Building a Resilient WorkforceFor Eastern Disability Steering Network (EDSN) 19th September, 2013

Introductions

Alison Battley

Principal Consultant at The Recovre Group

Registered Psychologist

T: 03 8689 4521

M: 0420 961 280

alison.battley@recovre.com.au

The Recovre Group

We make a difference by helping people to be safe, healthy and productive at

work.

The Challenge...

“the challenge for health care organisations lies in developing respect and care for their employees in the same way that they required their employees to care for patients.”

Peter Huggard – Senior lecturer, faculty of Medical and Health Sciences, University of Auckland

How to identify mental health issues early

How to manage this proactively

What can you do to promote this in your business

Key messages

Fast facts on psychological injury at work

• Stress claims are the most expensive form of worker’s compensation claims

• Caring professionals are in the top three occupational areas for stress, in both men and women – why?

Safe Work Australia statistics show the top sub-categories of Mental stress are: • Work pressure (33% of all Mental stress claims), • Work-related harassment &/or workplace bullying (22%), • Exposure to workplace or occupational violence (21%), • Other mental stress factors (14%)

• 70% of workers who report they experienced work-related mental stress did not apply for worker’s compensation

The case of Mary – 53 year old Residential Support Worker

• 15 years experience in the disability sector• History of depression ; unmarried and carer for her elderly mother• Team leader believes she can get “too attached to clients”• Mary rarely took annual leave and personal leave was only taken on days

where her mother was unwell• 6 months before Mary lodged her claim a long term resident passed away• Team leader noticed Mary was more irritable and forgetful in the 2-3 months

leading up to her claim• One-off Incident occurred where another worker accused Mary of giving a

resident the wrong medication• Mary ceased work the following day and subsequently lodged her claim• Diagnosed with Adjustment disorder with mixed anxiety and depression• Doubts about her skills as a support worker, anxiety about seeing staff

member, fears she can no longer cope with role• Extensive time off work and high claim cost

A ‘typical’ profile in helping professions

• High levels of empathy• Put others before

themselves - selfless• Patient• See the best in others• Kind • Caring• Don’t complain

• Reduced awareness of own needs & mental state

• Accommodating• May have pre-existing mental

health issues

Common contributors to stress in the helping professions

• Physically and/or cognitively demanding work

• Clients/patients with high needs

• Risk of exposure to verbal or physical aggression can be higher

• Critical incident or crisis situations can occur

• Grief following the death or transfer of clients/patients

• Work schedule (e.g., shift work, long hours)

• Organisational change (e.g. New programs)

So what do these factors tell us about the risk to employees in helping professions?

Compassion Fatigue – what is it?

• The stress from helping or wanting to help a suffering person• Those with enormous capacity for empathy are most at risk• Compassion fatigue is common in the helping professions –

including the disability sector• It is often identified by others before being

identified/admitted by the individual• Skills, experience and longevity do not result in “immunity” to

compassion fatigue

What characterises compassion fatigue?

• Feeling of being overwhelmed

• Exhaustion• Inability to focus• Decrease in

productivity• Unhappiness• Self-doubt• Isolation

• Poor sleep• Nightmares• Low mood• Irritability• Anger• Helplessness• Confusion • Loss of passion and

enthusiasm

Compassion Fatigue and Burnout

• Compassion Fatigue can be sudden onset and if addressed early can have rapid and full recovery

• Burnout is mental exhaustion caused by long term involvement in emotionally draining situations, and can be pervasive with difficult recovery

• If left untreated, compassion fatigue may lead to burnout and/or a diagnosable mental illness

Common diagnoses in helping professions

• Post-traumatic stress disorder: may develop from an acute stress or cumulative set of events, where there is a prolonged stress response eg. physical assault, car accident etc

• Depression: depressed mood, loss of interest & pleasure in activities, hopelessness, low energy & motivation, guilt, social withdrawal, sleep disturbance, teary, poor self-care, self-harm

• Anxiety disorders: Fear of losing control, fear of the unknown, avoidance, panic attacks, hypervigilance, physical symptoms

• Adjustment disorder: development of emotional and behavioural symptoms in relation to a definable stressor(s). Symptoms in excess of what might be expected and can result in withdrawal from normal functioning. Anxiety and depression

symptoms may be present.

