects of sexual harassment in the workplace, it has been argued that the duty to take reasonable care imposes a positive obligation on employers to reduce the risk of it occurring.

A work environment in which an employee is subject to unwanted sexual advances, unwelcome requests for sexual favours, other unwelcome conduct of a sexual nature, or forms of sex-based harassment, is not one in which an employer has taken reasonable care for the health and safety of its employees. A work environment or a system of work that gives rise to this type of conduct is not a healthy and safe work environment or system of work. An employer could be regarded as not having acted reasonably to prevent a foreseeable risk if practicable precautions are not taken to eliminate or minimize sexual harassment in the workplace.

Failure to fulfil the duty of care can amount to a breach of the employment contract as well as negligence on the part of the employer. This means that an employee who has been harmed could bring an action against their employer in contract or tort.

The guide can do with considerable translation to what businesses see as useful codes of practice in the application of safety management but perhaps that is for the private sector and State OHS regulators to work on.

There seems to be enough information available now on sexual harassment, fatigue, bullying, violence, fitness for work, shift work, depression and other matters, that the safety profession should be more embracing of these concepts in their own planning. Let’s hope that in this discipline we do not have to wait for generational change to achieve a change in approach.

Important victory for aircraft maintenance workers

The Department of Veterans’ Affairs may have to pay compensation to the maintenance crews of F-111 fighter planes. In the 1970s employees worked within the fuel tanks of the fighters with little, if any, PPE. In 2004 these workers were excluded from a healthcare and compensation scheme even though, according to one media report, evidence was presented that the workers had

a 50% increased risk of cancer
a two-fold increase in obstructive lung disease;
a two-and-a-half fold increase in sexual dysfunction; and
a two-fold increase in anxiety and depression.

One of the reasons the maintenance crews were denied compensation was that the Royal Australian Air Force (RAAF) had destroyed the maintenance records from before 1992.

An inquiry into the affair has received a submission from the commonwealth Ombudsman, John McMillan, and Labor MP, Arch Bevis, that strongly criticised the destruction and inadequacy of records.

In safety management, record-keeping is often seen, and dismissed, as “red tape”. The reduction of red tape is not the elimination of red tape and the reality of Australia’s increasing litigious legal system is that more records need to be kept, and for longer, than ever before.

Perhaps, the government, in its pledge to reduce red tape and business costs, should look at the lawyers’ insistence to business that the first port-of-call after an industrial incident is to call them so that everything becomes covered by legal-client privilege.

Perhaps it is the pressure to create paperwork than the paperwork itself that is the problem. In the case of the F-111 maintenance crews, regardless of the lack of paperwork, justice seems to be happening. It is just sad that so much pain and suffering had to be endured before getting close to a resolution.

Click HERE for a personal reflection on the health issues of the workers from one of Australian Rugby League’s champions, Tommy Raudonikis.

Category: depression

Mental Illness and Workplace Safety

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Happiness is a warm million

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Chronic disease report

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A sort-of resolution for Paula Wriedt

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Mental support research

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Sexual harassment and occupational health and safety

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Important victory for aircraft maintenance workers

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