Job Stress, or Psychological Injury?

Vince Scopelliti - Wednesday, October 03, 2018

Being aware of job stress, and proactive about its potential effect on staff and their ongoing mental health, is an important component of ensuring employee satisfaction and OHS in any business. 

But it is crucial not to confuse job stress with a psychological injury, which may or may not have been caused by the work environment. 

the difference between the two

A psychological or mental disorder includes a range of cognitive, emotional and behavioural symptoms which ultimately interfere with an employee's functioning and can significantly affect how they feel, think, behave and interact with others. 

This is to be contrasted with job 'stress', which can be better described by referring to physical and emotional symptoms arising in work situations. 

For example, an employee who is experiencing conflict with their manager and feels mildly apprehensive about working shifts with the manager, including feeling physical symptoms such as a slightly increased heart rate or perhaps perspiration, is likely to be suffering from job stress. 

An employee who has sustained a psychological injury may well experience 'stronger' symptoms more commonly associated with a diagnosis of anxiety or post-traumatic stress disorder arising from their interactions with their manager. 

Examples of psychological disorders

Psychological disorders can generally be grouped into three types: mood disorders (such as depression or bipolar disorder), anxiety disorders (including anxiety and post-traumatic stress disorder), and psychotic disorders (such as schizophrenia or borderline personality disorder). 

There is a wide spectrum according to which the severity of any condition can be assessed, and simply because an employee has been diagnosed with a condition that is generally perceived to be 'serious', such as schizophrenia, this certainly does not preclude them from being fully functioning members of your team. 

early signs and symptoms of psychological disorders

It goes without saying that the signs and symptoms of a psychological disorder differ depending on the type of injury. Although far from an exhaustive list, some symptoms could include:

  • Depression: significant changes in behaviour including difficulty concentrating, drinking more alcohol as a means of self-medicating, lack of energy, finding it difficult to manage tasks which were previously easily handled, increased absenteeism. 
  • Bipolar disorder: extraordinary levels of energy, dramatic change in personality in the workplace, struggling to meet reasonable deadlines, and symptoms of depression (when the employee is 'down')
  • Anxiety disorders: unusual irritability, anxiety attacks, excessive worrying about workload or specific tasks.
  • Schizophrenia: demonstrated suspicion of co-workers, 'odd' ideas or erratic behaviours, talking to themselves. 

Tactful and considered interventions are encouraged in circumstances where employers, managers or HR initially begin to notice signs of distress or job stress.

Although intervention and assisting an employee in seeking professional assistance can in some cases possibly prevent symptoms from deteriorating, and the employee from developing a full psychological illness, this should only be undertaken by qualified and sympathetic staff. Care also needs to be taken to maintain the privacy of the employee at all stages of the intervention process. 

how is a psychological injury diagnosed?

Only an appropriately licensed medical practitioner, such as a psychiatrist, psychologist or general practitioner should diagnose a psychological injury. It is anticipated that, if required, this medical practitioner will either prescribe appropriate therapy, pharmaceutical relief or both. Further, that practitioner should also conduct a 'capacity for work' assessment, if this is required before the employee is able to return to their usual duties. 

With appropriate support, even employees with significant psychological injuries or disorders should be able to continue working. Of course, this will require support from the employer in ensuring that potential 'triggers' are avoided as much as possible. 

Key determinants in assessing whether employees with psychological injuries are able to continue working include an assessment of their interpersonal functioning with their co-workers, the risks to the personal safety of any other employees, and the potential side effects of any medications. 

Our article Mental Health in the Workplace offers more information on mental health issues. Contact us to find out how we can assist with the trickier aspects of ensuring that your staff are as healthy, happy and productive as possible.

Mental Health in the Workplace

Vince Scopelliti - Wednesday, September 26, 2018

Making sure that your staff are fit and healthy, enabling them to perform their duties at an optimal level, forms an essential part of being an employer of choice. But beyond ensuring that your staff are physically capable, it is essential to also look after their mental wellbeing. 

