1. MANAGING STRESS AND EMOTIONAL WELFARE
Workplace stress is the welfare topic which has received the most coverage in recent years. It is also a source of litigation which has led to particularly high amounts of damages being paid to those who have sustained illnesses brought on directly as a result of work-related strain. An out-of-court settlement worth £175,000 was agreed following the High Court ruling in the landmark case of Walker v. Northumberland County Council (1995). Here a social work manager who had returned to work following a nervous breakdown was given inadequate support and an increased workload leading to a further breakdown. The court held that this amounted to a breach of the implied duty of care, because the second illness had been clearly foreseeable. In Ingram v. Worcester County Council (2000), a settlement of £203,000 was reached after a warden responsible for the regulation of travellers’ sites suffered a single breakdown after having been subjected to physical and verbal abuse from site residents. The fact that he had been undermined in his efforts by senior council officials and had suffered ‘prolonged and unremitting stress’ led to the finding that the duty of care had been breached (see IRS 2000a, p. 4).
Until recently there were fewer successful personal injury claims based on stress and lower amounts of damages awarded to victorious applicants. This trend followed the guidance given by the Court of Appeal in four linked cases heard in February 2002. The Court overturned the judgments of lower courts in three of the cases and reduced the damages that had been awarded in the fourth. They made the following important points in their judgment:
- Employers are not obliged to make searching enquiries to establish whether an individual is at risk.
- Employees who stay in stressful jobs voluntarily are responsible for their own fate if they subsequently suffer stress-based illnesses.
- There must be indications of impending harm arising from workload in order for an employer to take action.
- The employer is only in breach where the risk is foreseeable ‘bearing in mind the size of the risk, the gravity of the harm, the costs of preventing it and the justification of running the risk’.
- There are no occupations which should be regarded as intrinsically dangerous to mental health.
- Employers who offer confidential counselling services with access to treatment are unlikely to be found in breach.
- The illness must clearly be caused by breach of duty and not just by occupational stress.
- Damages must be reduced to take account of pre-existing disorders or the chance that the claimant would have fallen ill anyway.
Thanks to these rulings, employers were able to take a tougher line on stress-related absences and the management of these issues for much of 2002 and 2003. However, the respite was short-lived because in 2003 the Health and Safety Executive announced that its inspectors would soon be adding stress-related illnesses to their list of checks when visiting employer premises and that the first improvement notices concerning stressful working environments had been served. The Executive’s guidance makes it clear that employers are now expected to treat stress like any other health hazard, and that there is consequently ‘a legal duty to take reasonable care to ensure that health is not placed at risk through excessive and sustained levels of stress arising from the way people deal with each other at their work or from the day-to-day demands placed on their workforce’ (Willey 2003, p. 414).
A further development was the landmark ruling by the House of Lords in the case of Majrowski v. Guy’s and St Thomas’s NHS Trust (2006) where it was established that the Protection from Harassment Act 1997 applies just as much to bullies in a workplace as it does in cases involving disputes between neighbours or the activities of animal rights protestors. The test is that a harasser must have knowingly caused serious distress or alarm on at least two occasions. As a result substantial sums by way of damages can be awarded to people who suffer breakdowns due to the manner that they have been treated by managers or colleagues. The precedent was used in July 2006 by Helen Green in a well-publicised High Court victory over Deutsche Bank in which damages of £828,000 were awarded following two breakdowns caused by bullying co-workers.
Stress at work is not a new idea, although it was originally viewed in terms of executive stress (see Levinson 1964), and seen only to apply to those in senior management positions. The literature on the subject of stress at work is large (for example, Roney and Cooper 1997; Jex 1998; Macdonald 1999). It is defined by Ganster and Murphy (2000) as a form of ‘strain’ provoked in response to situational demands labelled ‘stressors’ which occur ‘when jobs are simultaneously high in demands and low in control’:
Stressors generally mean environmental factors that cause the individual to muster a coping response because they pose threat or harm. In the work domain examples of such stressors are high workloads, requirements for working fast and meeting strict deadlines, conflicting demands and interruption . . . Problems are seen to arise when exposure to such demands is chronic and elicits a strong enough pattern of responses to strain the individual’s physical and mental resources. (Ganster and Murphy 2000, p. 36)
The incidence of chronic stress is often seen as a ‘by-product’ of management initiatives adopted in many countries, including the UK, in the past twenty years. These include delayering, downsizing, the intensification of work, increased monitoring of staff, moves towards greater flexibility at work and competitive tendering. Each has placed increased burdens on staff groups who have had to accept lower job security, greater levels of responsibility and longer hours of work. The inability to reconcile such demands with family life is a further cause of strain. The results are twofold:
- adverse health conditions (such as heart disease, high blood pressure, ulcers, depression and panic attacks);
- behavioural consequences (such as insomnia, anxiety, poor concentration and increased consumption of alcohol, tobacco and other substances).
