WordPress.com - Work & Mental Health: Applying …...-positive manager behaviour (Donaldson-Feilder...
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Work & Mental Health: Applying an Integrated Approach in SMEs
Understanding Small Enterprise:Denver, October 2017
Tony LaMontagne Professor of Work, Health & Wellbeing
Director, Centre for Population Health ResearchDeakin University
Melbourne AUSTRALIA
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Work, Health & Wellbeing UnitVision: healthy and sustainable work for all
We seek to:
- advance the scientific and public understanding of work as a social determinant of health, and
- help shape policy & practice to better protect people from the harmful effects of work, while fostering its health-promoting qualities
- Prof Tony LaMontagne (Head) - Dr. Alicia Papas- Dr. Allison Milner (Honorary)- Dr. Amanda Allisey (Honorary)- Dr. Kathryn Page (Honorary)- Dr. Clare Shann (Honorary)- Ms. Julia Malone- Ms. Humaira Maheen- Collaborators- Students
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OTHER COLLABORATORS
Andrew NobletDeakin, School of Business & Law
Nicola Reavley, Tony Jorm & Nataly BovopoulosUniv of Melbourne
Peter SmithUniv Toronto, Institute for Work &Health
Angela Martin, Kristy Sanderson& Fiona CockerUniv of Tasmania
Tessa KeegelLatrobe University
Clare Shannformerly beyondblue: the nationaldepression initiative and Movember
Paul LandsbergisDownstate Medical Centre, New York
Aleck Ostry, Amber Louie &Jean ShovellerUniv British Columbia
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Thetalkintwoparts…
PartISpeakingtoresearchers,policy-makers&practitioners
PartIISpeakinghypotheticallytoaSBowner/manager
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ANINTEGRATEDAPPROACH…• Workplacementalhealthiscomplex…
• ButneedtofocusonactionsemployersandotherscantaketoprotectandpromoteMHintheworkplace…
• Soneedtodistilthecomplexitytoitsessence…
• Intermsthatareaccessibletoemployersandworkers,andareaction-oriented…
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AN INTEGRATED APPROACH
Workplace mental health intervention, to realise the greatest populationhealth benefits, needs to:
1. Protect mental health- by reducing work–related and other risk factors for mental health
problems in the workplace context (reduce the negative)
2. Promote mental health- by developing the positive aspects of work as well as worker strengths
and positive capacities (promote the positive)
3. Address/respond to mental health issues- in work context, regardless of cause (respond to issues)
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Workplace mental
health & wellbeing
Prevent harm
Promote the
positiveManage illness
Occupational Health/ Medicine,
Occupational Health Psychology, Public
Health
Medicine, Psychiatry, Psychology
Positive Psychology,
Management,Org Development
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Workplace mental
health & wellbeing
Prevent harm
Promote the
positiveManage illness
Occupational Health/ Medicine,
Occupational Health Psychology, Public
Health
Medicine, Psychiatry, Psychology
Positive Psychology,
Management,Org Development
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REDUCE WORK-RELATED RISK FACTORS
- What to do reasonably well-established for job stressors
- Systematic reviews (LaMontagne et al, 2007, Egan et al 2007, Bambra2007 & 2009)
- Combined work & worker-directed
- Stress management & prevention
- Systems approach
- Comprehensive approach
- Participatory approach
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REDUCE WORK-RELATED RISK FACTORS
- How to do this more challenging- Principles common, but solutions unique
- Generic concepts/constructs manifest differently & require
different responses (e.g. job control for sales clerk vs manager)
- Tailoring
- Context-dependence
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JOB STRESS INTERVENTION:PREVALENT PRACTICE
- Persisting view of the problem as individual-based
- Stigma issues for job stress as well as MH problems
- EAP’s most prevalent org response
- Insurance response can conflict with public health response
(Keegel et al 2009; Page et al 2013; LaMontagne et al 2012)
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SUMMARY: PREVENTING HARM• Strong job stressor focus
