Ian M. F. Arnold MD, MSc, DOHS,FRCPC, FCBOM, CSPQ, CRSP, CEA

OEMAC, October 03, 2011

Psychological Health and Safety –

Catalyzing Workforce and Workplace Change

OEMAC 29th Annual ConferenceNiagara on the Lake

Learning Objectives

1. Review the work underway to catalyze change in workplace psychological health and safety;

2. Understand the reasons for development of a workplace standard on psychological health and safety;

3. Recognize the reasons for the use of a consensus based approach and the role of occupational health physicians and other stakeholders in the development of the standard;

4. Learn about the current status of the standard and the needs and timetable for completion of the standard development.

Six Strategic Initiatives that shape our direction on Workplace Psychological

Health and Safety

Employment opportunities and/or sustainable income for the Aspiring Workforce (“Aspiring Workforce” project - CAMH);

Research project to define existing best practices “Integrated Approach to Workplace Mental Health” - SFU);

MHCC peer support certification and accreditation process under the direction of Lt. Col. Stephane Grenier;

Leadership Initiative – the business case; Review of the jurisprudence on psychological health and safety in

the workplace (Dr. Martin Shain); Development of workplace standards for psychological health and

safety.

The “Aspiring Workforce” Project

Understanding how to enhance employment opportunities and a sustainable income for the Aspiring Workforce;

Led by the Centre for Addiction and Mental Health with U of T and Queens University – completion Jan ‘12

Four components: Supported employment; Alternative business models (social enterprises); A new model of disability benefits; Mental health literacy for and about the Aspiring

Workforce;

Impact on OHPs – improved worker accommodation options, better mechanisms for managing disability, enhanced knowledge on psychological H and S.

An Integrated Approach to Improving Workplace Mental Healthcare in

Canada

To identify/critically analyse current models and promising practices in workplace mental health;

Conducted by Simon Fraser University;

A 6P approach: Dissemination plan under

development; now Ultimate deliverable of value to

OHPs - “PSYCHOLOGICAL HEALTH &

SAFETY: AN ACTION GUIDE FOR EMPLOYERS”

An Integrated Approach PSYCHOLOGICAL HEALTH & SAFETY: AN ACTION GUIDE FOR EMPLOYERS

POLICYCommitment by organizational

leadership to enhance psychological health and safety through workplace interventions

PLANNINGDetermination of key mental health indicators across the organization,

selection of actions, and specification of objectives

PROMOTIONActions taken to promote the general psychological

health of the workforce

PREVENTIONActions taken to prevent the occurrence of significant

psychological problems or mental disorders -- may occur at the primary, secondary or tertiary level

PROCESSEvaluation of implementation and results of actions taken to enhance psychological health

and safety

PERSISTENCESustainment of effective actions in a process of

continuous improvement

An Integrated Approach PSYCHOLOGICAL HEALTH & SAFETY: AN ACTION GUIDE FOR EMPLOYERS

PREFACE INTRODUCTIONTHE P6 MODEL AND ISO POLICY PLANNING PROMOTION PREVENTION – Primary, Secondary, Tertiary

Secondary Prevention Provide self-care tools Provide manager training Provide early intervention through EFAP PROCESS PERSISTENCE PH&S IN SMALL BUSINESS PSYCHOLOGICAL HEALTH AND SAFETY OF MANAGERS: A CRITICAL ISSUE INTEGRATING MENTAL HEALTH CARE AND THE WORKPLACE CLOSING COMMENTS

Table of Contents

An Integrated Approach PSYCHOLOGICAL HEALTH & SAFETY: AN ACTION GUIDE FOR EMPLOYERS

Provide manager training It is critical to give managers the knowledge and skills - - - -Why it matters Employees with patterns of declining or inconsistent job performance, interpersonal difficulties or other uncharacteristic behaviours may - - - - -How it is done Some larger organizations have developed manager training programs specific to their business or sector-- this may be useful if - - - - Useful tools• Managing Mental Health Matters, Great West Life Centre for Mental

Health in the Workplace: http://www.gwlcentreformentalhealth.com/mmhm/eng/main.html

• What you need to know about mental health: a tool for managers, The Conference Board of Canada: http://www.conferenceboard.ca/documents.aspx?did=1433

• A practical guide to managing and supporting people with mental health problems in the workplace: http://shift.org.uk/files/employers/lmr2009_web.pdf

There is a spectrum in management styles – not everyone has to like everyone – a manager can be tough without being disrespectful.Labour Lawyer

The Peer Project – Two components

1 Peer Support Practitioners: enhance the utilization of peer support through the creation and application of national standards of practice.

2 Peer Educators: encourage a change in societal attitudes towards mental illnesses through peer based education strategies specifically targeting adults in workplaces and later, youth in schools.

Immediate focus on Peer Support

1 Peer Support Practitioners: enhance the utilization of peer support through the creation and application of national standards of practice.

