1. WORK RELATED STRESS MANAGEMENT
*!*:!!! &
Tony!
By Intec (UK) Ltd
November 18th 2003

2. Health & Safety Executive
In May 2003 the HSE published standards for measuring employers’ performance in preventing work-related stress. The standards facilitate enforcement of stress-related offences and are likely to lead to the development of an Approved Code of Practice on stress.
In other words, it has become a punishable offence to do nothing about it. No heads in the sand.
(However current guidelines are dangerously vague).
It has also become increasingly popular for disgruntled employees to sue for stress caused in the working environment, and because of the vagueness of the law, employers are increasingly aware of the need to address the issue of stress at work.

3. Are Intec paying the price?
FACT
Work-related stress affects as many as one in five employees and is thought to be responsible for 6.5 million sick days each year.
This estimated to cost employers around £370 million and society around £3.75 billion per year – a heavy burden both in terms of financial cost and human suffering.
Are Intec paying the price?

4. Work-related stress is the second most common form of occupational ill-health, behind musculo-skeletal disorders.
Managing stress at work is difficult as staff are often reluctant to admit that they are suffering from work-related stress and managers do not always recognise the symptoms.
There are also problems with isolating work-related stress from stress associated with external, social or other factors.

5. Statement 1 WRONG Work related-stress is not a serious problem.
In the UK, as many as one in five people report being exposed to high levels of work-related stress.
An estimated half-million individuals report experiencing stress at a level that made them ill.

6. A little bit of stress is good for you.
Statement 2
A little bit of stress is good for you.
WRONG
Ill health due to work-related stress, or conditions ascribed to work-related stress, is the second most common type of work-related ill health reported.

7. Stress only happens to wimps.
Statement 3
Stress only happens to wimps.
WRONG
Anyone can suffer from stress. It all depends on the circumstances we are in at the time. Preventing it is good for employee health and well-being and good for business.

8. Statement 4
There’s nothing employers can do to stop work-related stress.
WRONG
Employers can take steps to prevent work-related stress in their organisations. As a first step, they can consult with their staff to identify problems and work towards agreed solutions.

9. What is ?
STRESS
What’s Why’s & Where’s

10. Definition Stress is a term with which we are all familiar, yet it is
notoriously difficult to define. There are many definitions
available, and the term is often used to describe feelings of
fatigue, distress and an inability to cope.
The most popular definition of stress is:
“When the demands and pressures placed on individual
workers do not match the resources which are available,
either from the organisation or within the individual,
stress can occur and endanger that person’s health and
well-being”

11. What are the symptoms? Increased heart rate. Increased sweating.
Headaches.
Giddiness & blurred vision.
Aching muscles, particularly neck and shoulders.
Rashes.
Reduced immunity to infections.
Depression and negative outlook.
Increased anxiousness, irritable & moody.
Increased intake of alcohol, caffeine, nicotine.

12. What are the symptoms? Reduced ability to sleep.
Lack of concentration.
Poor work performance.
Inability, or reduced ability, to cope with normal tasks and situations.
Increased sickness absence.
Poor timekeeping.
This is not an exhaustive list, there are lots more symptoms and an employee suffering from stress will encounter a combination of several of them.

13. Why Do We Get Stressed? Lack of control over work.
Conflicting demands.
Over & underwork.
Monotonous, repetitive work.
Uncertainty about job security.
Unrealistic targets or performance standards.
Peer pressure, including harassment.
Poor Management.
Lack of support from peers & managers.
Poor working environment.

14. Main sources of stress at work…
Physical
Psychosocial
Organisational
There are three main sources of stress at work.
physical stressors
psychosocial stressors
organisational stressors
Physical stressors include noise, heat and vibration. Workers are exposed to them not only in their physical working environment but also sometimes electronically or mechanically.
Psychosocial stressors concern social factors and relationships, including behaviours, attitudes and culture. They can also involve things like economic and social or family status (or attitudes to them at work and in wider society). They affect not only what people do but also the way they think and feel and how they are perceived by others.
Organisational stressors are sources of stress that arise from the nature of the work organisation -for example, systems of work, working conditions, working time arrangements, organisational structures and resources, management and supervision, staffing levels and so on.

15. Severe financial worries - Long term separation Own serious illness
Major Life Events – •
Bereavement
partner or
close relative
Divorce
Severs relationship
problems
Severe financial worries -
Long
term separation
Own serious illness
Serious illness of close
relative or friend
Moving house
Taking out a mortgage
Job loss
Children leaving home
Work is not the only source of stress in people’s lives. Stress can also be caused by events outside the workplace.
This is a list of major life events that are well known personal stressors. They are not within the employer’s control. But the effects of stress on the individual need to be taken into account in the workplace, not only because they affect the individual, and make them temporarily more susceptible to stress at work, but also because the combined effects of stress both at home and at work can make matters worse. The employer can and should control the risks of stress at work. Furthermore stress at work can affect people’s personal and family lives, and their families, and can even lead to increased risks of major life events such as serious stress-related illness or relationship breakdown.
There is a parallel with manual handling injuries here. If an individual injures their back doing DIY at home, a responsible employer would take this into account when allocating duties and ensure that work activities did not place him or her at risk of further injury. The same principle can be applied to stress.

