A safer conversation: work-related stress

Workloads and job descriptions have changed significantly in recent years, mainly as a result of organisational restructuring designed to weather the economic downturn. The increase in personal stress levels is one of the consequences associated with this changing work environment.

In 2011/12 around 430,000 workers in Britain reported suffering from stress, depression or anxiety they believed was caused or made worse by work. In fact, stress is the second most frequently reported work-related health problem in Europe.

A European opinion poll conducted by EU-OSHA found that more than half of all workers considered stress to be common in their workplace. The most frequently reported causes of work-related stress were job reorganisation or job insecurity; working long hours or excessive workloads; and bullying or harassment. The same poll showed that around four in 10 workers think that stress is not handled well in their workplace.

Have organisations revised the frequency and manner in which they monitor stress in line with changes to working conditions?

Andrea: There’s always been a certain amount of restructuring in business life, that’s just how things are, but obviously the recession has exacerbated that. There’s been a lot of anxiety about job security because of job losses, not just in this country but around Europe and in some countries that are under austerity measures like Greece.

Obviously that’s had a knock-on effect on the workforce, not just on people who are under threat of losing their jobs but also people who are left behind and feel under greater stress because they’re having to pick up the workload of colleagues who are not there anymore. In these cases you’ve got fewer people doing the same amount of work as before. You also have the survivor syndrome where people wonder why they’re still in work and their colleagues have been sacked, so that’s another cause of stress and anxiety.

I think probably it’s very difficult for organisations to keep on top of this because of fire-fighting situations. They are dealing with structural change and remaining in business. It’s difficult enough to try and manage stress in any case, so it’s very difficult to try to ensure the workforce is happy in these circumstances. Maybe the next few years will see a bit of consolidation around this, but it’s a difficult task for organisations.

Neil: It really surprises me that four out of 10 workers think that stress is not handled well, meaning that 60% of workers think that stress is handled well in the workplace, as that’s not a figure I recognise or believe.

I think stress is probably the disease of our age and is usually difficult to deal with. The trouble with stress is it’s really difficult to get a handle on because sometimes you get a sick note – or rather a fit note – that says ‘stress’ on it, but most of the time you don’t. Initially it comes through as back pain or flu or all sorts of generic issues. I don’t think organisations are that intelligent at identifying the stress data that’s coming through those issues. I don’t believe organisations have really got a handle on monitoring this, either directly from the indicators of the absence or actually the precursors where the sources of stress in the business are.

Could the extent of employee stress be identified through approaches such as structured staff interviews?

Neil: There’s a whole host of things. The reality is that you know whether you’ve got a stress issue in the organisation because people talk about it, you can feel a temperature of it. You can also use survey tools. Often organisations do very short surveys asking about a number of issues around business and satisfaction. You probably wouldn’t call it stress directly, but the kind of tensions of the business could get mentioned in those poll surveys. Large organisations have those, they can use them. I’m not sure they are used effectively at the moment. In a smaller organisation you should be able to tell the temperature of the business and what’s going on.

Sara: I’ve been delivering training in organisations who are interested and recognise that there is an issue with stress, so I work primarily in larger organisations that do recognise that it’s there and that do monitor it in terms of the sickness absence. I believe what Neil was saying in terms of what’s picked up. A lot of organisations have got a category called ‘stress, anxiety and depression’ which they will use to gather their data from, but, as Neil quite rightly said, stress is much wider than that because so many illnesses are linked with it and we don’t count those illnesses or those reasons for sickness absence within the figure that we’ve
got for stress, anxiety and depression.

I do believe that the problem is probably a lot larger than we might think it is, but things are starting to change; in the UK at least some organisations do take it seriously. I know that in some organisations it’s a board-level conversation because they understand the business case for investing in wellbeing, but I certainly expect that the smaller organisations don’t do it, probably don’t have the policies. Even some of the larger organisations don’t have policies. Where they’ve got policies there is at least a mechanism, some guidance on how to respond if somebody spots stress in a worker or a worker raises the issue. I think there is some monitoring going on but it’s only touching a small aspect of it.

Emma: It is a mixed picture in terms of how much priority is given to mental health, and stress within that, within organisations.

