Category: psychiatric

Mandatory reporting of stress-related injuries

An OHS colleague of mine, Col Finnie, has posted a comment to a recent SafetyAtWorkBlog article on depression.  As I work out the technicalities of having Col as a regular contributor to this blog, I felt that his comment warranted a little more prominence.  The original comment can be viewed HERE)

I find the whole issue of what is being done about work stress intriguing. Last time I looked stress claims outstripped manual handling injuries in the UK (if I recall right, that was about a year ago). You’d imagine that trend will also happen here in time.

I wonder if it might be worth considering getting doctors to report to their local OH&S agency when they have evidence that a particular business appears to be the source of an unusual number of stress related patients?

If it’s legitimate for the police or emergency wards to be a source of reports of info on apparent work related physical injuries, why shouldn’t that be legitimate for other types of injuries?

There is no reason for this idea to be considered a “witch-hunt”. I’d consider it an opportunity for a regulator to pitch in on getting a business on-track with how it’s dealing (or not dealing) with managing stress stuff. Clearly, the reporting approach would have to be handled carefully. It’s quite likely it wouldn’t work as a mandatory requirement. But guidance and an info program could be worked up to make sure the complex issue of stress is dealt with sensibly.”

Workplace depression approaches are too narrow

Further to other SafetyAtWorkBlog posts concerning Ms Paula Wriedt’s sacking, Ms Wriedt has issued a statement expressing her disappointment at Premier David Bartlett’s decision.

One comment from a newspaper columnist struck me as odd but worthy of note.  The columnist said that Paula Wriedt’s public statements have followed the line pushed by beyondblue, a depression support and lobby group.  I have had no dealings with beyondblue but note that newspaper articles often end with “For further information on depression contact…..” similarly television news reports.

beyondblue has been a spectacular success in self-promotion and, hopefully, increasing awareness of depression.  In the context of the Premier’s decision on Paula Wriedt, David Bartlett contacted the chair of beyondblue (and former Victorian Premier) Jeff Kennett, prior to his decision.  The Weekend Australian newspaper reported

“I have not taken this decision lightly; in fact, decisions don’t come any tougher than this,” Mr Bartlett said. He received support from former Victorian Liberal premier Jeff Kennett, the chairman of depression support group Beyondblue.

After speaking to Mr Bartlett, Mr Kennett told The Weekend Australian he believed the decision was a very tough call for the Premier, but added: “When you balance up all his responsibilities, the correct one. It might just be what Paula needs to start rebuilding her health.  That is, she doesn’t have other ministerial responsibilities now and she can now focus more directly on her recovery.”

beyondblue does admirable work and has acheived much but it is dominating the discussions on psychosocial issues in the workplace.  It is difficult for other groups to raise matters that are just as relevant to the workplace, if not more so, such as occupational violence, stress, dignity at work, and so on.

We are not yet clear on all the circumstances of Paula Wriedt’s suicide attempt, and we may never know.  We do not know if work stresses or private stresses caused her self-harm but that is not necessarily the point.  Occupational health and safety long ago left the confines of the workplace and controlling workplace hazards, particularly psychosocial issues, needs a bigger canvas.  There must be an approach that assists the individual in work and non-work contexts. 

Some countries and States are trying this through work/life balance initiatives but the approaches are usually skewed to focus on interventions on the individual rather than looking at the social structures.  In OHS we look at the “system of work” to determine the most effective interventions.  To affect true and lasting change, we must apply the “system of living”.  We must be careful not to over-emphasise the individual and be distracted from the cultural initiatives.

Media reporting of workplace bullying

As a publisher my mailbox is constantly bombarded by media releases.  Some are irrelevant but most relate to safety in some way.

Over the years the amount of attention given to workplace bullying has grown phenomenally.  In my opinion the attention it garners is way beyond the level it deserves.

That is not to say that those subjected to workplace bullying are not seriously harmed, they are, but the big-picture issue is disproportionate.

This is partly because many people who talk about workplace bullying do not apply the definition of the hazard, and as a result other non-bullying matters get included.  A media release I received today, 14 August 2008, illustrates this point.

Workpro has undertaken a survey of

“2,146 employees applying for work through recruitment agencies across Australia, to gain an understanding of the experiences and beliefs about bullying and discrimination among Australian employees today”.

The survey found

“almost one in three (30%) employees claiming they have been bullied at work; one in four (24%) claiming they have been discriminated against, and 44 per cent stating they have witnessed their colleagues experience either of these”.

That data is pretty clear and you can expect the Australian media to run articles on the survey results tomorrow.  These surveys usually get a good hit rate.

The media release provides the impression that 30% of employees have been bullied at work.  This is not the case.  Thirty per cent of employees who are looking to change jobs say they have been bullied at work.  This does not represent 30% of the workforce but that is the impression we are given.

Another part of the release is annoying.

“27 per cent of respondents say they feel bullying or discrimination has happened to them within the past two years.”

