employee well-being, mental health and careers guidance pete robertson lecturer/programme leader...
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Employee well-being, mental health
and careers guidance
Pete RobertsonLecturer/Programme Leader
Postgraduate Diploma in Career Guidance and Development
Mental health conditions at work
Incidence: 16 % + at any one timeEconomic 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 stressCareer 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...don’t 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
“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 ? o Yes, it is a very powerful causal factor but...
o Some reverse causality (health selection for job loss or re-employment)
o A minority are happily unemployed
Does work cause good health ?o It tends to but is not a panacea
o Poor quality work or insecure may have neutral or detrimental effects
o Some 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 pathenogenicHuge 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
Strengthen the individual
e.g. CBT based training
How does work fit into my life ?Leave the job? Go part time ?
Reduce risk exposure
e.g. Culture change; Tackle bullying; Work design
Work adjustmentCan I renegotiate my role ?
Can I develop through training ?
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Career guidance has several features consistent with a recovery based approach to mental health
Future focus
Identify resources (skills/experience/contacts/support)
Focus on choice & goals
Exploring work identity
Encourages networking
offers hope
strengths based approach
promotes sense of agency
rebuilding self-concept
builds social capital
For more information
Royal College of PsychiatristsWork 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.
