Following IOSH president Graham Parker’s keynote address at this year’s annual conference, and an increased focus on wellbeing by other organisations and firms, Dominic Cooper asks: should mental health really be the future focus for safety and health practitioners?
Despite Graham Parker stating in his keynote address that every work-related death is avoidable and unnecessary at the recent two-day IOSH 2017 conference held in Birmingham, there seemed to be a heavy focus on stress, mental health and well-being, perhaps as a result of the Health and Safety Executive‘s (HSE) Help GB Work Well and EU-OSHA’s The Healthy Workplaces for All Ages campaigns.
Sadly, what did not seem to be discussed was strategic direction on how to help stop people being killed or maimed at work.
Over the past 31 years, there have been 8246 workplace fatalities, and 4.42 million serious injuries at work according to the latest HSE RIDDOR statistics.
The cost to UK business as well as to the victims, their families and the National Health and Benefit systems has been enormous. In the past year alone there were 137 fatalities and 70 thousand serious injuries. However, looking at such statistics, we tend to forget that death is permanent, as are loss of limbs, body organs, etc. Stressed people on the other hand are still alive and in one piece – albeit unhappy.
Work-related stress, depression, or anxiety is defined by the HSE as “a harmful reaction people have to undue pressures and demands placed on them at work”. In other words, stress is due to a perceived imbalance between environmental demands and personal resources. However, very rarely does the profession make a distinction between eustress (good) and distress (bad) which recognises that everyone needs a certain amount of stress to perform well.
It appears stress has now become a catch-all phrase to encompass everyone’s unhappiness or dissatisfaction at work, whatever the reason. Clearly, someone experiencing chronic distress should not be at work, as they themselves could suffer a workplace injury, or cause an injury to someone else.
The trouble is finding the balance between eustress and distress for each individual at work, who cope differently to stressors. Plus, of course, we must remember that we can never separate people’s home-life stressors – e.g. divorce, bills, moving, boredom – from work. People do not leave their home stress at the door, just because they go to work. In other words, the safety profession will struggle to separate out work-related stress from home-related stress.
The recent 2017 release of statistics by the HSE about the prevalence of stress, anxiety and depression comes solely from the subjective Labour Force survey, where people self-report how they feel. Such surveys are fraught with methodological difficulties, and tend to be unreliable, and certainly should never be relied upon as the sole source of valid data to take national policy decisions.
A more objective method would be to ask the medical profession to provide statistics of those who have been treated for chronic distress, but this would take much more effort, and that’s assuming such statistics are even kept. However, it is interesting to note, that most of those reporting acute stress, anxiety, and depression are mostly public sector workers, particularly education, health and social care, who report workload pressures, including tight deadlines, too much responsibility and a lack of managerial support as the root causes.
Clearly, in both the public and private sectors these factors are the remit of Human Resources departments, whose policies & practices determine staffing levels, and the competency of those working in their organisations. Perhaps the public sector has much to learn from the private sector, or perhaps those in the private sector are simply more resilient.
Nonetheless stress, mental health, and well-being are topic areas of the workplace already well served by other professional bodies, such as the medical profession, counselors, human resource specialists, psychologists, and ergonomists.
Your average safety rep and safety manager or director is not an expert in stress, anxiety or depression. So the question becomes: “With limited resources, does the safety profession really need to get so heavily involved in these topic areas, to the detriment of basic HSE?
“After 30 years practice, I have a horrible feeling that the UK Safety Profession is losing its way, by trying to be all things to all men, crossing professional boundaries and losing its focus on the safety basics that actually stop people being killed and maimed in the workplace.
Am I right, or am I being alarmist? What do you think?
Dominic Cooper is CEO of behavioural safety experts, B-Safe Management Solutions
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Although I do agree with you that the basis of HSE is to prevent harm, injury and ill health, especially in industries such as manufacturing and construction. When it comes to work in places like offices, mental health and stress is a significant risk to the business which could lead to long term ill health if not talked about and dealt with compassionately and efficiently.
Thanks Jim, but is it the business of the safety profession to do the work of other more qualified professions?
Dominic, I would say it is down to each of us to decide where our own experience/knowledge reaches it’s limits and indeed if we should train further to go into areas such as mental health. I work with a wide array of companies and premises from office to construction and manufacturing and mental health is an issue at almost all places. Convincing all companies to use resources to support staff in this way is in my experience unlikely (maybe I’m not persuasive enough yet!) so taking a holistic view of H&S, I feel I can best serve the employees by increasing my knowledge to provide limited support myself and offer better advice on targeting efforts to support more serious cases.
We need more ‘Devils Advocates’ out there to test how hot it truly is in the kitchen but, to suggest absenteeism and sick-notes will provide a clue is simply flawed, as who, in their right mind, is going to ‘disclose’ the real reason for a work-stress induced sickie day or three off work as the majority now suffering in, sort of, silence manifesting in the ‘far from subjective’ rise in “presenteeism” and some £30bn odd cost of lost productivity is a reality check, let alone the associated £60bn social costs.
“Work Exposure Limits” (WEL) are increasingly being standardised and the concept recently ratified withing the BSI ISO 45001 due for release in the new year although many are already migrating from 9000 and 18001 series to the new management standard will surely change the context of H & S.
