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Bullying, discrimination and sexual harassment are rife among surgeons, according to a recent report from the Royal Australasian College of Surgeons.

“Now that the extent and impact of these issues is clear, there can be no turning back,” said Hon. Rob Knowles AO, Chair, Expert Advisory Group (EAG) on discrimination, bullying and sexual harassment advising the Royal Australasian College of Surgeons.

“We have been shocked by what we have heard. The time for action has come.”

EAG research has found that 49 per cent of Fellows, trainees and international medical graduates report being subjected to discrimination, bullying or sexual harassment. Bullying is the most frequently reported issue in 71 per cent of hospitals.

Part of the problem is attributed to unhealthy working conditions. There is an expectation that trainees should endure the same work practices that their supervisors had to put up with when they were training.

Some of those surveyed for the research complained of supervisors demanding unpaid overtime to ‘toughen up’ trainees.

Others pointed to grossly inappropriate comments, such as “you can join us in theatre – not to do anything, just for eye candy” and “I was told I would only be considered for a job if I had my tubes tied”.

A key finding of the Discrimination, Bullying and Sexual Harassment Survey was “that ‘known bullies’ are untouchable [by the College/societies and in the workplace] and that bullying has become normalised as a culturally accepted behaviour”.

For more details, visit the EAG report

Published on 24 September 2015 in the NSCA Foundation Safe-T-Bulletin enewsletter – available free every fortnight direct to your email. Subscribe online today.

Too many Australian workers continue to face the dangers of high stress and not enough exercise.

Although the proportion of Australian workers feeling stressed has decreased, the figures remain high, fluctuate and, in some cases, are incomplete. From 2004 to 2014, the proportion of Australian workers feeling moderate to high levels of stress fluctuated between 58 and 71.8 per cent, said the recently released ‘Health Profile of Australian Employees’. “The lowest rate was recorded in 2014, however, the data were incomplete in that year, which may contribute to the lower results,” the profile added.

A similar situation characterises psychological distress, which a large proportion of Australian workers continue to feel. “Over a six-year period (2009–2014) psychological distress levels fluctuated, with the proportion in the ‘implement lifestyle strategies’ or ‘recommend to GP’ categories peaking at 40 per cent in 2011 and dropping to 36.2 per cent in 2014,” the profile reported.

The profile also examined the physical health of Australian workers, showing that a large proportion of workers still fail to participate in adequate physical activity. “Overall the proportion of workers with inadequate aerobic activity or no regular exercised declined between 2004 and 2014 (from 64 per cent to 46.1 per cent). This is despite a peak of 66.5 per cent in 2012,” the profile said.

The risk of harm from alcohol consumption has improved. “The lifetime risk of harm from alcohol consumption fluctuated from 12.1 per cent in 2004 to a peak of 15.5 per cent in 2009. The prevalence then tended to decrease, and remained below the national prevalence (20 per cent) during this period,” the profile reported.

The proportion of smokers continued to decline, decreasing between 2004 and 2014 from 20.5 per cent to 10 per cent, the profile added.

Lack of exercise, psychological stress and distress, alcohol consumption and smoking “have been associated with chronic diseases, including diabetes, heart disease, some cancers and mental illness”, said the Workplace Health Association Australia (WHAA) in a media statement.

WHAA, in conjunction with the University of Wollongong, conducted the research for the profile, drawing upon the workplace health assessments of 30,000 Australian workers over the past decade.

For more details, download the profile

Published on 18 June 2015 in the NSCA Foundation Safe-T-Bulletin.

The rate of workers compensation claims for musculoskeletal and some other occupational diseases have plunged significantly in the past decade.

These latest figures are from the ‘Occupational Disease Indicators’ report released by Safe Work Australia this week.

The report says the rate of claims for musculoskeletal disorders caused by body stressing declined by 31 per cent between 2000–01 and 2010–11.

Infectious and parasitic claims dived 53 per cent from 2003–04 to 2010–11.

Cardiovascular diseases claims dropped 51 per cent from 2002–03 to 2010–11.

Respiratory diseases claims reduced 49 per cent between 2000–01 and 2010–11.

Contact dermatitis claims decreased 48 per cent between 2000–01 and 2010–11.

While the rate of workers compensation claims for mental disorders decreased from 2002–03 until 2008–09, it then began increasing, the report added.

For more details, visit the occupational diseases report.

Published on 17 July 2014 in NSCA Safe-T-Bulletin.

Tobacco kills half its users, says the World Health Organization in the lead-up to World No Tobacco Day on 31 May.

Six million people die from tobacco-related disease each year. “More than five million of those deaths are the result of direct tobacco use while more than 600,000 are the result of non-smokers being exposed to second-hand smoke,” WHO says in a media statement.

“Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths. Up to half of current users will eventually die of a tobacco-related disease.”

Smoking tobacco and other products is banned in most Australian workplaces.

Graphical images on cigarette packets have also been introduced, among other initiatives such as taxes, to persuade Australians not to smoke.

Taxes are viewed as playing a significant role in reducing tobacco use. “Taxes are the most cost-effective way to reduce tobacco use, especially among young people and poor people,” WHO says.

“A tax increase that increases tobacco prices by 10 per cent decreases tobacco consumption by about four per cent in high-income countries and by up to eight per cent in low- and middle-income countries.”

Total tobacco taxes in Australia accounted for more than 63 per cent of the final price of a packet of cigarettes in 2012.

New laws will increase the excise and excise-equivalent customs duty on tobacco over four staged increases of 12.5 per cent each over the next two years.

For more detail, visit World No Tobacco Day.

Published on 22 May 2014 in NSCA Safe-T-Bulletin.

By Denise Cullen

Mental Health may be on many workplace agendas, but whether it is being managed appropriately is questionable.

More than five million Australians participated in last year’s R U OK? Day by holding ‘meaningful conversations … to support those struggling with life’. Other campaigns, such as SANE Australia’s ‘Say no to stigma!’ and beyondblue’s ‘blueVoices’, similarly seek to raise awareness of mental illness.

Hollywood, too, does its bit to portray conditions ranging from depression (Side Effects) to schizophrenia (A Beautiful Mind). Then there are mental health ‘ambassadors’, such as tennis player Pat Cash and actor Garry McDonald, who openly describe the destructive force that mood disorders have had on their lives.

Yet, for all our chatter, people suffering mental illness still dwell in the shadows. It’s generally accepted that one in five Australians experience some form of mental illness each year. But a large-scale SANE Australia study released in November 2013 revealed that almost 50 per cent of workers who had taken time off work because of depression kept the reason hidden from their employer, fearing the loss of their jobs.

“It’s concerning that despite all the good work done to increase awareness about depression, many people still don’t feel it’s OK to talk about their illness,” says SANE Australia CEO Jack Heath.

The Australian Psychological Society’s (APS) ‘Stress and wellbeing in Australia survey 2013’ found that one in seven Australians reported depressive symptoms in the severe to extremely severe range. Another report, released in September 2013 and aptly titled ‘The Elephant in the Boardroom’, noted that 86 per cent of people with mood disorders would rather suffer in silence than discuss their condition with colleagues. Author of the study and director of ICMI Work Health Safety Solutions Graeme Cowan says respondents feared that disclosure would compromise their current projects or future careers: “With 83 per cent of respondents experiencing stigma in some form as a result of their mood disorder, this fear is not without merit,” he adds.

What not to do

Performance-driven work cultures might pay lip service to the maintenance of good mental health, but anecdotal evidence suggests otherwise. Often, employers find workers experiencing mental illness tiresome to manage.

Even well-intentioned managers can get it wrong. Horror stories include: a director violating a hospitalised employee’s privacy, because they felt the person’s colleagues ‘had a right to know’; colleagues railing against reasonable adjustments to which workers are entitled under anti-discrimination laws; and supervisors treating mental health problems as performance issues.

Roland Hassall, a partner with Sparke Helmore Lawyers, has seen it all too often. “I’m called in after someone has been terminated, and (the employer) is coming to me to help them mop up,” he says.

Why do such stories still emerge with grim frequency? One reason may be the subtext to the conversations we’re having—that mental illness springs, unbidden, from some mysterious part of the psyche; that we are powerless to prevent its appearance; that ‘it can happen to anyone at any time’. This is only partly true.

It’s recognised that some people are genetically more prone than others to bipolar disorder, schizophrenia, obsessive compulsive disorder, psychotic depression or a host of other conditions. But parallel lines of research are now probing other factors, such as stress levels, job design, high work demands, low levels of perceived control, bullying, incivility and even budget cuts. In other words, certain work environments are predictive of poorer mental health, irrespective of how genetically predisposed —or how resilient—employees are. Simply, some workplaces make people sick.

What’s being managed?

Current mental health management strategies are weighted towards recognising and responding to ‘early warning signs’ in individuals.

For example, an employee might look dishevelled or start isolating themselves from workmates. Having identified such indicators, supervisors or colleagues are urged to talk to the affected person, support him or her in visiting a GP or accessing the organisation’s Employee Assistance Program (EAP) and, according to R U OK? Day’s four-step process, put a note in their diaries to “call them in one week … (or) if they’re desperate, follow up sooner”.