Underestimating the importance of mental health in the workplace is likely to have lasting impacts on your workers, your business and clients. 

OHS legislation requires employers to provide a safe and healthy work environment for all workers, which does not cause ill health or aggravate existing conditions.

In a series of articles, we'll examine the impact of mental health issues in the workplace, how to take appropriate steps to support staff suffering these conditions, and how you can promote mental wellness in your organisation. 

WHAT IS mental health?

Mental health is about emotional, psychological and social wellbeing. For an employer, this means keeping an eye on whether your staff are struggling to keep on top of things inside and outside of work, and taking steps to assist them with dealing with any difficulties that may be impacting their productivity. 

There are many types of mental illness, including depression, anxiety, obsessive compulsive disorder, personality disorders (such as borderline personality disorder), bipolar disorder, and schizophrenia.

the scope of the issue

According to the Australian Human Rights Commission (AHRC), around 45% of Australians aged between 16 and 85 will suffer from the symptoms of mental illness at some point during their lives. In any given year, one in five adults will deal with a mental illness. 

Some workers will commence their employment already suffering from symptoms of mental illness, while others may develop their mental illness while at work. 

In many cases, the mental illness will develop separately from circumstances in the workplace. In others, a negative or "unhealthy" work environment will contribute to staff developing mental health issues or may exacerbate underlying conditions. 

Some factors which can contribute to poor mental health in the workplace include job stress, poor workload management or unrealistic deadlines, poor communication, bullying and an overall lack of support.

the impact of poor mental health

Research shows that the cost to business of failing to pay proper attention to mental health is significant. 

The AHRC reports that workers compensation claims relating to stress and associated mental illnesses cost Australian businesses $10 billion every year. The failure of businesses to recognise the potential impact of mental health issues and failure to implement preventative or remedial measures such as early intervention, has been estimated to cost over $6.5 billion per annum. 

Absenteeism due to mental illness is another issue, with an estimated 3.2 days lost each year per worker. 

The difference between job stress and psychological injury

When it comes to identifying mental health issues in the workplace, there is a difference between work stress and psychological injury. 

Psychological injury includes behavioural, cognitive and emotional symptoms which have the potential to significantly impact a worker's ability to perform their job and interact with co-workers. 

This can be distinguished from job stress, which is generally a reaction to a specific situation which can be resolved, and is not a standalone injury.

To disclose or not to disclose 

In some circumstances, it is important for employees to disclose their mental health status. This is particularly the case if they are taking medication which could affect their ability to perform their usual employment, or if there are general concerns about safety or interactions with other staff. 

An employer has an obligation not to discriminate against staff because of their physical or mental attributes, including their mental health.

Managing and supporting mental health in the workplace

Employers can provide support by having guidelines in place for how to talk to a worker who has disclosed that they are suffering from mental health difficulties, and how employees can adjust to dealing with a colleague with a mental health issue. 

It's also essential for employers to know how to address performance concerns involving employees who are experiencing mental health struggles, without discriminating or taking ill-considered disciplinary steps.

Creating a safe and healthy workplace for all

This starts with non-discriminatory employment practices and implementing long-term strategies to promote a healthy culture and a positive workplace where staff feel they are making a meaningful contribution to an overall goal, are supported and happy to come to work. 

It's also important to create direct services to assist workers with mental health issues who require support and adjustments in the workplace. According to the AHRC, every dollar spent on identifying, supporting and managing workers' mental health issues, yields nearly a 500% return in increased productivity. 

It is highly likely that at least one worker in your workplace will, at some point in time, have a long or short-term mental illness. While you do not need to become an expert in mental health, having a better understanding of what mental illness is (including its possible effects on a worker) enables you to be more effective in handling issues that may arise.  