EU including UK employers may have avoided the still born 2012 MSD Directive and the HSE Silver Jubilee “Safety Alert” once again focused on the ineffective occupational health interventions for DSE user operators nonetheless, there has been an “objective” Fatigue Screening and Mitigation Tool-Kit out there for 10 years, in addition to, from the mid 90’s, “good practice and guidance” promoting adaptation and/or customisation of DSE ergonomics when found to be sub-optimal by the majority of users.
However as, “screen interface ergonomics” was not covered when the standard UK DSE Regulations were introduced, in response to the 1990 EU Directive, UK employers have been able to dismiss CVS or Screen Fatigue, eye-strain, eye and headaches, WULD’s etc as, TEMPORARY, sort of, ignoring the RSI type injuries by blaming the operator and fostering the belief that screens are as harmless as Asbestos.
Well that hasn’t worked out too well over time and with the use of the Equality Act instead of occupational health and safety legislation to bring claims for ineffective prevention of over-exposure to work related stressors presenting in, at least a 20% loss in efficiency, performance and productivity, employers may have to consider how they are going to manage increasing insurance premiums sooner rather than later.
Agree that Occupational Health IS in the safety professions remit, but this is largely about objective physical health (e.g preventing lung disease, exposure to chemicals etc), not perceived mental health. One person’s bad stressor is another person’s challenge for personal growth
The trouble is currently the words ‘Mental Health’ are being used as an umbrella term, much like the ‘Dementia’ is for any age related decrement in perceivably sub-optimal performance and productivity due to over-exposure to any stressor leading to adaptation exhaustion and ill-health that is quantifiable or qualitative and can be measured or diagnosed objectively.
Wellbeing, on the other hand, more accurately reflects the predictable exposure to known work-stress hazards / risks whether environmental, material or psychological experienced by far too many dismissed as a “lack of resilience” pre-break down in physical and/or mental health.
This has been the excuse for Occupational Health Professionals in addressing the very real and debilitating affects of CVS / Screen Fatigue on DSE user operators over the last 25 years, insisting that the collection of symptoms are no more than temporary and subjective whilst accepting the 20% loss in productivity (1 day in 5) and significantly increased presenteeism estimated to be costing employers in the UK some £30bn.
So if, “productivity and sustaining optimal performance over time” is critical to extending the productive “working life-cycle” in the UK, now languishing 5th out the G7 countries performance league tables then, the basic “given condition” for the “wellbeing” of our human resources and known risks of injury to their long term physical and mental health will need to be addressed.
After all, it is not rocket science, in a knowledge based IOT economy, to raise self-awareness of the known, common, foreseeable and predictable current and future work exposure related hazards and risks, just a question of mindset of those, who are very good talking the talk in terms of Professional Politically Correct Ideologies rather than accepting their sub-optimal Personal Ideologies demonstrated in their systemic failure to walk the walk.
Dominic,
I agree that perceived stress is being used to determine the levels of mental health issues within industry and that safety is sometimes being side-lined with the emphasis upon MH management in companies. As OH&S practitioners, our main focus is upon physical health, but we are increasingly being expected to assist HR and management when dealing with MH.
In my experience across various industries over the past 15 years; it is rarely work which triggers the issue, but generally something from the personal life of the employee. A significant number then use work as the excuse and try to blame their employers.
We live in an increasingly global workplace, where companies are looking to reduce costs to stay competitive and retain a UK workforce. This adds a level of stress and often people are not able to cope with the added pressures this brings. We should remember that we have high levels of employment, compare with the 80’s, where unemployment was far higher.
I do disagree with what you say about the public sector though. Having an ex-teacher wife, I can state without fear of contradiction that the levels of pressure being placed upon those teaching 10 year olds and above is beyond acceptability. Parents, governors, politicians and the public have expectations which are making their lives extremely difficult and it is always the teacher’s fault; never the angelic pupil, when things go wrong. Working weekends and through holidays is the norm, if the teacher cares for the quality of children’s education. Others in the public sector have had to deal with little wage increases, coupled with a lack of resources over a number of years. Who would be a social worker in a deprived inner city? Not me!
It is too easy for people to site stress as the reason for their anxiety or lack of capability to deal with what life throws at us. Try working in the less developed parts of the world, where putting food on the table is a daily challenge and employment levels are low, with corrupt police, governments and environmental issues from pollution and deforestation etc. People here don’t run for the anti-depressants and counsellors; they simply get on with life. As our grandparents did and many of them went through far greater stressful situations than we do (wars, diseases, lower quality medical capabilities and childhood mortality being far higher etc.).
The OH&S profession is there to guide and assist management to protect life, prevent serious injury and occupational health issues ruining lives. We are not mental health professionals and we need to remember this.
There’s a very interesting TED talk by Kelly McGonigal, which those claiming stress should watch.
Thanks for the info on the TED Talk. Great video gives much more insights into stress and effects https://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend . BTW one of my daughters is a social worker, and she works 7 days a week (and is always on call). She copes by doing physical sports (skydiving & climbing) when time allows. In other words she has found a way to shake off the demands by doing stuff she enjoys (even though it worries the hell out of me!).
