Mental stress has accounted for an average of 95% of mental disorder claims over the past 10 years.
SafeWork Australia produced a report about this in April 2013.
Their findings were:
Mental stress claims are the most expensive form of workers’ compensation
claims because of the often lengthy periods of absence from work typical of
these claims.
>> Mental stress claims are predominantly made by women.
>> Men and women are more likely to make a claim for mental stress as they
get older but after they reach 54 years the likelihood that they made a claim
decreases.
>> More Professionals made claims for mental stress than other any other
occupation with over a third of their claims made for Work pressure.
>> There were more mental stress claims made for Work pressure than any
other sub-category.
>> The hazards that result in mental stress claims vary with worker age.
Younger workers are more likely to make claims as a result of Exposure to
workplace or occupational violence, whereas Work pressure is the main
cause of mental stress claims for older workers, peaking for those aged
45–49 years.
>> General clerks, School teachers and Police Officers accounted for the
majority of claims for Work pressure.
>> Women were around three times more likely than men to make a workers’
compensation claim due to Work-related harassment &/or workplace
bullying. Approximately one-third of all claims in this mental stress subcategory
were made by workers in the occupational categories of Advanced
clerical & service workers and General clerks.
>> For the industries with the highest number/rate of mental stress claims, the
majority of claims were for Work pressure. This was particularly true in the
Education sector. Claims for Exposure to workplace or occupational violence
were notable in the Retail trade industry, while the Transport & storage and
Health & community services industries dominated claims for Exposure to a
traumatic event.
WorkSafe Australia produced a further report in 2015 – Work-Related Mental Disorders profile
Their findings were that 6% of all workers compensation claims were for mental disorders .
The typical compensation payment for such a claim was $23,600 totalling $480 million for the 7820 Australian claimants. The average period of time spent off work was 14.8 weeks. 39% of these claims were for harassment/bullying/exposure to violence. 90% of all mental disorder claims were attributed to stress.
65% of all mental disorder claims were awarded to workers aged 40 or over.
For 1 million hours of work there were 0.5 mental disorder claims.
Occupations most at risk:
First responders-police, paramedics and firefighters comprising one in five of this group
welfare and community workers affirm one in 10 were compensated, prison officers, bus and rail drivers and teachers of whom one in five were compensated.
The more common conditions included reactions to stressors (41%), anxiety/stress disorders (28%) and post traumatic stress disorder (11%). Combined they accounted for, on average, about 4/5 mental disorder claims over the period.
The most up-to-date statistics are those provided by WorkSafe Western Australia in October 2016.
Their findings were that: Over four years, the number of stress-related claims increased by 25 per cent. In 2015/16, there were 547 stress-related claims lodged, representing
3.2 per cent of all workers’ compensation lost-time claims.
Although the number of stress-related claims increased, the frequency rate (claims per million hours worked) for stress-related claims is stable.
Females accounted for 59 per cent of stress-related claims compared with 41 per cent for males.
In terms of prevalence of stress claims, female workers tend to have a higher frequency rate.
The top three industries for stress-related claims were:
Health care and social assistance 25%
public administration and safety 24%
education and training 16%
The causes of stress and later claims included:
Work pressure 39%
Harassment and bullying 23%
exposure to a traumatic event 19%
exposure to workplace violence 14%
other causes 5%
There appears to be a significant drop in the number of stress-related claims in WA representing 3.2% of all workers compensation lost time claims, the WorkSafe Australia statistics were that 6% of all claims were stress-related. In Victoria in the late 1990s about 5.5% of all claims were stress-related. There appears to have been little real change in the incidence of stress-related disorders over the last 20 years.
The College has issued a strong position statement condemning the use of subpoenas to access patient records without their consent and refers to significant issues damaging patent- psychiatrist trust and possibly a breakdown in therapy. it is worth reading.
I have downloaded all the permanent impairment guidelines I can find in Publications, look in Guidelines Workers Compensation
Examination and provision of report and certificate — psychiatric — complex assessment (eg. reviewing significant documented prior psychiatric history) $3554.35 or $3863.35 (minus fee for intrpreter. Think about what you get paid.
I have just returned from five weeks in Africa. I went to the World Psychiatric Association meeting in Cape Town.
