psychosocial risk management - cigna · a complex picture! • types and severity of risks and...

Psychosocial Risk Management

Dr Stavroula Leka CPsychol AFBPsS FRSPH

Associate Professor in Occupational Health Psychology Director, Centre for Organizational Health & Development

Global Healthy Workplace Awards & Summit, London 11-12 April 2013

© PRIMA-ef Consortium

A complex picture  •  Types and severity of risks and complexity that

organisations face is growing with significant potential impacts on their operations, reputations and viability (PWC, 2012)

•  Felton and Keenan (2005): only 11% of 1000 surveyed directors claim to have a complete understanding of the risks their organisations currently face, whilst 23% stated to have limited or no understanding at all

•  Risk priorities still revolve around compliance and financial issues (Ernst & Young, 2010)

Ethics & People  •  Business highly connected with morality and

ethics (Ersdal & Aven, 2008) > concerns increasingly channelled towards labour, psychological and social issues (Ledwidge, 2007; Jain, Leka & Zwetsloot, 2011)

•  “With the worldwide focus on the ageing workforce, the acute scarcity of skilled professionals in many industries, as well as cases of significant fraud caused by a few – it’s no surprise that risk is all about people” (Bosserman et al., 2008:12)

Emerging risks  •  Developments in nature of work in relation to

design, management and organisation as well as the wider context of work are resulting in new and emerging risks, namely psychosocial risks (EU-OSHA, 2007; Dollard et al., 2007)

•  Related to issues such as work-related stress, violence, bullying and harassment, all of which have the potential to significantly impact on the healthiness of the individual, enterprise and society (Rasmussen, Hansen & Nielsen, 2011; Rick & Briner, 2000)

Psychosocial risks  

•  Those interactions among job content, work organisation and management, and other environmental and organisational conditions, and the employees’ competencies and needs that prove to have a hazardous effect on employees’ health and safety through their perceptions and experience  

Psychosocial Work

Environment Dimensions  

Psychosocial Hazards

(Downside risk)  

Psychosocial Factors

(Upside risk)  

Job  content   Lack  of  variety  or  short  work  cycles,  fragmented  or  meaningless  work,  under  use  of  skills,  high  uncertainty,  con8nuous  exposure  to  people  through  work  

Meaningful  work,  appropriate  use  of  skills,  work  retaining  employee  interest  and  engagement,  appropriate  support  

Workload    &  work  pace  

Work  overload  or  under  load,  machine  pacing,  high  levels  of  8me  pressure,  con8nually  subject  to  deadlines  

Appropriate  level  of  workload,  appropriate  work  pace,  sensible  and  achievable  deadlines  

Work  schedule   ShiA  working  (especially  irregular),  night  shiAs,  inflexible  work  schedules,  unpredictable  hours,  long  or  unsociable  hours  

Sensible  shiAs  and  reasonable  working  hours  to  maintain  work-­‐life  balance,  flexible  working  prac8ces  

Control   Low  par8cipa8on  in  decision  making,  lack  of  control  over  workload,  pacing,  shiA  working  

Par8cipa8on  in  decision  making,  control  at  work  

Environment  &  equipment  

Inadequate  equipment  availability,  suitability  or  maintenance;  poor  environmental  condi8ons  such  as  lack  of  space,  poor  ligh8ng,  excessive  noise  

Good  physical  working  condi8ons  according  to  good  prac8ce  guidance  

Psychosocial Work

Environment Dimensions  

Psychosocial Hazards

(Downside risk)  

Psychosocial Factors

(Upside risk)

Organisa=onal  culture  &  func=on  

Poor  communica8on,  low  levels  of  support  for  problem  solving  and  personal  development,  lack  of  defini8on  of,  or  agreement  on,  organisa8onal  objec8ves  

Clear  organisa8onal  objec8ves,  appropriate  support  for  problem  solving  and  personal  development,  good  communica8on  processes  