Dear both
In 25 years management experience I have found it difficult to distinguish between stress caused by Home or work – they feed off each other and who leaves their work life at the home door any more like my dad used to? iPhones are there to be answered …
People face very different stresses these days – no longer about survival – but there is an argument that our brains were not built to deal with the fast pace “always on” nature of modern life. Whatever your thoughts about people with perceived stress leading to anxiety and depression it is real to them and can cause them to take their own lives ( in their thousands more than die in an accident at work or on the roads) and in the case of our teenagers to self harm in their millions. This may not be the way you think the world and people SHOULD work but it is how they currently ARE working. Talking to them first and foremost about how to manage their thoughts is a start – ideally proactively and before they are ill best wishes Heather
Ps Dr Dom I left a big comment on your article this morning and it hasn’t come up – maybe they are moderating for profanity 😉 just a joke – I do agree with some of your points if not the overall thrust of your article x
As an after thought to comments, I am pretty sure, although of longer latency, Work related Non-communicable Diseases (NCD’s) are more prevalent than the immediacy of KSI’s – being killed or seriously injured, were there any, sort of, competition between the two.
Hello,
I am not in a position to agree with your assumption that recognising Stress and mental health will be to the detriment of basic H&S.
H&S professionals like safety issues, they are defined, tangible, black or white, with solutions may be shades of grey according to the level of acceptable risk. But what of the ‘health’ in H&S? With serious safety instances falling, awareness improving, Professionals must look beyond the safety issues, and address any health concerns.
Stress is catching up with back complaints as the biggest working time lost. Company’s will not have on tap access to the professions referred to, so I do believe, in the first instance, H&S professionals need to be able to identify issues, and be the conduit for staff to access the right help.
Your view that persons who suffer with stress, are better placed than those who receive death or life changing injury is obvious, but to label them as just ‘unhappy’ belittles the impact stress can make, which can be very real indeed to those unfortunate enough to suffer.
The challenge for the professional is two fold, to help protect the genuine individual, and defend the employer against escalated claims. I am not suggesting H&S professionals pick up a Psychologist mantle, but certainly I agree with IPP Graham we should be one of the avenues employees can turn to, and be able to identify and distinguish what is excessive/prolonged mental demands.
The whole point of challenging the current trend of focusing on stress and mental health, is that the UKs serious incidents and fatalities are not falling. The fatality rate has plateaued over the past 7 years, with some annual variation. Last years 70K serious injuries reported in RIDDOR equates to 192 people being maimed at work PER DAY!,
In contrast, HSE mental health absence report estimates based on GP records are around 480 per year! A vast difference to the estimated 526,000 figures being bandied about by the HSE based on data from the Labour Force Survey (LFS). The Mental Health figure based on the LFS is an illusion masquerading as fact! At an average of 192 maimings per day, it is imperative we do not lose focus on the serious injuries & fatality issue.
I agree, both as a health and safety professional and as someone who has had absence from work due to stress. I can tell you that my stress was not perceived, but very real. Yes, we have health in our titles but we have shied away from it for far too long as it is on the “hard to do” pile, compared with safety issues presenting immediate risks.
Hello Dom , nice to see you playing devils advocate on this one when are you in London so we can have a proper chat? There are aspects of what you say I agree with – namely for some H&S professionals to risk assess for stress as the HSE management standards would have – is a stretch it’s a very different type of risk assessment…. about how people interact with people rather than objects – having said that the ones who really get the cultural piece are perfectly placed todo it – maybe the best person in the organisation to do so. They’ve got the bit about culture – which is what this is all about too ! I also agree there is an issue with the stats – 1:4 is widely touted but the evidence behind that is flawed. However are you more likely to have to deal with a colleague with work related stress or one which has had an a accident at work? The former I would suggest.
Mental health and stress have not been anyone at senior level’s domain really to date (also agree with Nigel about stress and mental health being collapsed) However, HSE people have always in theory been responsible for health and therefore wellbeing.
I’n surprised you think there is no distinction made between good stress and bad stress – even the most basic MH awareness raising session covers that and most people know it already – and coping mechanisms are also widely discussed (everywhere in the media I believe!) the best of which is changing your thinking!
For me if H&S professionals do this alone it can be purely a bit of an awareness raising exercise. Where it really works is where they either work with HR or have a real good tie in with the board because stress at work comes down to leadership and management. Unless a programme covers what managers do and don’t do to help their workplaces thrive the conditions remain the same (like providing PPE first) love Heather x
Hi Heather. Not much fun playing devil’s advocate in this instance, but necessary. You are probably right that we are more likely to come across people ‘feeling’ stressed than an accident victim, but that will largely depend on your work environment (i.e. office vs industry). Most who have spoken to me about Stress at Work, concentrate on office people, although someone was trying to tell me that 436 people committed suicide last year in the construction industry alone – when challenged if these were due to work-related stress there was no response, simply because it is unknown.
The original study merely worked out the occupations of those who had committed suicide, but gave no indication they were caused by workplace stressors. It seems the UK has got into “group think” mode on the issue, while some people are using the stress agenda for their own aims (i.e. highlighting mental health in general). I am not denying that stress can be debilitating for those experiencing it, but do we really want to wind up and point the whole of the HSE profession to solving society’s general problems,at the expense of the huge numbers being killed or maimed as a direct result of their work?
I agree with you that stress at work often comes down to poor HR, poor management and poor leadership. Unfortunately, it is often the case that there are too few safety professionals working in organisations, and those that there are, are often overwhelmed with the number of tangible issues they already have to control, let alone less tangible issues like stress, anxiety and depression. Will let you know next time I am in London, so we can meet up for a chat.
” risk assessment…. about how people interact with people rather than objects ” There is NO-WAY that anyone is suggesting H&S Professionals should become all touchy feely counselors CBT trained for negotiating true or false assessment of any emotional / psychosomatic risk of employees self-harming / medicating ant-acids, energy drinks / coffee, alcohol whatever, stress related symptoms at all at all.
