Wellbeing & Productivity

“Addressing wellbeing at work increases productivity by as much as 12%.” (Mental Health Foundation, 2021).

Reference

Mental Health Foundation. (2021) How to Support Mental Health at Work. Available from World Wide Web: https://www.mentalhealth.org.uk/publications/how-support-mental-health-work. [Accessed: 30 May, 2021].

Book: Resilience – How We Find New Strength at Times of Stress

Book Title:

Resilience – How We Find New Strength at Times of Stress.

Author(s): Fredric Flach (MD).

Year: 2020.

Edition: First (1st).

Publisher: Hatherleigh Press.

Type(s): Paperback.

Synopsis:

Make stress your ally in the pursuit of happiness and personal fulfillment.

There’s no escaping stress. It appears on our doorstep uninvited in the shattering forms of death, divorce, or job loss. Stress even comes in the pleasant experiences of promotion, marriage, or a long-held wish fulfilled.

So why do some people come out of a crisis feeling better than ever, and others never seem to bounce back?

You will discover:

  • How to develop the 14 traits that will make you more resilient.
  • Why “falling apart” is often the smartest step to take on the road to resilience.
  • When the five-step plan for creative problem solving can help.
  • What essential steps you can take to strengthen your body’s resilience.
  • How to redefine your problem and restructure your pain to create a life you can handle, a life you can learn from and enjoy!

Drawing on more than thirty years of case studies from his own psychiatric practice, Dr. Frederic Flach reveals the remarkable antidote to the destructive qualities of stress – physical, mental, and emotional resilience.

Book: Psychology at Work

Book Title:

Psychology at Work.

Author(s): Peter Warr (Editor).

Year: 2002.

Edition: Fifth (5th), Revised Edition.

Publisher: Penguin.

Type(s): Paperback and Kindle.

Synopsis:

Applied psychology in work settings has made considerable progress in the 30 years since the original version of this book was published.

This new collection of essays aims to illustrate both the empirical and practical richness of the field as wellas its theoretical development.

The chapters cover psychological processes, the study of groups and workteams, and the nature of complex organisations as a whole.

Reflecting recent developments in psychology as well as society generally, topics range from skill and workload, shiftwork, personnel selection, training and careers, and the effects of new technology, leadership and management, to job stress and well-being, women in employment, corporate culture and processes of organisational change.

Book: Psychology in the Work Context

Book Title:

Psychology in the Work Context.

Author(s): Ziel Bergh and Dirk Geldenhuys.

Year: 2017.

Edition: Fifth (5th).

Publisher: Oxford University Press.

Type(s): Paperback.

Synopsis:

Psychology in the work context 5e is an introductory text for students of industrial and organizational psychology.

The book provides a comprehensive conceptual framework for understanding work behaviour and relationships at work and equips the student with a theoretical framework form which to analyse issues in the work place.

Book: Wellbeing at Work: How to Design, Implement and Evaluate an Effective Strategy

Book Title:

Wellbeing at Work: How to Design, Implement and Evaluate an Effective Strategy.

Author(s): Ian Hesketh and Cary Cooper.

Year: 2019.

Edition: First (1st).

Publisher: Kogan Page.

Type(s): Hardcover, Paperback and Kindle.

Synopsis:

Stress at work is rising year on year, long hours are becoming the norm and presenteeism is increasing across all industries. This is not only having a detrimental effect on employee health, happiness and productivity, but is also impacting the bottom line. HR professionals are uniquely placed to manage this modern workplace crisis by implementing a wellbeing strategy.

Wellbeing at Work is an essential, practical guide to designing and implementing an effective strategy that will reduce employee anxiety, increase staff engagement and improve overall performance.

Written by leading experts in the field, Wellbeing at Work takes readers through the entire process, from explaining why a wellbeing strategy is necessary in a fast-changing world of work and technological transformation to building momentum around it, and monitoring, measuring and evaluating its impact. The book also identifies common pitfalls and problems, and how to avoid them, explores important legislative considerations and provides example exercises and tools to use throughout the process.