Both can lead to increased rates of absence, high staff turnover, low levels of job satisfaction and the sustenance of a low-trust employee relations environment.
Stress and its consequences are often caused by a combination of strains originating in and outside work. A person who is normally able to cope well with the demands of a stressful job may cease to do so when home-based problems come to the fore, the major culprits being bereavement, debt and marital breakdown. There is thus a good business case for employers to provide formal mechanisms for emotional support, quite aside from the strong ethical case. The following are examples of available approaches.
1.1. Someone to talk to/someone to advise
A person to talk to could be the individual’s manager, or the human resource manager, but it is often more usefully someone who is distinct from the work itself. Occupational health nurses, welfare officers or specialised counsellors are the sort of people well placed to deal with this area. There are two benefits that come from this, the first being advice and practical assistance. This would be relevant, for example, if the individual had financial problems, and the organisation was prepared to offer some temporary assistance. Alternatively, the individual could be advised of alternative sources of help, or referred, with agreement, to the appropriate agency for treatment. The second benefit to be gained is that of having someone just listen to the individual’s problem without judging it, in other words, counselling. The types of work-related problems that employees may need to be counselled on are competence, underwork, overwork, and uncertainty about the future and relationships at work. Counselling aims to provide a supportive atmosphere to help people to find their own solution to a problem. Sometimes organisations formalise these approaches by establishing an Employee Assistance Programme (EAP) or subscribing to specialised counselling services (see below under Occupational health services).
1.2. Reorganisation of work
This is a preventive measure involving reorganisation of those aspects of work that are believed to be affecting the mental health of employees. This may include changes that could be grouped as ‘organisational development’, such as job rotation and autonomous work groups. Eva and Oswald (1981) suggest greater control over the speed and intensity of work, an increase in the quality of work and a reduction in unsocial hours.
Individually based training and development programmes would also be relevant here. Specifically for the executive, there is growing use of the ‘managerial sabbatical’. Some American companies have begun to give a year off after a certain number of years’ service in order to prevent ‘executive burnout’. In the UK, the John Lewis Partnership has a programme allowing six months away from work.
Recent research studies persistently show that stress at work can be substantially reduced by giving employees greater control over exactly when, where and how they carry out their jobs (see Silcox 2006). The evidence suggests that employees who perceive themselves to exercise little control over their jobs have much higher rates of sickness than those who say that they exercise high levels of control. Moreover, increasing the extent of employee control appears to have positive effects on performance and reduces employee turnover rates too.
1.3. Positive health programmes
Positive health programmes display a variety of different approaches aimed at relieving and preventing stress and associated problems, and promoting healthy lifestyles. There is increasing activity in terms of healthy eating and no-smoking campaigns and support, together with the provision of resources for physical activity. Corporate wellness programmes have been in place for a longer period in the USA, where the prime motivation was the reduction of medical costs (most employers covering these costs as a benefit for their employees). In the UK the programmes are more often seen as an employee benefit in themselves, with the hope that providing them will also encourage higher productivity and reduce absence levels. However, Mills (1996) argues that although there is a weak positive relationship between healthier lifestyles and the bottom line, there is little evidence that health promotion programmes are actually working. He argues that only a small number of employees are affected by such programmes and that these are likely to be those who already have healthier lifestyles. Mills suggests that blue-collar employees, who have the least control over their working lives, also tend to have less healthy lifestyles and are more resistant to health promotions. He suggests that all three factors are interrelated and connected in a complex manner with employee motivation. If Mills is right, this presents a challenge to organisations and suggests at the very least that they should evaluate positive health programmes as well as investigating the impact of the prevailing management style.
