Table of Contents
Introduction to module ........................................................................................................................... 2
Introduction to stress .............................................................................................................................. 5
Stress at work ......................................................................................................................................... 9
Stress and ill health .............................................................................................................................. 30
Emotions at work ................................................................................................................................. 44
Workplace wellbeing ............................................................................................................................ 65
Bullying in the workplace ...................................................................................................................... 89
Biological responses to stress .............................................................................................................. 100
Revision - Sem1 .................................................................................................................................. 117
Globalisation: cross-cultural influences on psychological wellbeing and mental health ........................ 122
Psychological effects of disaster response ........................................................................................... 129
Technostress....................................................................................................................................... 138
Return to work / Occupational health ................................................................................................. 142
Psychological contracts and health ..................................................................................................... 150
Human resources practices and wellbeing at work .............................................................................. 154
Integral approaches to leadership ....................................................................................................... 161
Job crafting – proactive approaches to work motivation ..................................................................... 165
The future of work .............................................................................................................................. 175
Revision – Sem2 .................................................................................................................................. 180
MENTAL HEALTH IN THE WORKPLACE
KCL
PATRYCJA_KUSACZUK@ICLOUD.COM
1
,Introduction to module
Learning outcomes
• Demonstrate a critical understanding of the relationships between work, working conditions and well-being and
mental health.
• Distinguish between a range of organisational factors and conditions that may be experienced as workplace
stressors.
• Show an understanding of the association between stress and ill health (i.e., psychoneuroendocrinology and
psychoneuroimmunology).
• To describe the contributions of psychiatry and occupational psychology to the prevention, promotion and
amelioration of occupational health and wellbeing.
• To critically evaluate research pertaining to mental health, Psychiatry and Psychology.
German wings case study
- Can‘t mention that the pilot should have disclosed his health status
- Health professionals cannot disclose information without the consent of the patient
Key facts
- Flight 9525 crash in the Alps (French area) - 150 died
- German airline - both French and German authorities were involved
- Found a note from a doctor saying he was not fit for work that day and that he had medications trashed
- The co-pilot locked the pilot out of the cockpit and programmed the descend of the plane
- 2 weeks ago he was being treated at a hospital - burnout/depression and hid it from the airline
- He never showed any signs of inner turmoil
- Avid runner, picture of health and youth but his illness turned him homicidal
- If there is an indication that a pilot is suffering from substance or mental health issues they are subject to additional
rigorous psychiatric screening
- Even if they are suffering from depression or anxiety - it is their duty to seek help or colleagues to report it
Who are the relevant stakeholders involved in the case
- Pilots (more scrutiny, more pressure and stress)
- Cabin crew (may feel unsafe to work, or face more scrutiny at work)
- Passengers (may feel unsafe travelling with the airline or any other airline in the future)
- Airline companies (making sure procedures are in place and followed correctly)
- People who fund or own airlines (decrease in business)
- The public (potential future customers, or employees)
What contributing factors can be considered - what has had a contribution to this negative outcome
- The mental state of the pilot
- Depression - onset, medication and its potential side effects, the pilot may have thought he was fit to work
however if experiencing a psychotic depressive episode it may have been difficult to see the reality of the
situation
- The negative connotations of losing flying rights - pilots go through tough training programmes and losing
these rights could have an impact on self-esteem and confidence
- Financial consequences if the pilot declared himself unfit to work - loss of work and income, the stress of potentially
losing a job
- German regulation was not fully compliant with part-med as the decision to issue the class 1 medical certificate should
have been referred to the LBA - this would have been an opportunity for a decision to be made from an independent
body and could have prevented the pilot from returning to work
Interventions that are considered a priority
- Workshops, support groups
- Training sessions for pilots and aircraft members about the general knowledge for mental health illness, let them
notice and report any concerning behaviors of their peers, form a peer support group.
- Held recovery sessions among pilots regularly. E.g., meditations, marathons, yoga sessions.
2
, - Since it is all self-reporting, psychologists can induce seasonal mental screenings to examine pilots mental
wellbeing
France Telecom, Orange France (2009) case study
- An increasing number of suicides in the workforce - highlighted by the media and the union
Problems
- Thousands of jobs were cut and relocated
- Implementing a strategy that unsettled employees and created a climate of anxiety
- Lombard told managers that he’d make people leave one way or another - through the window or the door
- Suicide rates are similar to the national average - but many who died left notes blaming the pressure from
management.
