Europeans lessons in addressing Psychosocial Risks

1. Europeans lessons in addressing Psychosocial Risks Work-related stress has the potential to negatively affect an individual's psychological andphysical health, as well as an organization's effectiveness. LCDP-X Seminar Series Catherine Marzin December 12, 2017

3. Why it matters… In the US Workplace suicide: • the death arose from an injury at the decedent’s work premises while the decedent was there for work; • the death occurred away from the work premises, but the decedent was engaged in work activity (e.g., performing work at a client’s premises); or • the death was related to the decedent’s work status (e.g., a suicide at home that can be definitively linked back to work)

4. UNDERSTANDING Psychosocial risks arise from poor work design, organization and management, as well as a poor social context of work, and they may result in negative psychological, physical and social outcomes such as work-related stress, burnout or depression. Video – EU OSHA on managing stress https://www.youtube.com/watch?v=4fGnfhGeoyE

5. Examples of working conditions leading to psychosocial risks are: • Excessive workloads • Conflicting demands and lack of role clarity • Lack of involvement in making decisions that affect the worker and lack of influence over the way the job is done • Poorly managed organizational change, job insecurity • Ineffective communication, lack of support from management or colleagues • Psychological and sexual harassment, third party violence

6. Work : source of pleasure or source of pain ? A place where one develops one’s own sense of identity and one’s relation to the world and to others Work Source of pleasure A place where one may experience different psychosocial phenomena Source of pain

7. European Union Directive Legal requirements: • European Council Framework Directive on the Introduction of Measures To Encourage Improvements In The Safety And Health Of Workers At Work, 89/391/EEC • Framework agreement on work-related stress (2004) and • Framework Agreement on Harassment and Violence at Work (2007) https://osha.europa.eu/en/tools-and-publications/publications/reports/psychosocial-risks-eu-prevalence-strategies-prevention

8. in France: workplace suicide officially recognized in legislation if a French employee takes his or her own life in the workplace, • it is immediately investigated as a work-related suicide and • the burden of proof is on the employer to demonstrate that the suicide was not work-related. Even if a suicide takes place outside of work, it is still considered as work-related if there is a connection with work– a suicide letter, a work uniform or use of a work implement.

9. WHY WORKERS KILL THEMSELVES Top factors responsible for workers being driven to suicide seem to be: • Bad jobs with too much work, • Too little control or poor or punitive management, • Unfairness at work, • Emotional labour, • Trauma, • Work-related harm, • Hazardous substances that effect mental health and • Access to means. 

10. Principal causes of work related stress Company Reorganization Precarious job Long work days Excessive workload Harassment Bullying at work lost work days Caused by work related stress

11. Psychosocial risks and their manifestations

12. Psychosocial risks affect the individual, the group, and the organization • It affects the individual : • Physical and psychological disorders • Behavioral problems • Addiction • It affects the group : • Aggressiveness • Conflicts • Violence • It affects the organization • Disorganization • Relational problems • Litigation • Loss of productivity, cost increase

13. Individually Work-related Stress and Burn-out Addictive behavior Several manifestations of psychosocial risks • Relationally Violence • from within • or from outside the organization Conflicts

14. A- Work-related stress and burnout

15. Work-related stress A European definition (EU-OSHA) adopted in France by the Framework Agreement of 2008 (ANI) People experience stress when they perceive that there is an imbalance between the demands made of them and the resources they have available to cope with those demands. Although the experience of stress is psychological, stress also affects people’s physical health. Common factors in work-related stress include lack of control over work, unsuitable demands being made of workers, and lack of support from colleagues and management. Stress is caused by a poor match between us and our work, poor relationships and presence of psychological or physical violence at a workplace, and by conflicts between our roles at work and outside it. Reactions to the same circumstances vary between individuals. Some people can cope better with high demands, than others. It is the individual’s subjective evaluation of their situation that is important. It is not possible to determine from the situation alone the amount of stress it may cause. Short-term stress – for instance when meeting a deadline – isn’t usually a problem: indeed it can help people perform to the best of their ability. Stress becomes a risk to safety and health when it is protracted.

