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.”

 

Workplace Choirs

As workplaces approach the winter break or Christmas, there will be in increase in communal singing.  One Australian has started to establish workplace choirs

Tania de Jong makes some good arguments about the benefits of greater worker contact and understanding through communal singing.  It sounds logical and I am sure there is evidence to show positive benefits,  just as there is to show the stress management benefits of laughing.

There are parallels everywhere with this not-wholly-original concept and one I am reminded of is the Fortune Battle of the Corporate Bands.  (Maybe the economic downturn will cause an increase in trios and duets)

I foresee lots of niggly problems such as the singing of religious songs during Christmas, and singing ironic songs that obliquely criticise corporate strategies and performances.  I can think of many and ask that SafetyAtWorkBlog readers suggest others through comments below.

Suggestions already include

Money, Money, Money – ABBA

I Wanna Be a Boss – Stan Ridgway

Nine to Five – Dolly Parton

 

Kevin Jones

“Pilgrim’s Plague” and workplace absenteeism

 Last year, Sydney Australia hosted World Youth Day (WYD).  In some ways Australia had not seen such a large influx of people from so many countries for a single event before.  The Sydney Olympics had a high proportion of locals attending and the 1956 Melbourne Olympics never had the infrastructure to provide so many overseas visitors.

For several months after the 2008 World Youth Day, it was rumoured that the level of absenteeism in workplaces was very high.  At the time of WYD there were several reports of quarantined pilgrims and the risk to public health of the Sydney population was assessed. (Peter Curson, professor of population and security in the Centre for International Security Studies at the University of Sydney wrote a discussion piece on this)

There were reports of influenza and viral gastroenteritis amongst pilgrims who were required to be quarantined.

The Medical Journal of Australia has released a report into the impact of World Youth Day on the emergency departments of hospitals (MJA 2008; 189 (11/12): 630-632).  This study found minimal impact in this sector of the hospital care.

However, SafetyAtWorkBlog is not aware of any research having been done on the impact of  World Youth Day on workplace absenteeism.  The EMJA study correlates World Youth Day with hospital admissions but it would be useful to see a comparative study of workplace absenteeism in the weeks after WYD, during the incubation period of influenza in particular.

World Youth Day did seem to overlap with the existing flu season in Australia’s winter but those statistical peaks are well-established and it would be interesting to see if those peaks had increased just after World Youth Day.

If there were a correlation, cost estimates for hosting the event may need adjusting to include the reduced productivity due to the “pilgrim’s plague”.


Physical activity, mental health, alcohol consumption and productivity

The Victorian Government’s workplace health strategy may be “coughing up blood” but health promotion continues.  Last week, Australian health insurer, Medibank Private, released some statistics and cost estimates related to physical inactivity.

According to the media release, physical inactivity costing the Australian economy $13.8 billion a year. The findings are based on research conducted in conjunction with KPMG-Econtech which builds on Medibank’s 2007 research and “captures the healthcare costs, economy wide productivity costs, and the mortality costs of individuals passing away prematurely as a result of physical inactivity.”

Craig Bosworth of Medibank Private says, 

“Most Australians are aware of the benefits of physical activity but this latest round of Medibank research has revealed some alarming effects of physical inactivity. An estimated 16,179 people die prematurely each year due to conditions and diseases attributable to physical inactivity and that is frightening. And whilst the majority of these are from the older population there is also a large number of people dying under 74 years of age due to physical inactivity, particularly in the male population.”

Bosworth goes on to say:

“Like other health risk factors, physical inactivity can have an adverse effect on organisations as well as individuals. Specifically, physical inactivity can impact on employee productivity by causing increased absenteeism and presenteeism, which impose direct economic costs on employers. The Medibank research has found that productivity loss due to physical inactivity equates to 1.8 working days per worker per year.”

Three audio statements on this research are available – physical-inactivity-telephone-grabs-edit

The SuperFriend Industry Funds Forum Mental Health Foundation has also released statistics on mental health in the workplace. The survey also found that 50 per cent of Australians admit to often feeling stressed and a quarter often feel depressed. 

John Mendoza, Chair of SuperFriend’s Mental Health Reference Group, said, “There is increasing evidence of a link between stress in the workplace and mental illness. The cost of workplace stress to Australian business is potentially crippling.” Listen – workplace-mental-health-edit

The Superfriends survey found

StreetWise
StreetWise
  • One in two Australians believe that having a few drinks is a good way to maintain or improve their mental health;
  • 80 per cent of Australians believe watching TV has a positive impact on their mental health;
  • Australians are putting their bodies ahead of their brains, with three-quarters of Australians engaged in activity to maintain or improve their physical health, while only 50 per cent are actively engaging in activity to maintain or improve their mental health.
  • Older Australians are more likely to heed the call ‘use it or lose it’. While 57 per cent of all Australians feel they take good care of their mental health, 68 per cent of those over 50 feel they are looking after themselves emotionally.
  • Australians aged 40 to 49 are the unhappiest and unhealthiest. Those in this age group are more likely to feel stressed and depressed and less likely to look after their physical and mental health.

A good starting point in planning to manage stress is the StressWise publication by WorkSafe Victoria.

For many decades, perhaps centuries, unhappiness at work was countered, to varying degrees, through the consumption of alcohol.  According to the latest Australian Unity Wellbeing Index people who drink everyday are the happiest, whereas non-drinkers have a lower sense of wellbeing.

