Category: psychiatric

Dipping into workplace violence

Jeff Sparrow recently gained considerable media attention with his book that reflected on violence in society.  Yossi Berger once described occupational health and safety as a “kind of violence” in his book of that title.  There is a lot of research  into occupational violence, much of it from the United States which, to some extent, has an unrepresentative view of this hazard.

An interesting, and brief, discussion on the matter is a chapter in the book “Perspectives on Violent and Violent Death” published by Baywood Publishing.  The existential perspective of one particular chapter may make it impractical for safety management purposes but as a background article for provoking thought, it is very good.

Without this chapter I would not have found the work of C E Newhill* into client violence in social work or that of C L Charles.  Charles identified some factors that have contributed to the “anger epidemic” which may provide some clues on understanding occupational violence.   These are listed below:

Stress management may be only a chocolate cake away

Safety professionals often struggle to manage stress in their employees and themselves but new research has found links between the consumption of chocolate and a reduction in stress.

The study in the Journal of Proteome Research entitled “Metabolic Effects of Dark Chocolate Consumption on Energy, Gut Microbiota, and Stress-Related Metabolism in Free-Living Subjects” Continue reading “Stress management may be only a chocolate cake away”

Prevention of depression is better than treatment

Depression as an occupational illness is one of the most difficult hazards faced by managers and safety professionals.  Depression is hard to understand and it is often difficult to recognise an employee who suffers from the condition, let alone, figuring out how the workplace may contribute to the illness.

[Mental health issues are going to receive increased attention in Australia following the naming of the Australian of the Year, Professor Patrick McGorry.]

A recent article in Journal of Occupational & Environmental Medicine reports on a study that looked at “the relationship between antidepressant treatment and productivity costs”. Continue reading “Prevention of depression is better than treatment”

Self development course contributes to a workplace suicide

What would you do if a work colleague strips, screams, acts “like a child having a tantrum”, starts to sing and then jumps out of a window to her death?  That is the situation that was faced by staff at the Sydney office of the Royal Australasian College of Physicians in December 2005.

Only days earlier, 34-year-old Rebekah Lawrence, had participated in a self-development course called “The Turning Point” conducted by Zoeros P/L trading as People KnowHow.  The course, according to one media report, the course included a session called “The Inner Child”

“in which those taking part were encouraged to develop a dialogue between their child and adult selves.”

Lawrence’s actions just before her death mirrored some of the course teaching.

PeopleKnowHow’s website has closed down with an announcement that all of its courses are under review.  Other organisations that provide similar courses are running for cover.  Transformational Learning Australia has said it

“…no longer has a professional relationship, affiliation or any other connection with People Knowhow.” [emphasis added]

TLA also says any relationship ended in 2005.  That the company has felt it necessary to make a media statement about the end of the relationship shows the extent of the effect of Rebekah Lawrence’s death on this industry sector.

TLA goes on to say that

Our organisation does not accept participants who have a recent history of chronic mental illness, participants under the care of a treating professional who have not obtained that professional’s consent to participate, or people who demonstrate a propensity towards psychological fragility or a significant lack of cohesion during the introductory sessions of the program.”

The New South Wales Coroner found that in the absence of any history of psychosis in Rebekah Lawrence that,

The evidence is overwhelming that the act of stepping out of a window to her death was the tragic culmination of a developing psychosis that had its origins in a self-development course known as ‘The Turning Point’ conducted by Zoeros Pty. Ltd, trading under the name of ‘People Know-How” on the 14, 16, 17 and 18 December 2005.

The full coronial findings are difficult to read due to the personal details of Lawrence’s life, her relationship with her husband David and the general picture of her personality that comes through.   An upsetting and enlightening interview with David Booth is available online from earlier in the investigation process.

The findings also provide considerable detail to the components of the course that Lawrence undertook.  There is a greater level of detail than would be expected to be known by someone signing up for such a course and this is where the lessons can be learnt for the OHS professional and safety manager.

It has become common in many corporations who are trying to improve or introduce a positive workplace culture, to supplement their own efforts with “self-help” or “self-awareness” courses.  Lawrence’s death has highlighted the lack of regulation or accountability in some sectors of this industry.  This also highlights the need for people managers to thoroughly investigate such courses to ensure that good intentions are not likely to increase the risk of harm or damage to the employees who participate.

An audio report on the Coroner’s findings is available online.

Counselling Services

Many workplaces often provide access to counselling services through schemes such as Employment Assistance Programs.  The Coroner’s recommendations have some direct bearing on the issue of “counsellors”.

“The Executive Director of the Australian Psychological Society, Professor Lynne Littlefield pointed out that there are no legal restrictions in Australia for practising under the title ‘psychotherapist’ or under the title ‘counsellor’ and therefore no public safeguards against untrained or incompetent practitioners in this field.

Professor Littlefield pointed out that although there were many skilled counsellors and psychotherapists, there were also many whose competence is questionable and without any regulating mechanisms to stipulate the required training and levels of competence, there was no way of protecting the public from these poorly trained practitioners.”