It so happened that on the way I went to the Kruger National Park, the Serengeti National Park, Zanzibar, Tanzania, Kenya and then drove the Garden Route from Port Elizabeth to Cape Town, all fabulous and astonishing. I managed to film some animal porn of two lions mating, typical, no foreplay and the act took 15 seconds!. I had the amazing experience in the Serengeti and in the Ngorongoro crater of seeing thousands of a zebra, buffalo, wildebeest, camels, elephants, hippopotami, lions, leopards, cheetahs, hyena and warthogs, amongst others.
But that is all by the bye. I attended a workshop at the WPA on Impairment Assessment in South Africa. The system is very different, there is no real workers compensation and transport accident schemes as such but a significant number of people make claims on their insurance policies particularly with total and permanent disability. A working group has been developing guidelines. There was a real sense of déjà vu particularly with regard to looking at the question of psychiatric opinion that was all over the shop.
All of you would be familiar with the usual requirements about contents of reports, opinions, reasons for opinions and so forth. Regrettably there is some talk about using AMA 6 and I strongly urged that this would be a mistake.
I will continue to be in contact with the working group to assist them in refining the document.
We are familiar with various websites that rate those who do independent medical examinations. Some of these posts are incorrect and indeed defamatory.
Here is an example of comments from the workcovervictimsdiary Website.
Those IMEs who totally disregard honesty should be eliminated from the process. Consider having the state refer to an IME doctor rather than the insurer and the whole attitude towards fairness and honesty would likely improve
Get rid of the (few) nutters doing most of the IMEs. If an IME doctor loses a certain amount of cases then don’t allow them to undertake more IME examinations. The reason these IMEs don’t succeed is because they are either wrong incompetent, dishonest or all three
Dr Alan Jager has sent us a post about a successful application to shut down such a website. It makes interesting reading
Al Muderis v Duncan [2016] NSWSC 1363 saw the applicant, an orthopaedic surgeon, make an interlocutory application to to restrain the continued publication on the internet of material he alleges is defamatory of him. The defendant had not responded to correspondence and was not represented at the interlocutory hearing.
The application arose against the background of a complaint by a patient to the Health Care Complaints Commission, which was dismissed. A medical negligence claim was also made and dismissed.
Later the patient pleaded guilty to offences of intimidation and using a carriage service to harass, menace or offend. He was convicted and sentenced to four months imprisonment suspended on conditions. An apprehended violence order was made prohibiting the patient from assaulting, molesting, harassing or threatening the doctor, engaging in any other conduct that intimidates him, or stalking him. The AVO made specific reference to operation of a website.
The court made orders as requested by the medical practitioner, including an order directed to the website host registration entity. The website now appears to have been taken down.
The Victorian Ombudsman has released a report regarding an “Investigation into the management of complex workers compensation claims and WorkSafe oversight”
This report is very critical of practices of WorkCover agent’s particularly with regard to doctor shopping and is unsparing in its criticism of certain IMEs in particular with regard to their bias and poor quality reports. The report is a damning with regard to actions taken by work safe about IME reports that are inadequate. Based on the reports the following recommendations relevant to psychiatrist were made. A copy of the full report is available in publications and a summary is also available.
Implement changes to the current IME system to:
Amend its IME complaint handling policy to provide scope for examination of complaints where a worker does not provide consent for the complaint to be provided to the IME, which may include the referral of the matters raised to the IME quality assurance division for intelligence gathering purposes.
Amend the IME quality assurance process to:
The American Psychiatric Association published guidelines for the psychiatric evaluation of adults in 2015. These guidelines occupy 170 pages. This is about the most complete and comprehensive guide I have ever seen although whether or not it is of any use is entirely up to you.
The Longitudinal Head Injury Outcome Study follows up a large cohort of individuals who have sustained moderate to severe Traumatic Brain Injury (TBI). This project aims to provide a comprehensive picture of the changes experienced by people who have sustained a TBI as well as their families over a period of 20 years. Changes are captured in terms of living skills, study, employment, recreation, as well as social and personal relationships. In addition, factors predicting outcomes are identified in each of these domains.
This study comprised 666 individuals from the Monash-Epworth Rehabilitation Research Centre (MERRC) database who had been competitively employed prior to injury, for whom Compensation data Base data were available and who had received loss of earnings payments after injury. In addition, using the CRD the authors were able to begin examining whether specific types of service utilisation were associated with employment status. Each individual’s services were aggregated over the first six months post-injury. This included medical services, such as surgeries, pathology, radiology, and psychiatry, as well as allied health services, which included psychology, social work, and vocational assistance.