December 2019 update
- A court decision was reached and 3 senior executives of France Telecom were considered guilty of bullying and
received jail sentences
Evidence-based management
- A lot of the work we do in organisations is not evidence-based
- Our decisions to adopt certain policies are not necessarily linked to strong evidence that supports that policy
- There’s a big contrast between social sciences and biomedical sciences. In biomedical sciences, it’s really an
evidence-based practice. You would not suggest medication or some therapy to someone without having really
strong evidence that supports the use of that medication or the recommendation of that therapy
- In social sciences and management, when we recommend a certain strategy or approach, we don’t always have the
evidence that supports our recommendation
Mental health in the workplace
- 70% of people with depression are in the workplace (source: partnership for workplace mental health)
- Many people with depression never seek care - you won’t know about them
- We already have issues of mental health in the workplace whether we like to recognise it or not, part of our
workforce is dealing with mental health issues and they may not share it with us
- Disclosure of mental health problems
- Individuals have a choice: they either share they have a MH problem or not. This is about employee
disclosure
- Many people with depression will not disclose it to their colleagues and employer
- The number of people who disclosed their stress or mental health problems to their employer or manager
has not changed over the last 5 years (source: CIPD statistics on the disclosure of mental health in the
workplace)
- 2011: Yes 43% No 57%
- 2016: Yes 43% No 57%
- Would an organisation hire someone with a mental health illness or disorder?
- There is a clear problem addressing MH issues within organisations - we know they exist but employees
actually do not discuss them
Solution?
- Screening or assessments
- False positives - saying someone has a MH problem when
they don’t actually have one
- Does it accurately detect genuine
- How strong is the link between depression and murder-suicide
anyway?
- How many pilots will we need to ban, to prevent another crash?
3
,Mental health tooklit
What are the costs?
- All interventions have some kind of cost
- Potential consequences of interventions
- People come forward and use resources available
- Increase stigma
- Fear of disclosing (career, promotion, the vulnerable one, etc)
- Increased number of pilots not seeking care from GPs
- Increased number of pilots hiding diagnosis from employers
- Opportunity costs
- Are we missing the chance to do something better
Developments in aviation
On 9th December 2016, EASA (European Aviation Safety Agency) published a proposal on new operational rules to better
support pilot mental fitness -this followed the Germanwings Flight 9525 accident.
Released in a document known as an Opinion (Opinion 14/2016), includes:
● Ensuring that all pilots have access to a support programme;
● Mandating airlines to perform a psychological assessment of pilots before the start of
employment;
● Introducing systematic Drug & Alcohol (D&A) testing of flight and cabin crew upon
employment, after a serious incident or accident, with due cause (i.e. following reasonable
suspicion), as well as
● Unannounced D&A testing after rehabilitation and return to work;
● Mandatory random alcohol screening of flight and cabin crew within the EU RAMP
inspection programme
4
,Introduction to stress
Learning objectives:
● To understand the multiple components of organisational behaviour
● To recognise the major objectives of interventions in Organisational Psychology
● To understand the stress process
● To recognise different disciplinary approaches to stress
● To recognise stressors, appraisal and coping as key features of the stress process
● To critically discuss the multiple stressors at the workplace
What is an organisation
Bloisi et al, 2007 Bratton et al, 2007 Martin & Fellenz, 2010, p. 5
A form of social system, made up A deliberately formed social group in Organisations are social entities that are
of people and a variety of which people, technology and resources goal-directed, that are inextricably linked
resources and subsystems are deliberately co-ordinated through with the environment yet have nominal
integrated to transform inputs formalized roles and relationships to boundaries, and that employ deliberately
into mission appropriate outputs achieve a division of labour designed to designed and ordinated activities and
attain a specific set of objectives efficiently approaches to achieve their objectives
Work organisations and organisational behaviour
- As psychologists we specialized in the study of human behaviour.
- As Occupational Psychologists we specialized in the study of human behaviour at work.
