When you think of head protection you may first think of Personal Protective Equipment (PPE). The PPE element for head protection seems like an oxymoron.

Why would you risk protection of the most important part of your body, and for what reason? If you’re protecting your head for the job you are currently doing; this now seems to disappear into some irrelevance.

If we turn the tables, however, it’s possible to concentrate on some things that are harder to pinpoint to physical hazards, but rather are psychosocial hazards. By examining the softer areas of head protection I can reveal that some of the occupational pathways chosen by many have a butterfly effect, that is, a very small change in initial conditions that creates a significantly different outcome. This may involve musculoskeletal disorders, mental disorders, noise-induced hearing loss, respiratory diseases, occupational cancers, contact dermatitis, infectious and parasitic diseases, and cardiovascular disease depending on the individual’s limitations.

According to the World Health Organisation, good mental health is not simply the absence of a mental disorder. It is a state of wellbeing whereby an individual can realise their own potential, manage everyday stresses, work productively and contribute to their community.

A mental illness significantly affects how a person thinks, behaves and interacts with other people. It is clinically diagnosed according to standardised criteria. Around two per cent of the population experience recurring mental illness, which significantly affects their quality of life. Mental illnesses are of different types and degrees of severity and include mood disorders, such as bipolar disorder or depression; anxiety such as phobias or post-traumatic stress; or psychosis, such as schizophrenia.

A mental health problem is a broader term including both mental illness and symptoms of mental illness that may not be severe enough to warrant a diagnosis of a mental illness.

In a practical sense, a mental illness or problem affects a person’s thinking, emotional state and behaviour, and disrupts the person’s ability to work or carry out other daily activities and engage in satisfying personal relationships.

Worldwide there has been an increase in work-related mental disorders, affecting all industries and professions. The major causative mechanism, recorded in the National Data set, is mental stress. Mental stress is coded as caused by work pressure, harassment, workplace or occupational violence, exposure to a traumatic event, suicide or attempted suicide and other mental stress factors.

As such, this report confines itself to discussion on work-related mental disorders associated with mental stress, which in itself has been identified as the causative mechanism in work-related mental disorders: stress, anxiety, depression, nervous breakdown, and effects of witnessing traumatic events.

Explaining stress

The Health and Safety Executive (HSE) has identified six categories of substantive factors that can be identified as potential causes of work-related stress:

• Demands • Control • Relationships • Change • Role • Support

Another potential risk factor is work-life balance. A vicious cycle can occur when mounting stress in one area of life spills over and makes coping with the other yet more difficult. Palmer et al developed a model of work-related stress that helped to inform the HSE approach. This added a seventh driver of stress – culture.This is defined as: “The culture of the organisation and how it approaches and manages work-related stress when it arises.”

Occupational stress may be a reaction people may have when faced with factors such as excessive work pressures, conflicts between individuals, and a lack of clear direction from the management, especially when the individual has inadequate resources to cope. It is exacerbated by little support from colleagues and supervisors (Loss Prevention Council 1998). NIOSH (1999) has defined stress as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources or needs of the worker.

Mental stress can be either acute or chronic in nature. Acute stress is defined as a rapid response to an abrupt, easily-identified cause that will often respond positively to some form of intervention. A return to normal life within a short time period is expected for the majority of people who experience an acute stress response (Kendall et al 2000).

Chronic stress is a cumulative reaction to a build up of pressures over a long period of time. It begins gradually and proceeds slowly. Chronic stress usually manifests itself in various ongoing physical and/or psychological symptoms such as hypertension, withdrawal and depression.

The effects of work-related stress on ill-health operate in a number of ways:

• Physiologically – nervousness, endocrinal or immunological reactions within the body can lead to symptoms of physical and mental illness

• Cognitively – working conditions and situations are interpreted by the individual as ‘stressful’ and therefore pathogenic

• Emotionally – seemingly trivial incidents are experienced as debilitating, dangerous or even life-threatening

• Behaviourally – excessive work strain encourages potentially damaging behaviours such as smoking, alcoholism, eating disorders, or self-harm

There are a number of theories used to determine the causes of stress. Each model incorporates key work variables and symptoms of stress. Although each theory proposes different combinations of factors to account for the antecedents and consequences of stress, most of the evidence points to aspects of the work environment that contribute to the experience of stress in the individual. A common set of work characteristics has been identified as risk factors for occupational stress and they are described in the following table (Comcare 2003).

Common conditions like depression and anxiety may impact on work performance, so it’s a good idea to think about how you manage mental health issues in your business.

Managing mental health

Employers have legal obligations in relation to the management of mental illness in the workplace. Workplace safety and health legislation requires that employers provide a safe and healthy workplace for all workers that does not cause ill health or aggravate existing conditions. This includes maintaining an environment that supports good mental health.

Both Commonwealth and State legislation address discrimination on the grounds of impairment and include requirements in relation to reasonable adjustments to meet the needs of employees. The definition of ‘disability’ in discrimination legislation is broad and includes both permanent and temporary mental illness. Some (but not all) mental illnesses can constitute a disability. Each individual case is different and will depend on the severity of impairment as a result of the illness.

Additionally, privacy legislation requires that personal information about a worker’s mental health status is not disclosed to anyone without the worker’s consent.

As a business and an employer, managing mental health within your business will help you to:

• Reduce staff absenteeism and working days lost each year

• Increase productivity in your workplace

• Create a mentally safe and healthy workplace

• Abide by work health and safety laws, which require employers to take reasonable steps to make their workplaces mentally safe and healthy

You also have legal requirements to look after your employees’ mental health, including:

• Providing a physically and mentally safe workplace

• Preventing discrimination against employees with a disability (including mental health conditions)

• Protecting your employees’ personal information – don’t tell anyone about your employees’ mental health conditions unless they agree to it and mental health status is not disclosed to anyone without their consent

• Ensuring your workplace does not take any unfair action against someone because of their mental health condition

Inclusive work environment

Employees do not have to disclose whether or not they have a mental illness unless it affects their ability to perform the ‘inherent’ requirements of their job. However, if agencies create a trusting and inclusive working environment, employees may be more likely to disclose, thereby allowing you to better understand and work with them to address their needs.

