Stress in the workplace

1. Stress in the workplace Dr Joan Harvey A picture of Joan earlier when preparing this talk…..

2. Stress Comes under HASAWA Kills people ‘karoshi’ in Japan Makes people ill ‘Cumulative trauma’ UK one of the world leaders Costs £billions; 3-5% of GNP Disrupts all aspects of life Still seen as stigmatic in many places ‘Presenteeism’ Reduces psycho-immunity Can be time- lagged e.g. argument and onset of infection linked to incubation time

3. definitions Stress Individual’s response to threats or danger By the time we call it stress, it is damaging to the system When it gets to that, it is genuine Pressure May be motivating for you, may be bad for you Need to distinguish this from stressors Danger otherwise is that most everybody is ‘stressed’ when they may not be Stressor Sources that elicit stress as a response

4. Sources of stress Work related Intrinsic nature of job Role Relationships Career development Structure and climate General- family, home, leisure, work Environment Home-work interface Peer pressure Critical life events

5. Work related stressors • Intrinsic nature of the job • Work overload, work underload, • Responsibility for… people, money, equipment • Time pressures and deadlines • Amount of personal control/ lack of it • Role • Clarity or ambiguity, conflicting demands • Relationships and supervision • With managers is the bigger problem in relation to trust and other work attitudes • Career development • Chances of progression [or otherwise] • Structure and climate • E.g. blame culture

6. Work attitudes and stress • All these are known to be negatively related to stress • Job satisfaction • Trust in management • Commitment and loyalty • And positively…. • Labour turnover • Some accidents and injuries • Sabotage, retaliation, sabotage

7. General stressors- family, home, leisure, work • Environment • Noise/vibration, lighting and glare, seating, heat/cold, humidity • Obvious examples include: • DSEs and keyboard, poor ergonomic design resulting in backache, • Home-work interface • Caring responsibilities • Dual-career issues • Peer pressure • Work groups norms, not letting people down, bullying • Critical life events • Marriage, house moving, death of a relative etc etc

8. Symptoms of stress Subjective states Anxiety, tension, low morale, alienation, tiredness, feeling run down, short attention span, lack of interest, no energy, easily upset, etc. Transient clinical changes BP, catecholamines, headaches, frequent colds and other infections, depressed immune system, indigestion, cramp etc. Physical health status CHD, asthma, diabetes, migraine, colitis, rheumatoid arthritis, depression, alcoholism, ulcers, psychosis, neurosis etc. Changes in behaviour Absence, errors, lack of trust, poor quality, etc.

9. 1 Stress 2 Acute medical e.g. heart attack and stroke 3 Musculoskeletal injuries 4 Mental ill health 5 Backpain 6 Recurring medical e.g. asthma 7 Minor illnesses 8 Pregnancy-related 9 Injuries and accidents 10 Home-family responsibilities 1 Minor illnesses 2 Stress 3 Musculoskeletal injuries 4 Back pain 5 Home-family responsibilities 6 Recurring medical e.g. asthma 7 Mental ill health 8 Accidents injuries not wk 9 Other, not due to ill health 10 Acute medical conditions e.g. heart attack etc Long term ---Absence--- Short term

10. Most of those two lists are either caused, or exacerbated by, stress Absenteeism varies by grade and job status; gender more complicated as it co-varies with grade to some extent Some of it goes unreported at higher levels And in a few cases at lower levels as well U-shaped pattern with age Absence generally at between 3% and 4.5%, can be as high as 10% Absenteeism and stress

11. Analysis of stress People not always good judges of when they are stressed Personality traits; e.g. Type A/Type B; learned helplessness, anxiety, disease-prone personality Identify symptoms Look for patterns in people Identify causes Need to know the context Then consider work and non-work origins Effects are cumulative May start early, e.g. attachment styles from childhood: secure less stressed, avoidant or anxious/ambivalent more so

12. Are you type A or type B? score 5, 4, 3, 2, or 1 for each pair

13. Are you type A or type B [cont]?

14. Your score 12-20 BB very laid back and not urgent 21-30 B not really urgent or dashing about too much 31-40 in the middle! 41-50 A quite time urgent 51-60 AA always rushing about in a hurry

15. What does type A type B mean in terms of stress? • Used to be thought that type A was a heart attack looking for a place to happen • Now we realise it is coping strategies that are important, and there are enough instances of Type Bs becoming ill due to stress

