by Dr Pamela Gellatly, IIRSM member and CEO of Healthcare RM

It is suggested that work-related stress is a major cause of occupational ill health. To what extent, however, does it really lead to poor productivity, human error, increased sickness absence, increase in accidents and a high turnover of staff?

In the UK, the Health and Safety Executive (HSE) states that 15.4 million working days are lost each year as a result of stress, anxiety and depression, at a cost of £52 billion to industry, individuals and the Government.  Yet these statistics relate to all workplace mental ill health, which may or may not be caused or made worse by work.

So how do you truly understand the impact of work-related stress in your organisation?  Well, if you are not assessing you are guessing!

Legislation in the UK and many other countries requires organisations to risk assess psychological hazards in the workplace in a similar manner to a physical risk assessment, but do you know how to assess not only the psychological hazards but who can be harmed and how?

The HSE Management Standards were developed to help indicate the sources of occupational stressors, but how these affect individuals varies considerably.  A study of 5,825 assessments over a two-year period identified the following:

The Psychological Risk Assessment variables
Psychological risks may occur from psychological risk factors, but they may also develop from physical stressors.  Age, gender, ethnicity, health status and many other external factors can contribute to the likelihood and severity of a hazard leading to harm.

So, what are the steps you need to take when carrying out a psychological risk assessment? Here are the five I recommend you take:

Step 1: Identifying the occupational hazards

Typical risks include:

• Pressure

• Shift work

• Lone working

• Targets

• Deadlines

• Customer attitudes/demands

• Heavy lifting

• Heat / Cold

• Travel

Step 2:  Identify/decide who can be harmed and how

This is the most difficult aspect as many psychological stressors are not evident in the same way that physical risks are.  Data are key to the risk assessment process and therefore you should consider both quantitative and qualitative data to include:

• Trends in sickness absence – departments, managers, job types, age groups, gender etc. to establish where your highest incidence occurs and when

• Known peak business periods such as winter/summer variations

• EAP (employee assistance programme) utilisation – analysing what trends are captured

• Healthcare plan claims

• Group Income Protection/Incapacity claims

• EL (employer's liability) claims

• Individuals being performance managed, under disciplinary, with a grievance etc.

• MHFA feedback

• Wellbeing – what do you know about the health of your workforce including levels of activity outside of work, weight (underweight, overweight, obese), sleep, nutrition etc.

• Presenteeism

• Occupational health reports

• Employee surveys 

• 1-2-1s

• Focus groups

• Team meetings

Examples of data to support risk assessment process

- Quantitative examples (from study of 24,000 mostly male employees in one year)

• 1 in 9 employees experienced a mental health episode 0.11%

• Under-29 age group (both male and female) were the most vulnerable followed by the over 65 age group

• Women did have a higher incidence across the younger age groups

• 1 in 63 employees attributed this to perceived work related stress – 0.015%

• 1 in 2,000 employees were diagnosed to have actual work related stress​ = 0.0005%

• Percentage of actual work-related absence for mental ill health circa 2% compared to the perception of circa 20%.

- Qualitative Data

Management Standards

Combine this with known occupational factors including: demands; role; relationships; control; change and support provided. 

Personal Risk Factors

Then combine this data with other personal factors that may be known/present to include:

• Problems with elderly parent/s, disabled or difficult children

• Caring for a loved one who is not well or someone who is severely disabled

• Relationship issues with partner, children, parents or other significant person

• Financial difficulties

Step 3: introduce controls to reduce risks

With psychological risks this is much more difficult, but should include consideration of:

• Modifications of roles/hours where certain job types have a high incidence (likelihood) and a high risk of more severe harm from work

• Modifications of role/hours for any individual who has been identified to be vulnerable due to occupational or personal stressors – this would normally be undertaken via your Occupational Health department

• Provision of specific individual support via an EAP, Private Healthcare Plan, Cash Plan or direct funding where this is likely to help and individual – again this would normally be assessed via an occupational health professional

• Provision of wellbeing support to address the range of individual risk factors that can also cause or contribute to stress, anxiety and depression including: inactivity, excess weight, poor sleep and sub optimal nutrition and or excess use of substances

Step 4: Document Findings

Data are key to this process and essential if psychological risks are to be reduced.  Often work is not the sole causation as mental ill health often arises when pressure is multifactorial.  

An individual may perceive that work is the causation but whether it is or not needs to be accurately assessed by a professional to ensure that the individual receives the most appropriate support.

Step 5: Review 

Ideally this should be every six months dependent on how often your business risks fluctuate and change.   

Summary

Access to good quality data, both quantitative and qualitative, will really help you understand what is happening in your organisation and what is really associated with work and what may be due to a wide range of other factors.  

This is not shirking your obligations but demystifying mental health by understanding the real-world data, which will enable you to reduce the risk of psychological harm in your organisation.  Failing to do this will mean that the business will keep offering support mechanisms that are less likely to address the real issues that your people need.