Bullying and discrimination are very different interactions.  Discrimination can be a one-off event, bullying must be a repeated action.  To ask about these two disparate items within the one question is inappropriate or, if the results of two questions are combined, it provides a false impression.  Did 10% nominate bullying and 17% say discrimination or was it vice versa?

The media release says

“When asked about their peers, almost half (46%) of respondents say they have seen their colleagues bullied or discriminated against within the past two years; 31 per cent of this group say multiple times.”

The point about definition made above applies here but why ask about other people anyway?  The multiple times quote muddies the water because it is impossible to be bullied once, a single attack is just that an attack or in OHS parlance, “occupational violence”.

A spokesperson for WorkPro, Tania Evans, says

“It’s quite shocking to hear from employees that this sort of behaviour continues to happen in modern times, but organisations need to realise that bullying and unfair treatment of staff is occurring and could be impacting their own workplace culture or worse still, exposing them to the risk of liability, possible fines and even brand damage.”

Now we have something called “unfair treatment” in the mix.  (And I hate “impact” as a verb) The penalties could be liability, fines or brand damage, what about workers compensation claims for stress and bullying?  Not only is this a substantial business cost, the cause of the claim may result in the employee never being able to work again or lead a functional life?  I place these risks higher than brand damage.

Media releases are not the be-all and end-all of a survey.  Press statements are intended to generate contact in order to provide further information and hopefully generate business opportunities.  Alarmism is an effective tool and this media release is unhelpful.

You can imagine the articles in tomorrow’s papers where the journalists, if they can be bothered, will have asked the OHS regulators or unions for their response to the statistics, even though it may only be those statistics in the media release that they have seen.

I would have liked this survey to be reported in two parts, bullying and discrimination, to reflect their difference but also to report on the different control mechanisms for the harm that each of these hazards can generate.

But, I forgot, that’s my job.

Kevin Jones

Irrational decision-making

Occupational health and safety often gets sidetracked from the main issue of preventing injury and illness at work.   I often hear employers, particularly in small business, complaining that their workers continue to do the wrong thing even though the employers have done everything they can think of.  

Sometimes an approach is offered that seems like a quick-fix to all the safety problems.  The one that always annoys me is behavioural-based safety.  BBS is like the Hydra and reappears regularly in different guises and with different jargon.

A podcast crossed my desktop this morning that provides a different perspective on “why rational people make irrational decisions”.  

The podcast illustrates the conflicts in trying to make the right decision by discussing the decision of a pilot in the Canary Islands who caused a major crash.  The pilot was also the head of safety at KLM Airlines.

The podcast does not focus on workplace safety but the discussion is probably the better for it.

New Guidance on Preventing Fatigue

Australian OHS authorities have been struggling for many years to address issues of fatigue in the workplace.  Partly this has been because the issue of stress and bullying came to dominate the psycho-social agenda.

The transport industry has pushed fatigue into the unavoidable hazard basket.  New South Wales’ experience with this issue has been particularly interesting and continues to do so. France’s experiment with a maximum set of working hours, partly on the grounds of occupational health and safety, has proven to be a brave experiment.  The Australian Trade Unions’ campaign on “reasonable hours” had safety echoes.

But, as with so many long-term OHS initiatives, Australia waited until England’s Health & Safety Executive (HSE) did all the leg work before tailoring fatigue guidelines to its own circumstances. At least this guideline acknowledges the HSE’s work.

On 4 August 2008, WorkSafe Victoria and WorkCover New South Wales published their guidelines on “Fatigue – Prevention in the Workplace”.  As far as it goes, it is a good addition to OHS information and, if its existence is publicised sufficiently, should place fatigue on the radar of OHS professionals.  Prior to this guide, the only fatigue information that WorkSafe produced was concerning fatigue in the forestry industry in March 2004! – hardly something that any other industry would see as relevant to themselves.

It is worth comparing some of the basic concepts that the OHS regulators have put forward.

The differing definitions reflect the perceptions of the OHS regulators, the state of knowledge at the time, the approach taken by the organisation consulted in the development of the guidances, they anticipate the level of resources allocated to the promotion and enforcement of fatigue management.  The contrast between the Victorian “definitions” of 2004 and 2008 are particularly marked.

Guidelines only go so far and then it is up to business to consider the advice and decide what to do.  The success of the new fatigue guideline won’t be in evidence for several years and, of course, that relies on the very dim chance of anyone undertaking an assessment of the guideline at all.

There are several issues that I think should be considered when reading the new guidance:

The role of the second job.

Second jobs, often undertaken by shift workers are assessed, if at all, for potential conflicts of interest.  The impediment in being “fit for work” in the principal employment is never assessed.  This guideline, in a roundabout manner, identifies this risk. 

The need for nightshift.

Often nightshift, or specific shift rosters, are traditional structures.  “This is the way it has always been done”.  The existence of nightshift in every workplace should be reassessed on a regular basis as economic factors change and as knowledge of the extent of harm presented by nightshift accumulates.