Full of advice, tips and insights from real-world case studies, this is the only book you will need to create a happier, more productive and more profitable organisation

Book: Mental Wealth: An Essential Guide to Workplace Mental Health and Wellbeing

Book Title:

Mental Wealth: An Essential Guide to Workplace Mental Health and Wellbeing.

Author(s): Emi Golding and Peter Diaz.

Year: 2019.

Edition: First (1st).

Publisher: Morgan James Publishing.

Type(s): Paperback and Kindle.

Synopsis:

Mental Wealth reveals an approach to workplace mental health and wellbeing that is proven to actually get results.

Despite having a huge impact on the productivity, profitability, and culture of organizations, there is very little guidance currently provided to managers and leaders on how to effectively manage workplace mental health and wellbeing. What does exist is often focused on the legal aspects of minimizing risk that it misses the psychology of workplace mental health and high performance and actually ends up creating risk for workplaces.

Mental Wealth is a guide for managers and leaders on how to manage employees who may be experiencing mental health issues in the workplace. Founders of the Workplace Mental Health Institute, Peter Diaz and Emi Golding, provide an essential foundation for addressing workplace mental health. Some of the essential foundations discussed include dispelling myths about workplace mental health, the factors that cause and contribute to mental health issues, the impact those factors are having on workplaces, the benefits of addressing mental health appropriately, and 7 Pillars for a mentally Wealthy Workplace. Mental Wealth also includes case studies and practical strategies that can be implemented for immediate results.

Book: Mental Health and Wellbeing in the Workplace

Book Title:

Mental Health and Wellbeing in the Workplace: A Practical Guide for Employers and Employees.

Author(s): Gill Hasson and Donna Butler.

Year: 2020.

Edition: First (1st).

Publisher: Capstone.

Type(s): Paperback, Audiobook, and Kindle.

Synopsis:

Provides guidance for both employers and staff on promoting positive mental health and supporting those experiencing mental ill health in the workplace

The importance of good mental health and wellbeing in the workplace is a subject of increased public awareness and governmental attention. The Department of Health advises that one in four people will experience a mental health issue at some point in their lives. Although a number of recent developments and initiatives have raised the profile of this crucial issue, employers are experiencing challenges in promoting the mental health and wellbeing of their employees. Wellbeing & Mental Health in the Workplace contains expert guidance for improving mental health and supporting those experiencing mental ill health.

This comprehensive book addresses the range of issues surrounding mental health and wellbeing in work environments – providing all involved with informative and practical assistance. Authors Gill Hasson and Donna Butler examine changing workplace environment for improved wellbeing, shifting employer and employee attitudes on mental health, possible solutions to current and future challenges and more. Detailed, real-world case studies illustrate a variety of associated concerns from both employer and employee perspectives. This important guide:

  • Explains why understanding mental health important and its impact on businesses and employees.
  • Discusses why and how to promote mental health in the workplace and the importance of having an effective ‘wellbeing strategy’.
  • Provides guidance on managing staff experiencing mental ill health.
  • Addresses dealing with employee stress and anxiety.
  • Features resources for further support if experiencing mental health issues.

Wellbeing & Mental Health in the Workplace is a valuable resource for those in the workplace wanting to look after their physical and mental wellbeing, and those looking for guidance in managing staff with mental health issues.

Reviewing Work & Mental Health in Doctors

Research Paper Title

Work and Mental Health in Doctors: A Short Review of Norwegian Studies.

Background

Previous studies have found relatively good physical health in doctors, whereas several studies now report relatively high levels of mental distress among them. This applies in particular to stress, burnout, and depressive symptoms – and especially among medical students and young doctors early in their careers. However, we lack representative prevalence studies of mental disorders among doctors. There is little empirical support for the notion that there is more mental distress in medical students compared to that in other university students, nor do they differ from other students with respect to personality traits.

Despite this, several studies have found more suicide among physicians than in other occupational groups. This may be partly due to their attempts in committing suicide being more frequently successful; yet, this may also represent the tip of an iceberg of frustration and inadequate mental health care among medical doctors.