Some employers are beginning to implement changes, while others are still fearful of talking about mental health, especially when they are facing internal challenges such as change management or job cuts. But businesses are starting to realise that small inexpensive changes can make a huge difference and reap rewards in terms of staff productivity, morale and retention, as well as reducing sickness absence. Initiatives to boost employee wellbeing benefit all staff, whether they are experiencing stress or have been diagnosed with a mental health problem.

Julia: The data shows that there is a considerable difference between the concern of managers on work-related stress and the actual measures in place.

In EU-OSHA we are currently working on the new European survey of enterprises on new and emerging risks (ESENER) which will once more have a focus on psychosocial aspects. First results are expected by the end of this year; further evaluation of the data will give more insight into whether there are now more companies effectively dealing with psychosocial risks. The current EU-OSHA campaign on managing stress and psychosocial risks at work is tackling this exact issue. It aims to increase the number of companies dealing successfully with stress and psychosocial risks by providing information and guidance to enable companies to take action.

Although the number of working days lost due to stress has fallen during the last decade (from 12.9m in 2001/02 to 10.4m in 2011/12), the estimated number of cases of work-related stress has remained unchanged. How do you read this data?

Neil: I think it is really interesting that it has become acceptable to report stress as an issue and that is perhaps why we have seen this big rise of stress coming through.

Fascinating things have happened over the last decade; partly around working patterns – we’re much more service industry-based now – partly because of information technology allowing people to have much more flexibility in where and how they work. I’ve seen that working from home is now sometimes getting in the way of recording sickness absence data. Is that person at work or off? There is a grey area; a person is doing a bit of work from home and that affects a company’s sickness absence figures because people are reluctant to say ‘I’m off sick’ when they can do a bit of work from home. How widespread is this grey area where people are choosing to work from home and not classified as sickness absence? It’s not seen as bad, it’s simply a new way of working.

Sara: I think you’ve got a point there. If I’m not feeling too good but I am at home then I will still work and that’s easier rather than it being recorded as any kind of sickness absence. However, I think it could also indicate that HSE has done a lot of work over the last 10 years to try and get stress on the agenda. There’s been a lot of work in some organisations of introducing the word ‘stress’, or ‘wellbeing’ in place of that, just to get the conversation going a little bit more; so it could be that the reduction in the number of lost days reflects the fact that organisations are spotting stress; and they are getting in there early and there are interventions. People aren’t going off sick for as long as before and organisations are certainly working harder to get people who’ve been off with a stress-related absence back to work.

Also, there’s much more awareness now about the need to make reasonable adjustments, to give people time to
get back into work and get back up to speed in terms of their capability. I think that might shorten the number of days off, which is what the data shows. However the data is also saying that the number of stress-related cases remains unchanged, so it’s not that people are experiencing it less; it’s just that perhaps it’s being managed better, certainly in some organisations.

Neil: I agree with that, I think actually we are just managing the data much better so we’re getting less absence.

Andrea: Home working is a good point and that raises some interesting questions. Many organisations I’ve worked with or talked to tend to find it difficult to anticipate stress, so they often think they could do more around catching it early and having the conversations early and spotting the signs. But what I’ve seen is that once someone is off with stress, the organisations tend to have very good procedures that kick in and deal with it. It might well be that the number of days people are off with stress-related illnesses is being reduced because organisations do have quite good procedures, by and large, to make sure that people are recorded and helped back into the workplace. So that might be an element behind those statistics. Obviously some organisations feel they could do a lot more in terms of getting people to be open and honest about how they’re feeling at work and then spotting the signs of stress; so there is more to be done.

Emma: Our research – a Populus poll of 2,060 workers – in March 2013 found that 34% of respondents rated work as either very or quite stressful, compared to 41% in 2011, so it could be read that stress has decreased slightly. However, we know that demands for mental health services are increasing year on year, as have visitors to our website and calls to our infoline. The Mind infoline received 50% more calls in 2012/13 than the previous year, with callers getting in touch with more acute and complex problems.