Interpersonal  rela=onships  at  work  

Social  or  physical  isola8on,  poor  rela8onships  with  superiors,  interpersonal  conflict,  lack  of  social  support,  harassment,  violence  

Good  rela8onships  at  work,  teamwork,  social  support,  appropriate  policies  and  procedures  to  deal  with  conflicts  

Role  in  organisa=on  

Role  ambiguity,  role  conflict,  responsibility  for  people  

Clear  roles  and  responsibili8es,  appropriate  support  to  meet  objec8ves  

Career  development  

Career  stagna8on  and  uncertainty,  under  promo8on  or  over  promo8on,  poor  pay,  job  insecurity,  low  social  value  to  work  

Appropriate  career  prospects  &  development  matching  skills  &  performance,  effort  reward  balance,  valuable/meaningful  work,  job  security  

Home-­‐work  interface  

Conflic8ng  demands  of  work  and  home,  low  support  at  home,  dual  career  problems  

Work-­‐life  balance,  suppor8ve  organisa8onal  policies  and  prac8ces  to  achieve  ‘life  balance’  

Work-related stress  

•  Pattern of emotional, cognitive, behavioural and physiological reactions to adverse and noxious aspects of work content, work organisation and work environment

•  Difference between work-related stress and pressure  

Prevalence and impact  •  Data from the European Union show that work-related

stress affects more than 40 million individuals (EU-OSHA, 2012) while in the USA, 69% of employees report that work is a significant source of stress and 41% say that they typically feel tense or stressed out during the workday (American Psychological Association, 2009)

•  In the 15 Member States of the pre-2004 EU, the cost of stress at work and the related mental health problems was estimated to be on average between 3% and 4% of gross national product, amounting to €265 billion annually (Levi, 2002)

•  Evidence of impact in developing countries building up (Kortum, Leka & Cox, 2011)

•  Job loss/ long-term unemployment is an established risk factor of elevated morbidity and mortality from addiction and stress-related disorders (esp. CVD, depression) (Gallo et al., 2004; Voss et al., 2004)

•  Yet, among employees with poorest quality of work mental health is getting significantly worse over time than in the case among unemployed people (Butterworth et al., 2011)

Some recent findings  

Reduced fatigue and depression is associated with retirement event (GAZEL-study)

Source: Westerlund H et al (2010) BMJ 341:c6149.

Source: Siegrist J., Wahrendorf M. (2011) in: The Individual and the Welfare State (ed. A. Börsch-Supan et al.) Springer Heidelberg

Macro indicators of national labour and social policies and mean level of work-stress in 13 European countries

(SHARE study)

Macro indicator: Percentage of workers participating in further education

Effort-reward ratio (country) and women‘s employment rate (18 countries study)

Source: unpublished findings T. Lunau, N. Dragano, J. Siegrist (2012)

Key messages  •  Good work is good for everyone – not necessarily any

type of work

•  It is not enough to devise public policies to keep people longer in employment, if both policymakers and businesses do not prioritize the development of a working environment that is conducive to longer and healthier working lives

•  Strong case for the link between psychosocial risk management and the sustainability of both businesses and society

•  Source: Langenhan, Leka & Jain, Safety & Health at Work, forthcoming 2013

Policy framework (in Europe as an example)  

•  EC Council Directive  89/391/EEC

•  Framework agreement on work-related stress (European Social partners, 2004)

•  Framework agreement on harassment and violence at work (2007)

•  National initiatives: e.g. Management Standards for Work-related Stress (HSE, 2004) – adapted in Italy 2010

Other examples of initiatives  •  EU-OSHA (European week for Work-related stress,

2002 and forthcoming campaign on Practical solutions for psychosocial risks, 2014-15)

•  European Pact for Mental Health (2006)

•  BSI, PAS 1010 (2011): first guidance standard on the management of psychosocial risks in the workplace

•  Senior Labour Inspectors Committee (SLIC, 2012) campaign on psychosocial risks

•  New Canadian national standard on psychological health and safety in the workplace (2013)

WHO HW Process Model

What do employers do?  

