Motivation and emotion/Book/2020/Workplace mental health

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Workplace mental health:
How can mental health be enhanced in the workplace?

Overview[edit | edit source]

Globally, governments develop policies and practices for workplaces to be physically safe (Work Health and Safety Act) but is mental health (MH) being neglected? The social determinants of health require important recognition, including the need to work (Maslow’s hierarchy of needs). A focus on positive work-life balance is required; assessing the relationship between individual and corporate practices. One in five Australians reported a MH or behavioural condition in 2017-2018 (AIHW, 2018). In 2014, research by PricewaterhouseCoopers equated every $1 spent on improving MH in the workplace an organisation would reap a $2.30 return (PwC, 2014).

This chapter considers ways to foster MH in the workplace.

Focus questions
  • What are the risk factors in ignoring workplace MH?
  • How can MH be improved?
  • What can a organisation do?
  • What part can an individual take?


Case study 1

Ruth is ruminating about work. She finds it difficult to sleep. During the journey to work Ruth experiences panic attacks. Whilst at work she feels scrutinised and unsupported. Recently during meetings she has forgotten what she was going to say. Ruth feels angry and vulnerable, she feels like a failure at work.

Case study 2

Peter has regular meetings with his workplace mentor. Through the "well-at-work" program, Peter attended training and used web-based resources. Peter liaised with his workplace health officer to amend any practices hindering his MH. He felt listened to and through this empathetic process his apprehensions reduced. Peter now sleeps well and feels a valued part of the organisation.

Workplace mental health[edit | edit source]

[Provide more detail]

Recognising workplace stressors[edit | edit source]

Occupational stress and psychosocial factors was examined by Nigatu and Wang (2018) through job demand and effort-reward-imbalance (EFI) to risks of depression (MDD). Their 4-year longitudinal study found high effort and low rewards the strongest predictor of emotional exhaustion, psychosomatic health complaints, high job strain, low autonomy which may lead to MDD, family conflict and learned helplessness. This high stress-low reward dynamic may also indicate low salary or employment instability. The job demands-resources (JD-R) model has be used to describe work and personal characteristics, well-being and performance at work (van den Berg et al., 2017).

Click on the link for an introductory video on bullying

Parodyfilm.svg 6 min. video

Figure 1. Bullying may be considered a risk factor to psychological health
Figure 2. Behavioural signposts that may indicate workplace bullying

Risk factors[edit | edit source]

Occupational stress describes employment related issues (stressor) that negatively affect workers leading to physiological and psychological changes (psychological stress) deviated from normal functioning (Newman & Beehr, 1978). Stressors include employment insecurity, bullying, psychological harassment, low social support and an effort-reward imbalance. These may be associated with anxiety, depression, burnout, alcohol dependence and suicide ideation. The physiological manifestations include panic attacks, lowered immune system, fatigue, change of appetite and sleep hygiene (Headsup.org.au, LaMontagne, 2014).

Workplace bullying, defined as ongoing, deliberate misuse or imbalance of power through repeated, persistent verbal, physical and social behaviour that intends to cause physical, social and/or psychological harm details in video link figure 1. and behavioural signposts in figure 2[Rewrite to improve clarity]. Experiencing bullying increases the risk of developing psychiatric disorders (Frizzo et al., 2013).

Organisations should consider the possible consequences if employees' experience MH disorders: workers compensation claims, disability pension, long-term absenteeism, reduced productivity, staff turnover, lowered morale and HR costs (Frizzo et al., 2012; Giorgi et l., 2016). Workplaces should be mentally safe and healthy, Australian Disability Discrimination Act 1992. See Work Health and Safety Act for employment legislation and Health and Safety UK to protect and support physical safety at work.

DSM-V Definitions to frequently experienced psychological disorders

Anxiety. Anticipated future danger with feelings of worry, distress, somatic symptoms of tension.

Panic attacks. Sudden onset of intense fear, often associated with physical symptoms including, shortness of breath, palpitations, choking, feeling of a loss of control.

Social exclusion. Imbalance of social power resulting in social exclusion or rejection. Examples include, bullying, teasing, intimidation, verbal abuse, humiliation, excluded from workplace activities.

