Psychosocial risk management at the workplace: European policy and practice Dr Stavroula Leka CPsychol FRSPH Associate Professor in Occupational Health Psychology Institute of Work, Health & Organisations Tallinn, 29 April 2010 © PRIMA-ef Consortium

Prevalence of psychosocial risks in the EU 1 Psychosocial risks, work-related stress, violence, harassment and bullying (or mobbing) are now widely recognised major challenges to occupational health and safety (EU-OSHA, 2007) Nearly one in three of Europe's workers, more than 40 million people, report that they are affected by stress at work (EU-OSHA, 2002) In the 15 Member States of the pre-2004 EU, the cost of stress at work and the related mental health problems was estimated to be on average between 3% and 4% of gross national product, amounting to €265 billion annually (Levi, 2002)

Prevalence of psychosocial risks in the EU 2 6% of workers from EU 27 report having been exposed to threats of physical violence either from fellow workers or from others (Eurofound, 2007) Physical violence from colleagues was reported by 2%, and from other people by 4% of workers Higher reported physical violence, as well as threats of physical violence, in the northern European Member States and a lower reported level of violence in the southern Member States 5 % of EU 27 workers had been subjected to bullying and / or harassment at the workplace over the past 12 months in 2005 Less than 2 % of the European workers are exposed to sexual harassment or unwanted sexual attention Again, there is a wide variation between countries on the level of bulling and/or harassment at the workplaces

Work & Health – Pathways Physical Work Environment Work Design & Management direct physical effect Individual cognitive processes Indirect stress effect Physical & Psychological Health

Psychosocial factors Concern person x environment interaction people’s subjective evaluations/appraisal of terms of employment, work organisation & interpersonal relationships “Those aspects of the work itself, the organisation and management of that work, and the social and organisational contexts to work, which have the potential for causing harm” International Labour Office, 1986

PSYCHOSOCIAL FACTORS - HAZARDS Job content Lack of variety or short work cycles, fragmented or meaningless work, under use of skills, high uncertainty, continuous exposure to people through work Workload & work pace Work overload or under load, machine pacing, high levels of time pressure, continually subject to deadlines Work schedule Shift working, night shifts, inflexible work schedules, unpredictable hours, long or unsociable hours Control Low participation in decision making, lack of control over workload, pacing, shift working, etc. Environment & equipment Inadequate equipment availability, suitability or maintenance; poor environmental conditions such as lack of space, poor lighting, excessive noise

PSYCHOSOCIAL FACTORS - HAZARDS Organisational culture & function Poor communication, low levels of support for problem solving and personal development, lack of definition of, or agreement on, organisational objectives Interpersonal relationships at work Social or physical isolation, poor relationships with superiors, interpersonal conflict, lack of social support Role in organisation Role ambiguity, role conflict, and responsibility for people Career development Career stagnation and uncertainty, under promotion or over promotion, poor pay, job insecurity, low social value to work Home-work interface Conflicting demands of work and home, low support at home, dual career problems

Health Outcomes Behavioural physical inactivity, excessive drinking & smoking, poor diet & sleep Affective anxiety, depression, distress Cognitive decision-making, attention Medical hypertension, heart disease, wound- healing, musculo-skeletal disorders, gastro-intestinal disorders, impaired immuno-competence Organisational job satisfaction, morale, performance, turnover, absence, organisational commitment, errors

How do employers identify problems? Employers tend to notice one of four things: Sickness absence Line managers and colleagues noticing short-term changes in performance and behaviour Performance management and appraisals Individuals reporting problems (eg to OH or HR) or accessing services Employers assume much of this financial burden both in direct treatment costs and through absenteeism, reduced productivity, and more frequent work-related accidents

Standards Overview 1 Council Directive 89/391/EEC on the introduction of measures to encourage improvements in the safety and health of workers at work European Commission guidance on risk assessment at work ILO-OSH 2001 guidelines on occupational safety and health management systems The Occupational Health and Safety Assessment Series (OHSAS) ILO Convention 187: Convention concerning the promotional framework for occupational safety and health