Presumed Risk Factors from Longitudinal Studies

What do we know about individual and work-related predictors and risk factors of mental distress from the prospective and longitudinal studies so far? Some landmark early follow-up studies in the United States and United Kingdom put doctors’ work and mental health on the agenda in the 1970’s and 1980’s. In the following, we will pay most attention to the Longitudinal Study of Norwegian Medical Students and Doctors (NORDOC). This study has since 1993/1994 followed repeatedly 2 cohorts of medical students (N = 1052) with 6 years apart for 20 years (2014), and there is now an ongoing 25-year follow up.

There are 2 main hypotheses with regard to possible risks factors. First, it may be due to individual factors such as personality traits, past mental health problems, etc. Second, contextual stress may influence mental health among doctors, whether this is unhealthy working conditions or negative life events (i.e., stress outside of work). Both individual and work-related factors seem to be of importance. Individual factors may be more important with respect to more severe clinical mental disorders, whereas work-related factors are more important for stress, burnout, and minor emotional disturbance.

In terms of individual factors, NORDOC has included personality traits, as one of very few studies in doctors. Neuroticism personality trait is related to vulnerability, self-criticism, low self-esteem, and proneness to stress compatible with the modern common term “hypersensitivity.” This trait predicts stress, anxiety, and depression in the general population, and, as expected, in NORDOC it predicts work stress, burnout, and even severe depressive symptoms among doctors. Studies among medical students and young doctors have found the combination of conscientiousness (or obsessiveness) and neuroticism seems to be especially important for school and work stress. In addition, NORDOC has identified a particular trait (reality weakness) that is associated with severe personality pathology. This trait predicts independently a need for mental health treatment, lack of help-seeking, severe depressive symptoms, and even aggravation of suicidal ideation among medical students and doctors. Another important individual factor is the increased rate of female medical students and young doctors. In Norway, there has been an increase from 55% to 70% of women in medical schools during the past 2 decades. We have previously found little gender differences in NORDOC, but a recent study among Norwegian medical students find considerable reduction in subjective well-being in 2015 compared to that 20 years ago, and this reduction was most prominent among the female students. This reflects recent trends in Norway and other Western societies which observe increased anxiety and depressive symptoms among young female adults.

With regard to contextual stress, it seems that both work-related stress and stress outside of work are of importance. NORDOC studies have found that demanding patient work is associated with mental health problems early in the medical career, and that difficulty with balancing life – such as work–home interface stress – is a sustaining problem over the course of the career. The detrimental role of such stress is also in keeping with studies among US doctors. Work–home stress predicts burnout (emotional exhaustion) in a NORDOC 5-year follow-up study. A promising finding is that such stress was less prominent in the youngest cohort of Norwegian doctors 10 years after leaving medical school. This may be due to increased coverage of kindergarten as well as changed and more liberal gender roles in our Scandinavian society over recent years.

There are also studies that associate time pressures and burnout with suicidal ideation among medical students and doctors. Sleep-deprivation due to call work and long hours may be one important reason for more depressive symptoms measured in young doctors. A recent NORDOC study of life satisfaction during 15 years of the career controlled for all possible individual factors, and found the following work-related predictors and possible risk factors: work–home stress, lack of colleague support, and emotional demands at work. Doctors often feel a 24/7 responsibility and obligation for individual patients and their treatment and this puts extraordinary emotional demands on this occupational group.

Does Stress among Doctors have Consequences for their Patient Care?

Many studies can indicate lowered quality of patient care among stressed doctors with burnout, but a large majority of these studies build on self-report by the doctors themselves of more errors and poorer care. We lack an empirical foundation for the notion that stress and burnout really impair doctors’ functioning with respect to observed poorer quality of care. There are 2 classical observation studies demonstrating that long hours and time pressures interfere with doctors functioning, but we lack studies that find burnout to lead to observed errors or poorer care. The burnout concept and scales are not very valid with respect to impaired functioning, for example, with respect to valid cut-off for defining a case.38 On the other hand, depression and other mental disorders lead to poor functioning. We need more studies on working conditions and the levels of stress and poor health among young doctors that lead to lowered patient care.

