Work Related Stress

By Mark Reddy 2007

Acknowledgement and Extracts from the WHO Website

All employers should carefully consider the systems that they have in place for assessing, preventing and otherwise managing work stress you must be aware of your organization’s systems and resources for managing stress.

Internal resources may include occupational health services, human resource management (personnel), training departments or other individuals with responsibility for staff well-being and health. Individual problems which are complex, difficult and not manageable internally are best dealt with by a counselling psychologist, clinical psychologist, counsellor, or an occupational physician who may consult with a general practitioner or other specialist functions as deemed necessary. Identification of any groups at risk within your organization is crucial and should accompany the examination of available organizational resources for managing work stress.

Good practice in implementing interventions to
Improve mental health at the workplace should:

·        include an early detection (early warning)
·        involve the participants in the whole project
·        be integrated into management philosophy;
·        include different levels of interventions, i.e.
     the individual, the social environment and working
·        Confidential Occupational support services: Experienced and qualified Psychotherapists and Psychologists providing therapeutic intervention and support

The Medical implications of employee assistance programme’s written by G. G. Lloyd, Y. Doyle+ and C. Grange shows that studies of minor psychiatric disorders in working populations indicate a prevalence of between 270 and 370 per 1,000 employees. Most of these disorders are believed to arise as a result of excessive stress either in personal life or at work.  These conditions are an important determinant of sickness absence, and are the second most common cause of absences lasting more than 21 days. Work effectiveness and staff turnover are also affected and the economic cost to industry is enormous.
There are three models of service: internal, external and a combination of the two. The internal arrangement can use knowledge of the organization's dynamics to enable changes in working practices which will modify an employee's psychological problems. In one organization, 25% of all referrals to the EAP were made by managers. However, such models are frequently perceived to lack independence and confidentiality which are important elements of a successful service. “Therefore it is vital to assure employees that the internal service is confidential with the power to inform and support change” Reddy. M. (2005)

Work-related stress is the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope.

Stress occurs in a wide range of work circumstances but is often made worse when employees feel they have little support from supervisors and colleagues and where they have little control over work or how they can cope with its demands and pressures.

A healthy job is likely to be one where the pressures on employees are
appropriate in relation to their abilities and resources, to the amount of
control they have over their work, and to the support they receive from
people who matter to them. As health is not merely the absence of disease
or infirmity but a positive state of complete physical, mental and social
well-being (WHO, 1986), a healthy working environment is one in which
there is not only an absence of harmful conditions but an abundance of
health promoting ones.

These may include continuous assessment of risks to health, the
provision of appropriate information and training on health issues and
the availability of health promoting organizational support practices
and structures. A healthy work environment is one in which staff have
made health and health promotion a priority and part of their working
lives. Having an effective Occupational Support service ensures this provision is supplied on the ground to all that need it.

The way we design jobs and working systems, and the way we manage them, can cause work stress. Excessive and otherwise unmanageable demands and pressures can be caused by poor work design, poor management and unsatisfactory working conditions. Similarly, these things can result in workers not receiving sufficient support from others or not having enough control over their work and its pressures.

Research findings show that the most stressful type of work is that which
values excessive demands and pressures that are not matched to workers’ knowledge and abilities, where there is little opportunity to exercise any
choice or control, and where there is little support from others.

The more the demands and pressures of work are matched to the knowledge
and abilities of workers, the less likely they are to experience work stress. The more support workers receive from others at work, or in relation to
work, the less likely they are to experience work stress.

Statistics Taken from the UK Health and Safety Executive

  • The 2006/07 survey of Self-reported Work-related Illness (SWI06/07) prevalence estimate indicated that around 420 000 individuals in Britain believed in 2006/07 that they were experiencing work-related stress at a level that was making them ill.
  • The 2007 Psychosocial Working Conditions (PWC) survey indicated that around 13.6% of all working individuals thought their job was very or extremely stressful.
  • The annual incidence of work-related mental health problems in Britain in 2006, as estimated from the surveillance schemes OPRA and SOSMI, was approximately 5,900 new cases per year. However, this almost certainly underestimates the true incidence of these conditions in the British workforce. The most recent survey of self-reported work-related illness (SWI06/07) indicates that an estimated 245 000 people first became aware of work-related stress, depression or anxiety in the previous 12 months.
  • Estimates from SWI06/07 indicate that self-reported work-related stress, depression or anxiety account for an estimated 13.8 million reported lost working days per year in Britain.
  • Survey data suggest the incidence rate of self-reported work-related stress, depression or anxiety in 2006/07 is of a similar order to that in 2001/02. There had been a fall between 2004/05 and 2005/06, but this was followed by a rise back to the previous level in 2006/07. Both changes were statistically significant. THOR surveillance data shows a mixed picture with a falling trend in psychiatrist reports of work-related mental health between 1999 and 2006 but with occupational physician reports rising between 1999 and 2001 and then remaining steady. The ONS omnibus survey shows an overall downward trend in the proportion of people saying their job was very or extremely stressful between 2004 and 2006, leveling off in 2007.

  • Occupation and industry groups containing teachers and nurses, along with professional and managerial groups particularly those in the public sector have high prevalence rates of work-related stress in the SWI and SHAW surveys. The THOR datasets SOSMI and OPRA also report high incident rates of work-related mental illness for these occupational groups, along with medical practitioners and those in public sector security based occupations such as police officers, prison officers, and UK armed forces personnel.

Mental health legislation - a necessary requirement

General principles for mental health legislation to protect the rights of the mentally ill include:
Respect for individuals and their social, cultural, ethnic, religious and philosophical values. Individuals' needs taken fully into account. Individual's need for health and social care must be assessed thoroughly. In particular, it is important to ensure that the views of an individual (and his or her carers) are considered. For this to happen there must be close liaison between health, housing and social care services.

Care and treatment provided in the least restrictive environment. In order to uphold this principle, legislation should be framed so that involuntary (formal) hospital admission is a last resort. This can be achieved through: clearly defined grounds for detention; procedural safeguards when the power to detain is used; an obligation to discharge when grounds for detention are no longer met; an independent review of the decision to detain.

Provision of care and treatment aimed at promoting each individual's self- determination and personal responsibility. It is vital that individuals are given the opportunity to exercise choice and make decisions about their own care and treatment. Legislation should aim to ensure that: treatment can be imposed only in strictly limited and clearly defined circumstances and must be the least restrictive alternative; where individuals are unable to make decisions for themselves, steps are taken to find out their wishes and feelings; clear information on treatment and detention is readily available; appropriate provisions for confidentiality are in force.

Provision of care and treatment aimed at achieving the individual's own highest attainable level of health and well-being. In addition, to issues of quality and continuity of care, this principle addresses the question of a "right" to treatment. It can also cover more general issues such as the requirement that the individual should be cared for properly in a safe environment and subject only to restrictions for reasons of his or her health or safety, or the safety of others. In this regard: there should be no restrictions on an individual's contact with friends and family, except in rare and clearly defined circumstances; stringent safeguards from abuse, exploitation and neglect should be in place.

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