Employee well-being, mental health and careers guidance Pete Robertson Lecturer/Programme Leader Postgraduate Diploma in Career Guidance and Development Mental health conditions at work Incidence: 16 % + at any one time Economic costs to business:
26 billion p.a. Under-performance & presenteeism Sickness absence Early withdrawal from workforce Total costs to wider society: 115 billion p.a. As above plus... Medical and care costs Tax lost + welfare benefits costs incurred
(Foresight Mental Capital Project, 2008; Sainsbury Centre 2007; Friedli & Parsonage, 2007) Sources of Stress Workload Hours/shiftwork Travel Physical risk Psycho-social risks
Bullying Sexual harassment Discrimination Isolation Tasks Repetition Control Emotional labour (Service sector)
Uncertainty Ambiguity Restructuring Job insecurity Culture Performance management Use of alcohol/drugs Careers and stress Career concerns are known to be a source of work stress (e.g. Baruch, 2009)
Metaphors of frustration Glass ceilings Golden cages Work/life balance Bi-directional conflict Older workers Network erosion Hush...dont tell your
clients about the health risks... Employment is nature's physician, and is essential to human happiness Galen of Pergamon, Greek physician, surgeon and philosopher, 172 AD Working is, for most patients, a positive clinical outcome and can be an intervention in its own right Royal College of Psychiatrists
Ergotherapy W.H.R. Rivers Robert Graves There is a strong evidence base showing that work is generally good for physical and mental health and well-being. Worklessness is associated with poorer physical and mental health and well-being. Work can be therapeutic and can reverse the adverse health effects of unemployment. That is true for healthy people of working age, for many disabled people, for
most people with common health problems and for social security beneficiaries...Work is generally good for health and well-being. (Waddell & Burton, 2006: ix). To summarise so far... Healthy workers encounter psycho-social health hazards at work that make them stressed or mentally ill ! Going to work helps unemployed people
with mental health conditions get better ! read the small print... Does unemployment cause mental health conditions ? oYes, it is a very powerful causal factor but... oSome reverse causality (health selection for job loss or re-employment) oA minority are happily unemployed Does work cause good health ? oIt tends to but is not a panacea oPoor quality work or insecure may have neutral or detrimental effects
oSome individuals at certain times may be vulnerable to psycho-social health hazards Marginal work Most accessible to unemployed with health conditions Insecure, temporary, low status, servile Underemployment pay, hours, qualifications, experience May lead to unemployment, not secure work Results in fractured employment biographies
Problems with the stress management industry Locates responsibility for causes and management of distress within the individual Focus on anxiety ignores the complexity of emotion at work Implies work is usually pathenogenic Huge evidence base shows unemployment is associated with greater mental distress
Necropolis The Whitehall studies Michael Marmot & colleagues explored health in the British Civil Service Found a status/income gradient in physical and mental health Social inequality has health consequences within organisations Control at work is a key issue e.g. Stansfeld et al (1999)
Mental health promotion (WHO, 2004) No health without mental health Health is more than the absence of illness Requires a climate that respects and protects civil/political/economic/social/cultural rights The workplace is a key arena for public mental health interventions Well-being and productivity Recent research suggests a healthy workforce
leads to enhanced productivity because of: Employee engagement and co-operation Sustainable performance e.g. Harter, Schmidt & Keyes (2002) Key messages about employees and mental health Unemployment: usually more stressful than work The quality of work is very important Income/status gradients at work affect health Work is a key arena for mental health promotion Positive well-being may promote sustainable
productivity Interventions and wider challenges Retention Flexible working Reasonable adjustments Training Support services: Employee assistance programmes (EAPs) Occupational health (OH) Vocational rehabilitation (VR)
Occupational therapy (OT) JobCentre Plus/DWP services Executive coaching/mentoring Stigma, media and culture Organisational culture Performance management Bullying Attitudes to mental health Lack of coherence in support services ?
A role for career guidance ? Three thoughts about the potential for career related support to contribute to the management of mental health issues at work. A holistic approach to career and mental health counselling may be desirable (Zunker, 2008) Career and personal concerns overspill & interact Work dominates waking hours & defines identity
Stress management vs career guidance approaches Future focus =Identify resources =(skills/experience/contacts/support) =Focus on choice & goals = offers hope strengths based
approach promotes sense of agency Exploring work identity rebuilding self-concept Encourages networking builds social capital
Career guidance has several features consistent with a recovery based approach to mental health For more information Royal College of Psychiatrists Work and mental health online resource: http://www.rcpsych.ac.uk/mentalhealthinfo/workandmentalhealth.aspx References BARUCH, Y. (2009) Stress and Careers. In C.L. Cooper, J. Campbell Quick & M.J. Schabracq (eds) International Handbook of Work and Health Psychology 3rd edition. Chichester: Wiley-Blackwell FORESIGHT MENTAL CAPITAL AND WELLBEING PROJECT (2008) Final Report. London: The Government Office for
Science. FRIEDLI, L. AND PARSONAGE, M. (2007) Building an economic case for mental health promotion: part 1. Journal of public mental health, 6, 3:14-23. HARTER, J.K. SCHMIDT , F.L. & KETYES, C.L.M. (2002) Well-being in the workplace and its relationship to business outcomes: A review of the Gallup studies. In C.L.M. Keyes & J. Haidt (eds) Flourishing: The positive person and the good life (pp205-224). Washington DC: Amercian Psychological Association. SAINSBURY CENTRE FOR MENTAL HEALTH (2007) Work and wellbeing: developing primary mental health care services London: SCMH STANSFELD, S.A., FUHRER, R., SHIPLEY, M.J. & MARMOT, M.G. (1999) Work characteristics predict psychiatric disorder: prospective results from the Whitehall II study. Occupational and environmental medicine, 56, 5: 302-307. WADDELL, G. & BURTON, A.K. (2006) Is work good for your health and well being ? London: Department for Work
and Pensions WORLD HEALTH ORGANISATION (2004) Promoting mental health: concepts, emerging evidence, practice. Summary report. Geneva: WHO. ZUNKER, V. (2008) Career, work and mental health: integrating career and personal counselling. London: Sage. Thank you... Any questions or comments ? [email protected]