What are the Most Common Mental Disorders among Doctors?

In general, doctors may have the same disorders that strike anyone else; doctors are not invincible. Although depressive symptoms seem to be prevalent in the early years of the medical career, some of this may be due to exhausting work stress by frequent on-call work. We lack representative studies on the occurrence of valid depression among doctors compared to that in other occupational groups. Suicide is more common among doctors than among other groups of academics, but since it is also very common in veterinarians, this may also be due to available knowledge and means (drugs) for committing suicide during mental health deterioration. Alcoholism and drug abuse is an additional known risk factor for suicide and the SAD triad (suicidal behaviour–alcoholism–depression) may be particularly important for medical doctors. From clinical experience with doctor–patients, we know the slippery slope from self-medication with tranquilisers to cope with the stresses to dependency of alcohol and drugs, in addition to other boundary violations. There are very few clinical studies including diagnostic interviews among doctors. One previous Spanish study emphasises the importance of dual diagnoses, especially in alcohol dependence and mood disorders. From own experience, we know that bipolar disorder (type II) is quite common among physicians, but we lack sound empirical studies that compare occurrence of mental disorders in doctors with that in other groups. American impaired physician programs have for many years shown high and promising recovery rates (70–80%). The programmes used to focus on addiction and substance abuse, but they now put increasing emphasis on psychiatric diagnoses. A family history, opioid use, and psychiatric comorbidity predicted relapse of substance abuse among doctors and other healthcare workers.

In Norway, we have implemented a successful low-threshold intervention, the Villa Sana programme. This intervention seems to reduce burnout in doctors. It includes 2 separate schemes, a 1-day individual counselling scheme, and a 1-week group-based scheme in a psychiatric hospital. The Norwegian Medical Association pays for the programme that is free for all doctors.

With respect to medical students and young doctors, we have also a large longitudinal study on mindfulness-based stress reduction. This is a randomised-controlled trial of second year medical and psychology students, and they have now been followed-up for 6 years, for the medical students into the first 2 postgraduate years. The reduction of emotional distress by mindfulness training is most prominent in female students.46 The training has a stronger impact among those with vulnerable personality (high neuroticism and conscientiousness). During the follow-up, there is an increase in active coping and reduction in passive or avoidance coping – the effects on ways of coping may be important psychological mechanisms of mindfulness training.

Future Research Challenges

We need more long-term follow-up studies that use validated instruments to capture changes in working conditions and their impact on physician health. For instance, there are few studies in doctors of Karasek’s Demand-Control model. There are more studies by this model in other healthcare workers. More studies are required that measure the effect of physicians’ health problems on their performance and patient care. Gender issues are important, since there are now more women entering the medical career. As mentioned, we also need more studies with diagnostic interviews that compare frequency of valid disorders in samples of physicians with that in other groups. Doctors are nowadays moving, and we should study the effect of globalisation on doctor’s health. Cross-national disparities may be due to differences in the health systems, working conditions, etc. Finally, we need more studies on positive psychology and factors that may promote and enhance well-being among physicians.

Reference

Tyssen, R. (2019) Work and Mental Health in Doctors: A Short Review of Norwegian Studies. Porto Biomedical Journal. 4(5), pp.e50. Published online 2019 Sep 9. doi: 10.1097/j.pbj.0000000000000050.

Mental Health & the HSE

Introduction

In their Annual Report and Accounts 2017/2018, the Health and Safety Executive (HSE) stated that there were “0.5 million work-related stress, depression or anxiety cases (new or long-standing) in 2016/17” (HSE, 2018, p.9).

What is the HSE?

“HSE is the independent regulator for work-related health and safety in Great Britain. We are committed to playing our part in the wider health and safety system to ensure that others play theirs in creating healthier, safer workplaces. We also deliver wider functions such as regulatory schemes intended to protect the health of people and the environment, balancing the economic and social benefits that chemicals offer to society.” (HSE, 2018, p.10).

