Attacking stress from all directions

There are so many different triggers for work-related stress and so many different manifestations of it that it is impossible to pinpoint one way that it should be tackled.

It could be that an employee is suffering from musculoskeletal problems due to a large workload that demands a lot of overtime and insufficient breaks. Or that someone is being bullied, leading them to suffer from anxiety attacks, headaches, sleepless nights or other physical or emotional reactions.

That is why it is imperative that organisations take a multi-disciplinary approach to dealing with workplace stress, as the broader the parameters, the more likely it is that the cause can be identified and the right solutions found.

If OH practitioners can work with HR, ergonomists, occupational psychologists, senior and line managers, health and safety advisers, trade unionists and any other relevant professionals, they stand a higher chance of reducing individual and overall workplace stress.

“It is important to cover all angles when it comes to stress,” says Robert Westlake, a chartered psychologist and clinical head of psychological services for Bupa Wellness, providers of preventative healthcare. “The more people that are involved, the more acceptance stress-related initiatives get within an organisation,” he adds.

Westlake says that those employers who have made efforts to reduce workforce stress have traditionally done so through a one-route approach, but he also thinks that some are beginning to see that the multi-disciplinary way is more likely to produce results.

However, Ben Willmott, employee relations adviser at the Chartered Institute of Personnel and Development (CIPD), and author of a recent CIPD report into employee absence, thinks there is still a lot of work to be done in persuading employers that inter-departmental collaboration is best.

“Employers are realising that there is a problem with stress, but they are not doing enough yet to bring all the strands together,” he says. “I am not sure that they are tackling it in a completely systematic and co-ordinated manner yet.”

Employee stress has become so much more prevalent and talked about the past few years that many employers have started taking it more seriously. Unfortunately, some still view it as a problem for individuals to deal with and do not take any responsibility for sorting out any issues, even if it is their fault that people are stressed-out.

“Some companies are doing a lot, some are doing something and others are just burying their heads in the sand,” says Dr Doreen Miller, a consultant occupational physician who used to be chief medical officer at Marks & Spencer.

The Health and Safety Executive’s (HSE) 2001/2 survey of self-reported work-related illness prevalence indicated that more than half a million individuals in the UK believed that they were experiencing work-related stress at a level that was making them ill.

Furthermore, it showed that self-reported work-related stress, depression or anxiety, accounts for an estimated 13.5 million reported lost working days per year in the UK.

Partnerships are vital

The fact that stress has moved up the strategic agenda is good news for OH practitioners, as employers are taking more of an interest in what OH has to say.

By joining up with other professionals who are interested in the stress debate, OH gains even more of a strategic voice.

Caroline Raymond, director of Stress in Perspective, an organisation that trains OH, HR and managers about work-related stress for the Institution of Occupational Health and Safety, thinks it is high time OH practitioners had more muscle behind them. “In the past, OH used to try very hard to get stress issues off the ground but it wouldn’t work because they couldn’t get the commitment of senior management,” she says. “But now, a lot of senior managers are aware that they cannot ignore health and safety issues like stress.”

Getting senior management buy-in to tackling stress and to tackling it from a multi-disciplinary approach is essential. Without that support, the impact of any initiatives tends to be limited.

To fight workforce stress, there needs to be an organisational culture that takes the problem seriously; and that culture needs to be set from the top. Ergonomist Claire Raistrick says the cultural aspect is often the first thing that needs to be changed. “You have to break through the cultures in an organisation.”

Senior managers are only one part of the solution, however. Even if the best policies and procedures are in place, the system won’t work if individual managers ignore them, or fail to take responsibility for reducing employee stress.

HR and OH need to train managers in how to identify workforce stress, what to do about it and what resources are available. Managers also need to have it drummed into them that they have a duty of care towards their employees that includes their well-being at work.

Information on what resources are available should be highlighted on company intranets and within employee handbooks and induction packs so that employees and managers are made aware of what is available to them. Providing this information upfront makes it more likely that employees and managers will seek help early, so making it easier for OH and HR to nip problems in the bud before they get out of control.

In theory, managers are well placed to notice and combat rising stress levels by virtue of the fact that they have an ongoing relationship with their employees and are responsible for their progress and well-being at work.

“Managers are the ones who often see the build up to stress and need to know how to stop it,” says Raymond. “They need to know the polices and resources and what their limitations are.”

Problems are exacerbated when it is the manager causing the stress. Unfortunately, this is all too common, whether it is a bullying issue, overly-high management expectations, the manager taking out their own stress on employees, or some other form of poor people management.

Involving HR

HR’s involvement in tackling these sorts of problems is essential as management competencies is part of the HR portfolio. “You need to make sure that HR professionals are involved to ensure that management is not creating stress,” says Willmott. “There could be issues of management style, workload, organisational change or pressure to meet targets.”

OH, HR and line managers should be working together to ensure that employees have clearly defined job roles with achieveable targets and the necessary training and support.

HR and OH can put their heads together to establish the root causes. Or it might be that an employee turns to OH with a stress-related illness, gives OH consent to consult with HR and it then transpires that HR already knows about problems in that particular department.