Overlap of Human Resources and OHS

I have bleated on for years about the silo mentality of the OHS and HR disciplines.  The demarcations have been eroding for ages in the real world of business and this trend has been increases as more and more psychosocial hazards are placed within the OHS context.  But the HR professional and the OHS professional continue to speak different languages and with competing agenda.

Fatigue cannot be successfully managed without a common understanding between HR and OHS.

Impairment

Impairment has been a concept floating around the trade unions for some time and they have never found the right approach to getting this on the OHS agenda.  Much of the content in the new fatigue guideline is broader than fatigue and deals with interaction with our employees and colleagues.  The guideline clearly identifies issues from outside work that may exacerbate fatigue in the workplace. (That other demarcation between work and non-work hazards does not apply to fatigue)

Fatigue impairs judgement as well as actions.  Mental fatigue is applicable to a broader range of occupations than physical fatigue and reaches into occupations that are not familiar with OHS, such as judges and politicians, whose important decisions must not be impaired.

 

Fatigue should not be one of the workplace hazards that are increasing shuffled off into the miasma that is work/life balance and wellness.  It relates directly to the traditional areas of OHS but can only be controlled by non-traditional approaches.  There lies the challenge.

Safety – on the fringe again

The Australian government has established an Australian Social Inclusion Board.  This is what the government says is the purpose and challenges of the Board:

This social exclusion is a significant barrier to sustained prosperity and restricts Australia’s future economic growth.

Promoting social inclusion requires a new way of governing. Australia must rethink how policy and programs across portfolios and levels of government can work together to combat economic and social disadvantage.

The Australian Social Inclusion Board which brings together leaders from around the country, will be instrumental in meeting this challenge.

Tackling disadvantage involves generating effective, practical solutions at the level of government, local communities, of service providers, employers and of families and individuals themselves.

The Australian Social Inclusion Board will consult widely and provide views and advice to the Government.

I am glad that consultation will be broad.  Narrow consultation, even in a tripartite structure, is often found to be too narrow and anti-inclusion.  It is acknowledged that as good as broad consultation is, change and influence comes from having a seat at the table.  I find it disappointing that an independent voice for occupational safety and health is not at the table given the higher rate of death and injury in workplaces of young workers, workers from outside Australia and workers with a poor command of the English language.

It would have been good to see the Australian government look beyond an artificial demarcation of work and non-work.  The OHS profession and OHS legislation dumped this demarcation several years ago when we started to deal with psycho-social hazards in the workplace and the impact of workplace hazards on non-work activities.

If there is not a seat at the table, given that the Minister for Social Inclusion is also the Minister for Employment and Workplace Relations and that the board’s Chair, Ms Patricia Faulkner  had an OHS role in the early 1990’s, I would expect safety (both occupational and non-occupational) to be a fixture on the board’s agenda.

Gaining Political Mileage Out of “handcuff(ed) psychiatric patients”

The New South Wales Liberal Party has released an email from the Pialla Mental Health Nursing Staff to WorkCover detailing their “security” concerns. The original email is available HERE.
The Liberals are making as much political mileage out of this issue as they can. 

Many media reports in Australia have said that some patients have been handcuffed to beds. Below is a typical media report:

Psych patients ‘handcuffed’ to beds
Staff at a Sydney hospital have been forced to handcuff psychiatric patients to beds in the emergency department for up to 36 hours because of a lack of space in the mental health ward, the NSW opposition claims. (The full article is available from http://au.news.yahoo.com/080507/2/p/16rjd.html)

The original email from staff makes no mention of handcuffs.  Indeed there is no mention of restraints of any kind.

The NSW Liberal’s media release (available HERE) states

The NSW Opposition has revealed staff at Nepean Hospital have been forced to handcuff and sedate psychiatric patients in the emergency department for up to 36 hours because of a chronic shortage of mental health beds, NSW Opposition Leader Barry O’Farrell and Shadow Minister for Health Jillian Skinner said today………..

“When patients are being handcuffed in busy emergency departments and staff express no confidence in the Iemma Government’s ability to respond to their concerns, you know the Minister is asleep at the wheel,” Mr Aplin said.

The disheartening thing about these sorts of statements that receive considerable media attention is that the original, perhaps, legitimate claims by overworked and under-resourced staff get forgotten.  I encourage you to read the original email and ignore the political hyperbole.
It is reported elsewhere that

“A spokesman for WorkCover said inspectors had visited staff at Pialla twice since the letter was sent and they would have continuing involvement with the ward.
Health Minister Reba Meagher said she had been informed WorkCover were satisfied with safety measures at the hospital.”

This is not to say that everything is now allright but it does show that issues raised are being addressed.

Importantly, most of these emails address the frustration at lack of communication and consultation, or that management is not taking staff safety concerns seriously.  This desperate letter from Pialla’s Mental Health Nursing Staff is a classic example.

© Workplace Safety Services P/L (ABN: 68091088621) and SafetyAtWorkBlog, 2008-2024. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Kevin Jones and SafetyAtWorkBlog with appropriate and specific direction to the original content.

Concatenate Web Development
© Designed and developed by Concatenate Aust Pty Ltd