Nevertheless, FM is very tangible object, in terms of environmental wellbeing / health and safety, shift / work patterns are again critical when guarding against human errors or fatigue related mishaps, misjudgment, oversight or omissions founded in work stress related fatigue / sleep deprivation.
Then there is my pet interest, the “20% lost productivity / presenteeism” linked to the majority of DSE user operators “subjectively reporting Screen fatigue or Computer Vision Syndrome (CVS)” when the mitigative tools have been available since the mid 90’s and “objective visual risk assessment and mitigation” has been around for over 10 years in education but, completely ignored in the workplace.
Employers have been dodging the bullet of “Digital Health & Literacy” for 25 years and even managed to kill-off the 2012 EU MSD Directive yet, five years on HSE panicking issuing another Safety Alert this April again, without any advise or guidance on prevention or mitigation although, this has been hiding in plain sight since the 90’s not only in regulation and on the IOT in W3C standards and “My Computer My Way” however, any “reasonable adaptations to relieve eye-strain and improve ACCESSIBILITY” have been left to the DSE user operator to implement themselves rather than being contained in any employers DSE induction training or even triggered in regular formal, standard DSE Risk Assessments that just focuses on the ergonomics of the furniture – Doh
I think this is always a difficult issue; from my perspective i think there are things that safety Professionals can do to improve employee health in relation to stress. In a previous HSE role I did a lot of work with Fire Services and there is no doubt that being a firefighter is a stressful job; i recall the FBU raising the issue in the 90’s because the number of suicides and family break-ups and divorce amongst firefighters was much higher than the national average for example. As a safety professional and inspector, could I wield any influence to reduce this? Yes – I felt I could by trying to influence Fire Service leadership to acknowldge the issue and engage experts to help them, if not resolve it, at least ameliorate it. So, no I agree the safety profession has no special competence here but it can provide a conscience and a humanitarian insight. If we see it, speak up about it right?
Hi Dom, in answer to your question – neither, just plain wrong-headed! Would you like to be driven in a taxi or train by a stressed driver, or worse flown by a fatigued or depressed pilot? There are obvious additional risks introduced into the workplace by a lack of wellbeing, whether physical or mental. I don’t think anyone is saying we should abandon classic safety in favour of wellbeing anymore than you or I would say we should abandon classic safety in favour of Behavioural Safety. The fundamentals are essential and a foundation to build on but increasingly never enough. It’s a call for wider integration of specialisms in a common cause, where there should be opportunities for efficiency and multiplier effect not a replacement of one for another. Enough of the narcissism of small differences as Freud might have said 😉
Hi Paul. Not sure the difference is small, hence the article. I think more than anything it is a case of prioritisation. I would prefer the profession eliminated serious injuries and fatalities before it moves on and embraces other topics.
Hi Dom, well we’re agreed that we’d both like to see serious injuries and fatalities eliminated 🙂 I just don’t see how that’s possible when lack of wellbeing is a clear contributory, if not primary, factor in some serious and fatal accidents. The differences are small, it’s two short steps from Behavioural Safety via Ergonomics to wellbeing. HSG 48 makes several references to stress and stressors and there are 2 pages devoted to “Designing jobs for mental well-being”. As per my comment elsewhere in the thread, Stress is to Wellbeing what Accidents are to Safety, a trailing indicator that there’s a failing somewhere in the management system. Avoiding Stress and Avoiding accidents are both down to good process design, adequate training and good supervision. I don’t mind who’s leading and who’s helping in that as long as it doesn’t lead to duplication like having 3 separate systems for Environmental, Safety and Quality Management then a 4th for Wellbeing. ISO 9001, 14001 and OHSAS 18001 share common concepts but differ mainly in the jargon. The introduction to OHSAS 18002 says in effect ‘for goodness sake don’t set up a separate system for document control’ yet many companies do still treat them separately. That’s a concrete example of the narcisism of small differences that leads to inefficiencies. Let’s not promote another instance with Wellbeing when managing wellbeing well can be largely covered by managing safety well. If that doesn’t persuade then coming at it from the legal perspective there is both a statutory and common law requirement to address risk related to stress in safety legislation. The HSWA S2 general duty of care and Management of Health and Safety Regulations Reg 3 being the most obvious ones that have case law, since 2002, that establish the principle in the UK at least. Let’s not forget too that Both Health and Safety and HR are management functions, the role of the professional is to advise them how to meet their responsibilities for safety and wellbeing rather than assuming (or having dumped on them) that responsibility!
Hi Paul, I have yet to see well-being cited as a contributory factor in a workplace incident (though that’s not to say they do not exist). I do agree that Human Error traps lead to failures in planning (knowledge/rule based), failures in execution (distraction/memory failures) or behavioural choices (short-cuts, optimising, overcoming org. problems), that in turn may lead to an incident. One known human error trap is “Person not fit for work” (i.e. heads not in the game before/after a break/leave period). I guess if someone is really stressed (looks and feels like frustration) they could conceivably cause an incident. However, as I said in my article, someone experiencing chronic stress should not be at work at all because of the danger to themselves or others. My point was that chronic stress is not as prevalent as the HSE/LFS stats make out, given GP data suggests an average of around 480 people per year. However, 70K maimings and 137 deaths is very clear-cut and points to an annual problem the HSE profession has not yet solved. As such, the HSE profession would be better served focusing on what is known to be the larger perennial problem. I do think you are right that the role of the HSE professional is to advise other professionals how to meet their responsibilities for safety and wellbeing rather than assuming that responsibility themselves (or having it dumped on them).