Such approaches are predicated on a healthy, supportive work culture being in place. But even then, lending a listening ear is necessary but insufficient. Similarly, other techniques, focused on helping employees manage stresses as they arise (‘reframe the problem’, ‘get a massage’, ‘focus on what you can control’), are helpful but inadequate.

There is no doubt that work stress contributes towards ill health—and stress levels are skyrocketing. Working Australians reported significantly lower overall worker wellbeing and job satisfaction in the APS ‘Stress and Wellbeing in Australia Survey 2013’ compared to previous years. Cowan notes this may be due to organisations needing to do more with less. Combined with long working hours, this “drives stress to harmful levels”, he says.

R U OK? Day research from 2011 found 40 per cent of people were typically “stressed out every day”, while 12 per cent rated their stress as extreme—at eight, nine or 10 on a 10-point scale—while the ‘Konekt Market Report’ from December 2013 found that mental injury cases incurred the highest average rehabilitation service cost, at an average of $1364, compared with other types of injury.

Signs of things to come

Against this backdrop, the prevailing practice of ‘patching damaged workers up and sending them back into the trenches’ seems to make little sense.

An alternative view is the notion that workers with mental illness are, to steal a family therapy term, society’s ‘symptom bearers’.  That is, the way we ‘do’ work is the problem, and the workers who break down are simply the most visible manifestations of a deeply dysfunctional system.

An upcoming Australian paper in the International Journal of Stress Management notes that interventions need to target work stress “at its source, with a view to prevention, rather than focus on individual approaches that are of  dubious long-term benefit”.

Co-author of the paper, the University of South Australia’s professor Maureen Dollard, explores how to ‘prevent circumstances that create mental illness’.  She has developed the concept of a workplace ‘psychosocial safety climate (PSC)’, which flows from the priority that senior managers place on production and profits versus workers’ psychological wellbeing. PSC incorporates a host of factors, including worker control over work timing and methods, opportunities to develop new skills, resource allocation and remuneration.

“It’s all a balancing act,” Dollard explains.  “It considers whether managers are OK about burning out workers and hiring new ones to replace them, for example, or whether there are top management supports for stress prevention … It might be that some control residing at managerial level can be shifted, to enable workers to control more of what goes on in terms of scheduling work, or determining how and where it is done.”

Employees working within organisations that have a strong PSC are likely to have high levels of psychological health and engagement. Equally, Dollard notes, “we see low PSC as the pre-eminent psychosocial risk factor at work, capable of causing psychological and social harm through its influence on other psychosocial risk factors.”

Money talks

Organisations unmoved by the moral imperative to ensure healthy workplaces may nevertheless be sold on the productivity benefits. Cowan says more than 70 per cent of organisational change efforts fail to boost productivity and profitability because workers’ mental stress is overlooked. It is, he adds, important to forestall the potential expenses involved in workers’ compensation claims or recruitment and retraining costs “if the employee decides they are not supported in the workplace and can no longer cope with the demands of the job”.

These might be stand-alone measures, such as offering a physical and mental wellbeing program, as employees with  a positive mood are 31 per cent more productive, sell 37 per cent more and  are 300 per cent more creative, according to a Harvard Business Review report.

Reviewing job design and whether employees are actually in the right roles is also crucial, as employees who use their  top five strengths on a daily basis are 600 per cent more likely to be engaged at work, according to Tom Rath and Barry  Conchie’s Strengths Based Leadership.

The costs of poor mental health on productivity are profound. A 2013 report published by the Sax Institute for the Mental Health Commission of NSW distilled findings from 45 different studies exploring the costs and impacts of mental ill health on the economy and  productivity. It found that mental illness served as a barrier to school completion and employment —for example, Australians with a mental health condition have unemployment rates up to four times higher than healthy others. At an organisational level, high psychological distress increases absenteeism by 1.7 per cent and decreases employee performance at work by 6.1 per cent, resulting in a net productivity loss of 6.7 per cent.

The ‘National Mental Health Report’ (2010) further pegged the nationwide impost, noting that outlays by governments and health insurers on mental health services in 2007–2008 totalled $5.32 billion, representing 7.5 per cent of all government health spending. Professor Allan Fels AO, chair of the National Mental Health Commission, points to the latest (2010) ‘Treasury Intergenerational Report’, which describes productivity as the key to higher economic growth in the face of an ageing population.

“Workforce participation rates by people with mental illness are lower in Australia than the majority of OECD countries,” he explains. Boosting participation rates would likely lift productivity too, suggesting, he says, that “mentally healthy workplaces are good for business”.

National Safety Magazine


Download the story in PDF The Slow Burn, By Denise Cullen (PDF, 348kB)

Published in National Safety magazine,  March-April 2014.




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