The authors have highlighted the presence of a good recovery group as well as groups of individuals who show poorer outcomes despite having similar injury severity. These are associated with greater emotional distress, low economic and family support, low resilience and greater service utilisation. This group also incurs greater costs. They also identified a group of individuals who were potentially affected by reduced self-awareness of injury-related changes, leading to under-reporting of problems and conversely by emotional distress potentially leading to some over-reporting of symptoms. Their findings further highlighted the factors other than injury severity that contribute to longer-term outcomes. These include the personal strengths of the individual, including independence and self-esteem and resilience, as well as economic and family supports, their level of emotional distress and motivation to recover.
The authors have identified some key predictors of early return to work (RTW) as well as more persistent unemployment. Individuals were more likely to return to work in the first 6 months if they had shorter duration of post traumatic amnesia (PTA) and if they were in managerial or professional occupations prior to injury. A combination of background, injury-related, and service utilisation variables predicted more persistent unemployment between 6 months and three years post-injury. Individuals were more likely to experience a protracted RTW if they were older, female, were labourers, machinery workers, or technician prior to injury, had longer duration of PTA, and had a moderate or major limb injury. In addition, greater utilisation of specialist practitioner, psychology services, and analgesic medication within the first 6 months was associated with delayed RTW. Conversely, assessment and rehabilitation for return to driving was associated with earlier RTW, highlighting the importance of driving for RTW. These findings demonstrate the roles of complex physical injuries, pain and mental health factors in delaying return to employment following TBI.
Post-traumatic stress disorder was the most common anxiety disorder and was associated with poor quality of life. PTSD was most commonly diagnosed between 6 and 12 months post-injury. Extended periods of PTA, cognitive dysfunction and hospitalisation following TBI may postpone symptom development rather than reduce the risk, with subsyndromal symptoms frequently preceding the development of full PTSD. This provides a potential time-window for early identification and treatment. Rehabilitation clinicians should be aware that patients might develop clinically significant trauma symptoms despite protracted post-traumatic amnesia. There was high comorbidity between PTSD, anxiety, and depression as well.
The cross-cultural study demonstrated the strong influence of cultural background on outcome following TBI over and above injury severity and other demographic factors. As a group, individuals from culturally and linguistically diverse (CALD) backgrounds reported less independence in daily activities, were more emotionally distressed, showed a heightened awareness of injury-related changes and less problem-focused coping than individuals from English-speaking backgrounds. They tended to believe that more external factors such as Chinese medicine, praying or having family take care of them would help their recovery. They were less likely to believe that their own behaviour could help their recovery. They were more distressed about role changes. However, there were marked differences across geocultural regions, and differences in the demographic characteristics of these subgroups (e.g., age, education) also appear to have been influential.
There may also be relationship issues that contribute to a decline in sexual functioning, including cognitive and behavioural changes as well as other stressors.
The authors have highlighted the presence of a good recovery group as well as groups of individuals who show poorer outcomes despite having similar injury severity. These are associated with greater emotional distress, low economic and family support, low resilience and greater service utilisation. This group also incurs greater costs. They also identified a group of individuals who were potentially affected by reduced self-awareness of injury-related changes, leading to under-reporting of problems and conversely by emotional distress potentially leading to some over-reporting of symptoms. Their findings further highlighted the factors other than injury severity that contribute to longer-term outcomes. These include the personal strengths of the individual, including independence and self-esteem and resilience, as well as economic and family supports, their level of emotional distress and motivation to recover. Having identified these key measures and profiles in patients assessed 6 months-10 years post-injury the authors aim to see if these measures are predictive in the early stages after injury. If it is possible to identify these groups early they may be able to develop and tailor appropriate treatments to address issues relevant to each profile with the ultimate aim of improving outcomes.
I have written a draft submission to the Medical Board of Australia expressing significant concerns about revalidation. The one area I have not included is probably the most important: What is the problem? Where is the evidence this complicated process is required? Is it just more Nanny state bullshit because the profession cannot be trusted?
These are the recommendations of thew Medical Board Expert Advisory Group. They are also present in the revised CPD program of the RANZCP
The recommendations include:
Reviewing performance:
The problem is that this is a generic list that does not fit some groups. The people who do medicolegal work measuring outcomes is meaningless. All of the third component has no relevance. Reviewing performances is also problematical particularly multisource feedback from peers, medical colleagues, co-workers, patient, other health practitioners. How on earth do we do that.