- So what can we expect to find when studying human behaviour at work?
The SHELL model: components of the work environment
- Initially developed by Elwyn Edwards (1972)
later modified by Frank Hawkins (1984)
- Conclusion 1: The concept of human behaviour
is a broad area - it actually involves quite a lot of
concepts - it is a umbrella concept
- Conclusion 2: There are so many areas, and they
are so specialised that it is mostly likely that the
understanding of human behaviour at work will
involve a variety of disciplines
5
,Interventions in occupational psychology
- Two major objectives in the study of human behaviour at work and organisations
- Productivity
- Efficiency, Effectiveness,
- Profit, costs (with HR, health, errors)
- Quality & errors
- Reliability of human behaviour
- Safeguarding or protection of Human Values
- Health & Safety (Occup. Health, Accidents and Incidents)
- Stress: stressors, consequences, mediators and moderators
- Modern stressors: work schedules, workplace violence and aggression, work-family
conflict
- Motivation, Satisfaction, Engagement
- Comfort, Well-being at work
- Quality of life, Life balance
Designing work for productivity and health
- WHO definition of Health
- Health is a state of complete physical, mental and social well-being and not merely the absence of disease
or infirmity.
- The definition has not been amended since 1948.
- The correct bibliographic citation for the definition is:
- Preamble to the Constitution of the World Health Organization as adopted by the International Health
Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States
(Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948
- Occupational health deals with all aspects of health and safety in the workplace and has a strong focus on primary
prevention of hazards.
- The health of the workers has several determinants, including risk factors at the workplace leading to cancers,
accidents, musculoskeletal diseases, respiratory diseases, hearing loss, circulatory diseases, stress related disorders
and communicable diseases and others.
- http://www.who.int/topics/occupational_health/en/
- Material risks – Hardware & Environment
- Psychological risks – Liveware & Software - Psychosocial Risks
- Data from Health & Safety Executive http://www.hse.gov.uk/statistics/overall/hssh1718.pdf
6
,Stress and Stressors
- Stress: no consensual definition.
○ Feeling or condition experienced when an individual identifies demands as higher than the resources,
he/she can draw on. (Lazarus & Folkman, 1984)
○ Work-related stress is experienced when the demands of the work environment exceed the workers’
ability to cope with (or control) them. EU-OSHA — European Agency for Safety and Health at Work
- 4 different concepts:
○ Stressor or demands
○ Stress response
○ Eustress
○ Distress or strain
- Stressor: physical or psychological stimuli present, perceived or anticipated; function of individual experiences,
appraisal processes, coping strategies and individual response
○ 1. Internal
○ 2. External
Internal
- Big life events
- Thomas Holmes & Richard Rahe (1967) Social Readjustment Scale
- This tool helps us measure the stress load we carry, and think about what we should do about it.
- Context
- In 1967, psychiatrists Thomas Holmes and Richard Rahe decided to study whether or not stress
contributes to illness. They surveyed more than 5,000 medical patients and asked them to say whether
they had experience any of a series of 43 life events in the previous two years.
- Each event, called a Life Change Unit (LCU), had a different "weight" for stress. The more events the
patient added up, the higher the score. The higher the score, and the larger the weight of each event, the
more likely the patient was to become ill.