16. Burn-Out 4 stages : • Idealism : High energy; ambition; ambitious goals; great involment and commitment • Plateau : Awareness that despite one’s effort, the results do not meet the expectations. The individual starts working evenings and week-ends. • Desillusionment : Period of frustration because there is no aknowledgment of one’s efforts. Impatience; irritability; cynicism; intake of stimulants and sleeping pills • Demoralization : « worn out » ; loss of interest towards one’s circle; energy is all wipe out; discouragement. The individual can no longer work.

17. Consequences for an organization Stress disorganizes : Increase number of work-related accidents Increase occurrence of absenteeism and sick-leave Increase turnover of personnel ; recruitment difficulties Demotivation; presenteeism Decrease in creativity Deterioration of social climate : poor work atmosphere; increase occurences of incivilities, and verbal and physical violence; conflicts; loss of confidence in the organization; insecurity

18. B- Addictive behaviors «Users try to cope with reality, instead of escaping it » «  Ils ne consomment pas de substances pour échapper à la réalité, mais pour y faire face » Dr William Lowenstein, French addiction specialist

19. Context • At international level : • Increase consumption of alcohol, illicit and prescribed drugs • In France : • The number of consumers of psychoactive medication has increased 10 to 20 times since 1970 • Increased usage of multiple substances (polyconsumption)

20. Consequences of addiction at work • Endangerment of workers’ health and safety, cause of work-related accidents • Perceived positive effect : disinhibition, concentration, coping against stress, relaxation, distancing oneself from problems, feeling of cohesion within a group… • Addiction is a self-medicing strategy, a way to adapt to the work environment

21. C- Work-related violence

22. Violence at work : definition «It is all behavior that humiliates degrades or damages a person’s well-being, value and dignity » « Work-related violence refers to both physical and psychological violence, directed at employees from either outside or within the workplace. » «Violence occurs when one or more workers or managers are assaulted in circumstances related to work » « Harassment at work occurs when one or more workers or managers are repeatedly and deliberately abused, threatened and/or humiliated in circumstances related to work. » European Framework Agreement on violence and harassment at work (2006), definition adopted by ANI (French framework agreement) (2010)

23. Impacts on workers and organizations • Impact on workers : Physical and psychological disorders Chronic stress PTSD • Impact on the relationship between workers and work: Discomfort at work; presenteeism; absenteeism Erosion of the feeling of belonging to a Groupwork (collectif de travail) Isolation; trivializing of problems; feelings of insecurity; demotivation • Impact on organizations: Loss of competences; loss of confidence • Heavy costs for the organization: legal risks as workers go on sick leave or resign, followed or not by law suits against the organization It is more profitable to invest in the prevention of violence

24. Impact on the organization • Worker leaves the organization without any legal action: Transfer, resignation, mutual cessation of contract • Worker takes legal action: Towards « Conseil des Prud’hommes » Worker contests a resignation, dismissal or redundancy “Conseil des Prud’hommes” qualifies such resignation as redundancy and organization must pay damages • Legal action against moral harassment One year imprisonment and/or a 15.000 Euro fine (in case of wrongful accusation, punishment is 5-year imprisonment and/or a 45.000 Euro fine)

25. « Quel que soit le contexte, ces procédés résultent d’une même volonté de se débarrasser de quelqu’un sans se salir les mains. » Marie France Hirigoyen D- Work-related harassment (or mobbing) ‹#›

26. Work-related harassment «Harassment at work occurs when one or more workers or managers are repeatedly and deliberately abused, threatened and/or humiliated in circumstances related to work, either at the workplace or in situations of work. » Suffering from harassment is different from feeling harassed

27. Different forms of harassment In terms of source : • Strategic • Transversal (leading to scapegoating) • Institutionnal • Individual In terms of direction : • Vertical and descending • Vertical and ascending • Cross-sectionnal (Debout. M. (1999). Travail , Violences et Environnement. Rapport du Conseil Economique et Social. Paris : Les Editions des Journaux Officiels).

