Employee well-being_ mental health and careers guidance

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					     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                 • Tasks 
                                – Repetition
•   Hours/shiftwork             – Control 
•   Travel                      – Emotional labour
•   Physical risk                    (Service sector)
                             • Uncertainty
•   Psycho-social risks         – Ambiguity 
    –   Bullying                – Restructuring
    –   Sexual harassment       – Job insecurity
    –   Discrimination
                             • Culture
    –   Isolation
                                – 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...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

 
            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 ?
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

vLocates responsibility for causes and 
 management of distress within the individual
vFocus on anxiety ignores the complexity of 
 emotion at work
vImplies work is usually pathenogenic
vHuge 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 
                 •   Stigma, media and 
                     Retention 
                     culture
                 •   Flexible working
                 •   Reasonable adjustments
                     Organisational culture
                 •    – Performance management
                     Training
                      – Bullying
                 •   Support services: 
                      – Attitudes to mental health
                     – Employee assistance 
                       programmes (EAPs)
                     – Occupational health (OH)
                     – Vocational rehabilitation (VR)
                      Lack of coherence in 
                     – Occupational therapy (OT)
                     – JobCentre Plus/DWP services
                     support services ?
                     – Executive coaching/mentoring
     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                           offers hope
=
Identify resources                     strengths based
=
(skills/experience/contacts/support)
                                       approach
=
Focus on choice & goals
=                                      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 ?
      p.robertson@napier.ac.uk

				
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