Standards Overview 2 Standards directly referring to the concept of psychosocial risk, and those specifically referring to the concepts of work-related stress, workplace violence, harassment and bullying have only been formulated in very few countries Currently there are a three complementary European approaches to addressing psychosocial risks at work: European Commission’s Guidance on Work-Related Stress (2000) European Standard (EN ISO 10075- 1&2) on Ergonomic Principles Related to Mental Work Load (European Committee for Standardization, 2000) The European Commission’s Green Paper on Promoting a European Framework for Corporate Social Responsibility (2001)

Standards Overview 3 Framework agreement on work-related stress Framework agreement on harassment and violence at work Ergonomic principles related to mental workload (European standard: EN ISO 10075) Council Directive 90/270/EEC on the minimum safety and health requirements for work with display screen equipment

Recognised gaps in research (knowledge), policy & practice Lack of awareness across the enlarged EU – often associated with lack of expertise, research and appropriate infrastructure Responsibility for understanding and managing the interface between work, employing and mental health varies across countries Lack of agreement on appropriate strategies and their implementation Lack of comprehensive framework to promote harmonisation and clarity across the EU

Presentation Outline PRIMA-EF Key principles of best practice in psychosocial risk management: policies, risk assessment, interventions European approaches to PRIMA: Focus on HSE’s Management Standards for work-related stress Key issues of importance Way forward

PRIMA-EF Developing a European Psychosocial Risk Management Framework FP6 - 2 year project 6 partners, 5 CCs: IWHO (lead), BAuA, ISPESL, TNO, CIOP, FIOH 2 international organisations (WHO, ILO) 6 liaison organisations: 3 international (US NIOSH, University of South Australia, Singapore Ministry of Manpower) – 3 EU (Institute for Social Policies - Bulgaria, HSE - UK, Cyprus International Institute - Harvard-Cyprus Initiative for the Environment & Public Health) 9 advisory organisations: DG-Employment, DG-SANCO, EASHW, European Foundation (Dublin), ICOH-WOPS, ETUC, ETUI, ETUI-REHS, BUSINESSEUROPE, UEAPME,CEEP, UNIZO © PRIMA-ef Consortium

PRIMA-EF Outputs 1 Definition of European Psychosocial Risk Management Framework Development of social dialogue and corporate social responsibility indicators Survey involving stakeholders on a tripartite basis Review and analysis of available methodologies to evaluate the prevalence and impact of psychosocial risks at work and work-related stress > indicator models © PRIMA-ef Consortium

PRIMA-EF Outputs 2 Comprehensive review and analysis of case studies of evidence-based, best practice interventions in different occupational sectors, worker groups, enterprise sizes and European countries Inventory of different approaches > Special reference to approaches that promote best practice in occupational health and safety and the management of psychosocial risks through corporate social responsibility and social dialogue principles and to gender-friendly approaches © PRIMA-ef Consortium

PRIMA-EF Outputs 3 Guidelines for: employers; trade unions; occupational health and safety professionals (such as occupational health psychologists) and practitioners PRIMA-EF guidance sheets, book and brochure www.prima-ef.org © PRIMA-ef Consortium

PRIMA-EF Outputs

Added Value Clarity of best practice principles, standards and actions Indicator models for monitoring Integrative framework that can be used for the EU overall and across member states Can be used as part awareness campaign linking policy to practice © PRIMA-ef Consortium

Management and organisation of work processes PRIMA-EF Framework, Enterprise Level PRODUCTION Design, development and operation of work and production Risk Assessment and Audit Translation/Action Plans Risk Reduction (Interventions) Programmes Organisational Learning Evaluation Innovation Productivity & Quality Quality of Work Workers’ Health Societal Outcomes Management and organisation of work processes © PRIMA-ef Consortium