Some approaches to corporate wellness include the use of yoga and meditation. Others, such as ‘autogenic training’, are based on these principles, but are presented in a new guise. Autogenic training is developed through exercises in body awareness and physical relaxation which lead to passive concentration. It is argued that the ability to achieve this breaks through the vicious circle of excessive stress, and that as well as the many mental benefits, there are benefits to the body including relief of somatic symptoms of anxiety, and the reduction of cardiovascular risk factors (Carruthers 1982). Another approach is ‘chemo feedback’, which is geared towards the connection between stress and coronary heart disease, high blood pressure and strokes. Chemo feedback (Positive Health Centre 1985) is designed as an early warning system to pick up signs of unfavourable stress. The signs are picked up from the completion of a computerised questionnaire together with a blood test. This approach, like others such as the Occupational Stress Indicator (see IRS 2000b, pp. 13-16), is being offered as a ‘stress- audit’ tool for use on a company-wide basis.
2. MANAGING PHYSICAL WELFARE
There are a number of ways in which managerial responsibility can be discharged to implement the organisation’s health and safety policy statement and to ensure compliance with legal requirements.
2.1. Making the work safe
Making the work safe is mainly in the realm of the designer and production engineer. It is also a more general management responsibility to ensure that any older equipment and machinery that is used is appropriately modified to make it safe, or removed. The provision of necessary safety wear is also a managerial responsibility – for example, making sure goggles and ear protectors are available.
2.2. Enabling employees to work safely
Whereas making the work safe is completely a management responsibility, the individual employee may contribute by his or her own negligence, working unsafely in a safe situation. The task of managers is twofold; first, the employee must know what to do; second, this knowledge must be translated into action: the employee must comply with the safe working procedures that are laid down. To meet the first part of the obligation management need to be scrupulous in communication of drills and instructions and the analysis of working situations to decide what the drills should be. That is a much bigger and more difficult activity than can be implied in a single sentence, but the second part of getting compliance is more difficult and more important. Employee failure to comply with clear drills does not absolve the employer and the management. When an explosion leaves the factory in ruins it is of little value for the factory manager to shake his head and say: ‘I told them not to do it.’ We examine the way to obtain compliance shortly, in the course of our discussion about training and other methods of persuasion.
In larger organisations the initiative on safe working will be led by the professionals within the management team. They are the safety officer, the medical officer, the nursing staff and the safety representatives. Although there is no legal obligation to appoint a safety officer, more and more organisations are making such appointments. One reason is to provide emphasis on and focus for safety matters. The appointment suggests that the management mean business, but the appointment itself is not enough. It has to be fitted into the management structure with lines of reporting and accountability which will enable the safety officer to be effective and which will prevent other members of management becoming uncertain of their own responsibilities – perhaps to the point of thinking that they no longer exist. Ideally, the safety officers operate on two fronts: making the work safe and ensuring safe working, although this may require an ability to talk constructively on engineering issues with engineers as well as being able to handle training and some industrial-relations-type arguments.
The medical officer (if one is appointed) will almost certainly be the only medically qualified person and can therefore introduce to the thinking on health and safety discussions a perspective and a range of knowledge that is both unique (in that organisation) and relevant. Second, the medical officer will probably carry more social status than the managers dealing with health and safety matters and he or she will be detached from the management in their eyes and his or her own. Doctors have their own ethical code, which is different from that of the managers. They are authoritative advisers to management on making the work safe and can be authoritative advisers to employees on working safely. They are invaluable members of the safety committee and potentially important features of training programmes. Occupational nurses also deal directly with working safely and often play a part in safety training, as well as symbolising care in the face of hazard.
2.3. Safety training and other methods of persuasion
Safety training has three major purposes: (1) employees should be told about and understand the nature of the hazards at the place of work; (2) employees need to be made aware of the safety rules and procedures; and (3) they need to be persuaded to comply with them. The first of these is the most important, because employees sometimes tend to modify the rules to suit their own convenience. Trainers cannot, of course, condone the short cut without implying a general flexibility in the rules, but they need to be aware of how employees will probably respond. In some areas the use of short cuts by skilled employees does not always mean they are working less safely, but there are many areas where compliance with the rules is critical, for example, the wearing of safety goggles.