• Also can protect MH through non-work-related prevention (e.g., physical activity)
• Strong on primary, secondary prevention
• Weaker on tertiary (e.g., early detection, RTW)
• Little on promoting the positive
• Disconnect between evidence-based practice and prevalent practice
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Workplace mental
health & wellbeing
Prevent harm
Promote the
positiveManage illness
Occupational Health/ Medicine,
Occupational Health Psychology, Public
Health
Medicine, Psychiatry, Psychology
Positive Psychology,
Management,Org Development
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PROMOTING THE POSITIVE:DEFINITIONS
• Complete health (WHO 1948), complete mental health (WHO 2004)
– "a state of complete physical, mental, and social well-being and not merely
the absence of disease or infirmity"
• Wellbeing–Meaning/purpose (soc & psychol functioning) & positive feelings & emotions
– Complete mental health = Flourishing/high wellbeing in absence of mental
illness (Keyes, 2005)
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PROMOTING THE POSITIVE:DEFINITIONS
- Overall aim in the workplace is individual and organisational flourishing (Meyers et al, 2013)
- Positive approaches move from avoidance goals(manage, control, reduce)…to approach goals(encourage, develop)
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PROMOTING THE POSITIVE
Strength-based methods
Positive outcomes
• Appreciative inquiry• Future search• Strength-based
development
• Subjective wellbeing• Eustress/challenge• Positive employee
capacities (e.g., engagement, resilience)
• Positive org attributes (e.g., climate, socialcapital)
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POSITIVE APPROACHES: EXAMPLE
Organisational development for promoting positive org capacities- positive manager behaviour (Donaldson-Feilder et al, 2011)
- workplace social capital (Sapp et al, 2010)
- culture of respect (Brun & Cooper, 2009)
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PROMOTING THE POSITIVE- Large meta-analysis of general literature (51 studies):
- sustainable enhancement of well-being and mitigating effect ondepression; greater benefits among depressed (Sin & Lyubomirsky, 2009)
- Review of pos psych intervention in organisations (15 studies): (Meyers et al 2013)
- enhance employee wellbeing- mixed evidence of enhanced performance- some evidence of alleviation of stress, depr, burnout, anxiety
- Empirical study showed positive mental health (WB) mitigated the effect of job stress on psychol distress (Page et al, 2014)
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PROMOTING THE POSITIVE
• Canalsouseworkplacesetting– forthepromotionofnon-work-relatedprotectivefactorsagainstmentalillness(e.g.,physicalactivity)
– forpromotingmentalwellbeingingeneral(e.g.,mindfulnesstraining)
• Morelikelytobetakenupbyemployeesifemployerhasfirstoptimisedpositiveaspectsofwork/jobs
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SUMMARY: PROMOTING THE POSITIVE
- Limitation: mainly individual level emphasis to date
- Moving to team, group, org level…
- May mitigate/moderate the impacts of job stressors on ill-mental health
- Least developed thread of integrated approach
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Workplace mental
health & wellbeing
Prevent harm
Promote the
positiveManage illness
Occupational Health/ Medicine,
Occupational Health Psychology, Public
Health
Medicine, Psychiatry, Psychology
Positive Psychology,
Management,Org Development
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RESPONDING TO MENTAL HEALTH ISSUES IN THE WORKPLACE
- Mental health literacy and anti-stigma main focus of programs entering workplaces over last decade
- MHL: “Knowledge and beliefs about mental disorders which aid their recognition, management or prevention” (Jorm 1997)
- Psychoeducation: awareness, knowledge, recognition, anti-stigma- Skills for early intervention / promoting help seeking (Kitchener & Jorm,2004)
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MENTAL HEALTH LITERACY IN THE WORKPLACE
• Examples:- Mental Health First Aid (international)
- beyondblue: national workplace program (Australia, from 2004)
- R U OK Day (suicide prevention)
• Widespread uptake by employers
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EVIDENCE OF EFFECTIVENESS IN THE WORKPLACE?