We know that presenteeism is a growing issue so it could be that people are coming to work even when they are unwell, which means they won’t be performing at their best. Many people fear that either admitting they’re experiencing a problem or taking time off sick will put them first in line for the chopping block. Some common causes of work-related mental health problems include poor communication with the manager, poor change management, increased workload, fear of redundancy and long working hours.

Time to Change, the anti-stigma campaign in England and Wales run by Mind and Rethink Mental Illness, has helped to increase awareness of mental health with the message that ‘it’s time to talk’ – not just to friends and family but also to colleagues. Employers are beginning to see the business case for supporting staff wellbeing and as such are starting to have conversations and trying to tackle the causes of poor mental health. Employers can show their commitment to supporting the wellbeing of their staff by signing the Time to Change organisational pledge.

How can an employer detect if there is a stress problem – do they have to wait for it to be reported first. Are campaigns really effective?

Sara: There are a number of things that you can do to detect whether there’s a problem. You can annually review the data that you currently collect in relation to how people feel about work, in terms of a staff satisfaction survey. You can also have a look at turnover rates. Obviously if there’s very high turnover rates in a specific area that indicates that there’s something not very good about that area, or similarly grievance rates or any other kind of industrial unrest. So there’s data that the organisation will have that will point towards some parts of the organisation being worse than others and so it might be worth having a look at what that data is telling you on an annual basis. You can also be more proactive in terms of carrying out annual risk assessments with teams, which means managers sitting down with their teams and asking ‘what have we got right? What haven’t we got right? How can we make changes and lessen the pressure for you around a number of different factors?’

You’ve also got your performance development review process (PDR) and if there are some questions in there about people’s wellbeing or ‘how are you managing the pressure?’ it would help people to open up about it. I also think that language is very important.

You mentioned about people not wanting to talk about stress. If you talk about pressure rather than stress I think you get a much more open response, much more willingness for people to talk about how pressured they’re feeling by different things. As well as PDRs, which might be once a year, there is general supervision; any one-to-one conversation managers have just encouraging staff to talk about how they’re feeling about work. It is about having a much more open culture, looking out for each other and spotting if anybody’s not doing too well, picking that up and addressing that as an issue.

Neil: There are definitely several hard and soft bits of data that can point to employee stress problems before they happen – such as staff turnover and workforce surveys. The most effective of all is, I think, the discussion with the line manager, the PDR, because a lot of this is about good line management skills.

About campaigning I can say that good campaigns are effective and bad campaigns are not. Good campaigns allow you to have conversations so it takes the stigma away from it, but they only really work if they’re then backed up by good occupational health support arrangements, so that those people who are starting to suffer have somewhere to go and something to do rather than just recognising issues and doing nothing.

Andrea: I would agree with all the comments about data and particularly the importance of line management. The line managers are crucial in developing relationships with the people they manage and seeing whether people are okay, detecting the first signs. Of course lots of people aren’t comfortable in asking whether others are stressed or pressured; that is something that’s quite difficult and very different to somebody who’s physically hurt, which is very clear; you can just talk about that, there’s no stigma around that.

However, if you’re asking people ‘are you okay? Do you feel okay?’ a lot of people won’t be comfortable asking that, so support for line managers is key in this.

Campaigning comes down to the culture of the organisation. If campaigns are supported by senior management, top management, they’re much more likely to be taken up around the organisation, so it’s really crucial to
have that buy-in from top management.

Emma: Early intervention is vital so employers shouldn’t have to wait for concerns to be raised about stress levels. It is important that organisations create space for employees to discuss any issues that are affecting their wellbeing at work – whether it’s workload, hours, relationships and so forth.

Equally important is that managers listen to and address these concerns early on. Organisations ought to be proactive in tackling the causes of stress before it gets to the point where they need to support staff experiencing health problems as a result of stress.

While most people experience pressure in their jobs, and small amounts of pressure can increase productivity, prolonged stress can be detrimental to physical and mental health. Managers need to check how staff are doing, not just in terms of their role but also their wellbeing. In doing this, they should bear in mind that some staff may not feel happy talking about these issues, and that employees need to know that their views will be listened to and their concerns addressed, without fear of stigma, discrimination, of them being perceived as weak or incapable.