Best wishes
I say, this has stimulated more reaction than anything else in recent times and, as someone who is actually diagnosed with a mental health condition (Bipolar) along with a shed load of other physical / neurological deficits / heart disease stuff, unexpected by age 45, driven by a damaged immune system.
Anyway, luckily the gift of Dyslexia always compensated as, an engineering design consultant, enabling me to earn a reputation for seeing opportunities rather than problems, out of the box, solution orientated, go to, ‘fix-it’ person when conventional ” can’t do that mindset ” approaches spectacularly failed.
Maybe, that is why I do not see a problem in defining a “basic set of given working condition” as the human organism, just like any machine, has a set of parameters in which it can sustainably and optimally function over it’s working life-cycle that, continues to be extended as the pension age is put back.
It is not so much just a question of the type of stress as, stress is normal, along with most organisms it promotes biological, physical, hormonal survival responses but, and it’s a big but, over-exposure to the common “known” physical, emotional / mental stressors WILL result in “adaptation exhaustion”.
If, the physical / cognitive stressor/s is sustained for longer than 90 minutes and/or ‘repetitive’ to the point where the body is no longer able to cope, tolerate, persevere and make adaptations sufficient to be resilient to the increasing levels of stress “fatigue” then, it will resorts to manifesting a debilitating level of discomfort, pain and/or illness sufficient to “enforce an escape from the stressor”.
So, provided the Human Resources, production line, environment and working conditions are basically optimised or “barriers to wellbeing / performance are mitigated” the levels of presenteeism can be organically reduced along with work-stress related Mental Health injuries.
Hence the S.M.A.R.T. Foundation promotion of “Digital Health & Literacy” targeted as DSE user operators in education as a specific group working toward being employees who will predictably present with fatigue related debilitating symptoms exacerbating the degree of presenteeism in the workplace.
Hi Nigel. Very erudite. Clearly you make some valid points that I hope people will make use of. As I replied to Paul earlier my concern is for the HSE professionals to focus on eliminating serious injuries & fatalities. Thus it is a case of prioritisation. However, if during that process, factors are identified that can also help reduce the demands on people, then why not deal with them. Best wishes
Just fascinated to note the increase in use of Equality Act, in preference to occupational health regulation / legislation, as this defines a debilitating health deficit, that lasts for 12 months or more, as a “Disabling” harm or injury therefore, enabling a claim to proceed into court. This then potentially opens the flood gates, along with the ‘retrospective’ findings in the court of appeal in Baker V Quantum Clothing & Ors that, the expediency of solely complying with safety regulation in the light of ‘current knowledge’ is insufficient defense when it is “known or should be known” that existing “work exposure limits” are ineffective in terms of protecting or mitigating injury.
As the ambulance chasing “no win no fee” commercial solicitors jumped on the “loss of hearing” band wagon following that case how long is it going to be before they start on “Mental Health” as, it is clearly linked to work related stress / fatigue, performance anxiety, presenteeism, decrement in productivity, founded in any significant loss of “wellbeing” as symptomatic.
With regard to serious injuries and fatalities there are few cases of ‘accidental’ incidents as, when investigators follow the ‘chain of causation’ do not find that stress “fatigue” or, so called, Pilot Error are not behind the events leading up to the accident / incident.
https://marketing.fatiguescience.com/acton/attachment/27084/f-006b/1/-/-/-/-/Science%20of%20Sleep%20Workplace%20Fatigue%20Ebook.pdf
Which brings me back again to the imminent release of BSI’s ISO 45001 & Work Exposure Limits (WEL) as, you can bet your bottom dollar the lawyers are going to be all over this like a rash in future Health & Safety claims regardless of any resistance from H&S Professionals to include “sub-optimal working conditions” within their remit as the courts will not have forgotten Exxon Valdez, Bhopal, Chernobyl, Three Mile Island, whatever more recent UK cases.
Again distracted from post and failed to attach:
https://www.usatoday.com/story/news/nation-now/2017/07/11/employee-takes-sick-leave-mental-health-ceos-response-refreshingly-rare/467249001/
A refreshingly provocative discussion with more posts than most I’ve seen for a long time! At the foundry I work for we are aiming at a new stage in the company of behavioural change and employee engagement. This is coming along nicely and even the “old boys” are now starting to buy into the need for certain safety standards and work in a safer way and open up with ideas they have held back, supressed for many years. We all see, read and contribute to many articles and topics during the year and engage with the industry bodies and such like, but it really all boils down to employee engagement through good management. You do not need to be an expert in any one field, but have knowledge and an understanding of most and know how and when to apply that knowledge or go and find out if you are unsure. Have one or two people find out more about mental health and talk to your employees and give them a route if they are finding it too difficult. But management must not laugh, nor get cross and dismiss it as that will be the biggest detractor to any positive outcomes and will affect the rest of your workforce in one fail swoop. Good management from the top and everything else, including the product, will follow.
So a summary of this debate to date seems appropriate. As well as this page on SHP there have been two threads on linkedin.
What have we learned? Well clearly there are three schools of thought. The first is that safety professionals should concentrate on reducing SIF incidents and maintaining a focus on the basics. The second is that Mental Health issues have historically been overlooked and underfunded within the HSE profession and that it is time for a change. Third, that the HSE professional should be able to do both at the same time. All are valid arguments, depending which camp you are in.