How to Deal with Bullying in Hospital Environments

Vince Scopelliti - Wednesday, June 06, 2018

Hospitals - very few people like them, yet many of us will be a resident at one time or another. Even though hospitals can be sources of great joy, places where babies are born, miracles happen and lives are saved, they also represent sickness, injury, death, and some pretty ordinary food! 

The people who work in them - the doctors, surgeons, nurses, aides, assistants, administrators and catering staff - perform difficult work in an extremely stressful environment. Imagine the potential consequences when the added stressor of workplace bullying is added to the mix.

Factors which facilitate bullying in this environment 

Hospitals and the healthcare sector remain a particularly hierarchical environment - carers need to get sign-off from nurses before passing out certain medications, nurses confirm recommended treatments with doctors, doctors and surgeons rely on their own pecking order. 

This hierarchy, and the importance of culture and following rules, automatically puts certain workers in a subordinate position relative to others.

Lateral violence, verbal, physical and psychological bullying among peers, can also be an issue in the health services. 

Combined with the stress of having to deal with time-critical emergencies, becoming involved in physically and mentally straining situations and dealing with the trauma of patients suffering, hospitals are the perfect breeding ground for hostility, anger and frustration.

Prevalence of bullying

Bullying in the healthcare sector is an under-recognised but pervasive problem. Hospitals often have scant or limited resources and staff are under significant pressure, which may contribute to the prevalence of workplace bullying.

The Australasian College for Emergency Medicine surveyed its members in 2017 and found 34% had experienced bullying, 16.1% had experienced harassment and just over six percent had been victims of sexual harassment. A landmark 2015 report commissioned by the Royal Australasian College of Surgeons showed that almost half of all surgeons had experienced bullying, discrimination or sexual harassment. 

The Victorian Auditor General Office, in its 2016 report to the Victorian Parliament, 'Bullying and Harassment in the Health Sector', stated 

"The Health Sector is unable to demonstrate that it has effective controls in place to prevent or reduce inappropriate behaviour, including bullying and harassment. Key controls that would effectively reduce this risk to employee health and safety are either inadequately implemented, missing or poorly coordinated." 

However, by its very nature, bullying in this type of workplace can be particularly difficult to detect and manage. 

Consequences of bullying

The potential consequences of bullying are significant. In addition to litigation arising from the bullying and costs associated with worker's compensation or other payouts, a number of issues can arise. These include:

  • High turnover amongst dissatisfied staff
  • Presenteeism - where staff turn up at work, but are unhappy or stressed and perform inadequately, which is particularly dangerous in a hospital environment. 
  • Increased absenteeism
  • A poorly functioning team environment that can adversely affect staff and patients.      

are there solutions to bullying in high-stress environments?  

Key strategies to help solve the problem include:

  • A focus on workplace culture, including by conducting regular cultural audits. 
  • Encouraging a 'mentor' or 'buddy' system (in consultation with unions where appropriate), or otherwise provide a supportive environment whereby staff are encouraged to vent or ask for assistance with any matters they are struggling with. 
  • Facilitating easy access for staff to obtain confidential counselling, or advice services. 
  • Fostering an environment where staff feel comfortable raising concerns and complaints with their peers and management.
  • Having clear zero tolerance policies regarding workplace bullying and harassment, which are easily accessible to all staff
  • Ensure that this zero tolerance policy, is demonstrated by senior management, so there is a top down recognition of adherence to the policy from all staff. 
  • Staff need to be regularly reminded of the consequences of any poor behaviour in the workplace and this should be reinforced during staff meetings.  

Bullying or harassment - in any workplace - is simply unacceptable. Many incidents of bullying or harassment may be unreported for fear of reprisals. All staff should be encouraged to report any incident. 

If your organisation needs any assistance in this area please contact WISE to arrange a no-obligation appointment or otherwise contact us to discuss how we may assist you. Our services include investigation, training, provision of a whistleblower facility (which can be tailored to suit your reporting needs), and review of policies

Issues with Intoxicated or Hungover Staff? What to do

Vince Scopelliti - Wednesday, May 23, 2018

Most adults like to indulge in the use of alcohol from time to time. Some even like to partake a little more frequently - which is generally not problematic, in the privacy of one's own home and social sphere.