16. What could this lead to?
MENTAL AND PHYSICAL BREAKDOWN

17. What can do about it? we
Yes, that’s us, not them. Remember, we are responsible.
There are some common problems in risk assessment and stress.
There are misunderstandings about the nature of stress and the stress response.
There is confusion between pressure(to which someone is exposed) and stress (which is a response to too much or too little perceived pressure) and between the stress response (which is a normal physiological response to a perceived problem or threat) and ill health (which can result from unresolved stress or continued exposure to stressors).
The approach to risk assessment is the same for stress as for other risks. It needs to focus on the causes, not just the effects. But there are different methods that can be applied to identifying hazards and evaluating, monitoring and reviewing risks and priorities.
The main problems with implementing risk assessments is lack of awareness and lack of commitment to action. The purpose of risk assessment is to ensure prevention of harm. That means that risk assessments must be implemented, monitored and reviewed to make sure they are effective. It is NOT a paper exercise.
It’s important to get the starting point right.

18. If the problem is spotted early:
Adequate risk analysis.
Thorough planning and a stepwise approach.
Combination of work-directed and worker-directed measures
Context-specific solutions.
Experienced practitioners and evidence based interventions.
1. Adequate risk analysis.
A baseline should be established through risk assessment. Surveys can be part of this process, but surveys should not be undertaken unless there is a clear intention of taking timely action on the results.
2. Thorough planning and a stepwise approach.
Clear aims should be set and target groups identified, as well as identifying tasks, responsibilities and allocating resources.
3. Combination of work-directed and worker-directed measures
Priority must be given to collective and organisational interventions to tackle risk at source. Worker-directed measures can complement other actions
4. Context-specific solutions. Employees’ on-the-job experience is a vital resource in identifying problems and solutions. Outside expertise may sometimes be necessary.
5. Experienced practitioners and evidence based interventions.
Only competent outside expertise should be used.
6. Social Dialogue, partnership and worker’ involvement.
Involvement and commitment from employees, middle and senior management is crucial for every stage of an intervention.
7. Sustained prevention and top management support.
Sustainable improvement is not possible unless management is ready to make changes. Risk management should become a principle of the way business is done
Social Dialogue, partnership and worker’ involvement.
Sustained prevention and top management support.
Source: How to tackle psychosocial issues and reduce work-related stress – summary of an agency report, published by the European Agency for Safety and Health at Work.

19. Suggestions for working together to reduce stress.
A few questions to ask before you take action.
Has the normal workload been increased?
Is the work demanding (intellectually/emotionally)?
Are the demands comparable to other colleagues?
Are the employees’ colleagues showing signs of stress?
Is sickness absence for the job normally high?
Has this employee a particular problem or vulnerability?
Have they already had and illness attributable to stress?
Have there been any uncharacteristic absence?
Stress is not an individual weakness. Nor is it just a question of mental health. The stress response is a normal physiological response that affects the whole body from hormone production to vital organs, including heart rate and muscle function.
Stress related illness can result from prolonged exposure to stressors, or can be an acute stress response (e.g. to trauma). Stress can be cumulative - like fatigue. Its effects may be physical as well as psychological - it can lead to lowered immunity, ulcers and heart attacks, not just to anxiety and depression. It has short-term symptoms but it can also do long term damage, including life-threatening conditions, unless preventive action is taken.
If people see the stress response or the symptoms as the problem, then they may see ‘coping strategies’ as the solution. While these may be helpful to the individual, they do not prevent the risks - they only control the response.
Risk assessment is designed to help prevent people being harmed at work, physically, mentally or emotionally. If work causes stress, then all the risks - not just the psychological risks - must be assessed.
For risks of stress to be properly identified, the assessors need a proper definition of stress - and they need to understand the nature of the stress response.

