Category: psychiatric

“Getting back on the (trauma) horse”

Mental health in the workplace is one of those recent manifestations of psychosocial hazards.  It continues to evolve and during this process one is never quite sure where the best and most relevant information can be obtained.

Cnfusion for the safety professional can come from new, slightly off-topic, issues that can skew the public perception and understanding of exactly what it is one is trying to manage.

Is it reasonable to take inspiration (if that is the right term) from studies of Iraq War sufferers of post traumatic stress syndrome in providing clues to handling mental health issues at work?  

During tertiary risk management courses the debt owed to the armed forces and their planning processes is acknowledged but soldiers operate in a unique culture of accountability, clearly defined duties and a rigid hierarchical structure.  In most circumstances only the broadest of concepts could be translated to the real (non-militarised) workplace.  In a similar way studies of Scandinavian workforce management are interesting but are highly unlikley to be transferable outside the cultural geography.

A very recent example of this problem of getting excited about innovation and then wondering about its genuine applicability, can be seen in the TV show, Catalyst, (video available online for a short time) broadcast by the Australian Broadcasting Corporation on 16 April 2009.  

The program provides a profile on a computer simulation program that purports to aid the rehabilitation of war veterans by returning them to traumatic events of the war zone.  It seems that the theory is the same as “getting back on the horse that threw you”.

In OHS terms, the applicability for firefighters, emergency response personnel etc is obvious but SafetyAtWorkBlog has reservations.  The use of video simulations and games by the armed services before, during and after combat is discomforting.  

Managers and health care professionals may need to carry some of the responsibility for the cloudiness of mental health and trauma by applying the hyperbole of trauma to relatively benign workplace issues.  Many elements of work are being described as traumatic when they are not.  They maybe disturbing, disconcerting or even harmful but there is a big difference between being punched in the face by a psych patient and driving over a car of civilians in an armoured vehicle.

In other industry sectors, such hyperbole would be described as spin.  It is the responsibility of OHS professionals to cut through the spin and not be distracted by “exciting”, but indirect, innovative solutions.  Let’s look for the evidence and operate from what we know works.  At least until new evidence appears.

Kevin Jones

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.)

OHS context of leave entitlements

Family-friendly work initiatives always get increased attention around International Women’s Day.  This is a shame as work/life balance is not gender specific, however the dominant Western family structures make the application of the concept relative to gender.  As long as the matter is perceived as a “women’s issue”, it will struggle for attention in a basically patriarchal society.

Family-friendly work structures are predominantly associated with hours of work and leave entitlements.  These don’t seem to be OHS matters as they are mostly handled through HR or the pay department however there is a link and it is a link that work/life and work/family advocates may use as a strong argument for their cause.

Leave is a worker entitlement for several reasons:

  • Situations may occur where the employee is required to stay home to look after an ill relative;
  • The employee may stay home as they are too sick to work; and
  • The employee may feel they need time away from work to rebalance their lives.

The second point has an OHS relevance because going to work while sick may introduce a hazard to your work colleagues – presenteeism.  In many jurisdictions it is a breach of an employee’s OHS legislative obligations to not generate hazards for their work colleagues or members of the public while at work.

The third point relates to an individual’s management of stress and/or fatigue.

In Australia, some workplaces allow for “doona days” (or for those in the Northern hemisphere’s winter at the moment “duvet days”).  These are days where a workplace and the employee would benefit psychologically from some time-out in order to “reboot”.

It may also be a valid fatigue management mechanism where long hours have been worked to the extent where attending the workplace may present hazards to others, or to themselves by feeling impaired, or have the employee working well below the appropriate level of attentiveness for the job to be properly done.

Leave entitlements, to some extent, form part of the employer’s legislative obligations to have a safe and healthy work environment.  But they also support the worker’s obligations to look after themselves and not present hazards to others.

The OHS element of leave entitlements should be emphasized when discussions of family-friendly workplaces occur.  Not only does it legitimately raise the profile of OHS in business planning, it can add some moral weight to an issue that can get bogged down in industrial relations.

Some readers may want to check out recent presentations to the US Senate in early-March 2009, by various people on the issue of family-friendly work structure.  These include

Eileen Appelbaum, Director of the Center for Women and Work at Rutgers University,

Dr Heather Boushey, Senior Economist at the Center for American Progress Action Fund,

Rebia Mixon Clay, a home health care worker who cares for her brother in Chicago. (Rebia’s video is below)

Kevin Jones

Cancer fears in Tasmanian school

Over recent years Australia has had its share of cancer cluster fears, most of which have not had a cause identified.  Cancer clusters are one of the most difficult workplace hazards to manage for several reasons:

  • Worker’s fear for their health;
  • Management fears for its staff;
  • Some management worry about the related business costs;
  • Clusters can generate considerable media coverage; and
  • Noone knows what’s really going on.

An August 2008 case appeared in Tasmania and, therefore, got almost no coverage in other States, even though it occurred in a media-friendly venue, a school.  The experts say that the incident is not technically a “cancer cluster” however semantics is the least of the worries for the participants and, in terms of safety management (and the management of any “outrage”), the differentiation is irrelevant.

In early March 2009, the investigation was completed and, sadly, no cause was identified.  In 3 March, the Director of Public Health,  Dr Roscoe Taylor, issued a media statement.

The investigation concerned the potential risks from electro-magnetic radiation from nearby power lines.

Dr Taylor found there was no statistical significance in the cancer rates of employees who had worked at the school

“Taking into account the lack of identifiable hazards, as well as the very small population we are dealing with, the most probable explanation for the numbers of cancers appears to be chance variation,” said Dr Taylor. 

“This was a rigorous and thorough investigation and while we probably can’t provide staff with the absolute assurances and certainty they would have been looking for, I think the results of the analysis mean we can be fairly confident that there has been no serious threat to public or occupational health at the school.

More details and Frequently Asked Questions are available.  A particularly useful factsheet on clusters is available HERE.

The Australian Broadcasting Corporation’s Health Report has an excellent podcast available in which cancer clusters in workplaces are discussed.

Kevin Jones

Is there a Mars safety and a Venus safety?

A research paper released last month in Germany caught my attention even though it does not relate directly to research undertaken in a work environment.  

There seems to be an established train of thought that men and women choose to take risks based on some sort of gender criteria.

Alison L. Booth and  Patrick J. Nolen have published “Gender Differences in Risk Behaviour: Does Nurture Matter?”  They researched risk behaviour along gender lines in secondary education, a different sample choice to other researchers who mostly looked at their university students.  Booth and Nolen found

“…gender differences in preferences for risk-taking are sensitive to the gender mix of the experimental group, with girls being more likely to choose risky outcomes when assigned to all-girl groups.  This suggests that observed gender differences in behaviour under uncertainty found in previous studies might reflect social learning rather than inherent gender traits.”

Gender studies are fraught with ideological baggage and it is a brave person who chooses this line of study, as I learnt through studying sociology and Russian literature at university (but that’s another story).

The full report is heavy going for those with no sociology background but the research flags an issue that could be useful to pose to the growing band of workplace psychologists and culture gurus – what are the gender-based variations in unsafe behaviours in the workplace?

Could the available research mean different safety management approaches in workplaces with different gender mixes?  

When people talk about workplace culture, could there be a male culture and a female culture?  (We certainly refer to a macho culture in some industries)  In other words, is there a Mars safety and a Venus safety?

Workplace safety tries hard to be generic but has variations based on industry types.  Perhaps we should be looking more closely at the demographics of these types and varying our safety management approaches?

Kevin Jones

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.

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