2 Peer Educators: encourage a change in societal attitudes towards mental illnesses through peer based education strategies specifically targeting adults in workplaces and later, youth in schools.

Peer Project - Strategic Outcomes

PEER PROJECT

STANDARDS of PRACTICEACCREDITATION

BODY – Sustainable

approachEvaluation framework

EVIDENCE BASE

Consumer / Survivor engagementNote 1: Outreach to 600 peer support workers and agencies across Canada. 281 currently / actively engaged in helping shape the future of peer support through this project;

The Intent of the Peer Project

Create the conditions required to leverage, on a wide scale, the acquired skills of people who have lived mental health experience.

Provide a robust enabling framework for organisations and systems to enhance current peer programs or launch new peer initiatives, build capacity, and help address the growing mental health needs;

Value to the OHP – a new resource to help employees enhance their personal resiliency and better manage workplace psychological health and safety challenges.

Targeted segment of the peer support continuum

Professional Friendship Peer Support

Formal InformalPeer PeerSupport Support

Future certified peer support

workers

Examples of types of peer support include:Forensic inpatient servicesAcute inpatient services Community based NGOsRespite services and alternatives to acute inpatient stays Peer operated “warmlines”Primary mental health carePeer led trainingWorkplace peer support programsOthers as appropriate

What are standards of practice?

Standards of practice establish the knowledge, competencies, training/education, experience and values of a given function

The Canadian standards of practice for Peer Support will allow the voluntary certification of peer support workers. This credential will be transportable from coast to coast

The Canadian Peer Support standards of practice are being established based on a nationwide, comprehensive consultation process tapping into the wealth of knowledge and experience in this field

Research based project

The gathering of evidence-based data is required to promote the expanded use of peer support

A reliably consistent standard methodology (standards of practice) is required to allow the gathering of empirical data based on project evaluation results

Underpinned from the outset with outcomes based performance measurement and evaluation strategies

(Ottawa U, Queens, Centre for Addiction and Mental Health, Centres for Disease Control and Prevention (CDC) Atlanta Georgia)

Standardsof

Practice (SoP)

Code of Conduct

Competencies

Experience

Knowledge Syllabus & ManualBCSS Vic Branch

Assessment Tools Baynton & Ass

Certification ServicesPolicy / Process /

Infrastructure

SoP ManualHealthy Brains – Healthy Business

Code of conduct

Certification ValidationVolunteer community based peer support organisations such as the Nova Scotia Research Foundation; Manitoba Schizophrenia Association; BC Schizophrenia Association Vic.; Association Quebecoise en Readaptation Psycosociale;Ontario Peer Development Initiative

Workplace & MH System Demonstration site

Promising sites: Private SectorPublic SectorLaw Enforcement & First RespondersMH System

Evaluate

Evaluate

Phase IConsultation2010 / 2011

Phase IIDevelopment2011 / 2012

Phase IIIImplement / Evaluate & Adapt

2012 / 2014

Organisational Qualities

Readiness Assessment

CMHA

Principle of Practice

Values

Practicum

Evaluation Methods

& Outcomes

Evaluation StrategyCDC – Deloitte – Ott U

– CAMH - Queens

Plan

The Aspiring Workforce Project The Integrated Approach – Guideline The Peer Project The MHCC Leadership Initiative; Developing the Business Case; Risk Management – the Shain Reports; The National Standard for Workplace

Psychological Health and Safety.

Driving Change in the Workplace

Mental Health Leadership Initiative – Moving forward – A Work in Progress

The Mental Health Leadership Initiative includes: Key aspects of the Roundtable’s 2007 “CFO Framework for

Mental Health and Productivity”; Evolving legal requirements; A comprehensive framework approach to manage Mental

Health in the workplace; The Mental Health Leadership Initiative is a key strategic

tool to drive acceptance of the next steps in improving workplace mental health and psychological safety;

The Value to the OHP –Provides downloadable videos from senior labour, workplace, and organizational leaders and information on steps to take to move forward. Key point – the organization needs leadership support and a champion.

The Business Case is Clear for improving Workplace Psychological

Health and Safety

1. Corporate Social Responsibility Includes employees as well as external stakeholders

2. Cost Effectiveness In productivity as well as cost trend management

3. Recruitment and Retention The competition for talent

4. Risk Management OH&S, Human Rights, Disability Legislation

The Shain Reports - Mental injury and psychological

safety in the workplace

Mental injury is not the same as mental illness. It is harm to mental health [mental suffering] that significantly affects the ability of employees to function at work and at home;

“A psychologically safe workplace is one in which every practical effort is made to avoid reasonably foreseeable injury to the mental health of employees” (Shain, 2009).

“A psychologically safe workplace is no longer a “nice to do”. It is now a “must do”

“We observe seven major trends in the law becoming stronger by the year.

We can characterize these trends as pressures building toward a perfect legal storm, where the whole is far

greater than the sum of the parts.”

Dr. Martin Shain said...

