Putting stress strategies in place

Stress may be a by-product of the modern, technological age, but we deal with it in the same way we would have once reacted to a woolly mammoth. According to author and management consultant, Pam Elder, a ‘Stone Age Physiology in a Space Age World’ means that our stress response and brain-body action link and the psychological issues of perceived threat and its effect on our physiology have changed very little, writes Greta Thornbory, consulting editor.

Elder was the first speaker at a one-day conference held by IRS Lexis Nexis in July, which looked at stress in the workplace and the clear link between poor work organisation and subsequent ill health.

The HSE website shows that there is a convincing body of work that illustrates this link, and its research has found that one in five people find their work stressful.

Dr Tony Erlam, senior medical inspector at HSE, is closely involved with HSE initiatives on stress and presented the HSE’s perspective.
Work-related stress is a serious problem for organisations, the HSE believes, and tackling it effectively can result in significant benefits. There are strategies that organisations can put in place to help prevent and control work-related stress, and the law requires organisations to take such action. Erlam outlined the current initiatives including examples of inspection and project work undertaken together with details of the draft management standards.

These are targets of good management that address the six identified stressors (see below). Erlam pointed out that organisational culture has to be looked at before these six stressors can be tackled, and that culture is in itself a seventh cause of stress.

Beverley Lancaster, a learning support assistant, gave a moving talk on her experiences of suffering from stress in the 1990s after 20 years working for local government. The reality is so different from my own experience as an OH nurse.

Lancaster talked about having to go back and face failure all over again when her return-to-work did not work out. She describes graphically how someone, with years of experience and the right qualifications to do the job, can be made to feel totally inadequate and undermined by policy changes and management decisions. It took around 12 years for her case to be resolved and, even now, some eight years later, the scars are not totally healed.

Her story was followed by a report on the strategies that HR are responsible for putting in place. Sally Crowe, an expert on the Investors in People (IIP) programme, highlighted the benefits and challenges of proper investment in people models of employment. There are ‘saboteurs’ within organisations, she admits, and frequently a need for director-level coaching to support the organisational structure, policies and IIP standards.

Keith Fortescue and Garry Newman gave a brief overview of stress and the legal implications for employers. A contract of employment has ‘implied terms’, they reported, which means that an employer will provide a suitable working environment, safe systems of work and reasonable support. When this fails, the contract may be regarded as broken by the employer and there may be a case to answer.

They supported their talk with examples from case law, particularly the recent case of Barber v Somerset County Council. Barber was awarded 101,000 in damages and interest for stress-related problems when working as a maths teacher. The ruling from the House of Lords said that even a small reduction in Barber’s duties, coupled with the feelings that the senior management team were on his side, may have made a real difference to the outcome of this case.

The final session of the day was delivered by Fiona Colgrave, manager of Occupational Health Nursing Services, National Business Unit, at Capita Health Solutions. Colgrave said OH was the gatekeeper to deal with those suffering from stress-related problems. However, OH also has a large part to play in supporting management in dealing with such problems. Stress, she said, is a state and not a medical condition. She emphasised the importance of referral to OH and early contact together with the confidentiality one can expect from the OH department.

Return-to-work plans must be feasible and adaptable for a phased return. Only those with severe mental illness would be deemed unfit to attend an OH interview or disciplinary matters. She added that a quality health assessment was essential, together with developing an agreed rehabilitation plan, suitable therapeutic interventions – such as cognitive behavioural therapy – flexible return to work plans with work adaptation and adjustment where necessary.

Work-related stress is a serious problem for organisations and the law requires them to take action. Tackling it effectively can result in significant benefits both to the employer and employee.

Six Identified stressors

– Demands: workload, work scheduling, physical environment etc

– Control: decision, authority, and autonomy

– Support: organisational, colleagues, practical and emotional

– Relationships: resolving conflict, teamwork, bullying issues

– Role: role ambiguity or conflict

– Change: new ways of working, change strategies

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