I am in the first camp of concentrating on eliminating serious injuries & fatalities. It is noticeable that those in the second camp, tend to have a financial/commercial stake in the HSE profession driving this stress agenda forward. Those in the third camp, have a point that the HSE profession could do both at the same time. However, this must not be to the detriment of basic HSE, which is currently what appears to be happening.
We have also learned that the statistics surrounding MH are an illusion. The 2017 HSE stats of 526,000 people suffering MH issues is not reflected in GP referalls which point to an average of 480 per year. A vast discrepancy, which shows that the Labour Force Survey is an unreliable source for making national policy decisions regarding the HSE professions remit. It also turns out that MH is a national political issue (Theresa May asked for a report on MH ealier in the year), and the reports everyone is acting upon are based on – yes, the Labour Force Survey!
It is also telling how the MH statistics are being misused. The Office of National Statistics on suicides shows that nationwide there is a significant downward trend in suicides over the past 10 years or so, but this is not highlighted. Instead, we are told there is a major problem of suicides in construction, although the HSE statistics say there is no problem with stress in construction. However, no one can say that the suicide rate of those who happen to be working in construction is a result of working in construction. When looking closely we discover that the reasons for suicides are likely due to features of the job such as low pay, job security and the wider socio-economic characteristics of individuals employed in a particular sector. We also find that MH issues are prevalent with those with serious long-term physical ill-health issues. Thus it is not construction that is causing people to commit suicide, it is other factors outside the control of the HSE profession.
In my view, stressed people need to be dealt with by specialists, not HSE professionals (their 1st priority IS to stop workplace deaths and serious injuries). Someone who is in a chronic state of stress is clearly visible to co-workers (i.e. looks and feels like frustration) can be reported to HR by colleagues so specialist help can be administered. My argument is that the HSE profession should concentrate on stopping workplace injuries & deaths. These statistics are based on hard facts (RIDDOR), not perception surveys and estimates.
Soooo, where does the £30bn cost of presenteeim come from and, if not related to mental health as, a generic header for sub-optimal wellbeing founded in either environmental, physical and/or psychosocial deficits accounting for some 20% lost productivity, does it solely come from KSI cases?
Does it include or exclude WULD’s and MSD’s or is anything less than a KSI is only a near miss that doesn’t really count regardless of productivity losses due to presenteeism not including social costs?
When does the expediency of overlooking or turning a blind eye to implementing regulation / legislation not come back to haunt H&S Professional as in the retrospective case of Baker V Quantum Clothing & Others where, relying on doing “just enough and claiming ignorance” was found to be “ineffective” and the employer/s should have known better ?
Whether the WHO ‘Better Workplace’ nudge campaign founded on the UK Whitehall ‘ll’ Study or HSE Better Display Screen RR561 2007 highlighting the human factors in Health & Safety or the BSI ISO 45001 ‘Work Exposure Limits’ are expediently ignored, if not directly linked to immediate physical risk, Work Exposure Limits (WEL) will include the spectrum of sub-optimal working resulting over-exposure to “any stressor” resulting in fatigue, error, mishap and accidents to individuals and mass KSI’s incidents.
So whilst physical, Mental ill-Health and/or long-latency NCD’s as, a result of failure to implement systems to safe-guard against over-exposure to stressors of any kind, will be a another professionals responsibility to treat, the “chain of causation” in or of that injury will come back to sub-optimal H&S !
“Assessing Risk” to human resources is the name of the game and, unless employees can be converted from being negligent actors in their own ill-health / minor or more serious mishaps to being self-aware, pro-active & engaging in self-assessment they will continue complacently expecting someone else to save their bacon, only raising awareness or complaining when they are KSI, what what ?
Indeed, it is not the job of the HSE manager to be involved in the care and rehab of persons with mental health issues. However, surely it is part of their job to analyse if workplace factors are contributory?
I am also mindful that a single case of stress does not mean the workplace is broken, but it might well act as a trigger to begin thinking about what may have been a contributory cause. If the problem then becomes more widespread they woudl be better armed to help develop strategies to mitigate the identified causes.
Excellent article which I totally agree with all points made
Thanks Douglas. Appreciate your support
DSE compliance “at just 10%”, study claims – need I say more ?
Hi Dominic,
Mental health or mental wellbeing should be a focus for health and safety practitioners, clearly not to the detriment of taking actions to avoid or reduce future workplace death and serious physical injury. The causes of the latter are well documented and well understood by H&S professionals. Why Is a strategy or campaign required to kick start people into action on what is a well-known issue?
Less widely known are the issues surrounding mental health in the workplace and this justifies the campaigning which is going on.
By their very nature, H&S practitioners seek to prevent harm to people and inevitably crossover with many other areas of expertise such as FM and HR. They have a wide knowledge of workplace diseases, syndromes and hazards to physical health. Mental health is not an entirely separate bubble from physical health. Yes, the subject is served by other professions but they are not on the shop-floor. I cannot see how or why H&S practitioners cannot be involved. They are instrumental in putting into place arrangements for mental health first aid and risk assessment.
In a similar way to physical first aid, mental health first aid is not about diagnosing a particular condition, providing counselling or solving a situation, it is about picking up signals when people may exhibit changes in their normal behaviour or personality, finding out about how they really feel and pointing them in the right direction towards professional help, e.g. stabilising the patient whilst waiting for medical help to arrive. The best placed people to do this are line managers or work colleagues as they work with their staff or fellow colleagues on a day to day basis and are most likely to notice any changes. Send them on a 2 day Mental Health First Aid course (search MHFA England) to make a significant step towards managing mental health in the workplace. The process is not too time consuming and easy to implement.