• Meta-analysis of 22 workplace mental health interventions(Martin et al, 2009)
- small but positive overall effects of intervention on symptoms ofdepression and anxiety
• Some RCT-based evidence of effectiveness of workplace MHL interventions: improved MHL and
MH (Kitchener & Jorm, 2004; Jorm et al, 2010)
• Systematic review of 16 studies: Workplace anti-stigma interventions can improve ee knowledge & supportive behaviour, impacts on stigma were mixed (Hanisch et al, 2016)
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SUMMARY: MANAGE MENTAL ILLNESS- Illness-based/focused
- Strong on tertiary, weak on primary
- Strong on individual, weak on org/envt
- Little on promoting the positive
- Effectiveness evidence base developing
- Strongly embraced by employers
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INTEGRATEDAPPROACHINFURTHERDETAIL…
• LaMontagneADetal(2014):Workplacementalhealth:Developinganintegratedinterventionapproach.BMCPsychiatry14;131:1-11.
• LaMontagneADetal(inpress):Developinganintegratedapproachtoworkplacementalhealth,Chapter13inTotalWorkerHealth:IntegrativeApproachestoSafety,Health&Wellbeing (Eds:HudsonHLetal),AmericanPsychologicalAssociation.
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ILLUSTRATEDINSME ANDPOLICECONTEXT
• LaMontagneADetal(2014):Anintegratedapproachtoworkplacementalhealth:anAustralianfeasibilitystudy.IntlJMentalHealthPromotion,16(4):205-215
• LaMontagneADetal(2016):AnIntegratedWorkplaceMentalHealthInterventioninaPolicingContext:Protocolforaclusterrandomisedcontroltrial.BMCPsychiatry,16(49)
• PageKMetal(2017):Workplacementalhealth:DevelopmentofanintegratedinterventionstrategyforanAustralianpolicingorganisation,In StressinPolicing (Eds:RonaldBurke),Abingdon,UK:RoutledgePublishingUK,Chapter20,pp:244-357
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PartIISpeakinghypotheticallytoaSB
owner/manager
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CONVERSATIONWITHSBOWNER
• ThesympatheticSBownerasks—whatshouldIdoaboutworkplacementalhealth?
• Youneedtolookatthreethings:
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CONVERSATIONWITHSBOWNER
• But…why,isallthatreallynecessary?• Mentalhealthproblemsarecommon
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Mental Health Problems Common Among Working People
Point prevalence ~20% of working age population affected by a mental health problem (OECD 2012)
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CONVERSATIONWITHSBOWNER
• But…why,isallthatreallynecessary?• Mentalhealthproblemsarecommon• Soyou’relikelytoencounterthisasaboss/manager,ormaybeevenbeaffectedyourself
• Youalsohavelegal(andethical)obligationsifyouareanemployer
– OH&S
– Equalopportunity&humanrights
– Disabilityemployment
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Illnessesassociatedwithjobstressors
Common mental disorders• Depression,
anxiety, burnout, suicidality
Cardiovascular disease• Hypertension,
coronary heart disease
Poor health behaviours
Workplace injury
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JobstressorsinSME(comparedtolargerworkplaces)
• Higherautonomy/jobcontrol,flexibility(positive)• Higherprevalenceoflongworkinghours(espowners),higherworkload(?),lowerjobsecurity(?)• Higherpersonalandfinancialinvestment:over-commitment(-),butalsohigheroptimism,motivation(+)•Work/lifeimbalance(?)• Smallstaffnumbers:challengingtotakesickleave,recleave
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CONVERSATIONWITHSBOWNER
• Butwedon’thavetheresources…• StartsmallwithawarenessraisingtofosteranenvironmentwhereMHcanbediscussed– bymarkingWorldMentalHealthDay,orhavinganRUOKDay
• AreyoupartofaSBnetworkorsomekind,suchasaCoC?– bandtogetherwithotherSB’stoshareprogramorsupportservices,get
economiesofscale
• Informalplans,strategiesokaswellasformal
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CONVERSATIONWITHSBOWNER
• But…theydon’tunderstandtheneedsofSB…• That’schanging—growingrangeofworkplaceMHprograms,materials,andmoreforSBofvariouskinds
• BusinessinMind workplaceMHprogramforSME(openace$$)– featuringbusinessowners’storiesandexpertcommentary–www.businessinmind.edu.au
• HeadsUp,beyondblue’s newSBpages…(openace$$)• Wecanhelpyounavigateinternetresources,helpingyouselectevidence-basedadviceandprograms
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HeadsUpSmallBusinesspages
https://www.headsup.org.au/healthy-workplaces/for-small-businesses
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CONVERSATIONWITHSBOWNER
• AreyoutellingmeI’mnowresponsibleformystaff’smentalhealth!?