Stressor. Any emotional, physical, social, economic factor that disrupts the normal physiological, cognitive, emotional or behaviour balance.

Worry. Unpleasant thoughts that cannot be controlled by altering attention to other things. It is often persistent and out of proportion to the subject.

Nuvola apps korganizer.svg
Quiz: Choose the answer closest to how you feel

1 Do you have problems concentrating at work?

Sometimes
Yes, I find work very stressful
Never

2 Do you worry about work during the weekend?

Sometimes
Yes, I think about work on and off all the time
Never

3 Do you have problems sleeping?

Yes, I regularly have trouble sleeping
Sometimes
Never

How can workplace mental health be improved?[edit | edit source]

Essential to enhancing MH within the workplace is to create a workplace environment that cultivates health, safety and well-being.  Well-being has been defined as the “presence of positive feelings and functioning,” (LaMontagne et al. 2014). A psychosocial safety climate (PSC) is a joint confidence that employees and employer have a commitment for promoting and enhancing well-being through organisational policies and practices including shaping a climate of inclusion and protection. Through their longitudinal research, Bond and colleagues examined PSC in 1,700 South Australian police officers through anonymous questionnaires during two-time periods. Stations with low (negative) PSC reported elevated workplace bullying and post-traumatic stress symptoms. Conversely, high (positive) PSC officers felt appreciated and content.  Bond and colleagues concluded that stations that followed protocol, articulated a no-tolerance to workplace bullying resulted in a positive PSC (Bond et al., 2010).

Italian research of 326 adults from factory and office based private workplaces studied the relationship between emotional intelligence (EI) and workplace bullying. EI was found to be an aid in avoiding the experience of bullying. The converse was also found; if there was a deficit in EI either due to a lack of skills-set or workplace burn-out or stress then this may lead to experiencing workplace bullying, or other negative workplace relationships because of the lack of self-management ability. Namely, suffering from MH issues (that may arise from workplace bullying or elsewhere) have shown to reduce emotional regulation.  Their findings suggest that EI is paramount for manoeuvring through life’s stressful experiences and the partnership of organisations to provide a non-bullying safe environment to enable individuals to continue to develop their coping skills (Giorgi et a., 2016).

Primary interventions Acts as an early detection to protect and reduce workplace risk factors[Rewrite to improve clarity]. An employer may partner with the employee to modify a job description, which may include increasing their autonomy and adapt their working environment to better meet needs.

Secondary interventions These strategies or programs endeavour to reduce stressors or perceptions of a stressful situation before the issue develops into psychological distress with an employee-directed response.

Tertiary intervention Reacting to issues, for example the individual who has a health condition[Rewrite to improve clarity].  This could include assessing their physical working conditions, reducing working hours and working from home. There will also be liaison with other stakeholders to manage a return-to-work program.

Authors suggest an integrated approach to improving workplace MH has more utility than individual interventions[factual?].  By promoting MH in workplace, identifying employee strengths and positive capacities which will in-turn generate a shared view with positive engagement and a supportive culture. Without leadership promotion there will not be employee uptake. Authors also suggest addressing MH issues regardless of origin, introducing psychoeducation to improve MH literacy and promoting early help-seeking to avoid long-term interventions[factual?].

(LaMontagne et al. 2014; Richardson & Rothstein, 2008).

Stress management intervention[edit | edit source]

Stress management intervention (SMI) programs or activities are designed to reduce stressors.  These programs are usually constructed for the individual to use as an aid to minimise negative outcomes from the exposure to stressors, reduce intensity or perception thereof and improve general coping abilities.  They may also be group based with a therapist, web or book and tape based. Programs will generally last for several weeks, vary in length and contain several techniques. Richards and Rothstein (2008) carried out a meta-analysis of 36 studies and 55 interventions and reviewed the previous 45 study meta-analysis from van der Klink et al. (2001) and found that cognitive behavioural therapy (CBT) was more successful (d = 1.16) than any other intervention. When comparing each SMI objective, CBT as a single-mode SMI was found to be an active process whereby negative thoughts were acknowledged, challenged and maladaptive behaviour modified.  The relaxation and meditation SMI were often favoured but due to the passive nature of the interventions stress was found to only be temporarily refocused.