But occasionally problems with alcohol or even drug consumption can creep into the workplace, with staff under the influence while at work or under performing because of the after-effects. 

Employers have an OHS duty of care to all employees so they need to ensure that alcohol in the workplace does not give rise to safety risks. Employees also have a duty of care to themselves. Let's take a look at how employers can manage alcohol and drug-related issues in the workplace.

underlying factors and potential consequences

Alcohol and drug-related problems can occur in any workplace, across different industries. They can arise due to any number of factors, including personal issues experienced by the employee, stress, ongoing addiction, or poor workplace culture, to name a few. 

The potential consequences of alcohol or drug consumption - whether recreational or prescription - include the risk of injuries sustained by other staff and customers, absenteeism, lost production or general lack of competence, and a reliance on rehabilitation or workers compensation. 

The cost of these problems to business varies, however 1 in 10 workers say they have experienced the negative effects of a co-worker's misuse of alcohol.   

identifying alcohol or drug-related risks

One of the best ways to avoid difficulties with drugs and alcohol in the workplace is to identify potential risks and develop workplace policies that address these. 

These are some of the factors to consider when determining the level of risk facing your business:

  • Are your workers engaged in a high-stress environment? 
  • Is the operation of heavy machinery, vehicles or other equipment a requirement of your business?
  • Are there legislative or safety requirements to ensure that anybody operating this equipment is free from the influence of substances? 
  • Do staff potentially have access to illegal or significant amounts of pharmaceutical drugs, whether for their own consumption or for resale?

implementing a workplace drug and alcohol policy

At a minimum, your workplace policies should spell out:

  • Whether your company has a zero-tolerance policy for any types of drug or alcohol consumption;
  • Whether staff are required to declare reliance on specific pharmaceutical medications;
  • If random drug or alcohol testing is undertaken in the workplace; 
  • What expectations are placed on drug and alcohol consumption at work-related functions;
  • What the potential consequences of intoxication in the workplace could be

It is important to note that Section 12 of the Fair Work Act defines "serious misconduct" to include an employee being intoxicated at work. It would therefore be reasonable to dismiss an employee under those circumstances. 

It is also worthwhile ensuring that HR and other executive employees have undergone training in identifying staff who are intoxicated in the workplace or have perhaps formed habits of dependence. 

how to approach a worker who is under the influence 

When staff members suspect that a colleague may be under the influence of drugs or alcohol, it is important to be extremely sensitive in approaching that person. The specific approach will, of necessity, be dictated by various factors, including:

  • The relevant industry;
  • The workplace culture and structure;
  • The employee's role and seniority; 
  • The personal circumstances of the employee;
  • Whether the occurrence is 'once off' of suggests a pattern of behaviour; 
  • The legal environment;
  • The duties and responsibilities of the employee.

An employee is likely to be more responsive if they are approached from the perspective of a safety concern rather than an accusation. This is particularly the case where the behaviour or intoxication may arise from physical injuries, acute distress or prescribed medication which the patient is reacting badly to. 

During the process of drafting a workplace policy relating to drug and alcohol consumption, management should consider appointing and training specific staff members whose role it is to approach employees who are suspected to be under the influence of substances. 

These staff members could include managers, counsellors, health and safety representatives or HR representatives. A chain of command should also be instituted so that staff who have been tasked with making initial contact have somebody else to turn to for assistance if their initial approach fails.

If an employer dismisses an employee for drug/alcohol abuse and ends up with a claim for unfair dismissal, then a good employer defence would include that they had a workplace policy and approach that not only included clear consequences but also emphasised that the employer views abuse as a health issue and therefore seeks to help the employee overcome their abuse (this would be in cases where abuse outside of work is affecting performance as opposed to being intoxicated or high at work). 