Data on employee turnover, sickness and absence rates, job and organisation satisfaction is often held and monitored by HR. That data is very important as it highlights areas of concern and any patterns that are emerging.

“It is very important to look at issues such as absence patterns and staff turnover, particularly on a departmental basis,” says Willmott. “You need to analyse data very carefully to identify any patterns so to address them, and you might have to take a closer look at some departments. The sooner this is done, the better.”

Another increasingly popular HR practice is the setting up of employee assistance programmes. This is something that Bupa Wellness does, both as an in-house and external service.

“We are combining the OH angle with an EAP programme,” explains Westlake. “There’s a much better chance of people tackling stress if you approach it from both angles.” It might be that an employee voluntarily refers themselves to an EAP, that a manager has recommended it or that OH has referred them.

For Westlake, the problem with OH referrals is that it usually means the symptoms have already progressed. Not that he thinks the OH role is not vital. “Say an employee goes to see OH with stress-related illness, rather than their GP. They get much more time, much more opportunity to open up and get to the root of the matter,” he says. “OH can get involved in organisational risk assessment, looking at polices and procedures.”

OH practitioners know the organisational culture and working practices, which means they have a much more complete picture of what is going on.

One crucial element to cross-professional working is that confidentiality is maintained and employee consent is always sought before involving other professionals. “Confidentiality is the cornerstone to all of this,” says Westlake.

Some organisations run stress audits. These can be performed through in-house teams or through external providers, such as Dr Miller or Bupa’s Wellness service. This entails involving several parties, otherwise you get an incomplete picture. “I see it as a diagnostic tool,” says Westlake. “And HR is often the sponsor of these stress intervention projects and the main point of contact.”

Working with trade unions

Trade unions can be good sources of information on employee welfare and management problems. They often act as a channel between employees and the organisation, and healthy lines of communication between HR, OH and unions can help when workplace problems need to be sorted out.

Working in partnership with trade unions also reassures employees that the organisation genuinely cares about their well-being.

If stress has reached such a high level that an employee has taken prolonged absence leave from work, it is even more important that several different parties are involved to ensure the problems are addressed and that the return to work is managed as well as possible. HR and OH need to work with line managers to reach practical solutions; be it that the person returns to a different type of work, starts on a reduced working week with shorter hours or is helped in other ways.

Often, there is an overlap between what HR, OH, EAP programmes and other relevant professionals do when tackling stress. But that need not be a problem, as long as confidentiality is maintained. Even if an employee is working with OH and HR to resolve a situation and has to go over the same ground, it is better to ensure that all the necessary issues are raised and solutions sought.

In fact, the more channels that are available, the more likely it is that an employee will turn to one of them. Some individuals are more likely to discuss physical problems first and while they may think the work physiotherapist or ergonomist will only ask about their physical well-being, the practitioner should ask a whole range of what Raistrick calls psycho-social questions.

“I come at it from a workplace analysis – ergonomic assessment angle,” she says. “It takes in a whole variety of factors, such as work organisation, pressures of carrying out tasks, problems with management or co-workers, etc. There are definitely links between physical effects being made by an overload of stress and increased muscle tension increases muscular problems.”

Early intervention is key, so the more options there are for staff to air problems in a non-threatening environment, the better for them, OH and the company.

In the past few years, there has been an increase in other forms of treatment as well, such as on-site massages, reflexology, yoga and aromatherapy. Anything that gives employees time to unwind is a good thing and can increase a feeling of overall organisational well-being. But Willmott is quick to point out the limitations of such treatments.

“If new therapies are introduced to supplement other key measures, they are a good idea, but if they are seen as a solution in themselves, they are not,” he says. “If you have an individual who is being bullied by a manager, it doesn’t matter how many yoga sessions they go to, it won’t make any difference to how they feel at work.”

The message is that reducing and managing stress levels can only happen when treatments complement each other and a multi-disciplinary strategy is essential in order for this to happen.

All the interested parties need to agree what the aims, procedures and working practices will be, communicate with each other on a regular basis and review how the partnership is going. Raymond remembers working on a project with a particular police force where OH, HR and the HSE did not work in a collaborative manner. This led to a lot of duplication and disappointing results. “You have to work as a team, not individual sources,” she says.

All partnerships require commitment and being open minded to ideas, but working with other relevant professionals should be beneficial to OH, employees and organisations as a whole.

How to ensure a successful working partnership with other relevant professionals

– Clarify all your aims and ways of working from the start

– Ensure everyone understands what is really meant by the term stress

– Communicate regularly and clearly

– Work together with a common aim

– Ensure firm policies are in place and understood by all

– Continue updating your knowledge and thinking about work-related stress

– Ensure openness and ownership by all

– Review how the partnership is working six months down the line and on an annual basis

– Monitor your organisational data on stress

Useful contacts

British Association for Behavioural and Cognitive Psychotherapies (BABCP)
01254 875277,

Institution of Occupational Safety and Health, 0116 257 3101,

Mental Health Foundation, 020 7802 0300,

Royal College of Psychiatrists,
020 7235 2351,


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