Most are secondary interventions and tool based (Giorgi et al, 2016; Richardson & Rothstein, 2008)[grammar?]:

  • Stress management
  • Goal setting
  • Time management
  • Assertiveness training
  • Social interactions and support groups
  • Meditation and relaxation
  • EMG biofeedback programs
  • Mindfulness
  • Journaling
  • CBT
  • Enhancing EI and regulation

Stress and coping[edit | edit source]

Figure 3. Transactional model of stress and coping, a visual representation. Richard Lazarus, 1984

Emotions are a complex challenge. Coordinating processes of experiencing feelings, body responses and expressing reactions; self-regulating emotions instead of by our emotions[grammar?]. Early detection and prevention should be utilised by employing primary interventions of modifying workplace environments and strategies to improve coping (Giorgi et al. 2016, flow state).

Ford and Gross in their meta-analysis of 2019 on “why beliefs about emotions matter” found that believing emotions are controllable will generally predict greater cognitive reappraisal and eventual success of ER, although people may be less empathetic because of this expectation. Conversely believing events are negative and cannot be changed may indicate a risk of MDD, particularly in youth. Cultural norms were highlighted as a distinct difference and require further research. This modern research links with Ryff’s (1995) 6-factor model of psychological well-being representing strong findings that well-being could be measured through autonomy, environmental mastery, personal growth, positive relations, life purpose and self-acceptance.

Hebere et al. (2016) developed a web-based stress management training that was implemented in a German workplace. The program was based on Lazarus’ transactional model of stress (figure 3.). The program was enacted through guided interventions, text messages to promote engagement and motivation, interactive exercises and human support for goal setting, 6-step procedure to problem solving, ER strategies and relaxation training. Positive results were found at a 6- and 12-month evaluations for stress reduction (Hebere et al. 2016).

Sweeny and Dooley (2017) found that worry can be beneficial if used as a prompt to action. They established that levels of worry can be utilised as useful only when the ratio of arousal to autonomy is satisfied. Namely, if the worry is enough to encourage action but not so large that it is paralysing. When worry is inevitable (waiting for a result) then a coping mechanism is enacted to diminish negative results, make plans for alternatives or feel increased positivity if the outcome was positive.

Emotion regulation[edit | edit source]

Affective events theory describes everyday ups and downs reflected at work. It is the frequency and accumulation of events rather than the intensity of one particular event that determines outcomes. “Uplifting events” more frequent positive feedback and supportive colleagues after a negative event appears to be more important and may “reverse negative consequences” (Charmine et. al., 2016. p.7).

Autonomous emotional labour may be summarised as emotions individually controlled and reflected at work. Namely, an employee’s positive emotion for their job then reflected in their work[grammar?]. This could be encouraged by providing a break area for freely expressing emotions (Charmine et. al. 2016, p.228).

Emotional intelligence (EI) is the process enabling assessment and evaluation of emotional information accurately, individually and in others, and to adapt emotions correctly to be able to function in an ideal manner in complex situations (Charmine et. al. 2016, p.175).

Emotional regulation (ER) is the process and evaluation of emotion in relation to individual goals and the decision to modify a response and monitor the success. A belief that emotions are controllable predicts greater cognitive reappraisal and eventual success of ER. Extrinsic regulation may be represented as rumination. Team leaders should be explicit and intentional, implicit reactions are automatic and not useful (Ford & Gross, 2018). Affect control theory details evaluation, activity and strength of emotion which are suggested to affect the events that follow and whether this is congruent with self-identity. This may be linked with ER as part of culture (Strongman, 2003. p.279).

Transformational leaders are an example of ER by breaking norms, engaging staff intellectually, shared goals, giving feedback. These leaders are emotionally stable, show empathy, seem in touch with their feelings, able to encourage employees through less aggressive and altruistic methods. Employees need to feel they are an effective team member in a productive workplace. This will only occur with an “emotional commitment from employees, innovation and conflict-free decision making towards achievement” (Strongman, 2003. p.243). Charmine et al. (2016) summarise their management strategies for team-building: conflict resolution skills, teaching leadership development to understand and regulate emotions, stress management and wellness programs, creating an environment to express and accept emotions and an area for employees to unwind from events.