– NO
–Butyouareresponsibleforprovidingworkthatispsychologicallysafetotheextentfeasible(espifyouareanemployer)
– Andyoushouldbeabletorecognisesignsofpossiblementalhealthproblems,howtotalkaboutit,andhowtoreferpeopletoappropriatehelpwhenneeded
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CONVERSATIONWITHSBOWNER• Ok,sosupposeIgivethisatry.WheredoIstart?• Small.Pictureplantingalittletreewiththreebranches…andgrowingitovertime.Startwithonethingoneachbranchandaddonasyougo...
Prevent harmRespond to MHP
Promote the positive
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CONVERSATIONWITHASBOWNER
• Firstlookatwhatyou’redoingalreadyonProtectingfromharm• Doyouinformallycheckinwithstaffonaregularbasis?– ‘How’dthatjobgoyesterday?’‘Haveeverythingyouneedforthatclient?’
• Doyouadjustthingsasneeded?Liketakingonextrahelpinpeakperiods?[OH&Stranslation:workloadmanagement]
• Doyoufollowup? [OH&Stranslation:I-A-C,monitoringeffectiveness]
• Managingwellisconsonantwithjobstressprevention
Requirements of the job
Resources required to get the job done
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CONVERSATIONWITHASBOWNER
• Ok—nowlet’sseehowyoumightalreadybePromotingthe+• Doyouknowyourstaff,theirdifferentstrengthsandlimitations?[usuallyyes,avirtueofbeingsmall!]
• Doyouknowwhatyourindividualstafflike abouttheirwork?• Isitpossibletogivethemmoreoftheworktheylike?
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CONVERSATIONWITHASBOWNER
Sally’saskilledaccountsmanager,butshedoesn’tseemengagedlately.Turnsoutshe’dbekeentogetherheadoutofthebooksmoreoftenandhavemorepersonalinteractionwithclients.So…youprogressivelysharemoreclientrelationsresponsibilitieswithSally,shegetsmoreengaged,andyou’refreeduptodosomethingelse…[promotingthepositive—bothemployeeMHandthebusiness]
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CONVERSATIONWITHASBOWNER• NowontoRespondingtoMHissuesastheymanifestatwork• Ifyouhaven’texperiencedasamanageryet,soonerorlater…• DuetostigmaagainstMI,peoplemayexplainMH-relatedsicknessabsenceinotherways
• Howdoyoudealwithstaffsickdaysnow?• Let’sbuildonthat,mentalillnessisn’tthatdifferentfromotherillnessesthatrequirepeopletotaketimeoff
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CONVERSATIONWITHASBOWNER
• Thekeyknowledgeandskillsyouneedhere:–howtorecognisesignsofpossibleMHproblems,haveconversations,offer
support,andpointpeopletofurtherhelpwhenneeded
• Keytoremember:you’redoingwhatyoucantosupportthepersonintheirworkrole,notsolvetheirMHproblem
• ThiscanextendtoreasonableaccommodationsforsomeoneRTWfromamental(orother)illness,disability
• Thisiswhereyou shouldskillupasapriority
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CONVERSATIONWITHASBOWNER
Ok,sowhatnext?• Howabout––ThinkingaboutyourownMHasaSMowner/manager?
–someweb-basedawarenesstrainingforstaff?
–someone-on-oneorgroupdiscussionswithstaffaboutwhat’sgoingwellandwhatcouldbeimproved?