Safety training needs to be carried out in three settings: at induction, on the job and in refresher courses. A variety of different training techniques can be employed, including lectures, discussions, films, role playing and slides. These methods are sometimes supplemented by poster or other safety awareness campaigns and communications, and disciplinary action for breaches of the safety rules. Management example in sticking to the safety rules no matter what the tempo of production can also set a good example.
Research by Pirani and Reynolds (1976) indicated that the response to a variety of methods of safety persuasion – poster campaigns, film shows, fear techniques, discussion groups, role playing and disciplinary action – was very good in the short term (over two weeks) but after four months the initial improvement had virtually disappeared for all methods except role playing. From this it can be concluded that: first, a management initiative on safety will produce gratifying results in the obeying of rules, but a fresh initiative will be needed at regular and frequent intervals to keep it effective; and, second, the technique of role playing appears to produce results that are longer lasting.
2.4. Embedding a safety culture
Exhortation from management and training initiatives play a significant part in improving safety in a workplace, but they are increasingly recognised as being insufficient. Most accidents occur because employees act unsafely. What is really required, therefore, is the embedding of a safety culture (or climate) so that everyone behaves in a safe manner without consciously thinking about doing so.
So far in this chapter we have made a clear distinction between emotional and stress- based illnesses derived from work and physical injuries sustained at work. In fact the two are closely linked as occupational stress is a significant cause of physical injury. When people become stressed and tired they tend to make mistakes and pay less attention to safety matters than they would in other circumstances (Clarke and Cooper 2004). It follows that significant progress towards the creation of a safety culture can be made by reducing stressors and improving satisfaction among workers. Policy, procedure and training interventions play a role, but unless employees have a positive attitude towards their work, are clear about what they should be doing and are able to work at a pace and in a manner which enables them to work without undue stress, no genuine, long- lasting culture of safety can be sustained.
3. OCCUPATIONAL HEALTH SERVICES
Occupational health and welfare is a broad area which includes both physical and emotional well-being. The medical officer, occupational health nurse and welfare officer all have a contribution to make here. In a broader sense so do the dentist, chiropodist and other professionals when they are employed by the organisation. The provision of these broader welfare facilities is often found in large organisations located away from centres of population, especially in industrial plants, where the necessity of at least an occupational health nurse can be clearly seen.
In terms of physical care the sorts of facility that can be provided are:
- Emergency treatment, beyond immediate first aid, of injuries sustained at work.
- Medical, dental and other facilities, which employees can use and which can be more easily fitted into the working day than making appointments with outside professionals.
- Immediate advice on medical and related matters, especially those connected with work.
- Monitoring of accidents and illnesses to identify hazards and danger points, and formulating ideas to combat these in conjunction with the safety officer.
- On-site medical examinations for those joining the organisation.
- Regular medical examinations for employees.
- Input into health and safety training courses.
- Regular screening services (e.g. cervical cancer screening).
Employee Assistance Programmes (EAPs) have become reasonably common in recent years as a means of providing both practical and emotional support for employees. Counselling forms a major part of their activity, although the remit goes well beyond problems that people may be experiencing in the workplace. Any source of stress (financial worries, bereavements, relationship breakdowns, etc.) can lead to absence and diminished performance at work. EAPs are the main formal method used to provide support at difficult times. Not only are they valued by employees and thus likely to improve recruitment and retention, they also can pay for themselves by helping to save organisations money that would otherwise be lost paying people who are absent or performing below par. It is also possible to subscribe to specialist EAPs which employees are able to call confidentially and free of charge. An example is the cancer information service offered by the charity CancerBACUP (see IRS 2006b). It reckons that 500,000 employees in the UK suffer from some form of cancer at any one time and that around 10 per cent have close friends or relatives with the disease. Their helplines are staffed by specialist cancer nurses. They also have an e-mail-based information service and provide educational information.
Source: Torrington Derek, Hall Laura, Taylor Stephen (2008), Human Resource Management, Ft Pr; 7th edition.