PRIMA-EF Framework, Policy Level POLICIES AFFECTING THE CHANGING WORLD OF WORK (economic, public health, labour market, trade policies, etc.) Risk & Health Monitoring Translation/Policy Plans Intervention Programmes Societal Learning Policy Evaluation Innovation Economic Performance Quality of Work Public & Occupational Health Labour Market Impacts The macro level risk management policy process Outcomes © PRIMA-ef Consortium

Policy Level Hard vs soft law EU, national vs enterprise level Stakeholder agreements CSR The role of international organisations

Ethics and Corporate Social Responsibility PRIMA is about people, their mental and physical health status and business and societal interests Protecting the psychosocial health of people is not only a legal obligation, but also an ethical issue and falls within the remit of corporate social responsibility

Good PRIMA is good business Best practice in relation to PRIMA essentially reflects best practice in terms of: organisational management, learning and development social responsibility and the promotion of quality of working life It leads to: higher productivity higher quality of products and services greater attractiveness at the labour market greater capabilities for innovation

Psychosocial risk assessment should be based on data collected through tools such as surveys, individual or group discussions or observation methods take into consideration diversity issues and should not ignore the wider context, such as occupational sector characteristics or socioeconomic and cultural variations across member states recognise and make use of the knowledge and expertise of working people in relation to their jobs treat information at the group level (not catalogue individual views about work) and measure consensus in expert judgments on working conditions

Practice PRIMA should a continuous process – part of normal business operations In every day practice, psychosocial risks have many causes. As a consequence there are no quick fix solutions; a continuous management process is required To be effective it is important to understand the most important underlying causal factors before solutions are selected

Ownership by all stakeholders It is important that the main actors involved in PRIMA are responsible for the work to be done and have ownership of the process They can be supported by internal or external experts or by external service providers but outsourcing ownership to service providers is a failure factor

Evidence-informed practice PRIMA is a systematic, evidence-informed, practical, problem solving strategy. It should aim at producing a reasoned account of the most important psychosocial factors associated with ill-health for a specific working group and one grounded in evidence Most important of all is that the solutions chosen are fit for purpose

Different levels of interventions with focus on measures at source The emphasis in European legislation on health and safety is on primary risk prevention targeted at the organisation as the generator of risk However specific actions targeted at the individual level can also play an important role depending on the extent and severity of the problem within organisations and its effect on employee health

Success Factors for Interventions for Work-related Stress 1 Intervention Content: Aspects and elements of design of intervention: Theory-based intervention and evidence-based practice Conducting a proper risk assessment Tailored-focus/ adaptable approach Systematic and stepwise approach Accessible to all key stakeholders and user-friendly format Comprehensive stress management approach Competency building skills development

Success Factors for Interventions for Work-related Stress 2 Intervention Design: Evaluation of intervention: Strong study design with control Planned systematic evaluation as part of intervention design Intervention evaluation should be linked to intervention aims, goals, and identified problems Use of a variety of outcomes measures and evaluative approaches (including process evaluation) Short-term and long-term follow-up up over several time points Comparative analysis across groups and sub-groups within intervention

Success Factors for Interventions for Work-related Stress 3 Intervention Context: Implementation success factors: Top-down and bottom-up approach Facilitate dialogue and communication among key stakeholders Raising awareness on psychosocial issues and their management within organisation Accessibility and usability of tools, methods and procedures across all members of the organisation

Key Priorities for Action in Interventions Developing Capacity Building Programmes to support continuous improvement cycle Evaluating and researching process issues and mechanisms that underpin Interventions Developing the knowledge base on preventative approaches for work-related stress Research into practice Developing a framework on guidance and standards for work-related management and prevention and in their evaluation Movement towards increased multidisciplinary research and practice Awareness raising on psychosocial issues in workplace and work-related stress at the level of the employee and the organisation Building the business case for psychosocial risk management More research examining and evaluating comprehensive management interventions More high quality intervention research and evaluation examining long term effects Developing and maintaining social dialogue among stakeholders Increased research and evaluation for organisational level intervention with a complex system © PRIMA-ef Consortium