Similarly peer-reviewed medical records. We have no medical records we have reports. The reports are assessed by the various statutory schemes and by lawyers and ultimately attested in court. There is no recognition of that. Peer review is something that we do anyway but again there are no medical records so how can there be peer review of medical records other than peer review of reports. Most of us read many reports from our colleagues and sometimes give feedback with regard to these. We also have peer discussion of cases but we don’t have to deal with critical incidents.
I urge you to make your views known if you agree with this analysis.
The Transport Accident Amendment Act 2016 was enacted in mid April 2016 (see effect of changes). The Act reverses the provisions enacted in the Transport Accident Amendment Act 2013 that limited the right of families of people who die or are severely injured in transport accidents to seek compensation for psychological injury.
The requirement that claimants with psychiatric injuries needed to seek treatment for three years before they can bring a serious injury claim has also been reversed. It did not recognise that many people suffering from mental illness find it difficult to reach out for assistance. Furthermore, it was especially difficult for claimants living in rural areas who may have limited access to mental health services.
This is a victory for common sense
The Victorian ombudsman has taken it upon herself to have an enquiry into the use of Independent medical examiners by WorkCover agents. We have had significant concerns about potential outcomes. In particular one of our members has been targeted by the ombudsman with the possibility of a recommendation that he no longer see WorkCover claimants. In an interesting denial of natural justice he has had no opportunity so far to respond to allegations made by a disgruntled claimant. In general however the focus of the investigation is on the agents rather than on Independent medical examiners. Nevertheless the Victorian Branch of the faculty of forensic psychiatry thought it would be useful to make a submission to the Ombudsman explaining our obligations including the College code of ethics, guidelines for medicolegal examinations, the WorkCover handbook for medicolegal assessment and legal requirements of expert witnesses. You can see a copy of the submission here
This review funded by the ISCRR demonstrates that in many instances, injured workers with long-term complex injuries experience difficulties when receiving health services in the context of workers’ compensation systems. Independent medical examiners were a source of contention for both injured workers and healthcare providers (HCP), and likely exert a negative influence on the therapeutic relationship. Healthcare providers experience problematic interactions with insurers, and injured workers bear the brunt of healthcare providers’ frustration as some HCP’s offer poorer quality service or refuse to treat compensable clients as a result.
Supportive patient-centred interaction with HCP’s who have high job satisfaction is important for injured worker recovery. Reduction of organisational pressures and improving communication between insurers and service providers could result in increased job satisfaction for HCP’s and ensure that providers are more amenable to operating in compensation systems. Improved HCP participation and job satisfaction will more than likely have a corresponding positive influence on injured workers’ recovery and return to work.
The new indexed rates for Independent Impairment Assessment (IIA) services provided to WorkSafe Victoria from 1 July 2016 has been increased by 1.24%! Where did they get that figure?. Notice NO fee for reading, faxing etc.
The Victoria Police mental health review-summary report was released on 31 May 2016. This review referred to the negative views of mental health issues in the Victoria Police and made 39 recommendations including a prevalence study to gain accurate data on the organisational mental health and suicide risk profile with the possibility of other jurisdictions also becoming involved; developing an organisationwide comprehensive mental health literacy program involving mandatory participation by all employees and leaders; augment the existing police psychology unit and identify progress in reducing mental health stigma and develop a program to focus on expected behaviours and manage inappropriate behaviours. (full report)
These appear sensible recommendations. One of the advantages of long-term involvement in this field is that I am aware of previous similar reviews that made sensible recommendations including the development of the police psychology unit.
However the inescapable fact remains that Police work is inherently unpleasant. Police are required to repetitively deal with unpleasant people, unpleasant situations and are sometimes in fear for their life. There is no other job where there is a realistic prospect that a person may not return home from work because they have been killed.
Policing takes place in an organisation that is hierarchically based, performance focused and where people with mental health issues are not able to undertake full operational duties and frequently there is no adequate work available for them and there is always a stigma about mental health issues.
I remember speaking to a federal Minister for Health some years ago about the stigma of mental illness. He rubbished that notion and I said to him “How would you feel if your colleagues saw you coming out of a psychiatrist’s office?” He had the grace to admit that he would be embarrassed.
All of us who see police officers have heard of place breaking down having seen one to many fatalities or other such similar distressing experiences. This is particularly a problem for those who work in the sexual offences unit and those who do road patrol work. Most of the recommendations deal with the aftermath of the development of mental health issues. Particular emphasis is placed on the Sexual Offences and Child Abuse Investigation Teams with recommendations that they be allocated police psychology unit support to provide mental health screening, They should have opt out provisions either on a temporary or permanent basis and a supervision model.
it is very well to talk about changing the culture, implementing leadership programs, education sessions and so forth but, in practice, how does that work when people are exposed to repetitive trauma?
