1. Institute of Occupational Medicine, Research Park North, Riccarton Edinburgh Workplace Stress Management Do not be afraid…... Rachel E. Mulholland Chartered Occupational Psychologist

2. Opening the Can….. Why ? Is stress not just mental backache ? Challenges Putting your best foot forward

3. Prevalence of ill-health Self-reported Work-related Illness (SWI 03/04) DiseasePrevalence Musculoskeletal Disorders1 108 000 Stress, Depression & Anxiety 557 000 * Breathing & Lung Problems 183 000 Hearing Problems 81 000

4. Why are we bothered? Legislative requirements 12.8 million lost work days due to stress in 2003/04 £7 billion cost to society Average of 28.5 days off per year Sources: (SWI03/04) & TUC

5. Stress and Health at Work (Smith et al, 2000) 20% of workers ‘very’ or ‘extremely stressed’ (approx. 5 million) Prevalence 10 times higher than previous estimate Associated with: frequent minor physical symptoms mental ill-health and undesirable behaviours

6. Whitehall II Study (Stansfield et al) works stress doubles the risk of future psychiatric morbidity high job demands, low social support, low decision authority and effort-reward imbalance associated with increased risk of psychiatric disorders common stressors identified: high workloads; long hours; working fast; lack of support; insufficient information; low decision authority; high job demands

7. Employer Views (IOM, 2001) 87% viewed stress as a cause of work-related ill-health Emergency Services (65%) & Local Government (55%) - most likely to report work-related stress problems Increased awareness of Stress but BARRIERS to tackling issue often attitudes and uncertainty

8. Key points from Case Law Walker V Northumberland £175,000 ‘…his illness was attributed to the impact on his personality at work’ Key points of Law: Foreseeability and Causation

9. Stress - ‘main psychosocial work hazard’ ‘… the adverse reaction that people have to excessive pressures or other types of demand placed upon them, it arises when they feel they cannot cope’ HSE Definition

10. Clarity out of Confusion Stress is not a disease but it can impact upon health via physiological and behavioural pathways when prolonged and excessive It can be caused by work and non-work factors Individual differences play a part too!

11. HSE Management Standards Demands – being able to cope with the demands of the job Control – having an adequate say over how work is done Support – having adequate support from colleagues and superiors Relationships – not being subjected to unacceptable behaviours Role – understanding roles and responsibilities Change – being involved and informed in organisational changes

12. Challenges for the Fire Service Significant changes taking place: Integrated Risk Management Planning (IRMP) Integrated Personal Development System (IPDS) Increasing risk of violence to fire-fighters What are the impacts of such changes? How and who is involved in decision-making?

13. Challenging Questions to Ask How does our structure support our aims? What is our culture? How well are we performing? Have we any indications of problems? How do we recruit and develop staff? What support structures are in place? Do we play lip service to stress?

14. The effects of stress on the individual (I) Health symptomsPsychological symptoms - gastro-intestinal problems- dissatisfaction - allergies- anxiety - skin diseases- depression - diabetes - burnout - hypertension & heart disease- nervous/mental breakdown - lots of persistent minor illnesses- increased irritability - disturbed sleep- poor concentration - decreased self-esteem

15. The effects of stress on the individual (II) Behavioural symptoms - negative health behaviours - excessive drinking, increased drug use - poor diet - irritability - reckless driving - suicide

16. Effects on Organisation High absenteeism High staff turnover Low morale/poorer performance Poor working relationships High number of early retirements Decreased productivity/quality Increased disputes

17. Critical to Risk Assess - gather & analyse data Primary prevention: address the causes of stress at source e.g. audit, provide resources, reduce sources of stress be proactive Secondary prevention: management awareness and training and health promotion activities good rehabilitation and work integration strategies Tertiary prevention: helping people cope better with symptoms provision of counselling services/EAPs, etc

18. Were my actions appropriate? How might I revise them for the future? Step 5 Carry out a Stress Risk Assessment What are the main stressors in my work area? Step 1 Are any of my team vulnerable and if so in what way? Step 2 What are the risks? Likelihood Severity Frequency Step 3 What action can I take to help prevent it? Step 4

19. Putting your best foot forward Reward and recognise staff Promote positive management & communications Increase flexible working Increase team working Conduct job studies to understand better how jobs could be done Develop appropriate Policies and Procedures

20. Critical Success Factors Senior Management Commitment Being proactive Open & honest communications Positive & Supportive Culture - (trust, participation)* Appropriate selection, training & development Consistency and fairness of treatment Proper management of change ACCEPT STRESS AS A HEALTH & SAFETY ISSUE

21. Thank you for listening