Shame and powerlessness should be considered important emotions. Employees have to surrender power and control to their employer. Shame may be experienced through not gaining a positive evaluation or promotion, redundancy or sacking. Shame may be experienced within the workplace leading to lower self-esteem, psychological illness, bullying, disadvantage from a lack of diversity: gender, sexual, faith or physical characteristics (Strongman, 2003. p.243).

Tools for ER at work include promoting positive emotions, increasing arousal through mood playlists, videos, digital nature soundscapes. Currently video games are used for stress relief, social media for reflection; mobile applications could track mood and prompt mindfulness training. Digital ER may be beneficial or harmful, for example, benefits may include sharing resources, enabling engagement with immediate access or harmful through binge-watching media. (Gross, 1998 & 2015). Wadley et al. (2020) ask the questions, is ER different in a digit environment? Does digital technology assist in modulating emotion? Ashoori et al. (2015) shaped these ideas to manipulate lighting, music and images (wall displaying a Zen garden) at a workplace which resulted in assisted decision making.

Failure tolerance should be encouraged with an openness to revise and update knowledge and ask for advice, namely learn from mistakes (Strongman, 2003. p243). Parodyfilm.svg Mark Rober explains this re-framing process in his YouTube video.

Self-Determination Theory[edit | edit source]

How to create environments for others to flourish[grammar?]. SDT may be viewed across cultures as the process of work being just a job, the only reason of attending this employment is the extrinsic motivation of earning a salary.  With this view dissatisfaction and potential psychological distress may occur. When an intrinsic motivational choice is made, namely the person and environment is viewed together, then employment may be regarded as enjoyable with good workplace relationships that increase well-being and foster good psychological health. Through the sub theory of Cognitive Evaluation, autonomy can be improved with perceived competence which employers can illustrate through positive feedback. Positive emotionality the absence of negative emotion, having a sense of purpose and satisfied with life (Ryan & Deci, 2000).

What can organisations do?[edit | edit source]

An organisational culture should be fostered to encourage active participation in their employees’ psychological life journey.  When organisations are encouraged to participate in MH literacy there is an increased culture of MH awareness and general uptake of interventions than without any positive encouragement or contact as illustrated in figure 4 (Kristman et al., 2019).

Figure 4. Organisational strategy to enhance workplace well-being. Adapted from CSA Assembling the pieces guidebook (2014).

This could include:

  • Organisational documentation and training to know psychological and physical health requirements as set out in law. MH awareness training to encourage organisations to continue fostering their workplace environment and to implement a system of workplace psychological health assessments (CSA, 2014).  
  • Organisational health checks - structured assessments that relate the organisation's perceptions of workplace MH with corresponding policies in relation to the reality of how employees perceive the situation and preferred practical support to be implemented (NHS.org).
  • Implement SMI.
  • MH First Aid for all employees.
  • Psychological and physical health promotion and awareness.  Asking, “How do you feel at work?” “Are you aware of your MH?” “How do you care for others at work?”
  • Autonomy, encouraging personal engagement in a role.
  • Training to recognise psychological stressors and ways to limit.
  • Flexible working arrangements

(Beehr & Newman, 1978; Kristman et al., 2019; Richardson & Rothstein, 2008; Safety Work Australia, 2016).

The National Standard of Canada for Psychological Health and Safety in the Workplace actively seeks to encourage organisations to prevent physical and psychological harm in a workplace through worker conditions, management practices, decisions and communication processes. This standard has detailed 13 items for an organisation to attend to, see table 1. (Kristman et al., 2019). This would be suitable for implementation in workplaces to encourage a psychologically and physically safe environment.

Table 1.

Workplace factors for organisations to implement a psychologically and physically safe workplace, adapted from Kristman et al. 2019

