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Dr Carlo Caponecchia [email protected]

Outline

•  Psycho-what?

•  Psycho-why?

•  WHS frameworks and assumptions

•  What should we be doing about psychosocial hazards?

•  What are we doing about psychosocial hazards?

•  What barriers are contributing to the mismatch?


Psycho-what?

•  Widespread lack of confidence with terms related to “psychosocial” (eg. Leka et al., 2015; Leka Jain & Lerouge, 2017; Kunyk et al. 2016; Caponecchia & Wyatt, 2009, 2011)

•  Different usages based on subdiscipline

•  Age-old confusion of hazard (source of harm) and risk

•  Different issues included under this term by organisations

•  In organisations, psychosocial is often interpreted as meaning:

•  “STRESS” (Leka et al, 2015) or

•  MENTAL HEALTH (DISORDER)


“Psychosocial”

•  Factors in the environment (including the social environment) that can have an effect on mental processes (eg. thoughts, attitudes, expectations, perceptions, motivations, emotions) and behaviours.

•  These psychological processes have a physiological base (ie. they are “psychobiological”)


Identification of Psychosocial hazards

•  “aspects of job content, work organisation and management and environmental and organisational conditions that have the potential for psychological and physical harm” (Cox 1993).

•  Examples (see Leka & Cox, 2008; SWA, 2018; Caponecchia, 2019)

•  Job content – task variety, use of skills

•  Workload, pace/timing and schedule

•  Control and autonomy

•  Work environment and equipment

•  Relationships, supervision

•  Roles – ambiguity, conflict

•  Career development

•  Bullying, violence, harassment, discrimination behaviours (often included; may be a combination or outcome of other hazards eg. Leka et al., 2015)


Wider environment Job security & casualisation; Location, industry & economy; Regulation

Organisational factors Culture & values; Leadership, Management commitment & competencies, transparency, trust (eg. reporting, attitudes to time off due to injury)

Psychosocial hazards

Job content variety, use of skills Workload, pace and schedule Control and autonomy Environment & equipment Relationships, supervision Roles: ambiguity, conflict Career development Bullying violence, discrimination, harassment See also revisited

”Onion” model of Wilson & Sharples (2015); Stevenson (1999)


Why are we talking about psychosocial issues? •  Psychosocial factors are fundamental to WHS, because they are

fundamental to health

•  Psychosocial issues can manifest in any industry, regardless of task, equipment, role or complexity

•  Psychosocial factors contribute to other types of injury – not just psychological outcomes

•  Eg. Musculoskeletal Disorders

•  (National Research Council US; 2001; Macdonald & Evans, 2006; Lang et al., 2012; Gerr et al., 2014; Oakman et al., 2018)


More reasons why… •! Managing psychosocial hazards is part of

WHS duties (and has been for a very long time)

•! “Health” (now explicitly!) includes psychological health

•! Nationally agreed guidance from Safe Work Australia 2019

•! New international standard on Safety Management Systems AS/NZS ISO45001 Section 6.1.2.1 specifies the following as part of hazards to identify:

•! “how work is organized, social factors (including workload, work hours, victimization, harassment, and bullying), leadership and the culture of the organization”

•! Proposed new International Standard 45003: Psychological health in the workplace


So what should we do?

Scope & context

Risk assessment:

Identify Assess

Evaluate

Control (Risk treatment)

Com

mun

icat

ion

&

cons

ulta

tion

Mon

itor

and

revi

ew

Adapted from AS/ISO31000:2018


Assumptions of Risk management and WHS

•! Proactive, preventative

•! Control hazards at the source

•! Not focused on individuals, or individual level interventions

•! Continual improvement

•! Importance of CONTEXT at first stage of risk management

•! For example, facility type; patient/resident type; geographical location; staff diversity (gender mix, sexuality, employment type); role in community


IDENTIFICATION of Psychosocial hazards

•  “aspects of job content, work organisation and management and environmental and organisational conditions that have the potential for psychological and physical harm” (Cox 1993).

•  Examples (see Leka & Cox, 2008; SWA, 2018; Caponecchia, 2019)

•  Job content – task variety, use of skills

•  Workload, pace/timing and schedule

•  Control and autonomy

•  Work environment and equipment

•  Relationships, supervision

•  Roles – ambiguity, conflict

•  Career development

•  Bullying, violence, harassment, discrimination behaviours (often included; may be a combination or outcome of other hazards eg. Leka et al., 2015)


CONTROL of psychosocial risks

•  Control through work design (see Parker, 2015; Tuckey, Zadow, Li & Caponecchia, 2019; Caponecchia 2019)

•  Using a range of principles as needed eg consultation; effective training, assessment & skill development; task and workflow analysis…)

Safe Work Australia (2019). Work related psychological health and safety: A systematic approach to meeting your duties.