Maybe we need to think of the United States Air Force flight surgeon model. The flight surgeon has the power to stop someone flying. We also need to think about what do we do to provide for people with mental illness to return to the workforce. We know that going back to work as soon as possible is best for people with work injuries but not if they are going back into the same work situation that caused the injury.
I was astonished to receive an invitation from eReports to attend a weekend workshop in Melbourne conducted by Prof Mohammed Ranavaya, president of the American Board of Independent Medical Examiners. The training will be on the transition from AMA 4 to AMA 5.
As far as i’m aware there are no plans In Victoria to change from AMA 4 to AMA 5 and furthermore I notice that the section with regard to psychiatric impairment rating is from 345 to 4:30 PM on 23 July, 2016, the Saturday of the week end of the course and last for 45 minutes. Considering that there is virtually no difference between AMA 4 and AMA 5 with regard to chapter 13 what is there to be said? Furthermore no jurisdictions in Australia, apart from in the Northern Territory, use chapter 13. In Victoria and South Australia the GEPIC is used and in other states the PIRS.
The cost, from what I could work out is US $595 for the Saturday, the two workshops on Sunday total US$750 and the fee for the examination from 5:30 PM to 9 PM is $995 and for the non-physical examination from 530 to 7 PM is $350. You we please today that if you sign up for everything you receive a $100 discount.
The problem of course is that AMA5has been used widely for years apart from in Victoria where no changes are planned to move to AMA 5. I have difficulty understanding why anybody would bother.
A classic example of one hand not knowing the other or the perils of partial information. In Resources you will find 2 papers from NIH. The first recommends bupropion (Zyban) for use in depression because of lack of weight gain when tested against fluoxetine and sertraline. The 2nd paper is patient information from Medline Plus and warns against the risks of taking bupropion both for smoking control and for depression! More mind boggling, read for yourself
Philip Morris has written a trenchant criticism of the new CPD program on the College Discussion site.
He write – Seems like regarding the College CPD program we are back to where we started from in 2002 when we fought and won a fight against the College making a (then) coercive CPD program compulsory. The subsequent review liberalized the program and made it psychiatrist needs relevant rather than a coercive instrument.
I now see that the College will be making its CPD program compulsory from 2017. But of concern the program to be released at the end of the month will be making parts of it mandatory (beyond the current Peer Review Group component).
There is a new compulsory section called Practice Development and Review with a five-hour mandatory minimum time allocation. Things that must be done here include a practice audit (NZ style – as NZ Fellows have to do an annual mandatory practice audit as demanded by the NZ Medical Council, not the College), a ‘360 degree’ review survey (private practitioners will have to pay for an outside agency to do this for them at $200-300 a pop!), structured quality improvement, risk management projects, root cause analyses, online quality improvement, and research projects.
Nearly all of these activities are ones done in public sector settings and where the participating psychiatrist will be paid by government salary to do the activity – very different to the compliance costs put on the shoulders of private psychiatrists.
I am told by the College CPD staff the introduction of this section was in part to help our NZ colleagues overcome confusion about the practice audit requirements of their NZ Medical Council – if the College mandates a practice audit for all Australasian Fellows then NZ Fellows will not be confused by competing demands for CPD from their Medical Council and the College. But this is no justification for making an onerous CPD component mandatory for Australian Fellows.
I have enquired of the College CPD staff about the rationale behind these changes and what evidence there is to justify making one form of CPD mandatory over another form – no evidence base or explanation has been provided other than ‘it is a good thing for doctors to do’.
The College has not asked the membership to comment on the new CPD program – it will be published as a ‘finished work’. I am not against change in the CPD program but believe any compulsory change to the program must be justified by robust evidence of benefit to psychiatrist’s knowledge and skills or patient welfare before making sections mandatory in a now compulsory program.
There was no detail on the College website about the new program so I talked to the College staff in the CPD office – Shudipta Saha and Ben Patterson (Manager). That is where I found out the coercive nature of the changes, that they are largely of relevance to public sector psychiatry practice, and that there was no evidence base offered to support these changes showing how this form of compulsory CPD makes any change to physician knowledge and skills or patient outcomes better than other types of CPD. An evidence base might be available but it has not been provided. Nor has a justification been offered as to why the Practice Development and Review component of CPD now needs to be compulsory – previously it was optional.