Workplace factor Definition/requirements
Organisational culture The work environment is characterised by trust, honest and fairness.
Psychological and social support All workers (including supervisors and leadership) are supportive of an employees' psychological and physical health challenges, and respond as appropriate and when required. Employees perceive this support.
Clear leadership and expectations Leadership is effective and supportive, enabling employees to know their responsibilities and contributions to the organisation.
Civility and respect Employees are respectful and considerate in all interactions.
Psychological demands There is congruence between an employees' interpersonal and emotional competencies in relation to their work requirements.
Growth and development Employees receive encouragement and support in the development of their interpersonal and emotional work requirements.
Recognition and reward There is appropriate acknowledgement and appreciation of an employees' efforts in a fair and timely manner.
Involvement and influence Employees are involved in discussions and decisions in relation to their work.
Workload management Tasks and responsibilities can be achieved within the time available.
Engagement Employees feel engaged and enjoy their work and are motivated to do their job well.
Balance There is recognition of the need for balance within the workplace and personal life demands.
Psychological protection Employee psychological safety is protected.
Protection of physical safety Management ensures the physical safety of the employees.
Nuvola apps korganizer.svg
Quiz: Stress management and intervention programs (SMI)

1 Would you consider using a web application based SMI?

Perhaps
No
Yes, I would find that useful

2 Would you participate in workplace wellness activities (for example, mindfulness, yoga, walking groups, support groups)?

No
I like the thought of them, but probably not
I may consider attending if my friends were also participating

Figure 5. Biophilic design, connecting natural environments

What can individuals do?[edit | edit source]

It is important to consider work and home environments (biophilic design figure 5 and 6). Physical workplace strategies to consider

  • Reflect on Ryff's (1995) 6 facets of well-being: self-acceptance, interpersonal relations, autonomy, environmental mastery, purpose in life and personal growth.
  • Team morning teas: how is everyone tracking?
    Figure 6. Strategies for individuals to enhance MH
  • Creating an open environment for team conversations. What are our challenges? How can we support each other? Being engaged and using well-being resources leads to resilience.
  • Re-evaluate joy at work by decluttering and organising a more efficient workspace (Kondo & Sonenshein, 2020) Parodyfilm.svg.
  • Scheduling pleasant activities: group activities (organising a pleasant activity builds anticipation and triggers a dopamine release)
  • Building a psychologically safe workplace, Amy Edmondson TEDxParodyfilm.svg


Virtual workplace strategies

  • Decide on a working space that is seperate from your general living space, where you can close the door.
  • Set working time boundaries.
  • Maintaining on-going communication via workplace chat facility.
  • Creating schedules for exercise: stretches and walks.

(apa.org)

Taking time out

(Beehr & Newman, 1978; van den Berg et al., 2017)

Conclusion[edit | edit source]

Take-home message

Enhancing workplace MH requires a partnership and belief between all stakeholders. A cultural change is necessary to create and continue to develop a workplace environment that enhances health, safety and well-being by fostering autonomous motivation. Full integration of the working environment, workplace practices, psychological interventions and psychoeducation is required with a move from viewing work as an extrinsic motivator. As workplace environments diversify between office and home-based the challenges continue. Activation of four basic strategies should be considered. Planning through discussions with all employees, engage and implement the waterfall change from leadership down, check that the plans are effective and adjust as necessary for a cohesive workplace, and congruence.

More multidisciplinary research and development between psychology, public health, business and information technology is essential to understand the challenges and implement change. Technology can enable individual support and psychoeducation to avoid interventions and promote workplace strategies to enable people to live more congruent lives.

See also[edit | edit source]

References[edit | edit source]

Abrams, Z. (2020). Psychologists’ advice for newly remote workers. APA.org. http://www.apa.org/news/apa/2020/03/newly-remote-workers.

Australian Bureau of Statistics. (2018). National health survey: first results, 2017–18. ABS cat. no. 4364.0.55.001

Ashoori, M., Bellamy, R., & Weisz, J. (2015). Creating the mood: design for a cognitive meeting room. 33rd Annual ACM Conference. 2001–2006. https://doi.org/10.1145/2702613.2732786

Beehr, T., & Newman, J. (1978). Job stress, employee health, and organisational effectiveness: a facet analysis, model, and literature review. Personnel Psychology, 31(4), 665–699. https://doi.org/10.1111/j.1744-6570.1978.tb02118.x

Bond, S. A., Tuckey, M. R., & Dollard, M., F. (2010). Psychosocial safety climate, workplace bullying, and symptoms of posttraumatic stress. Organization Development Journal, 28(1), 37–.