HSE and Stress

HSE states that where (work-related) stress is prolonged it can lead to both physical and psychological damage, including anxiety and depression, and that work can also aggravate pre-existing conditions, and problems at work can bring on symptoms or make their effects worse.

They go on to state that whether work is causing the health issue or aggravating it, employers have a legal responsibility to help their employees. Work-related mental health issues must to be assessed to measure the levels of risk to staff. Where a risk is identified, steps must be taken to remove it or reduce it as far as reasonably practicable.
Some employees will have a pre-existing physical or mental health condition when recruited or may develop one caused by factors that are not work-related factors.

Employers may have further legal requirements, to make reasonable adjustments under equality legislation.

Information about employing people with a disability can be found on GOV.UK or from the Equality and Human Rights Commission in EnglandScotland, and Wales.

There is advice for line managers to help them support their employees with mental health conditions.

What is the Stevenson Farmer ‘Thriving at Work’ Review?

In 2017, the UK government commissioned Lord Stevenson and Paul Farmer (Chief Executive of Mind) to independently review the role employers can play to better support individuals with mental health conditions in the workplace.

The ‘Thriving at Work’ report sets out a framework of actions – called ‘Core Standards’ – that the reviewers recommend employers of all sizes can and should put in place.

The core standards were designed to help employers improve the mental health of their workplace and enable individuals with mental health conditions to thrive.

By taking action on work-related stress, either through using the HSE Management Standards or an equivalent approach, employers would be able to meet parts of the core standards framework, as they would:

  • Form part of a mental health at work plan;
  • Promote communications and open conversations, by raising awareness and reducing stigma; and
  • Provide a mechanism for monitoring actions and outcomes.

Can Mental Health and Work-related Stress be Interlinked?

Work-related stress and mental health problems often go together and the symptoms can be very similar. For example, work-related stress can aggravate an existing mental health problem, making it more difficult to control. And, if work-related stress reaches a point where it has triggered an existing mental health problem, it becomes hard to separate one from the other.

Common mental health problems and stress can exist independently. For example, an individual can experience work-related stress and physical changes such as high blood pressure, without having anxiety, depression or other mental health problems. They can also have anxiety and depression without experiencing stress.

The key differences between them are their cause(s) and the way(s) they are treated.

  • Stress is a reaction to events or experiences in someone’s home life, work life or a combination of both.
  • Common mental health problems can have a single cause outside work, for example bereavement, divorce, postnatal depression, a medical condition or a family history of the problem.

However, an individual can have these sorts of problems with no obvious causes. Employers can help manage and prevent stress by improving conditions at work. But they also have a role in making adjustments and helping the individual manage a mental health problem at work.

Linking HSE’s Management Standards, and Mental Ill Health and Stress

Although stress can lead to physical and mental health conditions, and can aggravate existing conditions, the good news is that it can be tackled.

By taking action to remove or reduce stressors, an employer can:

  • Prevent an individual becoming ill; and
  • Avoid those with an existing condition becoming less able to control their illness.

HSE’s Management Standards approach to tackling work-related stress establishes a framework to help employers tackle work-related stress and, as a result, also reduce the:

  • Incidence of mental ill health; and
  • Negative impact of mental ill health.

The Management Standards approach can help employers put processes in place for properly managing work-related stress. By covering six key areas of work design employers will be taking steps that will:

  • Minimise pressure;
  • Manage potential stressors; and
  • Limit the negative impact that the work could have on their employees.

References

HSE (Health & Safety Executive). (2018) Annual Report and Accounts 2017/18. Available from World Wide Web: http://www.hse.gov.uk/aboutus/reports/ara-2017-18.pdf. [Accessed: 18 November, 2019].

HSE (Health & Safety Executive). (2019) Mental Health. Available from World Wide Web: https://www.hse.gov.uk/stress/mental-health.htm. [Accessed: 18 November, 2019].