• There is a rising tide of liability for employers who fail to provide a psychologically safe work environment;

• Employers lack the tools to assess and address workplace risks to psychological health and safety;

December 2009 - MHCC/WAC, with Great West Life, held a consensus meeting in Vancouver – National Standard supported by all attendees, consensus statement issued:

“It is our vision to see the development of a National Standard of Canada on psychological health and safety in the workplace by December 1, 2011, and uptake by employers resulting in a measureable improvement in psychological health and safety within three years of that date.”

Early 2010, discussions held with Canadian Standards Association (CSA) and the Bureau de Normalization du Quebec (BNQ);

02/10 - Statement of Understanding agreed to by MHCC, CSA, BNQ;

The Path to the present: A Standard for Psychological Health and Safety in

the Workplace

The Path to the present: A Standard for Psychological Health and Safety in

the Workplace

Funding for standard development – HRSDC is the lead with support from Health Canada and the Public Health Agency of Canada (PHAC) – January 2011;

Support for MHCC specifically for this project also provided by Bell Canada – January 2011;

The Standard development process is on a fast track -agreement with BNQ/CSA finalized in February 2011;

4 of 5 Technical Committee meetings already held; Draft for 60 day public comment mid fall, 2011; Final draft March 2012; Release – June/July, 2012.

The Path to the present: A Standard for Psychological Health and Safety in

the Workplace

Objective: to provide a methodology that will lead to measurable and sustainable improvements in psychological health and safety;

Stand alone, voluntary standard; Will align with other international

efforts - British Standards Institute Performance Standard (PAS 1010), OHSAS 18000 and CSA Z1000 and Z1002, and the BNQ Healthy Enterprises standard;

Standard to follow the ISO framework.

Factors impacting Workplace Psychological Health and Safety

Workplace and Workforce

Psychological Health and Safety

Social Factors

Physical Factors

Individual Factors

Environmental Factors

The Path to the present: The Technical committee

Code Min Max Actual Description

EI 3 4 3 Employee Interest e.g CAW, CLC

GI 5 6 6 General Interest - Samra, Shain

OI 5 6 6 Organizational Interest e.g. AC

RP 4 6 5 Regulatory/Policy/Underwriter

Interest e.g. HC, HRSDCSP 3 4 4 Professional Services, e.g CMHA

Key Areas Impacting Workplace Psychological Health and Safety

Psychological Support, Organizational Culture, Clear leadership & expectations, Civility and respect, Psychological job fit, Growth and development, Recognition and reward, Involvement and influence, Workload management, Engagement, Balance Psychological protection Positive physical environment

The Path to the present: A Standard for Psychological Health and Safety in

the Workplace – Features (DRAFT)

The Standard will include a preface, an introduction, scope, normative references and definitions, the standard process, and several annexes;

The process follows the ISO format;Commitment, Leadership, Participation;Planning Implementation;Evaluation and Corrective Action;Management Review and Continual Improvement.

The process respects the HIRARC principles – Hazard Identification, Risk Assessment Risk Control

The Path to the present: A Standard for Psychological Health and Safety in

the Workplace – Features (DRAFT)

Five annexes are also included to help users:Annex A – Supplemental background informationAnnex B – Resource compendiumAnnex C – Sample audit toolAnnex D – A discussion of relevant legislation or regulation

as of 2011Annex E - Related Standards and GuidesAnnex F - Annotated Bibliography

Conclusions

A systematic and sustainable approach for psychological health and safety, on a parallel with how physical health and safety is managed, is becoming a business and social imperative;

The MHCC’s WAC is working with various partners to develop tools that will assist employees and employers to improve workplace mental health;

These tools will provide Occupational Health Practitioners with new methods to deal with Psychological Health and Safety challenges in the modern workplace.

Positive workforce and workplace change is on the way

A selection of Canadian resources available on-line

The MHCC Leadership Initiative: http://www.mhccleadership.ca/

The Peer Support Project: http://www.mentalhealthcommission.ca/English/Pages/PeerProject.aspx

The Shain Reports:http://www.mentalhealthcommission.ca/SiteCollectionDocuments/Key_Documents/en/2009/Stress%20at%20Work%20MHCC%20V%203%20Feb%202009.pdf

Guarding Minds at Work: http://www.guardingmindsatwork.ca/

The Great West Life Centre for Mental Health:http://www.gwlcentreformentalhealth.com/english/index.asp

Working Through It – Stories of People dealing with workplace mental health issues:http://www.gwlcentreformentalhealth.com/english/display.asp?l1=2&l2=17&l3=173&d=173

The Mental Health Commission of Canada (MHCC): http://www.mentalhealthcommission.ca/

The Service System Advisory Committee’s “Making the Case for Peer Support” (http://www.mentalhealthcommission.ca/SiteCollectionDocuments/peer/Service%20Systems%20AC%20-%20Peer%20support%20report%20EN.pdf )

Workplace Strategies for Mental Healthhttp://workplacestrategiesformentalhealth.com/display.asp?l1=7&l2=187&d=187