O'Connor (2016) Examining mental fitness for work - Unfit or safe for duty

Examining mental fitness for

work: Unfit or safe for duty?

Frank O’Connor

1

Meet Elizabeth

o A few years of experience

o Hasn’t been handling ordinary work very well

o That’s every day here – our work won’t wait

o She needs comforting when things go badly for customers

o Bursts into tears but Doc says she’s just stressed and tired

o Sometimes she needs hours before she’s ready to work

o She says she’s all rightIs she safe to work?

2O'Connor (c) 2016 - Examining mental fitness for work: Unfit or safe for duty? p2 of 19.

Most often requested

o After employment has been

offered

o As a condition of a transfer

or promotion

o After an incident involving

reduced work performance

or lapse of safety

o After or during an illness

o Following an injury


There may have been a change

… to conditions in either or

both of workplace and the

employee’s health

o The change may be expected

to be temporary or enduring

o Reassessment may be needed

if conditions change further

o Satisfactory performance:

� working safely and consistently

� to the standard expected

� without undue impact on others


Falling mental capacity matters

o In high-stakes workplaces,

even with well-formed

safety practices, a loss of

mental capacity increases

risk and is often concealed


Changing working conditions?

Significant change in

o Work processes or tools

o Place or layout of work

o Techniques and skills

o Demands made of worker

o Transfer to another location

o Changes at present location


Changed employee personal

health conditions?

o … which may be made worse by the work

o … which limit, reduce or prevent satisfactory job performance

o … make it unsafe to do the job without undue risk to

� self

� others

� public

� Weakness while recovering after injury

� Light duties at work while getting over serious illness

� Tendinitis that limits reach and carrying capacity

� Loss of ability to recall names and numbers

� Ear infection affecting balance in a scaffolder

� Deficient colour vision in an electrician

� Extra physical exertion on an existing heart disorder


What’s “Mentally Fit for Work”?

If capacity for work is free

from interference from

o Alcohol or drugs (legal or ?)

o Insufficient rest and sleep

o Distractions in state of mind

= Mentally fit for work

Is safe this simple?


Mental Safety at Work?

o Even where the stakes

aren’t so obviously high,

people still have to work

safely, whatever else is

going on in their lives


“Fitness For Work” Assessment?

o when an employer wants to

be sure an employee can

safely and reliably perform

a specific job or task under

specified working

conditions, without undue

hazard to self or others


Assess what?

Work details

o Job outputs and inputs

o Working conditions

o Demands made on workerJob descriptions often not enough

Worker details

o Experience and training

o Performance record

o Concerns notedSupervisor reports often poor


How is the assessment done?

The assessor may

consider capacities:

o Physical or mental abilities

o Past and present conditions

o Sensory acuity

o Level of skill

o Functional limitations

Often assumes a “medical” issue

Physically FFW ≠ mentally FFW


Questions of fitness for work

A suitable assessor?

�GP for aggressive outbursts?

� Psychologist for skin allergy?Assessor matched to purpose?

Qualified in whose view?

A differential diagnosis?

Some job analysis?

� A GP may do neither

� An occupational health

physician may do bothHow does good enough look?

Who gets to decide?

What’s the problem

anyway?


What is my concern?

o Describe your concern

� Is the person able to

understand?

o Describe why you are

concerned

� Is the person willing to

cooperate?What will you say?

o What do you need to

know?

�No more, no lessBalance safety with privacy


What might a mental safety

inspection look like?

What does it find?

o Limited reporting

� “Fit for the work” or

� “Unfit for the work” or

� “Fit, subject to work

modifications” (specified)

o Limited validity

� Period before reassessment

� Reasons for reassessment

� Conditions in or excluded

� Sources used/consulted

What does it not find?

� Fault or liability

� Prognosis in detail

� Treatment

� …

o May not find (or need)

� Causes or precursors

� Diagnosis

� …


Decision Support Process

Notice change

o Review with others

o Plan when we’ll check

Assess concern

o What does ‘risky’ look like?

o One of those conversations?

Respond to improve

o Give and get help

o A rest? A change? A break?

o Action planning

o Monitor – how does it look?


Unable or Unwilling to Cooperate?

Does the person

o want to change the situation?

o have the skills and knowledge

to address the issue?

o have the energy or motivation

to address the problem?

What problem does the

behaviour cause for the

organisation or for the

employee?

o Is this clear to the employee?


Why does concealment happen?

Why don’t people ask for

help?

o Self-disclosure has

advantages and risks

o Disclosure may be narrow

or broad – it depends

People seek help for

others much more

readily than for

themselves

How does a safety culture

practice affect the state

of minds on the job?

o What goes wrong most

often?

o Which laws apply?


O'Connor (2016) Examining mental fitness for work - Unfit or safe for duty

Documents

Transcript of O'Connor (2016) Examining mental fitness for work - Unfit or safe for duty