- Scores
- 11-150 - low to moderate chance of
becoming ill in the near future
- 15-299 - moderate to high chance
- 300-600 - high or very high risk
External
- Daily events
- Examples
- Not findings your keys, Road traffic, Lack of sleep, Security scare, shopping, close deadlines, car
breakdown, incivility, noise level, job dissatisfaction, meal prepping, problems with kids, loneliness,
queues, gossip, relatives, neighbours, work relations
Stress and stressors
- Stressor: physical or psychological stimuli present, perceived or anticipated; function of individual experiences,
appraisal processes, coping strategies and individual response
o Internal
o External
- Appraisal of stressors
o Primary
o Secondary
- Coping strategies
o Problem-focused
o Emotion-focused
7
,Stress and Appraisal
- Primary appraisal – assess the impact/significance of the event
o Motivational significance of the situation and can be divided into three categories:
▪ irrelevant, where the stimuli has no implication for the person's well-being;
▪ benign-positive, where the outcome is deemed as positive with pleasurable emotions; and
▪ stressful, characterised by harm or loss, threat and challenge
▪ (Lazarus & Folkman, 1984) - Locus of control (Internal Versus external) associated with
explanations that you usually give to your own experiences. Internal involve you and your action,
external involve other associated factors such as luck
▪ Internal LOC – what can we do about this stressor if nothing = stress
• Process events are more stressful because of the need to be in control
▪ External LOC – stress I just part of life, its not in my control
- Secondary appraisal
o What can we do about it; depends on how much control a person feels they have, actions likely to improve
the situation, and the stakes involved (Lazarus & Folkman, 1987) - Personal resources, Self-efficacy
Coping strategies:
- Problem-focused altering the person-environment
o Seeks to change the relationship by acting on either the environment or the person (Lazarus, 1993) and is
achieved by evaluating the stake in the encounter and using confrontive coping strategies, self-control,
accepting responsibility, planful problem solving, and positive reappraisal (Lazarus & Folkman, 1987).
- Emotion-focused managing the emotional distress
o attempts to either change the way the stressful environment is viewed, or to change the personal meaning
of the situation resulting in distancing from the event, escape-avoidance or seeking social
approval/support (Lazarus, 1993) Associated with CBT
- Other coping strategies:
o Primary Coping
o Proactive Coping
o Reactive Coping
o Anticipatory Coping
o Preventive Coping
Summary
- Stressor
o Variety of stressors in our life
o Personal experience that combines physiological and psychological components
- Appraisal
o Relevant or not
o What can we do about it
- Coping strategies
o Problem-focused
o Emotion-focused
8
,Stress at work
Learning objectives
• Identify the main stressors in the workplace associated with individual factors, job characteristics and working
conditions.
• Recognize work and the workplace as major contributors to relevant life events
• To critically discuss the multiple stressors at the workplace
Stress and stressors
- 4 different concepts
o Stressors or demands
o Stress response
o Eustress
o Distress or strain
- Stressor
o Physical or psychological stimuli present, perceived or anticipated; function of individual experiences,
appraisal processes, coping strategies and individual response
o Internal and external
- Appraisal of stressors
o Primary
o Secondary
- Coping strategies
o Problem-focused
o Emotion-focused
Stress and the workplace
- Variety of models of workplace stress
- Multiple stressors (job and working conditions)
- Diversity of approaches
- Lead to a multitude of interventions
o Individual
o Organisation
- No one best way on how to deal with stress
- Balance between individual & organisation
- Organisational strategy to manage stress (monitor, prevent, ameliorate)
- Accommodating individual needs (personalised medicine; customised stress management)
Workplace stressors
- Cooper & Marshal, 1967, p.268
- Cary cooper was interested in understanding some of the health effects that could be observed in senior managers.
He was interested in understanding how working conditions and exposure to workplace stress could be associated
with cardiovascular disease and mental ill health
- 5 dimensions that work as a stressor
o Intrinsic to job
o Role in the organisation
o Career development
o Relationships at work
o Organisational structure and climate
9
, Job content questionnaire JCQ
- Karasek (1979), Karasek & Theorell (1990)
- Contradictory evidence in the literature
o Higher status occupations were more satisfied than others with their jobs, were more mentally healthy,
but at the same time experienced greater emotional tension concerning the events occurring on their jobs.
o Self-developing challenge is a major determinant of higher job satisfaction - JOB CRAFTING
- Job demands – job characteristics, distinct concepts
- No distinction between stressors & decision latitude (job control, skill discretion)
o The opportunity to use skills/competencies and make decisions at work is associated to less strain
- Job demands (psychological demands)
o Job stressors such as the combination of high working pace and high time pressure (e.g., a high
‘‘workload’’), workload, required concentration, frequency of interruptions, etc.
- Decision latitude
o Skill discretion
▪ High skill required, Learn new things,
no repetitious work, creativity
o Control (decision authority, autonomy)
▪ the extent to which employees are
able to take autonomous decisions on
the job and to influence their team
and organisation.
▪ Freedom as to how to work, allows a
lot of decisions, assist in one’s
decisions, have a say over what
happens
10