Job re-design strategies

•  Analyse and see if we need to change:

•  Who’s doing what

•  How much of it they’re doing

•  How often they’re doing it

•  Who they’re doing it with

•  What else they might do

•  What makes their task start

•  What happens when they finish

•  Who they communicate with, and how

•  Where and how they get support, supervision, monitoring


Controls Psychosocial hazard

Examples of controls

Job content – variety, use of skills

Design through consultation new workflows or component tasks to a job, supported with available data

Workload, pace, schedule

Staffing; Consultation on rostering, duty hours, flexibility

Control, autonomy

Increase participation in decision making, especially in re-design process, relevant training to equip workers to have increased decision lattitude

Environment & equipment

All levels of HOC, good physical ergo and related fields

Relationships, supervision

Team building, workflow and reporting lines, competency based training, feedback mechanisms, mentorship programs. Multiple points of contact, reduced hierarchy

Role conflict & ambiguity

Job descriptions and role statement review, redesign workflows, review role expectations

Bullying Range incl reporting systems, policies and procedures, but also the controls for the other contributing psych hazards

Violence Depends on type (client, internal, external); incl. engineering controls, procedures, training, culture dvt, debriefing & support


So what are organisations doing?

•  Mostly strategies that are:

•  Focused on individuals and/or

•  Act after harm has occurred (tertiary) and/or

•  Don’t directly address the hazards

•  Examples include

•  Mental health promotion

•  “self care”

•  Resilience training

•  Wellness


Implementation

•! In addition, these individual- focused strategies are often poorly implemented

•! Encourage talking about mental health without competency, preparation, trust

•! “Squeeze in a massage”

•! Encourage exercise and riding to work, but poor facilities at work


Barriers to improved prevention

•  Work design seems abstract and scary

•  WHS competencies tend to focus on compliance, rather than understanding the background systems and assumptions

•  Limitations in how we view workplace mental health

•  SCALP model


SCALP model: views of mental health at work

S Stable and Binary

CA Clinical Assessment

L Lunch

P Performance and

productivity

Stable and

Assessment

Performance

productivity


SCALP model

S Stable and Binary Dynamic

CA Clinical Assessment

Clinical and sub-clinical

L Lunch Taken home with you

P Performance and

productivity

Work affects MH,

productivity & performance


Summary

•  Preventing and managing Psychological hazards are a key element of WHS duties

•  Risk management frameworks should be applied

•  Context is crucial, as it is for all risk management activities

•  Increased awareness of psych hazards under a WHS frame is needed

•  not just mental health promotion, wellness or self-care, but prevention of the sources of harm through work design


References

•  Caponecchia, C (2019). Risk management and bullying as a WHS hazard. Prevention of workplace bullying through work and organisational design. In D’Cruz et al., eds. Workplace Bullying: Dignity and Inclusion at Work. Springer.

•  Caponecchia, C., & Wyatt, A. (2009). Distinguishing between workplace bullying, harassment and violence: a risk management approach. Journal of OHS Australia & NZ, 25(6), 439-450

•  Caponecchia, C., Wyatt, A (2011). Preventing workplace bullying: An evidence based guide for managers and employees. Sydney: Allen & Unwin.

•  Cox, T. (1993). Stress Research and stress management: Putting theory to work. Sudbury: HSE Books

•  Gerr, F et al., 2014). A prospective study of musculokeletal outcomes among manufacturing worker: II Effects of psychosocial stress and work organization factors. Human Factors, 56, 178-190.

•  Kunyk D, Craig-Broadwith M, Morris H, Diaz R, Reisdorfer E, Wang J.(2016). Employers’ perceptions and attitude toward the Canadian national standard on psychological health and safety in the workplace: A qualitative study. Interntional Journal of Law and Psychiatry. 44.

•  Lang J, Ochsmann E, Kraus T, Lang JWB, (2014). Psychosocial work stressors as antecedents of musculoskeletal problems: A systematic review and meta-analysis of stability-adjusted longitudinal studies. Social Science & Medicine.75:1163-74.

•  Leka, S., & Cox, T., (2008). PRIMA-EF. Guidance on the European framework for psychosocial risk management. WHO. http://www.prima-ef.org/

•  Leka, S., Jain, A., Lerouge, L. (2017). Work-related psychosocial risks: Key definitions and an overview of the policy context in Europe. In L. Lerouge, (ed.). Psychosocial risks in labour and social security law. A comparative legal overview from Europe, North America, Australia and Japan. Cham: Springer


References •  Macdonald W, Evans O. (2006) Research on the prevention of work-related musculoskeletal disorders: Stage 1, Literature

review. Canberra: Safe Work Australia.

•  National Research Council (US) Institute of Medicine panel on MSD. (2001). MSDs and the workplace: Low back and upper extremities. Washington: National Academy Press.

•  Oakman J, Macdonald W, Bartram T, Keegel T, Kinsman N. (2018) Workplace risk management practice to prevent musculoskeletal and mental health disorders: What are the gaps? Safety Science.101:220-30.

•  Parker, S.K. (2015). Does the evidence and theory support the good work design principles? An educational resource. Canberra: Safe Work Australia.

•  Safe Work Australia (2019). Work related psychological health and safety: A systematic approach to meeting your duties. Canberra: Safe Work Australia.

•  Tuckey, M., Zadow, A., Li, Y., & Caponecchia, C. (2019). Prevention of workplace bullying through work and organisational design. In D’Cruz et al., eds. Workplace Bullying: Dignity and Inclusion at Work. Springer.


What do we mean by work design?

•  “content and organisation of one’s work tasks, activities, relationships, and responsibilities” (Parker, 2015).

•  Examples of decisions to be taken when designing work (Parker 2015):

•  Which activities should be grouped together to form a meaningful job?

•  Which decisions should be made by employees and which by their supervisors?

•  What feedback does the employee get when carrying out his/her job?

•  Does the employee have an opportunity for social contact?

•  How many tasks in the job, and is this level of task demands reasonable?

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