Rebekah Lawrence’s death is receiving considerable media coverage in Australia at the moment and the New South Wales Government is carefully considering the Coroner’s recommendations concerning the regulation of some areas of the self-development industry.  Employers and safety professionals are going to have a very different set of criteria shortly from which such workplace-related courses need to be evaluated.

One media report has indicated the start of the ramifications of this unfortunate death:

“The NSW Health Minister, Carmel Tebbutt, said she had asked her department for ”urgent advice” on the case and would consider the coroner’s recommendations. A code of conduct for counsellors and psychologists had already been implemented and the Health Care Complaints Commission now monitored practitioners.

The Royal Australian and New Zealand College of Psychiatrists called for closer monitoring and accountability of self-help and psychotherapeutic courses.”

Kevin Jones

A good book of safety solutions case studies

Australia has many safety awards programs.  SafetyAtWorkBlog has reported on some of the practical solutions from the awards and lamented how the prominence of such solutions fades quickly as the mainstream media ignores them.  The blog has also shown examples of a hard copy solutions database that existed in Victoria and Australia for a couple of decades.

The European Union’s Agency for Safety and Health at Work has recently released, online, a publication in support of its risk assessment campaign that shows how safety solutions can be presented and shared without worrying about commercial-in-confidence or intellectual property.

Jukka Takala, Director of EU-OSHA, says in his foreword

“This report supports the campaign by providing information on successful interventions in the workplace illustrating how the hazards identified after a risk assessment can be eliminated or controlled. The report is aimed at those who are responsible for carrying out risk assessments in the workplace and for preparing decisions on risk elimination or control measures.”

The report, “Assessment, elimination and substantial reduction of occupational risks“, also provides a list of some very useful elements for preventative safety

“The employer shall implement the measures (necessary for the safety and health protection of workers) on the basis of the following general principles of prevention:

(a) avoiding risks;
(b) evaluating the risks which cannot be avoided;
(c) combating the risks at source;
(d) adapting the work to the individual;
(e) adapting to technical progress;
(f) replacing the dangerous by the non-dangerous or the less dangerous;
(g) developing a coherent overall prevention policy;
(h) giving collective protective measures priority over individual protective measures;
(i) giving appropriate instructions to the workers”

The report is very useful in its clarification of the role and potential benefits of risk assessment.  Each solution is described, in detail, as a case study and the report includes guarding issues, manual handling and psychosocial hazards.  On the latter category, here is the summary for psychosocial hazards in hospitals

“Stress in hospitals – assessment of psychosocial and physical risks

Hospital work is known to be physically and psychologically demanding.  A pilot project was therefore set up in a hospital with 470 employees to assess workplace risks and organisational aspects.  The workers were exposed to physical strain, risks from chemical and biological agents and psychosocial strain.  They were also stressed by administrative tasks. After the assessment the results were analysed, action plans drawn up and measures implemented.  Risk assessment became a standard part of quality and health management systems, including training.”

One of the particularly interesting element in this program was that one of the first sources of information it used was quality management documentation.  Quality management is one of the most under-utilised sources of OHS and strategic planning data.  As long as quality managers do not perceive quality as a business element above that of safety, environment or any other, as long as they accept that each element is of equal importance in integration of management system, the quality data will be indispensable.

The quality data is followed up by interviews with middle- or line managers, questionnaires and observations.

Of all of the control measures, this organisational change was very clever:

“The administrative tasks, in particular, were perceived by the nurses to be distracting and onerous.  They felt that paperwork kept them away from important care work.  Consequently, administrative tasks were delegated to the night shifts, where there was more time to devote to them as the amount of care work fell at night.”

This looked at workload in a peak/off-peak context that fits with the natural rhythm of the clients.  The paperwork night-shift may be a suitable solution for other workplaces and the night-shift workers may have increased productivity due to the lack of distractions.

EU-OSHA keeps producing reports and publications that call out for a broader readership than Europe and this is a great example.

Kevin Jones

Leadership – research, mental health and what true leadership is.

Scandinavia produces some of the best research into OHS issues.  However, due to the social structure of Scandinavian countries, the research has little direct and practical application outside the region.  The research is best taken conceptually as it will need to be evaluated closely to determine local applicability.

(TIP: whenever an OHS researcher says “recent Scandinavian studies show….” remind the researcher which country they are in and ask them to explain the practical application in the local context)

In early 2009, there was a bit of media attention about research that found, according to researcher Anna Nyberg

“Enhancing managers’ skills – regarding providing employees with information, support, power in relation to responsibilities, clarity in expectations, and feedback – could have important stress-reducing effects on employees and enhance the health at workplaces.”

In October 2009 Anna Nyberg’s thesis on the issue was released.  According to the abstract to her thesis

“The overall aim of this thesis was to explore the relationship between managerial leadership on the one hand and stress, health, and other health related outcomes among employees on the other.”

Nyberg’s thesis details the needs for some adjustments in the research to allow for “staff category, labour market sector, job insecurity, marital status, satisfaction with life in general, and biological risk factors for cardiovascular disease.”  These adjustments are important to remember when reading any of the media statements about Nyberg’s research.