European Approaches to Psychosocial Risk Management 1 Health circles – Federal Association of Company Health Insurance Funds (BKK) – Germany Istas21 (CoPsoQ) Method - Trade Unions’ Institute of Work, Environment and Health (ISTAS) – Spain The SOBANE Strategy applied to the management of psychosocial risks - Belgium

European Approaches to Psychosocial Risk Management 2 SME-vital – Health Promotion Switzerland – Switzerland The Prevenlab-Psicosocial methodology – UIPOT, University of Valencia – Spain Work Positive pack with HSE’s Management Standards – Health and Safety Authority, Health and Safety Executive and National Health Service – Ireland, Scotland, England and Wales

HSE’s Management Standards for Work-related Stress Statements of good management practice on six common sources of work-related stress A ‘toolkit’ for the assessment and reduction of exposure to these six sources of work-related stress

Background 1990s HSC consultation exercise about how work-related stress should be tackled Opted for standards of good management practice for a range of stressors rather than regulation Rationale: managers familiar with a standards approach in OSH. Also enable measurement of performance (employee health and organisational performance)

6 Management Standards Demands amount and difficulty Control how and when work is done Support regular and sustained encouragement Relationships at work unacceptable behaviour, respect, conflict Role ambiguity, conflict Change Management and communication of organisational change Content of Work Context of Work

Each standard contains… (1) [1] ‘platform statement’ that represents good practice E.g. Demands: employees indicate that they are able to deal with the demands of their jobs, and systems are in place for individuals’ concerns to be raised and addressed

Each standard contains… (2) [2] States to be achieved (i.e. what should be happening) E.g. Demands The organisation provides employees (including managers) with adequate and achievable demands in relation to the agreed hours at work People’s skills and abilities are matched to the job demands Jobs are designed to be within the capabilities of employees Employees’ concerns about their work environment are addressed

Implementation The gap between the state to be achieved and the current situation, as perceived by the workgroup can be ascertained through the Risk Assessment process Indicator Tool Analysis Tool Interventions

Key issues of importance 1 Policy evaluation and its accompanying infrastructure across the EU Policy level interventions: lack of recognition as key area underpinning primary, secondary and tertiary prevention Process and outcome evaluation Longitudinal research Multidisciplinary approach Facilitation of social dialogue and involvement of key stakeholders: European social model © PRIMA-ef Consortium

Key issues of importance 2 Promotion of comprehensive approach to psychosocial risk management – linked to best business practices and to broader community and societal levels Awareness, education, development of expertise (also of inspectors) Occupational health services availability and coverage © PRIMA-ef Consortium

Key issues of importance 3 Monitoring – micro and macro levels > Different levels of indicators needed Lack of evaluation at both levels and especially at macro level Monitoring tools Standards development CSR link: stakeholder communication, internal and external reporting, values and systems © PRIMA-ef Consortium

Way forward Developing PRIMA framework in other countries WHO Network of CCs in OH > work with developing countries underway > adaptation of framework in the future Training materials > PRIMA-eT Standard development > PAS1010: BSI (December 2010) Establishment of PRIMA Network of Excellence © PRIMA-ef Consortium

PAS 1010 on Psychosocial Risk Management Will provide clarity on the basis of a framework unifying different approaches Will increase business accountability and allow uniformity to spread through stakeholders Will promote dialogue among stakeholders which is expected to facilitate improvements in the area of psychosocial risk management and allow occupational health to be contextualised in relation to other business activities Ready by December 2010

Thank you! Stavroula Leka Stavroula.Leka@nottingham.ac.uk www.nottingham.ac.uk/iwho www.prima-ef.org © PRIMA-ef Consortium