28. How harassment works • Techniques pertaining to relationships • Techniques pertaining to an attack of work, with double-bind injunctions • Punishment techniques • Techniques pertaining to isolating a worker • Persecution techniques

29. Workplace mobbing : 5 phases Phase 1 : Triggering event Phase 2 : Workplace conflict Phase 3 : Management & administration get involved Phase 4 : Identification of the aggressor by management & administration Phase 5 : Exit of the target

30. So what is a leader to do?

31. Finding balance between risk factors and protective factors (Risk decrease) Protective factors • feeling of belonging • social support • meaning-making, interest in the work • … (Risk increase) Risk factors • overload (ou « under-load)) • lack of autonomy • Lack of latitude to act • feeling unrecognized • … Psychosocial disorders Individual and/or collective symptoms

32. 3 types of prevention policy • Primary Prevention: Fighting psychosocial risk factors at the roots • Secondary Prevention: Strengthening reactivity against psychosocial risks (=Building Resilience) • Tertiary Prevention: Taking care of workers displaying work-related suffering

33. Primary prevention • Quantitative and qualitative diagnostic of psychosocial risk factors • Mapping of risk manifestations and risk factors • Accompagnement dans la mise en place d’actions correctives • Support in setting up a policy of well-being at work • Tertiary prevention • 24/7 psychological hotline • On-site psychological support team • Post-traumatic intervention • Addiction prevention • Return to work support program • Secondary prevention • Seminar engineering • Transfer of competency • Awareness raising : psychosocial risks; mobbing; stress; violence and conflicts • Professional experience feedback • Analysis of professional practices From the organization to the individual Three levels of prevention (summary)

34. How to establish and use indicators of psychosocial risks • Organizational indicators : data concerning human resources and the functioning of the organization (Means, results, human resources) • Health and safety indicators • Indicators of complaints : data concerning individual and collective complaints Weak signals should also be taken into account : tension and poor atmosphere; latent conflicts; isolation…

35. SO… In Conclusion Pain is a way to alert; suffering at work is an alarm before being a problem It is best to look at an organization as a whole instead of focusing merely on an individual, so as to find organizational solutions that will benefit all At the heart of the prevention and management of psychosocial risks : being of presence, fostering dialog and communication, paying attention

36. ... Bottom line “The Standard you walk past is the Standard you accept” If you become aware of any individual degrading another, then show moral courage and take a stand against it. Lieutenant General David Lindsay Morrison AO Chief of Army, Australia URL: https://www.youtube.com/watch?v=QaqpoeVgr8U

37. SHARED MATERIAL AFTER THE TALK How to spot manifestations of psychosocial risks Several signs of individual suffering : • Emotional signs : crying, anger outbursts; nervous laughter; excitement… • Physical signs : fatigue; sleep disorder; eating disorder; concentration problem; blood pressure; heart problem; anxiety; pains; vertigo; faintness; asthenia… • Psychological signs : Hypersensitivity; irritability; nervousness; worrying; demoralization; depression; sense of guilt; loss of sense of self; exhaustion; suicidal ideation and suicide • Behavioral signs : isolation; conflicts; incivility; aggressiveness; violence ; scapegoating (bouc émissaire)

38. ADDITIONAL SLIDES

39. Primary Prevention Diagnosis and action plan Weekly group meetings Regular group supervision and practice analysis Continuing education Participatory management style Clarification of job specifications Taking action against organizational causes of PSR Goals Adapting work to the person and not the opposite Acting on Groupwork (collective at work) Longterm effects on work and the organization Improvement of work conditions Fighting risks at the root Advantages Requires the support of all parties involved, including management Requires a commitment over time Requires time and energy Limits

40. Secondary Prevention Stress-management workshops, Conflict resolutions Seminars, conferences,workshops on psychosocial risks Personnal development workshops, … Knowledge and know-how regarding stress Goals Builds workers’ awareness of psychosocial risks Develops coping capacities against PSR Interesting for at-risk professions Strenghthening reactivity against PSR Advantages Does not impact work conditions that are potential causes of PSR Short-term strategy Can lead to great frustration and anxiety when workers recognize own PSR situation and no further action is taking place Responsibility to find coping strategies lies on individuals and not on the groupwork Limits

41. Tertiary Prevention Psychological support hotline Post-traumatic intervention Medical and psychological care Return to work support program Treatment Rehabilitation Return to work Follow-up Goals Quick response to an emergency, which may prevent a worsening of the situation Information, help and support given to the workers suffering Service rendered confidentially and on an voluntary basis Care of workers suffering from PSR Advantages Person-centered approch that does not look at Groupwork and work organization Aimed at workers showing or having shown signs of PSR Targets consequences instead of causes of dysfunctions Limits