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HeadsUpSmallBusinesspages
https://www.headsup.org.au/healthy-workplaces/for-small-businesses
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Workplace mental
health & wellbeing
Prevent harm
Promote the
positiveManage illness
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CONVERSATIONWITHASBOWNER
• SoIhopethatgivesyouaconcretesense…• Andasensethatyou’reprobablyonthewayalready• Youcouldsimplyseethisasgoodmgmt/businesspractice…• Whatyouandyourstafflearnwillserveyououtsideofworkasmuchasatwork
• So,plantyourtree,tendit,andovertime…
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FUNDINGACKNOWLEDGEMENTS• AustralianNationalHealth&MedicalResearchCouncil(NHMRC)
• VictorianHealthPromotionFoundation• WorksafeVictoria• InstituteforSafetyCompensation&RecoveryResearch
• beyondblue• Superfriend
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THANK [email protected]
ResearchGate
http://www.deakin.edu.au/cphr/our-research/work-health-and-wellbeing-unit
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FormsofSME
• Rapidlyevolving(e.g.,‘gig’economy)• Overlapb/wSMEandself-employment• Internationallydefinedbysize(e.g.,eenumbers,revenue)
EntrepreneursSole traders/own account SEContractorsFreelancersFamily businessesPartnerships
Micro (<5 employees)Small (5-20 employees)Medium (21—200 employees)
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ORGANISATIONALLEVELCONSIDERATIONSINSMECONTEXT
• >99%ofbusinessesinUK,Australia,otherOECDcountries• >50%ofworkersemployedinSMEinUS,otherOECDcountries…
• Butonly~5%offercomprehensiveHPprograms(US)• Resourcebaseforstrategydevelopment&programslower
– Human(specialistknowledge)&financial• Morelikelytobemotivatedby‘companysuccess’thanhumanitarianormoralresponsibility(Hughesetal,2011)
• RoI,employerresponsibilitiesmaybemotivators(?)
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REDUCE WORK-RELATED RISK FACTORS- What to do reasonably well-established for job stressors
- Systematic reviews (LaMontagne et al, 2007, Egan et al 2007, Bambra2007 & 2009)
- Combined work & worker-directed
- Stress management & prevention
- Systems approach
- Comprehensive approach
- Participatory approach
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REDUCE WORK-RELATED RISK FACTORS
- How to do this more challenging- Principles common, but solutions unique
- Generic concepts/constructs manifest differently & require
different responses (e.g. job control for sales clerk vs manager)
- Tailoring
- Context-dependence
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JOB STRESS INTERVENTION:PREVALENT PRACTICE
- Persisting view of the problem as individual-based
- Stigma issues for job stress as well as MH problems
- Work stress and MH problems as stereotypically feminine weakness
- EAP’s most prevalent org response
- Insurance response can conflict with public health response
(Keegel et al 2009; Page et al 2013; LaMontagne et al 2012)
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Workplace mental
health & wellbeing
Prevent harm
Promote the
positiveManage illness
Occupational Health/ Medicine,
Occupational Health Psychology, Public
Health
Medicine, Psychiatry, Psychology
Positive Psychology,
Management,Org Development
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WORKPLACE MENTAL HEALTH LITERACY:A DEFINITION OF INTEGRATED APPROACH?
Mental health literacy:- “Knowledge and beliefs about mental disorders which aid their
recognition, management or prevention” (Jorm 1997)
Workplace mental health literacy:- the knowledge, beliefs, and skills that aid in the prevention of mental
illness and the promotion of wellbeing in the workplace, and the recognition, treatment, rehabilitation, and return to work of working people affected by mental illness (LaMontagne et al 2014, 2017)
–
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INTEGRATED APPROACHES: EXAMPLES• Happening to varying degrees internationally in policy & practice:–beyondblue National Workplace Program (Australia)
–Mind: For Better Mental Health (UK)
–Mental HP in the Workplace (European Agency for S&H@W)
–Guarding Minds at Work (Canada)
–Canadian Standard for Psychological H&S in the Workplace
(Canada)
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CAUTIONARY NOTES
• Over-emphasis on individual (often employer default)• Conflating of mandatory & voluntary employer responsibilities
• First priority to prevent harm
• Confidentiality/privacy issues• Too much focus on softer targets
• For example: communication over job control & security• Those most in need probably least likely to receive?• Exacerbation of inequalities (prevention paradox)
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Integrated Approach: Summing Up
An integrated approach to work & mental health could result in:- Greater reach of job stress and MHL intervention
- Rebalancing of focus on work and worker
- Transferable (work/non-work) MH literacy skills
- Improved mental health & wellbeing
- Preventive synergies?