Canadian Standards Association (CSA). (2014). Assembling the pieces. https://www.csagroup.org/store-resources/documents/codes-and-standards/SPE-Z1003-Guidebook.pdf

Charmine E. J. Hartel, Neal M. Ashkanasy, & Wilfred J. Zerbe. (2016). Managing emotions in the workplace. Taylor and Francis. https://doi.org/10.4324/9781315290812

Deci, R. M., & Ryan, E. L. (2000). Intrinsic and extrinsic motivations: Classic definitions and new directions. Contemporary Educational Psychology, 25(1), 54-67. https://doi.org/10.1006/ceps.1999.1020

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). American Psychiatric Association.

Ford, B., & Gross, J. (2018). Why beliefs about emotion matter: An emotion-regulation perspective. Current directions in psychological science : a Journal of the American Psychological Society, 28(1), 74–81. https://doi.org/10.1177/0963721418806697

Frizzo, M., Bisol, L., & Lara, D. (2013). Bullying victimization is associated with dysfunctional emotional traits and affective temperaments. Journal of Affective Disorders148(1), 48–52. https://doi.org/10.1016/j.jad.2012.11.046

Giorgi, G., Perminienė, M., Montani, F., Fiz-Perez, J., Mucci, N., Arcangeli, G., & Giorgi, G. (2016). Detrimental effects of workplace bullying: Impediment of self-management competence via psychological distress. Frontiers in Psychology, 7, 60–60. https://doi.org/10.3389/fpsyg.2016.00060

Heber, E., Lehr, D., Ebert, D., Berking, M., & Riper, H. (2016). Web-based and mobile stress management intervention for employees: A randomized controlled trial. Journal of Medical Internet Research, 18(1), e21–. https://doi.org/10.2196/jmir.5112

Kristman, V., Lowey, J., Fraser, L., Armstrong, S., & Sawula, S. (2019). A multi-faceted community intervention is associated with knowledge and standards of workplace mental health: The Superior Mental Wellness @ Work study. BMC Public Health, 19(1), 638–11. https://doi.org/10.1186/s12889-019-6976-x

Kondo, M., Sonenshein, S. (2020). Joy at work: Organizing your professional life. Bluebird.

LaMontagne, A., Martin, A., Page, K., Reavley, N., Noblet, A., Milner, A., Keegel, T., & Smith, P. (2014). Workplace mental health: Developing an integrated intervention approach. BMC Psychiatry, 14(1), 131–131. https://doi.org/10.1186/1471-244x-14-131

NHS. (n.d). Health and well-being for employees and organisations. https://www.nhsemployers.org/retention-and-staff-experience/health-and-wellbeing

Nigatu, Y., & Wang, J. (2018). The combined effects of job demand and control, effort-reward imbalance and work-family conflicts on the risk of major depressive episode: A 4-year longitudinal study. Occupational and Environmental Medicine, 75(1), 6–11. https://doi.org/10.1136/oemed-2016-104114

PricewaterhouseCoopers. (2014). Creating a mentally healthy workplace: Return on investment analysis. pwc.com.au.

Richardson, K., & Rothstein, H. (2008). Effects of occupational stress management intervention programs: A meta-analysis. Journal of Occupational Health Psychology, 13(1), 69–93. https://doi.org/10.1037/1076-8998.13.1.69

Ryff, C., & Keyes, C. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69(4), 719–727. https://doi.org/10.1037//0022-3514

Safe Work Australia. (2016) https://www.safeworkaustralia.gov.au/system/files/documents/1702/preventing-psychological-injury-under-whs-laws.pdf

Strongman, K. (2003). The psychology of emotion: From everyday life to theory (5th ed.). Wiley.

van den Berg, J., Mastenbroek, N., Scheepers, R., & Jaarsma, A. (2017). Work engagement in health professions education. Medical Teacher, 39(11), 1110–1118. https://doi.org/10.1080/0142159x.2017.1359522

van der Klink, J., Blonk, R., Schene, A., & van Dijk, F. (2001). The benefits of interventions for work-related stress. American Journal of Public Health (1971), 91(2), 270–276. https://doi.org/10.2105/ajph.91.2.270

Wadley, G., Smith, W., Koval, P., & Gross, J. (2020). Digital emotion regulation. Current directions in psychological science: a Journal of the American Psychological Society, 29(4), 412–418. https://doi.org/10.1177/0963721420920592

External links[edit | edit source]