This can be done by having an Employee Assistance Program (provided by an external provider); having a mental health and wellbeing policy; and an 'RUOK' approach - whereby managers encourage a culture of everyone looking out for each other and literally asking, are you ok? After all, such welfare approaches are exhausted over a reasonable period of time an employer would be safe to move to disciplinary approaches. 

Employers may also need to assess whether the issue is widespread, ie. a workplace culture of abuse. If this is the case, then there maybe engrained cultural issues that need to be investigated and remedied.   

What can employers do?

Workplaces are encouraged to establish a workplace drug and alcohol policy and procedure that can be followed in the event of a drug or alcohol-related incident in the organisation. 

WISE can assist you in drafting these policies, or assessing your current policy, and training staff. Alternatively, we can provide investigative services for any incidents that have occurred in the workplace. 

How to Implement and Promote Workplace Policies

Vince Scopelliti - Wednesday, April 04, 2018

A suite of robust policies and procedures is an essential element of good governance in any organisation. Often employers discover that their policies and procedures are inadequate, only once their actions are reviewed by a tribunal or court. 

Adequate workplace policies are key mechanisms for outlining exactly what the standards of conduct are in your organisation. Workplace policies should clearly and succinctly explain the topic covered and provide the procedures that need to be followed in a given area. 

Let's take a look at the features of a well-written policy, plus the best ways to implement, promote and review these important business documents.

the benefit of a well-written policy

The benefits of a well-written policy cannot be overstated. Sometimes policies are mistakenly seen as 'stating the obvious' in the workplace. Yet, without workplace policies that set out clear requirements and processes, confusion and mismanagement can spread across the organisation. 

A good place to start when developing a policy or procedure is to seek the ideas and input from the key people involved. This can improve staff commitment to the policy if they observe in the final document that their voice has been heard. 

In terms of style, a well-written policy must demonstrate clarity and specificity. While it is in order to outline at the beginning of a policy where it 'fits' into organisational objectives, generalisations should be avoided. 

For example, rather than requesting that 'staff should make sure that they respect client privacy when it comes to using files', a well written policy is likely to include specific directives such as 'Hardcopy client files must be stored in the section F compactus within 30 minutes of use'.

developing policies to suit your workplace

There is an art to developing and introducing workplace policies that will be read, understood, accepted and actually used. 

Firstly, all stakeholders in the organisation - staff, suppliers, clients, contractors - need to see that management is fully in support of the policy's content. Policies without perceived support and commitment from management are unlikely to gain traction with staff. 

Similarly, policy developers must consult effectively with staff about the proposed policies and welcome their comments; after all, they are the ones likely to be dealing with the contents on a day-to-day basis. 

A well-written workplace policy needs to clearly define key terms within the policy. New employees will need to familiarise themselves with expectations of their role and responsibilities as quickly as possible, without the confusing jargon. Defining 'the obvious' terms can save frustration and costs down the track. 

introducing policies and procedures

Once the scope and substance are ascertained, the policy must be documented and distributed effectively. 

Make sure that the initial publicity effort is multi-media and ensure that during induction of new employees, in team meetings, on the intranet, at training, in the staff bulletin and on the kitchen cork board (plus anywhere else that works), you give clear information about the policy and where to find it. 

Following up on your publicity about the policy and refresher training is essential and should be carried out regularly across the organisation.

Evaluation and review

No matter how well written, a good policy or procedure will still need to be evaluated and reviewed. 

A logical starting point can be to check effectiveness against key objectives. For example, injury rates or client complaint numbers might be used to gauge the success or otherwise of a particular policy. 

Another good source of information to help you assess the policy will be the people actually impacted by its wording. 

Policy developers need to be truly open to ideas when it comes to reviewing existing policies. Good governance and strong organisational achievement will often depend upon robust, realistic and clearly-worded policy documents. 

WISE Workplace can review your current policies, advise you on their appropriateness and update your suite of policies and procedures. Contact us today!