Section 4 – Identifying Problem Areas

Impact

The impact of mental health problems in the workplace has serious consequences for the worker and the company. Annual losses to the Canadian economy due to mental illness in the workplace are now estimated at $51 billion. Employee job performance, rates of illness, absenteeism, accidents and staff turnover are all affected by the mental health of employees. Common mental health problems affect an estimated one in five or 20% of the working population at any given time.

Do Certain Jobs Present Higher Risks?

A review conducted by British Occupational Health Research Foundation of the international literature and secondary analysis of the ONS Psychiatric Morbidity Survey (Stansfield et al, 2003) shows that certain occupations are at greater risk of mental ill health than others. Using Standard Occupational Classifications (SOC), major groups at risk include clerical, secretarial, administrative support workers, machine operators, social workers, industrial workers, sales people and certain professional groups.

British national surveys suggest that teachers, nurses, social workers, probation officers, police officers, the armed forces and medical practitioners have a higher incidence of work-related mental illness.

Using combined data from the 1993 and 2000 surveys, sub-major SOCs with a higher risk included managers and administrators (especially general managers in government and large organizations), teaching professionals, other associate professionals, clerical and secretarial, and other sales and personal services occupations. Occupations with a lower prevalence than the overall prevalence included craft and related occupations, science and engineering professionals, personal services professionals and interestingly – given the international literature – plant and machine operatives.

The foundation goes on to suggest the reasons for high rates of mental disorder in particular occupations are associated with high levels of job demand, combined with lack of long-term security and particularly high emotional demands in working with people. Conversely, low rates of mental disorder may be accounted for by high levels of skill discretion, good general working conditions and the social desirability of not reporting psychological symptoms.

According to the World Health Organization research on Mental Health and Work: Impact, issues and good practices; employers have tended to take the view that work and/or the workplace are not causation factors in mental health problems. However, whatever the causal factors, the prevalence of mental health problems in employees makes mental health a pressing issue in its own right. Although, effective mental health services are multidimensional, the workplace is an appropriate environment in which to educate individuals about, and raise their awareness of, mental health problems.

Mental Health Issues and Workplace Absence

There is a strong association between mental health problems and sickness absence. Half of those employees with psychological disorders are reported to have taken time off work in the previous year, compared with a quarter of all employees (Stansfield et al, 2003). Other reviews have demonstrated similar patterns of excess sickness absence, with depression being the major reason cited (Carter, 1999).

Long-term absence, particularly stress related, appears to have worsened in recent years (Henderson et al, 2005). The percentage of individuals experiencing spells of long term (21 + days) absence has increased from 5% in 2001 to 5.7% in 2003, i.e. 44% of all days lost. While the decision of employees to take time off work involves complex social and economic factors, as well as personal feelings of wellness or illness, low levels of time off sick are also not necessarily a good thing for an individual employee. Employee reluctance to admit to mental health problems for fear of stigma can lead to an employee waiting until the workplace relationship has become too difficult to ask for help, thus leading to more serious problems and the possibility of permanent job loss (Thomas et al, 2003).

Mental health problems may be triggered by work, but they may also be triggered by life events outside of the workplace. Duration and severity of mental health problems are often determined by a complex array of factors other than the immediate trigger. To effectively address the issues, there is a need to look at the individual experiencing mental health problems, the compounding characteristics of the workplace, and the remedies needed to improve the employee’s well-being.

Mental Well-Being in the Workplace

The workplace is one of the predominant environments that affect our well-being. There is a growing understanding of how work promotes or hinders mental wellness and oppositely, mental illness. The impact of employment on personal growth, identity, improved self-esteem and social network development is obvious and most mental health professionals agree that the workplace environment can have a significant impact on an individual’s mental well-being.

Consequences of Mental Health Problems in the Workplace

According to Stress at Work: A Guide for Employers: (UK Health & Safety Executive. Crown, 1995); the consequences of mental health problems in the workplace can be summarized as follows:

Absenteeism

  • increase in overall sickness absence, particularly frequent short periods of absence
  • poor health (depression, stress, burnout)
  • physical conditions (high blood pressure, heart disease, ulcers, sleeping disorders, skin rashes, headache, neck- and backache, low resistance to infections)

Work performance

  • reduction in productivity and output
  • increase in error rates
  • increased amount of accidents
  • poor decision-making
  • deterioration in planning and control of work

Staff attitude and behaviour

  • loss of motivation and commitment
  • burnout
  • staff working increasingly long hours but for diminishing returns
  • poor timekeeping
  • labour turnover (particularly expensive for companies at top levels of management)

Relationships at work

  • tension and conflicts between colleagues
  • poor relationships with clients
  • increase in disciplinary problems

Maintaining a healthy and safe workplace includes incorporating and addressing all the above risk factors into the Workplace Mental Health Plan.

Barriers Leading to Stress in the Workplace

People with mental health issues face numerous barriers in obtaining equal opportunities, supports and inclusion due to attitudinal barriers which cause social exclusion. For people with mental illness, social, (including the workplace), exclusion is often the most difficult barrier which exists. This exclusion is usually associated with feelings of shame, fear and rejection. It is clear that mental illness often leads to social exclusion and stigmatization both towards the person who has mental illness and their families. This greatly increases workplace stress.

It is our intention to use these workplace supports and information documents to guide employers and employees in raising awareness of the benefits of good mental health practices and assist in the implementation of a mental health plan to maintain a safe and healthy working environment.

Stressful Characteristics of Work

Condition Defining Hazard

Work Characteristics (demands, control and support)

Organizational function and culture
  • Poor task environment and lack of definition of objective
  • Poor problem-solving environment
  • Poor development environment
  • Poor communication
  • Non-supportive culture
Role in organization
  • Role ambiguity
  • Role conflict
  • High responsibility for people
Career development
  • Career uncertainty
  • Career stagnation
  • Poor status or status incongruity
  • Poor pay
  • Job insecurity and redundancy
  • Low social value to work
Decision latitude/control
  • Low participation in decision-making
  • Lack of control over work
  • Little decision-making in work
Interpersonal relationships at work
  • Social or physical isolation
  • Poor relationships with supervisors
  • Interpersonal conflict and violence
  • Lack of social or practical support at home
  • Dual career problems
Task design
  • Ill-defined work
  • High uncertainty in work
  • Lack of variety of short work cycles
  • Fragmented or meaningless work
  • Underutilization of skill
  • Continual exposure of client/customer
Workload/work pace
  • Lack of control over pacing
Quantities and quality
  • Work overload or under load
  • High levels of pacing or time pressure
Work schedule
  • Shift working
  • Inflexible work schedule
  • Unpredictable working hours
  • Long or unsociable working hours
Consensus from literature outlining nine different characteristics of jobs, work environment and organization which are hazardous. Source: HSE Contract Research Report No. 61/1993. Cox T. Stress Research and Stress Management: Putting Theory to Work.

For further information on mental health in the workplace, please visit our Workplace page, or to inquire about getting skilled help to assist in your workplace needs, contact us.