There were five studies within the thesis and, according to the abstract, they found the following:

“Attentive managerial leadership was found to be significantly related to the employees’ perceived stress, age-adjusted self-rated health and sickness absence due to overstrain or fatigue in a multi-national company.”

“Autocratic and Malevolent leadership [in Sweden, Poland, and Italy] aggregated to the organizational level were found to be related to poorer individual ratings of vitality…. Self-centred leadership … was related to poor employee mental health, vitality, and behavioural stress after these adjustments.”

“… significant associations in the expected directions between Inspirational leadership, Autocratic leadership, Integrity, and Team-integrating leadership on the one hand and self-reported sickness absence among employees on the other in SLOSH, a nationally representative sample of the Swedish working population.”

“… significant associations were found between Dictatorial leadership and lack of Positive leadership on the one hand, and long-lasting stress, emotional exhaustion, deteriorated SRH [self-reported general health], and the risk of leaving the workplace due to poor health or for unemployment on the other hand.”

“In the fifth study…a dose-response relationship between positive aspects of managerial leadership and a lower incidence of hard end-point ischemic heart disease among employees was observed.”

But what can be done about the negative affects of poor leadership on health, safety and wellbeing?  The thesis is unclear on this, other than identifying pathways for further research in this area.

The SafetyAtWorkBlog  recommendations, based on our experience, are below

  • Carefully assess any training provider or business adviser who offers leadership training.
  • Ask for evidence of successful results in the improvement of worker health and wellbeing, not just a list of client recommendations.
  • Look beyond the MBA in selecting senior executives.  If you expect executives to establish and foster a positive workplace culture, they need to have to be able to understand people as well as balance sheets.
  • Remember that the issue of leadership as a management skill is still being investigated, researched and refined.  It is not a mature science and may never be, so do not rely solely on these skills.
  • Some say that leadership cannot be taught and cannot be learned.  Some say that leadership, as spruiked currently, is not leadership, only good management.  Leadership only appears in times of crisis and manifests in response to critical need, not in response to day-to-day matters.

This last point needs a reference – page xiii of “Seventh Journey” by Earl de Blonville

“… leadership cannot be taught.  If it is being taught, it may just be management, rebadged at a higher price.  The second discovery was that leadership is not about the leader, which will confound those with a needy ego.  There were two more things that revealed themselves to me: leadership is all about paradox, which is why it resists attempts to tame it into a curriculum, and at its core leadership is lonely, requiring the strength that could only come from a grasp of its intrinsic paradox.”

Kevin Jones

Annual holidays get a TV makeover

Regardless of concerns over the veracity of data, Tourism Australia’s “No Leave, No Life” campaign is continuing to develop its media presence.

The Seven Network announced this week that “No Leave, No Life” will form the basis of a television program to be broadcast from 5 December 2009.  As is the nature of TV shows, when a new successful format is found, it can travel around the world. So, be warned.

The rationale of the “No Leave, No Life” tourism campaign is that employees hold on to their annual leave entitlements and amass many weeks’ leave.  The employer groups have supported this campaign, principally, because this reduces the salary reserves each company must carry to cover the entitlements.Individually, employees can convince themselves that they are indispensable.  The risk, from the workplace safety perspective, is that the individual is not accessing the mental health and stress relief that can come from being away from a workplace for several weeks.

Having no break from work mode can unbalance one’s life and put considerable strain on personal and family relationships.  Just like adequate sleep can have productivity benefits, so can taking annual leave on a regular basis

There is also the organisational benefit that can come from breaking the routine.  Just as individuals may come to believe they are indispensable, so an organisation can come to rely too heavily on individuals.  A healthy corporate system should be able to cope with the absence of any staff member or executive for a short period of time (the period of annual leave).

Business continuity would dictate that a business can continue without key people permanently.  Coping without these people for a short period each year can be considered a trial run of continuity.

In relation to the new television program the Seven Network advised SafetyAtWorkBlog that each episode is structured around the removal of a worker who has a large amount of annual leave from their workplace for a holiday within Australia (hence the Tourism Australia support).  The viewer appeal, other than watching someone else have a good time, is that a comedian is used to fill the role of the holidaying staff members.  The show is likely to illustrate several points – no one is indispensable, a regular holiday is an important individual activity, and, although not indispensable, the employee and their effort is valued by the organisation.

The show will follow people from these occupations:

  • a paediatric nurse in a cardiac ward;
  • a sales manager in a brewery
  • an ambulance paramedic; and
  • a charity events manager.

The OHS role and benefits of regular leave are not as overt in the program as they could be but that is not he purpose of the program.  It is clearly a program that would not have existed without the Tourism Australia campaign.  It has been designed to encourage Australians to take holidays and to holiday within Australia.

It is hoped that if and when people return to work refreshed they may realise how important regular leave is to their own wellbeing and mental health but having stress management or career burnout as a motivation for the employees themselves to take leave would have been more instructional.

Of course, it should be pointed out that businesses are doing themselves no good by allowing for the accumulation of excessive leave in the first place.  In fact, it could be argued that by not enforcing the taking of leave the companies are increasing the stress of their employees and contributing to the social dysfunction that can result from such a work.life imbalance.

Kevin Jones

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