The case of Mary

What could be some reasons for Mary not coming forward?

What could be some reasons for management not getting involved earlier?

Barriers for staff admitting to stress/fatigue

• Fear of being labelled weak or a whinger

• Fear it may affect employment or career prospects

• Think that stress is a normal part of their role or may not be aware of how severe their stress / fatigue has become

• Bargaining with oneself – “if I just make it through the next month, things should get easier”

• Unsure of options available to manage their difficulties or supports available

Manager Myths – what holds us back?

• I’m not sure what to say / ask them• I’ll look silly / intrusive / awkward • They wont want to talk to me about it• If they’re off work they don’t want hear from me• They’ve been here for years, they’ve got it all worked

out• I know there is stuff going on, I’m just giving them

space• I don’t know what to do if they say there is a problem

What are the costs if not addressed early?

• Direct costs to the employer

are only the tip of the

iceberg in terms of overall

costs of psychological injury

• Majority of costs are

indirect or hidden

What are the costs to the organisation if mental health concerns are not addressed?

• Increased sick leave• Increase in lodgement of stress claims & workers

compensation premiums• Absenteeism• Poor work performance & potential risk of negligence • Reduced morale amongst staff• Loss of experienced & valued staff • Retraining• Effects to quality of service• Effects to trust & confidence of patients & families • Tarnished company image

Breaking through the barriers

How can organisations support staff and continue to meet business needs?

Management/leading is a balancing act

Factors that can lower the risk of stress & compassion fatigue

Supportive work environment High Autonomy Manageable workload Utilisation of skills Job satisfaction Procedures for evaluating psychological work hazards Personnel trained in identifying symptoms of work stress Training in adaptive coping strategies Early referral and intervention

Risk Assessments

Support for staff

• EAP and Critical Incident Debriefing - are these utilised?• Engagement / opinion surveys & opportunities for feedback• Professional development opportunites and training• Opportunities for debriefing and discussion of challenging or high

needs clients with colleagues and/or management• Resilience / stress management training for staff • Policies and procedures around supporting staff who have

physical or mental health concerns – what can be put in place?

REPS: What managers can do

• Recognise the signs and symptoms• Encourage self-care practices• Provide variety and flexibility • Share the positives and success stories

• Role model positive behaviour• Encourage supportive workplace environment• Provide opportunities for staff to debrief• Seek help

How do we achieve this balance?

• Decisions made on facts• Fair & Consistent• Transparent processes• Explain decisions and impacts• Take onboard feedback and employee input• Use empathy• Understand and know the relevant policies and

legislation

What can I do right now?

• Regular promotion of the importance of reciprocal communication between staff and management

• Ensure strong policies around dealing with workplace health (including mental) issues

• Ensuring staff and management are adequately trained (and refreshed) on what to look for and how to deal with potential mental health issues

Summary

• Helping professions have a high occurrence of psychological claims and are often the most costly

• Prevention is better than cure• Early intervention can minimise issues and prevent

long term illness• Prolonged stress and compassion fatigue are health

and safety risks and should be treated as such• Strategies at the individual, management and HR

level need to be considered

Further resources

• WorkSafe Victoria www.worksafe.vic.gov.au• APS Website www.psychology.org• The Black Dog Institute www.blackdoginstitute.org.au• Beyond Blue www.beyondblue.org.au• R U OK day www.ruokday.com

If you would like to know more about us?

Visit: www.recovre.com.au

Recovre is an RTO and we deliver Community Health, Workplace Health & Safety and Business qualifications. Including Certificate III and IV in Disability. Visit: www.recovretraining.edu.au

Call: 1300 550 276

Questions?