Less easy is the process of removing stigma towards mental health which prevents sufferers from speaking out if they find friends or work colleagues to be dismissive or less than empathetic towards mental health issues. Dominic Coopers term “perceived stress” demonstrates dismissiveness and a pre-judgmental attitude. We should not discriminate against genuine sufferers of stress, anxiety or depression through any experiences of dealing with people who “swing the lead” and use stress as a scapegoat. The health & safety profession is often used as a scapegoat so the feeling should be familiar.
The workforce is an employers most valuable asset. Human health encompasses the physical and mental. There is no clear dividing line between the two and one can affect the other. A workplace injury with extended time off can lead to depression, depression can lead to injury in the workplace where insufficient care might be taken with machinery or working at height. If necessary, work processes and activities can be redesigned to reduce stress.
Early intervention is key. Giving help to a sufferer of stress or depression at an early stage may prevent a suicide. A suicide in the workplace or serious injury resulting from the attempt would affect co-workers mental health which returns us to the need for mental health first aiders, at which time it would be too late. Preventing a suicide contributes potentially towards preventing a workplace death or serious injury. Is this not part of the overall aim?
Moving on from the moral argument, the HSAWA includes mental health within the definition of “health”. It is part of the employers legal duties. There are duties also under the Equality Act which covers disability discrimination, encompassing both physical and mental.
Statistics Great Britain 2016:
137 workplace deaths
1792 road traffic accidents
5668 deaths by suicide
A lot of attention is paid to the first two figures. We need to focus on the third as well. Concern over many mental health statistics coming from the public sector was expressed stating that perhaps lessons should be learned from the apparent good record of the private sector. It is more likely that there are a large number of unreported mental health concerns due to stigma and negative culture in the working environment. 1 in 4 persons approaching the NHS do so for mental health services. The private sector cannot be that squeaky clean.
Mental health is there, just like physical health and needs to be protected. Death from suicide is just as permanent as a workplace death. Suicide is a permanent solution to a temporary problem and can be prevented. Some mental health issues may not originate in the workplace but that is where they can manifest themselves, so we have to address it.
Phil Hopkins
People are asking me why is a focus on serious injuries & fatalities needed, when it is a known problem, and the scale of the Mental Health problem is thought to be much greater.
Well, up to Mid-October in 2017 there were 73 workplace deaths recorded via RIDDOR to the HSE. At approximately 511 serious injuries per death we can estimate a further 37,300 serious injuries so far (based on 70K serious injuries / 137 deaths in 2016/17). We are only half way through the year, so may well end up by years end with around 146 deaths!!!
Of those deaths, the breakdown by sector is:
Construction = 25 plus an estimated 12,775 serious injuries
Services = 15 plus an estimated 7765 serious injuries
Agriculture = 13 plus an estimated 6643 serious injuries
Waste/Water treatment = 9 in (plus an estimated 4599 serious injuries
Manufacturing = 8 plus an estimated 4088 serious injuries
Extractive/Utility 3 plus an estimated 1533 serious injuries
Some accuse me of demonstrating dismissiveness and a pre-judgmental attitude to Mental Health (MH) by using the term “Perceived Stress”. The MH data that has and is being used to buttress all the arguments as to why HSE professionals should be responsible for peoples MH is the Labour Force Survey (LFS). As it states on the Office for National Statistics website, “The LFS is a national survey run by the ONS of currently around 37,000 households each quarter. HSE commissions annual questions in the LFS to gain a view of work-related illness and workplace injury based on individuals’ perceptions. The analysis and interpretation of these data are the sole responsibility of HSE”.
Thus, my use of the term ‘perceived stress’ is simply stating a fact. Obviously I care about people suffering chronic MH problems, but this debate is not about my feelings/attitudes, it is about the MH burden being placed on the HSE profession that could cause a significant loss of focus on people being killed and maimed at work – which is an acute problem that has not yet been solved.
So, when we dig into the LFS data, we find some 526,000 people report they are stressed, anxious or depressed. So the question has to be asked “At what point does stress, anxiety and depression become debilitating?” In the UK, access to MH services are free on the NHS, but in most cases you will need a referral from a GP. So the obvious place to look for an answer is the records (THOR) for the number of GP referrals. Here we find only an average of 480 per annum!!!! IF we assume the LFS figures are accurate, applying the statistical Normal Distribution Curve with a 5% tail we should have 12,800 people being referred by GPs for severe or chronic MH problems – clearly this is not happening! It certainly could be argued we are being urged to use a sledgehammer to crack a nut, as it appears many of those with ‘perceived stress’ are only suffering mildly. In other words, the problem is not severe enough for the HSE profession to take its eye off of serious injuries & fatalities.
We then turn to the problem of suicides, which many proponents of MH throw around to justify the HSE professions focus on MH (Including the Farmer/Stevenson Report). From Coroner records, the total number of intentional self-harm suicides in the UK (inclusive of non-residents) for 2016 are:
Country Total Number Working Age (15-65)
England/Wales 3789 3331
Scotland 603 534
Northern Ireland 297 271
Totals 4689 4136
Total UK deaths by Industrial Disease 2761
Total UK Deaths by Accident/Misadventure 7,692
According to the statistics the likely reasons for suicides include unemployment, socio-economic deprivation, separation from life partner and children, drugs/alcohol abuse, job insecurity, and long term physical health issues. In fact, the biggest portion of suicides are committed by those already diagnosed with schizophrenia. So the problem we have, which no-one seems to want to recognise is that the vast majority of the UK’s suicides are not work related. There is certainly a gap in the work-related ill-health data concerning MH, which makes the task of accurately assessing the scale of the problem doubly difficult.