20. Stress Risk Assessment
ROLES and
RELATIONSHIPS •
role definition? •
role ambiguity / conflict? •
relationships with others? •
attitudes / culture?
Resources play an important part in creating a healthy workplace. They may not be adequate. They include external resources (provided by the organisation or others) and internal resources (belonging to the individual). For example:
is there enough time to get the work done?
Are there enough people to do it / supervise it / manage it?
If there are budgetary constraints, what activities and resources do they restrict? How do they affect the organisation and the work?
suitable and sufficient supplies of materials and facilities required for the job / services / finished product?
equipment / technology? Are they fit for purpose? Do they work? Are they properly maintained?
Is there adequate information, instruction, training and supervision? Have needs been identified and met? Are managers and supervisors trained? Do people have the skills and experience they need for the job?
Are there adequate welfare facilities at all times? Are there any occupational health facilities?
What are the risk factors for stress?
Roles and relationships are important risk factors for stress, both at work and at home. Because work can affect home, and vice versa, the roles and relationships people have at home are also relevant here. Role ambiguity is a know risk factor for stress. Are roles clearly defined? Is there any ambiguity or role conflict? Are perceptions of other people’s roles accurate and fair? Do they lead to conflict or risks of violence?
Working relationships are important too. Look at relationships between colleagues,teams, managers, decision-makers, support staff. What about members of the public, clients and customers and service users? On shared sites, what about contractors and other employers, and agency staff? Can people contact friends and family at work within reason if they need to?
What about the relationship between work and personal life? Is there a healthy work life balance? What prevents it?
Some of these issues concern the organisation, some concern individuals. Independent audits and union surveys can be particularly helpful here. They need to be be inclusive and anonymous. These can be highly sensitive issues. Confidentiality must be ensured. •
relationship between work
and personal life?

21. Stress Risk Assessment
INDIVIDUAL FACTORS •
background / culture? •
personal circumstances? •
characteristics?
Individual factors also need to be considered. People are not all the same and neither is their stress response. What affects one person will not necessarily affect another, or it may not affect them in the same way. Differences in background and culture, skills and experience, personal circumstances, individual characteristics such as health status, ethnicity, sex, pregnancy age or disability as well as physical characteristics and personality type may all be relevant factors.
These factors, and past experiences, can affect perception and response to stressors both at work and at home. These are not individual weaknesses - they affect perception, susceptibility and response.
MHSWR requires you to record risks to ‘vulnerable groups’ and to young workers and expectant, new and nursing mothers.
Identifying these individual risk factors means recognising diversity. It involves handling sensitive personal information and it is therefore essential that there are assurances of confidentiality and care in the handling and recording of information. •
perception / response?

22. Stress Risk Assessment
ENVIRONMENT •
physical? •
psychosocial? •
environmental
The working environment can be another source of occupational stress. ‘Environment’ covers both the physical environment and psychosocial environment. Look for:
(a) physical hazards / stressors - e.g.
heat /noise / vibration
hazardous substances
overcrowding / lack of physical privacy / confined spaces
poor workplace design and layout
postural problems / other ergonomic problems
(b) psychosocial hazards / stressors - e.g.
violence
lack of control
isolation
conflict
attitudes and culture
Workplace attitudes and culture are important here. Is personal privacy at work protected and is personal dignity at work respected? Is there any evidence of discrimination, harassment, bullying or abuse? What are the problems? Who is at risk?
hazards and risks?

23. If the breakdown has happened
If the person is still at work, get them home.
Arrange medical aid, doctor or even hospital.
Keep in contact. They need support.
Give them time to recover, it could take a long time.
Review why it happened and act on it.
Do not forget that their workload has to go to someone else. They then become a target.

24. Returning to work In their own time.When they are ready.
A couple of visits in a week.
Gradually increase the time.
They will talk about the problem when they are ready, do not rush them.
No pressure.
Constant support, review the job with them.

25. What are we trying to achieve?
To get the individual well and back to work.
To make them feel that they are a valued team member.
To try eliminate the possibility of re-occurrence.

26. How are Intec trying to achieve this?
Occupational Health Centre. All employees have access if they are feeling unwell or need to talk to someone to the NHS’s ‘Health for Work Adviceline’. If necessary we will arrange for independent counselling.
Stress Questionnaire
Back to work interviews will hopefully improve sickness rates and identify where workplace stress is a problem.
Sandwich day and this manager presentation: together with handouts should increase awareness of the problem of stress and how to tackle it.
Optional Blood pressure checks
Risk Assessments where requested
Increasing awareness amongst managers and employees
We will be looking at stress from all angles, and from both a work and personal point of view.
Occupational Health Centre
NHS ‘Health for Work Adviceline’ – will provide details of a local drop in centre if required
Can use it in a relaxed way
Helps eradicate sickness problems
Pre-selection health questionnaires
Back to work interviews for those who are off sick more often than most.
Blood pressure checks can be arranged through the Occupational Health Centre.
Mark Hepworth will arrange Risk Assessments and guide managers through the process, where they are necessary.
We will also be sending out an anonymous questionnaire on stress to see the degree to which we are currently affected.

27. Are there any questions?