16. Are you stressed? Please rate each of the following for how often you are like this: 7= very frequently through to = very infrequently: Fidgeting Hair twiddling TATT No concentration Irritable Lack of interest Unable to cope Make mistakes No energy Feel run down Tense Easily upset

17. Add up your scores. The maximum is 84, minimum12, midpoint 4812- 25 little or no evidence of stress, or you hide it well!26- 35 not too stressed, but some36- 45 the majority of us are here46- 55 moderate but nothing to worry about56- 65 getting higher evidence of stress66- 75 oops.. need to think about how stressed you are getting76+ even more oops, need to do something about this

18. Work overload Higher anxiety levels Unsatisfactory work relationships Poor work-life balance Poor sleep Lower overall job satisfaction Absence due to ill-health in last 12 months > Length of Service Role ambiguity Negative psychological and physical well-being Long hours Lack of interesting work Poor management of change Poor quality supervision Low involvement in D-M Lower overall QoWL Strongest predictors of stress at work in HE [QoWL survey 2008]

19. The John Walker case Northumberland CC Right up to European Court He got £175,000 in 1996 NCC made changes as a consequence, introducing EAPs Unions can help employees fight for compensation.. Within legal framework of HASAWA Proof is needed Settlements include several >£80,000

20. Stress Management Interventions [SMIs] Some down to the individual and aim to help with coping with stress Some of necessity require organizational change to reduce or remove the sources of stress

21. Stress management interventions Training solutions Time management Assertiveness Presentation skills Relaxation Physical exercise Stress inoculation Preparatory For retirement To help alleviate anxiety due to redundancy

22. Time management: how long should you allow for emails if you get 50 a day? • 30 minutes • 31-45 mins • An hour • 1.5 hrs • 2 hrs • Over 2 hrs

23. Allocation of time: do you organise your time? • Not at all • Weekly • Weekly with time estimates • Weekly, revised daily • Just put things into the diary

24. How often do you underestimate how long things will take? • Frequently • Sometimes • Rarely • Never

25. Assertiveness: if someone asks you to do something and you really have a deadline to meet, how do you respond? • OK, leave it with me • Not now, but maybe later • Not now but if you bring it to me in 2 hours I will definitely do it then • I will see what I can do

26. SMIs Situational Solutions Mostly concern physical environment Include glare, seating, These can be improved at a cost to the organization Cognitive solutions Cognitive behaviour therapy Behaviour modification Occupational health may be able to refer you, or your GP can Also needed for extreme cases such as phobias Can be expensive to the organization

27. SMIs [cont] General social support solutions The anxious seek out company of similar others May be helpful, but can make things worse For social comparison, anxiety reduction, information seeking reasons Loneliness Serious health consequences, including mortality Implications for University policy for helping retired staff

28. SMIs Workplace support issues Employee Assistance Programmes -evidence that these are cost-effective to the organization Counselling - - also been recommended for for a variety of mental health issues Healthy lifestyle programmes Helpful policies e.g. health, childcare Job design, moving responsibilities from managers downwards may actually help Provide support and training where stress inherent in the job itself

29. SMIs Personal solutions and coping styles Avoidance based don’twork Alcohol, smoking, drugs, ‘Worrying’ the issue doesn’t work either Control based dowork Problem- focused and cognitive approach Get information Remove uncertainty Carefully manage [and limit] the time allocated to thinking about the problem Emotion- focused Look for feel-good factors Positive distractors such as exercise Change your sensitization

30. SMIs [cont] • Pre-stress interventions to aid coping • Stress inoculation • Desire for control vs. felt control • Coping resources • Coping preferences

31. Conclusions and points to note Not enough known about how well each approach works, and in what circumstances Stress can lead to some forms of anxiety and vice versa Most solutions involve either time or money or both and tend to be people-intensive

32. People who may appear stressed? Ask people questions about how they feel and identify symptoms from those Ask how often they feel this way Probe into possible causes- ask how things are at work/home Ask about any recent illnesses and whether feel run down etc.

33. Last few points to note Stress can also, if unresolved or unremitting, lead to depression and loneliness, even to death Remember that most people not usually able to articulate or even recognise their own stress, just say they feel TATT, etc.

34. Thank you for listening Dr Joan Harvey Joan.Harvey@ncl.ac.uk