Forecasting Work Design Organisation

and Management

[Sources]

Employee Behaviours

− Health and Wellness − Safety

− Ill health − Absenteeism − Presenteeism − Turnover − Accidents/Near

Misses [Outcomes]

•  Only about 50% of companies inform employees on psychosocial risks or implement interventions

•  44% of all enterprises had used information or support from external sources on how to deal with psychosocial risks

•  Of these enterprises, 38% reported that they need additional information or support in three key areas: how to conduct psychosocial risk assessments, how to design and implement preventive measures, and how to deal with violence, harassment or stress

•  These 3 key areas were also reported by enterprises that had not used information or support from external sources on how to deal with psychosocial risks

•  No major variations by country, sector or size

Key enterprise needs (ESENER, EU-OSHA)

PRIMA-EF •  Developing an Excellence Framework for

Psychosocial Risk Management

•  6 partners: I-WHO (lead), BAuA, ISPESL, TNO, CIOP, FIOH

•  2 international organisations (WHO, ILO)

•  10 advisory organisations: DG-Employment, DG-SANCO, EU-OSHA, Eurofound, ICOH-WOPS, EAOHP, ETUC, ETUI, ETUI-REHS, BUSINESSEUROPE, UEAPME,CEEP, UNIZO

© PRIMA-ef Consortium

A note on the concept of risk  

•  The concept of risk has changed over time •  Risk has been conceptualized differently in

different contexts but increasingly complex •  ISO 31000: risk as an “effect of uncertainty on

objectives” •  Conceptual shift from traditional definitions,

acknowledging both the potential upside and downside impact of risk on objectives

•  However, in health and safety risk is traditionally conceptualized in a negative manner: perception?

Risk Management  •  Identification, assessment, and prioritization of risks • 

•  Minimizing, monitoring and controlling the likelihood and consequences of risks occurring, whilst realizing opportunities

•  Strategic risk management: managing risks “that could inhibit an organization’s ability to achieve its strategic objectives with the ultimate goal of creating and protecting stakeholder value”

•  Stakeholders include shareholders, but also employees, and society at large

PRIMA-EF Enterprise Model  

PRODUCTION Design, development and operation of work and production

Risk Assessment and Audit

Translation/Action Plans

Risk Reduction (Interventions) Programmes

Organisational Learning

Evaluation

Innovation

Productivity & Quality

Quality of Work

Workers’ Health

Societal Outcomes

Management and organisation of work processes Outcomes

PRIMA-EF Outputs  •  PRIMA-EF guidance sheets,

book and guide

•  WHO PRIMA-EF guide now available in 12 languages (English, French, German, Italian, Spanish, Finnish, Portuguese, Dutch, Polish, Greek, Japanese, Chinese)

•  PRIMA – eTraining •  www.prima-ef.org

PRIMAeT Background •  Supports the implementation of

Publicly Available Specification (PAS) 1010, the new first guidance standard on the management of psychosocial risks in the workplace that has been published by the British Standards Institution (BSI) and has been developed by the PRIMA-EF Consortium in collaboration with BSI, EU-OSHA, WHO, HSE, ETUC, EEF

•  PAS1010 has been written so that it compliments all existing occupational health and safety management systems

•  WHO Audit tools for developing Healthy Workplaces

•  2 versions: for SMEs and LSEs

•  Key indicators to achieve good practice according to WHO process model across all areas of influence

Fit with forthcoming WHO Healthy Workplace Audit tool

Key messages  •  Psychosocial risks underpin every business activity

– so here to stay!

•  All organisations engage in enterprise risk management in different areas of business activity

•  A shift in culture towards recognizing the duality of the concept of risk is needed – risk encompassing both potential threats and opportunities

•  Risk management can be powerful dynamic positive tool in achieving organisational outcomes and developing healthy workplaces

Thank you!

Stavroula.Leka@nottingham.ac.uk

www.nottingham.ac.uk/iwho www.prima-ef.org

www.prima-ef.org/primaet.html

© PRIMA-ef Consortium