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RESOURCES• ReducingStressintheWorkplace:anInfographic (launched21June2013bytheVictorianHealthPromotionFoundation,MelbourneVICAUSTRALIA): http://www.vichealth.vic.gov.au/Publications/Video-Gallery/Reducing-Stress-Healthy-Workplaces.aspx
• LaMontagneADandKeegelT(2012):ReducingStressintheWorkplace:AnEvidenceReview,FullReport.Melbourne:VictorianHeathPromotionFoundation(VicHealth),52pages.Openaccessathttp://www.vichealth.vic.gov.au/workplace
• PromotingPositiveMentalHealthintheWorkplace– GuidelinesforOrganisations(2015).http://www.superfriend.com.au/supporters/research/promoting-positive-mental-health-in-the-workplace-guidelines-for-organisations
• WorkplacePreventionofMentalHealthProblems,GuidelinesforOrganisations(2013):https://mhfa.com.au/cms/guidelines#mhfaprevent.
• GuidelinesonProvidingMentalHealthFirstAidintheworkplace(2016):https://mhfa.com.au/resources/mental-health-first-aid-guidelines#mhfaworkplace
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RESOURCES• WorksafeVictoria:PreventingandManagingWork-relatedStress– AGuidebookforEmployers.
http://www.worksafe.vic.gov.au/forms-and-publications/forms-and-publications/preventing-and-managing-work-related-stress-a-guidebook-for-employers
• TheCopenhagenPsychosocialQuestionnaire(COPSOQ):http://www.arbejdsmiljoforskning.dk/en/publikationer/spoergeskemaer/psykisk-arbejdsmiljoe
• GuardingMindsatWork:AWorkplaceGuidetoPsychologicalHealth&Safety:http://www.guardingmindsatwork.ca/
• UKHealth&SafetyExecutiveManagementStandardsforWork-RelatedStress:http://www.hse.gov.uk/stress/standards/
• NationalStandardofCanadaforPsychologicalHealthandSafetyintheWorkplace:http://www.mentalhealthcommission.ca/English/national-standard
• WorkplaceStress:ACollectiveChallenge(publishedbytheILOforWorldSafety&HealthatWorkDay,28April2016):http://www.ilo.org/safework/events/safeday/lang--en/index.htm
• Great-WestLifeCentreforMentalHealthintheWorkplace(accessed24October2016):WorkplaceStrategiesforMentalHealth:https://www.workplacestrategiesformentalhealth.com/
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REFERENCES- BambraC,GibsonM,SowdenAJ,WrightK,WhiteheadM,PetticrewM.Workingforhealth?Evidencefromsystematicreviewsontheeffectsonhealthandhealthinequalitiesoforganisationalchangestothepsychosocialworkenvironment.PrevMed2009;48(5):454-61.
- KitchenerBA,JormAF.Mentalhealthfirstaidtraininginaworkplacesetting:arandomizedcontrolledtrial.BMCPsychiatry 2004;4:23.
- JormAF.Mentalhealthliteracy:empoweringthecommunitytotakeactionforbettermentalhealth.TheAmericanPsychologist 2012;67(3):231-43.
- JormAF,KitchenerBA,SawyerMG,ScalesH,CvetkovskiS.Mentalhealthfirstaidtrainingforhighschoolteachers:aclusterrandomizedtrial.BMCPsychiatry 2010;10:51.
- LaMontagneAD,KeegelT,LouieAM,OstryA.Jobstressasapreventableupstreamdeterminantofcommonmentaldisorders:Areviewforpractitionersandpolicy-makers.AdvancesinMentalHealth 2010;9(1):17-35.
- LaMontagneAD,KeegelT,VallanceDA,OstryA,WolfeR.Jobstrain—attributabledepressioninasampleofworkingAustralians:Assessingthecontributiontohealthinequalities.BMCPublicHealth,2008:9pages.
