Supporting staff with a disability and advising managers about workplace adjustments is part of the contribution made by occupational health nurse (OHN) practitioners to health and performance at work. This paper describes an approach that has the potential to be effective in raising both awareness and understanding of physical or mental disability issues among staff rather than employers.
According to the Disability Discrimination Act (DDA),1 a person has a disability if they have a physical or mental impairment that has substantial and long-term adverse effects on the person’s ability to carry out normal day-to-day activities. Changes to the DDA, effective from December 2005, include:
Removal of the requirement that a mental illness must be clinically recognised before it can amount to a mental impairment
Amendment to the definition of disability, so that a person with HIV, certain types of cancer, and multiple sclerosis is deemed to be disabled from the point of diagnosis
A positive duty on public bodies to promote equality of opportunity for disabled people.2
Against this background, Bangor University’s disability equality scheme is reviewed on an annual basis. An action point from the university’s equality meeting in October 2009 was a review by the occupational health practitioner (OHP) of support being offered to staff with a declared disability. To undertake this review, the OHP designed a model to better understand the experiences and views of disabled members of staff at work3 (pictured below).
Methodology
At Bangor University, HR records contain information about staff with a disability. In October 2009, 55 employees were listed with a disability, and of these, 14 were selected at random by the OHP to become a sample group for the review of support being offered to them at work. They were invited to participate in a survey to help understand the experiences and views of the disabled staff.
A questionnaire was sent out to the group and the responses were received 10 working days later. Twelve people (86%) responded. To gain greater clarity around the points raised, the OHP then conducted a telephone interview with some of those who had returned the questionnaire.
Of those who responded, three did not complete the questionnaire, stating they did not have a disability. Their HR records were amended as necessary. Three people did not complete the questionnaire and did not give a reason for not responding.
Results
All respondents confirmed that the confidential nature of their disability had been respected. Additional information was the impact of disability required sick leave and confirmed the confidential nature of sickness absence had been protected during that time
Knowing what the university does well to support disabled staff received feedback including acknowledgements that the OH, line manager and HR support network is effective
The response to whether issues surrounding disability are listened to and needs met in a timely way generally confirmed this was the case for physical disabilities. Interestingly, other responses highlighted a need to switch the emphasis for raising awareness about disability issues from managers to staff – especially for mental health issues.
“Some people are very understanding and helpful, others are not, either because they do not understand the disability (eg, through common misconceptions about the disability) or because it impacts on their workload.”
Pilot
In January 2010, a pilot workshop was organised by the OHP to address mental health issues. Mental health is about how we think, feel and behave.4 Although we cannot see the internal disability of a mental health issue, it can affect our perceptions of one another’s behaviour and the way we interact at work.
The workshop aimed to support the mental health of everyone
Its objective was to improve the understanding and management of mental health disabilities at work
Boundaries were set to ensure the health problems of individual staff were not discussed.
Structure
Attendees included eight people, plus three facilitators – a staff representative, a mental health adviser, and the OHP. Each facilitator headed a sub-group that considered different scenarios that were designed to raise questions about mental health and its impact in the workplace.
Scenarios
Judy has a responsible admin job in an office with a heavy workload and tight deadlines. For most of the time, she is an excellent employee, but sometimes she becomes socially withdrawn, her timekeeping becomes erratic, her ability to keep up with the demands of the job falters, and she has frequent absences from work for vague reasons such as “debility”.
Some of her co-workers are concerned to see Judy like this, but others have started to resent that she does not appear to be pulling her weight, and have recently started to exclude her from conversations and social events.
In the past month or so, her bouts of illness have become more frequent. Her boss has summoned her to his office for a chat. On the day scheduled for the chat, Judy does not appear, but instead calls in sick with vague flu-like symptoms.
Marvin works in a unit producing materials for an educational organisation’s web pages. He has been hired for his original ideas and creativity. Although his work is excellent, if sometimes a little too original for the liking of his boss, his work colleagues find him difficult to work with. He seems to be able to work, laugh and talk at the same time, which disturbs some of his quieter co-workers. If asked to quieten down, he can become aggressive.
Recently, he has been observed walking around eating his lunch, laughing and talking to himself. This has caused alarm, not only in his own office, but more widely, and his bizarre behaviour has become a favourite subject of gossip. His dress has recently become more eccentric and his personal hygiene has deteriorated. He reveals, with apparent unconcern, that his landlady has thrown him out of his lodgings and that he is living in a squat with seven “really cool people”, but no washing facilities.
Karen is a quiet, anxious person who is extremely conscientious about her work. Several years ago, she spent some time in a psychiatric hospital; this is known to her work colleagues, who sometimes whisper about it behind her back, and are guarded and reserved in their dealings with her. Recently, Karen’s unit moved to a large, open-plan, office. Karen was moved from the middle of the office to the far corner, and was given a screen to work behind.
It is rumoured that she has been to OH to complain about the open-plan working arrangements. Resentment has started to spread that she is being treated more favourably than the other workers; one employee has gone as far as to contact her union representative and was thinking of raising a grievance, but decided to drop it. Months later, Karen was appointed to work on a special project that required someone hardworking and conscientious. Her work colleagues were appalled that someone with Karen’s problems was appointed to such a responsible position, and the union representative was contacted again.
Process
Each sub-group discussed the:
Effect of mental health at work (eg, changes in the ill person’s behaviour, attitude and relationships with others)
Impact this has on work colleagues (eg, how people felt about the behaviours exhibited)
Impact on performance at work (eg, relationships, quantity and quality of work)
Effect of work on frail mental health
Management of disturbed behaviour.
The sub-groups then met and a spokesperson gave feedback to the larger group for wider discussion. The mental health adviser then summarised key points for the management of each scenario. At the end of the workshop, a handout of additional resources to support mental health at work was circulated.
Outcome
To understand whether the pilot workshop was worthwhile and improve the content of future workshops, attendees were invited to complete an online survey. The most useful aspects were found to be:
The use of thought-provoking case scenarios
Sharing supportive strategies
Small discussion groups that allowed all views to be shared
The mental health adviser summarising key points from each presentation.
The respondents felt a need to:
Highlight the university’s systems of support for mental health issues, including the employer’s duty of care
Consider issues around culture and diversity
Consider the impact of mental health issues among students, not just scenarios about employees.
Attendees were invited to complete a rating scale to gauge their overall opinion of the workshop based on how the course was presented, its relevance to individuals and whether questions were effectively addressed.
The outcome revealed that attendees felt more comfortable and confident with mental health behaviours.
In conclusion, the review of support being offered to members of staff with a declared disability provided the evidence for an on-going programme to raise awareness and understanding of physical or mental disab-ility among staff rather than employers.
Joe Patton MSc, BSc (Hons) OHND, RGN, RMN is an occupational health nurse practitioner at Bangor University.
References
1 Disability Discrimination Act 1995.
2 Lewis, J & Thornbory, G (2006) Employment Law and Occupational Health: A practical handbook p121 ISBN-10:1-4051-4972-8
3 Patton, J (2009) A Review of support to staff with a disability.
4 www.nhs.uk/conditions/mental-health