Organisations can create a supportive work environment that promotes diversity and supports good mental health through a range of activities that may include:

• Championing a work culture of respect for diversity and support for individual strengths and needs

• Reducing the stigma associated with mental illness in your workplace

• Dispelling myths around mental health through newsletters, posters or forums

• Treating mental health problems like any other illness

• Ensuring staff are aware of your employee assistance programme and how to access it

• Promoting flexible work practices such as flexible working hours or working from home where appropriate

• Encouraging staff to maintain a balance between physical, mental and social wellbeing

• Encouraging help seeking behaviour with your staff

• Fostering connectivity throughout your community

• Promoting a culture of performance feedback that encompasses regular one-to-one discussions between managers and employees

• Encouraging regular team meetings

• Acting on discrimination or bullying, including the use of inappropriate language

• Using prominent and respected champions to reinforce messages about mental health and the importance of maintaining supportive workplaces

Training and awareness

A lack of understanding can prevent people from providing support to colleagues affected by mental health problems or illness in the same way that they would if their colleague had a physical illness. Coordinating awareness raising activities, providing information and training staff will develop a greater understanding of mental health and contribute to a more supportive culture.

Agencies should consider addressing topics such as:

• Mental health awareness or a mental health first aid course

• Stress management and work/life balance

• Time and project management

• Interpersonal skills and negotiation

• Diversity and disability awareness training

• Information sessions or events based around R U OK? day and Mental Health Week

Seek to achieve these goals by encouraging people to take personal ownership of their own mental health and wellbeing.

Here are some steps your business can take to look after the mental health of your employees:

• Increase awareness of mental health conditions and reduce the stigma in your workplace

• Support employees with mental health conditions in the workplace and prevent discrimination against them

• Identify and minimise workplace risks to your employees’ mental health

• Encourage your employees to look after their own mental health

Talking about mental health

Regular meetings with all employees should be a part of day to day good management practice. They allow for discussion regarding work performance and an opportunity for managers to raise any concerns for an employee’s wellbeing. They also provide a confidential environment for an employee to raise health and wellbeing problems or concerns they may have. Some employees may choose to disclose their health issues, while others may not.

There may be occasions where an employee has not spoken of a mental health problem, but you notice a change in behaviour, workplace relationships or work performance that is out of character for the employee. While it can be a sensitive issue to address, it is reasonable to discuss these matters with the employee if there is concern for their safety or wellbeing, or if their job performance is negatively affected. It is particularly important if you feel they may pose a risk to themselves or others.

Strategies such as mental health first aid workshops will assist in providing managers with the skills to raise and discuss these issues in a respectful and sensitive manner with employees, providing an opportunity to discuss any changes to work practices or the working environment that can be put in place to support and assist the employee.

Treating people equally doesn’t mean treating people the same. Section 66R of the Equal Opportunity Act 1984 provides for reasonable adjustments to afford access to employment to persons with an impairment. In some situations, the fact that the worker has not disclosed their mental illness will limit or even prevent you from providing reasonable adjustments or support. In other situations, it will still be possible to proceed with an adjustment to assist your employee regardless of their non-disclosure. Broader strategies in the workplace with an emphasis on creating a safe and healthy work environment for all will also benefit workers with an undisclosed mental illness (Human Rights Commission, 2010).

Reasonable adjustments

If an employee chooses to disclose a mental illness, the approach to managing it should be tailored to the individual and the workplace. It is important to work with the employee to determine if any changes to their work practices or environment are needed, what they should be and how long they may need to be maintained, and how often the arrangements should be reviewed, in the same way that would occur with a physical illness.

Remember to focus on the behaviour and not the illness. It is important to ask the employee what adjustments may best support them in the workplace. Do not automatically assume that time off work will be helpful, as it could make things worse.

Employees experiencing one-off or intermittent occurrences of poor mental health as a response to life events may need only short term adjustments to assist them to return to health. Regular reviews will ensure that adjustments can be modified or ceased if no longer needed or are still appropriate if the arrangement is to be extended.

The choice of actions should be guided by consultation with your employee and with appropriate professional advice. In all cases you should respect employee confidentiality and disclose information only with consent.

Depending on the severity of the illness or problem, reasonable adjustments could include:

• Changing some aspects of the job or altering the way in which tasks are undertaken

• Flexible working arrangements or part time or flexible working hours

• Physical modifications, for example a workplace that has privacy or less noise and distractions

• Additional levels of support such as a buddy, a coach or a mentor to provide assistance as needed

It is important to openly discuss with the employee the impact that any job or role modifications may have on work value, particularly if the arrangement is likely to be, or becomes, long term. Regular meetings will provide opportunity for any issues that may arise to be respectfully and openly discussed and resolved.

In all cases, you should engage in joint and flexible problem solving to identify and reduce any triggers for mental problems or illness and to establish and maintain the right level of support over time.

In closing

Resources and support for employees are needed to ensure mental health is addressed at the workplace, as people spend the majority of their lives at work. Some people experiencing mental health problems or illness may not seek help, even though effective treatments are available. The workplace can play an important role in whether someone seeks help or not. It is important that managers do not take on the role of counsellor for employees dealing with a mental health problem. They should have an understanding of the support available should an employee need it, or if they have concern for an employee’s health and wellbeing.

Published: 10th May 2016 in Health and Safety Middle East