- CockerF,SandersonK,LaMontagneAD:Estimatingtheeconomicbenefitsofeliminatingjobstrainasariskfactorfordepression.JOccupational&EnvironMedicine2017,59(1):12-17
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REFERENCES• LaMontagneAD(2012).InvitedCommentary:Jobstrainandhealthbehaviours-developingabiggerpicture.AmericanJournalofEpidemiology 176(12):1090-1094.
• LaMontagneADandMilnerA(2016).InvitedCommentary:Workingconditionsasriskfactorsforsuicicalthoughtsandbehaviours.OccupEnvironMedicine.On-linefirstOctober222016
• LaMontagneADetal.Interventiondevelopmentandimplementation:understandingandaddressingbarrierstoorganizational-levelinterventions.In:BironC,Karanika-MurrayM,CooperCL,editors.ImprovingOrganizationalInterventionsforStressandWell-Being:AddressingProcessandContext.London:Routledge/PsychologyPress,2012:21-38.
• LaMontagneAD,KeegelT,LouieAM,OstryA,LandsbergisPA.Asystematicreviewofthejobstressinterventionevaluationliterature:1990—2005.IntlJOccup&EnvironHealth2007;13(3):268-80.
• LaMontagneAD,KeegelT,VallanceDA.Protecting&promotingmentalhealthintheworkplace:Developingasystemsapproachtojobstress.HealthPromotionJournalofAustralia2007;18(3):221-28.
• MilnerA,SpittalMS,NiedhammerI,ChastangJ,PirkisJ,LaMontagneAD(2016):Lowcontrolandhighdemandsatworkaschronicpsychosocialriskfactorsforsuicide:anAustraliannationalpopulation-levelcase-controlstudy.PsychosomaticMedicine.EpubAug31,2016.
• MilnerA,PageK,WittK,LaMontagneAD(2016):Psychosocialworkingconditionsandsuicideideation:Evidencefromacross-sectionalsurveyofworkingAustralians.JOccupational&EnvironMedicine58(6),584-587
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REFERENCES• MartinA,SandersonK,CockerF.Meta-analysisoftheeffectsofhealthpromotioninterventionintheworkplaceondepressionandanxietysymptoms.ScandJWorkEnvironHealth 2009;35(1):7-18.
• NobletA,LaMontagneAD.Theroleofworkplacehealthpromotioninaddressingjobstress.HealthPromotInt 2006;21(4):346-53.
• PageKM,LaMontagneAD,LouieAM,OstryAS,ShawA,ShovellerJA(2013):Stakeholderperceptionsofjobstressinanindustrializedcountry:Implicationsforpolicy&practice.JPublicHealthPolicy,34(3):447-61
• PageKM,MilnerAJ,MartinA,TurrellG,Giles-CortiB,LaMontagneAD(2014). Workplacestress:Whatistheroleofpositivementalhealth? JOccupational&EnvironmentalMedicine, 56(8):814-819
• ReavleyNJ,RossA,KillackeyEJ,JormAF.Helpingemployeessuccessfullyreturntoworkfollowingdepression,anxietyorarelatedmentalhealthproblem:guidelinesfororganisations.Melbourne.CentreforYouthMentalHealth,UniversityofMelbourne,2011.- -
• http://www.mhfa.com.au/cms/wp-content/uploads/2012/02/8671_return-to-work_guidelines.pdf• SandersonK,AndrewsG.Commonmentaldisordersintheworkforce:recentfindingsfromdescriptiveandsocialepidemiology.CanJPsychiatry 2006;51(2):63-75.
• StansfeldSA,CandyB.Psychosocialworkenvironmentandmentalhealth--ameta-analyticreview.ScandJWorkEnvironHealth 2006;32(6):443-62.
• Sultan-TaiebH,LejeuneC,DrummondA,NiedhammerI.Fractionsofcardiovascular• diseases,mentaldisorders,andmusculoskeletaldisordersattributabletojobstrain.IntArchOccupEnvironHealth 2011;84(8):911–25.