However, we are told there is a major problem of suicides in construction, although the actual HSE statistics say there is no problem with stress in construction. Nonetheless, no one can say that the suicide rate of those who happen to be working in construction is a result of working in construction. The ONS itself states “While the work reported here shows that individuals in certain occupations are more or less likely than others to die by suicide, the analysis does not provide any evidence on causation. For instance, while it is possible that certain jobs make suicide more or less likely, it could also be the case that people’s characteristics attract them to certain lines of work. Similarly, while it is possible to speculate why certain occupations have a high or low risk of suicide, the analysis reported here does not uncover whether particular occupations are exposed to specific risk factors that make suicide more or less likely (for example, job-related stresses, job-related conditions, socio-economic determinants)”.
In contrast, to the total number of suicides, there were also 7,692 deaths by accident/misadventure outside of the workplace. Clearly, this is an even bigger problem for society than MH. Importantly for the HSE profession there were 2,761 deaths directly caused by Industrial Diseases – which are clearly work related. So the HSE professional has its work cut out just to control industrial disease and serious injuries and fatalities – things it already knows, that don’t require special campaigns according to some.
However, all these facts don’t actually matter anymore. As Lawrence Waterman wrote last week in the IOSH magazine, the HSE has been on the wrong-end of the Farmer/Stevenson report (based entirely on erroneous LFS data), and has been forced to accept all its recommendations by the Government.
The government were being asked to provide billions of pounds to improve the state of the nation’s MH services from various quarters. As we all know it is struggling to find money for anything. However, it has found the ideal solution. Place the burden on industry, and the HSE profession in particular. So politics has dictated the MH agenda not facts.
So now we see MH emphasised in HSE publications despite the problems of muscular-skeletal problems and other issues being of more pressing concern. It also appears that all MH issues can be resolved by MH First-Aid training according to its advocates. Very Orwellian indeed.
Where the profession goes from here is unclear. Perhaps next year we will be asked to fix the nations obesity problem. What I fear is that the number of people being killed and maimed at work will increase, as the attention of HSE professionals is diverted.
I’m with you, Dominic.
Politics is driving this MH/stress preoccupation; we need to keep our focus on the real H&S issues.
Thanks Safety Lady. I really appreciate your support
Interesting discussion. I won’t add to what has already been said, but, unless I missed something on my scamper through the posts, very little has been mentioned about training people to manage stress in the first place? You can have two guys at work with identical jobs, one who has a pile of paper everywhere and the desk is in a mess and he is clearly struggling and another who has a clear desk, a smile on his face and is relatively fulfilled. Why can one manage the stress better? Can the other one be educated to manage it? I think so to a degree. It helped me go form the first to the second (OK, the smile is a bit too far..) S
I have been looking at the academic workplace stress literature to try and get a better feel for the size of the MH problem. Meta-analytic studies involving millions of people show there is no clear statistically significant relationships between workplace stress and actual outcomes such as cancer (Heikkilä,et al, 2013), diabetes (Sui, 2016), coronary heart disease (Virtanen, 2103) or sickness absenteeism (Darr & Johns, 2008). Conversely, symptoms of psychological stress are over reported in nearly all “stress” surveys (Goodwin et al.,,2103). Such independent results, as I have been arguing, again point to the size of the MH problem being over-stated, or exaggerated. Serious injuries & Fatalities, and Industrial Diseases are a much bigger perennial problem than workplace stress. As such, the HSE profession must give these latter areas a much higher priority than workplace stress.
Nevertheless, the cumulative, compound affect of workplace psychosocial stressors identified in the longitudinal civil service Whitehall ‘II’ Study has been used by the WHO as the foundation for their Global Better Workplace Nudge Campaign promoting the development of occupational health strategies to address the human factors insidiously affecting employees physical and emotional “Wellbeing”, over time, as a driver of resultant injury to the individual employees physical and/or Mental Health.
“Fatigue” has also been recognised as a Safety Critical element in many, so called accidents, ending in significant numbers being KSI following disaster investigations into the chain of causation so, I am not yet convinced that biopsychosocial deficits cannot be ignored, let alone fatigues role in presenteeism and lost productivity due to unaddressed workplace stressors exacerbated by sub-optimally calibrated DSE interface ergonomics, debilitating user operators over the last 26 years now, simply due to failure to train users to effectively set-up / customise / optimise their display screen for them.
A simple practice taking no longer than 15 minutes and saving a lifetime of discomfort, eye and headaches etc manifesting in stress related 20% loss in performance, productivity and more serious stress related breakdowns including increased risk of WULD’s, MSD’s.
Although I agree that there is a risk in adding burdens to OS&H practitioners that should rightly sit in the line management structure, there is overlap between stress and injury given the strong risk factor of workplace stress itself in causing safety to be ignored. Anecdotally, I’m sure we’re all familiar with stories of corners being cut when people are under pressure to deliver with insufficient resources.
Nigel, you highlight another area of collective failure of the HSE profession. If we cannot resolve our current agenda why would we wish to add further burdens?