Amanda Hagan of Australian Unity summarises some of the research findings and supports the link between physical activity and positive wellbeing. Listen – australian-unity-wellbeing-index-aap-medianet-edit

WorkHealth – end is nigh after less than one year

Early in 2008, the Victorian Government sprung a surprise on the OHS and health promotion industries by announcing a world-first initiative – WorkHealth.  This program was to be funded by interest generated from the WorkCover scheme to the tune of hundreds of millions of dollars over the next five years.

WorkHealth loses stakeholder support

Two weeks ago, a well-respected OHS professional advised that key stakeholders in WorkHealth were very cool on the program.  This confirmed previous questions raised in SafetyAtWorkBlog about the promotion, transparency and organisational support for WorkHealth.  The professional stated that others were questioning the placement of WorkHealth in the OHS field rather than in health promotion.

Rumour has existed for some months that WorkHealth is a scheme that has been pushed by a narrow range of OHS and workers compensation advocates.

What made WorkHealth so interesting was that the concept originated from within the workers compensation field with workers compensation money.  At the time, the wisdom of committing such a large amount of money to the initiative was questioned by many in the trade union and business areas.  Why head in this direction when there were established mechanisms to reduce OHS and workers compensation costs?

The global economic problems, it is suspected, would have flowed to the investments of the WorkCover scheme and it would be interesting to know what the revenue allocation to WorkHealth now is calculated at.

OHS/Industrial Relations conflict

In The Age newspaper on 26 October 2008, WorkHealth gained some attention as business groups have now seen the criteria for the health assessments of workers.  David Gregory of the Victorian Employers’ Chamber of Commerce and Industry described the criteria as a potential “industrial weapon”.  According to the article,

“WorkSafe told The Age the idea of an initial ‘tick test’ screening process had been abandoned, and the proposed $130 million worth of prevention programs are not in the pilot at all.”

As is evident from the quote, it is the pilot scheme that is being rolled out, however it is clear from the comments of David Gregory and the state secretary of the Australian Manufacturing Workers’ Union, Steve Dargavel that industrial relations sensitivities have not been considered.

Gregory makes excellent points that good OHS professionals are already aware of – workplace safety can only succeed when industrial relations implications and conditions are considered before any intervention process.

OHS has broadened to include the hazards of fatigue, stress, anxiety, depression, workloads, bullying and other matters that have encroached on health promotion and human resources over the last decade or so.  A worker health program would have been more likely to be accepted through this osmosis rather than a surprise announcement.

Is this the end?

WorkHealth could work if it had been generated as a workplace application of public health programs.  The challenge would have been to legitimise the expenditure in an already cluttered health promotion sector.  How would WorkHealth have achieved this testing regime when business is already assessing its workers for psychological disorders, cholesterol, prostate health, hearing, asthma, and a whole range of modern health issues?  It is unlikely that it could so.

It came down to health assessments in a different context – a context where there had been insufficient groundwork to establish the value of the program to its fundamental stakeholders, the unions and employer groups.  To a much lesser extent, the program was not sufficiently integrated into the WorkSafe authority’s program before the announcement.

Also, the timing has been proven to be wrong.  The global economic problems are beginning to squeeze business’ bottom line.  The calls for workers’ compensation premium relief will increase in the same way that businesses have begun questioning the viability of an emissions trading scheme.  WorkHealth is likely to be one of those program cut, so the government will claim, due to the changing economic climate.  The lessons to be learnt are more wide-ranging than just economics.

New presenteeism survey figures

Frequently I receive audio media releases from the US about a range of workplace safety matters.  These releases are scripted and can sometimes sound corny but within them is a usually a useful nugget of information.

The latest one I received concerns presenteeism and mental health so, being so close to World Mental Health Day, I thought it is worth mentioning.  The audio release is from Cigna Health Care, an American insurance company, and can be heard by clicking 35580_09ny08-0039-_cigna-w

Cigna has a couple of fact sheets in support of the survey findings and an article specifically concerning mental health and wellness which may be worth a look. 

An earlier posting on presenteeism is available and I recommend going to the World Health Organisation, UN or ILO sites for more independent information.

When managing stress, are safety managers looking at the wrong thing?

Today is World Mental Health Day and the media, at least in Australia, is inundated with comments and articles on mental health.  This morning, Jeff Kennett, a director of beyondblue, spoke on ABC Radio about the increasing levels of anxiety that people are feeling in these turbulent economic times.  Throughout the 5 minute interview, Kennett never once mentioned stress.  This omission seemed odd as, in the workplace safety field, stress is often seen as the biggest psychosocial hazard faced in the workplace.

SafetyAtWorkBlog spoke with Clare Shann, the senior project manager with beyondblue’s Workplace Program, about the role of stress in the workplace and its relation to mental health.  She clarified that stress is not a medical condition but a potential contributor to developing a mental illness, such as anxiety disorders or depression.

To put the situation into context, there is a fascinating interview with a Darren Dorey of Warrnambool in Victoria.  The 20 minute interview was conducted on  a regional ABC Radio station on 9 October, and describes the personal experience of depression and anxiety that stems, to some extent, from work.

It seems that in trying to manage stress, OHS professionals may be focusing on the wrong element in worker health.  Perhaps what are considered workers compensation claims for stress should be re–categorised as claims for mental illness.  This may result in a better acceptance of the existence of this workplace hazard.

An exclusive interview with Clare Shann can be heard clare_shann_mental_health

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