By Niki Ellis

Adjunct Professor, Institute for Safety, Compensation and Recovery Research and Department of Epidemiology and Preventive Medicine, Monash University

www.nikiellis.com.au

Follow @ProfNikiEllis

Recently an organisation asked me to consider what being a mentally healthy workplace might look like for them. It was a great brief, they were up for it. I started by having a look at their business strategy and found they were growing, planning to further develop their leadership and workforce and IT platform to enable them to be competitive and make the most of the opportunities they could see.

I then reviewed their current investment and performance in health and safety and concluded that they were a strong performer in the traditional health and safety model. By that I mean they aimed for zero harm in relation to the prevention of injuries. They had started a workplace health promotion program, but it was early days, and quite a long way off best practice.

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• A team from Johns Hopkins recently described best and promising practice as:
• Health education
• Supportive social and physical environments
• Integration with HR, infrastructure and environmental health and safety
• Links between HP and related programs eg EAP.
• And that it works if:
• Goals are aligned to business
• Program design is evidence-based
• Theory-based implementation
• Ongoing evaluation

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What they did have was R U OK, and a great start on a health portal. Way to go.

Potential for web-based interventions

In another project I am working on for the life insurance industry we have done a rapid review on the management of psychological claims.

The review found that with regard to treatment there was huge potential with web-based interventions for mental health.

A Canadian case study illustrated the future with a confidential web-based mental health self-management resource. This allows someone to assess their own mental health, provides information on treatment and rehabilitation, with supporting material for doctors and then tools for tracking progress.

The resource was based on recent evidence-based guidelines, and was being marketed to insurers and employers.

A proposal to become a mentally healthy workplace

Meanwhile back in Australia, having assessed the broader strategic environment and what programs were already in place relevant to mental wellbeing; not just in health and safety and workplace health promotion but also in HR more broadly (EAP, diversity strategy, respectful workplace policy etc), I developed a proposal for becoming a mentally healthy workplace.

This drew on two sources of information: Tony La Montagne’s model of an integrated approach to mental health in the workplace; and Gloria Sorensen’s conceptual model for an integrated approach to the prevention of ‘work-related injuries and illness and the enhancement of overall workforce health and wellbeing’.

Tony La Montagne is at the University of Melbourne and his model has four components:

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• Prevent harm from psychosocial hazards
• (using work to) Promote positive mental wellbeing
• Early detection
• Manage illness and minimise consequences.

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Implementation science is key

Sorensen (above) is the Queen of the integrated approach to workplace health and safety. She is the head of the Centre for Work, Health and Wellbeing at Harvard University.

A colleague of La Montagne’s told me the light bulb went on for Sorensen when she was running Quit programs at a foundry, and realised the uselessness of talking to workers about them giving up cigarette smoking in an environment filled with toxic fumes. She presented a generic conceptual model, drawing on implementation science, with the following elements: context (external and organisation); interventions, mediating factors in the work organisation or work environment, mediating factors related to workers, expected early outcomes, and then expected final outcomes, at the first international conference on Total Worker Health, American for the integrated approach, in October last year. (Selected papers from the conference can be found here)

Drafting the strategic direction

Using both frameworks I generated draft strategic directions for this organisation, which essentially draw together and build upon many different strands of activities already in existence across the organisation, with the aim of assisting to deliver on the broader business plan.

These included:

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• Work design and re-design: Proposed as they were building a new IT platform, the idea is that health and wellbeing becomes a consideration in that work. For existing work process, suggested the addition of psychosocial hazards to the existing risk management system, possibly by using the routine employee opinion survey to collect information on the psychosocial working environment and leadership performance.
• Proposed the concept of work-life balance as a great link between individual behavioural change and work environment change. Could be a focus of communications on the strategy.
• Extension of a middle management development program on mental wellbeing which had already been developed and run out to some. This is key, if you ramp up conversations about mental health in a workplace you need to be confident middle management can deal with mental health issues, otherwise you may see this reflected as an increase in stress claims.
• Inclusion of health and productivity, especially mental health, in review of the leadership development program.
• Continue to develop the health portal in relation to mental wellbeing, noting evidence of effectiveness of web-based self management support and improving mental health literacy.
• Streamlining business metrics: Opportunity to ensure that relevant indicators for mental wellbeing and their link to productivity are included.

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I provided three options for the goal. The first two were based on integrated thinking. One was very broad, an aim of improving organisational performance through health. The second was more tightly focussed – improving workforce capability and wellbeing by including mental health considerations in the development of leadership, systems and workforce. The third option was based on extending the traditional model to better include mental health – that is to contribute to achieving zero harm through programs aiming to minimise psychosocial risks and to promote mental health (separately, as is the tradition).

Bravo to this organisation for taking this topic seriously and giving it a good shake. They are in a good position to succeed as they have a strong foundation in a high performing traditional workplace health and safety program, and they are not unused to the concept of psychosocial ergonomics.

There are benefits to be had for workers in terms of improved health outcomes and benefits to employers in terms of performance, presenteeism and absenteeism.

But it is going to take a lot more than asking R U OK.

 

First published in Inside OHS, 28 May 2015

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