My position (and one I stood by as far as I could when I was chair of the College CPD committee in the mid 2000s) is that any compulsory component of CPD should have a robust evidence base showing the advantage of the compulsory CPD activity over other CPD activities and that any introduction should be done in a consultative and collaborative way with the College membership, not as an imposition from above.
Unfortunately, this seems to be what has happened with this CDP change. I was referred to the College Psych-e bulletin newsletters of the past year by the College CPD staff as evidence that the membership was notified of the changes.
When I looked through these Psych-e bulletins the only reference to specifics of the now-to-be compulsory Practice Development and Review section was in the August 2015 Psych-e bulletin as follows “To further enhance the quality improvement of practices, the College is considering the inclusion of optional activity in multi-source feedback as an aspect of the CPD Program. This exercise is widely used by many specialist medical colleges both nationally and internationally as it provides a valid and reliable assessment of one’s management and behaviour, which in turn leads to reflection, goal setting and further skill development.” This is reference to the ‘360 degree review’ technique embedded in the Practice Development and Review section. Note that in August the inclusion of this section is optional. And there is no information provided to support the assertion that the multi-source feedback is valid and reliable.
By the November Psych-e bulletin we are informed that the CPD program will now be compulsory from 2017 as follows “RANZCP makes Continuing Professional Development Program compulsory for all Fellows from 2017”.
And by in the January 2016 Psych-e bulletin we are told that the now compulsory CPD program will have “a Practice Development, Quality Improvement and Review activity” with “required components of 5 hours of practice review / quality improvement activities”.
So no where following the mention of an optional multi-source feedback activity in August 2015 is there any discussion about the details of the proposed compulsory five hours of Practice Development and Review section and certainly no attempt to consult the College membership more broadly about theses changes or to offer any evidence base to support these changes.
In my view this is a very poor way to introduce a compulsory change that has implications for the medical registration of fellows. I wonder if this reflects a ‘corporatist’ and paternalistic attitude of the College to its members – we are to be ‘managed’ rather than consulted about change – I hope I am wrong.
I was told by the College CPD staff I was the only one so far to voice any concerns about the changes. I encourage any who have similar concerns to me about these imposed changes to CPD to you make formal and written representations to the College CPD staff (email Shudipta Saha at Shudipta.Saha@ranzcp.org) and to your College state and territory and NZ representatives.
A chain of clinics opened in Australia recently fronted by an academic physiologist with no medical or psychiatric training. They advertised widely. I searched the web-site, no indication what treatment they were using for depression – turned out to be ketamine! Numerous breaches of regulation lead to their closure. Looks like the same problem is rampant in the USA, see this article.
To mark World Day for Safety and Health at Work, the International Labour Organisation has released a major report on the impact of workplace stress and how to tackle it. The document is replete with statements I found astonishing, eg
In Workplace Stress: A collective challenge, ILO researchers review the latest studies on the prevalence of workplace stress and its impact on workers’ mental health and wellbeing.
A 2014 Australian stress and wellbeing survey, they say, found nearly half of participants reported work demands as “barriers to maintaining a healthy lifestyle”, while an earlier study found seven in 10 Australians said stress was affecting their physical health.
“Global competitive processes have transformed work organisation, working relations and employment patterns, contributing to the increase of work-related stress and its associated disorders,” ILO senior occupational health specialist Valentina Forastieri says.
According to the report, studies show psychosocial risks are linked to “health-related behavioural risk, including heavy alcohol consumption, overweight, less frequent exercise, increased cigarette smoking, and sleep disorders”.
Within the workplace, mental health disorders associated with psychosocial risk causes “increased absenteeism and presenteeism, disturbed labour relations, reduced motivation of staff, decreased satisfaction and creativity, increased staff turnover, internal transfers and retraining, and generally a poorer public image”, it says.
Exposure to workplace stress is also associated with cardiovascular disease and musculoskeletal disorders, while long-term exposure to emotionally demanding work situations can lead to burnout and depression.
The report identifies 10 types of psychosocial hazards divided into two groups:
The ILO report recommends seven measures to prevent work-related stress:
“Awareness on these issues is growing,” Forastieri says.
“In most countries policymakers and social partners have become involved in concrete interventions to tackle psychosocial hazards, which are the causes of work-related stress,” she says.
“A comprehensive OSH management system would ensure improved preventive practices and incorporation of health promotion measures.
“This should include psychosocial risks in risk assessment and management measures with a view to effectively managing their impact in the same way as with other OSH risks in the workplace.”