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SAFETY & HEALTH: General Health

Mind Your Work


The impact of mental disorders on work.

IT is estimated that one in four Malaysians suffer from a mental disorder. Mental health problems are among the most important contributors to the burden of disease and disability worldwide. According to the WHO, depression will be one of the largest health problems worldwide by the year 2020.

However the prevalence of psychiatric morbidity in the workplace is not known.

The 1996 Malaysian national health survey revealed that 10.7% cent of the population had mental illness and 10.5% cent of adults suffered minor forms of mental illnesses such as stress, anxiety, excessive worry, psychosis, etc.

Social changes and the economic uncertainty arising from globalisation will result in large numbers of our workforce being subjected to some form of anxiety, depression, and mental stress in relation to their jobs and working lives.

The impact of mental disorders on work productivity is dramatic: productive workdays are lost, costing employers money.

The consequences are immense, for the workers, their families, and the communities they live in.

What is mental illness?

Mental illness leads to a significant impairment of one’s thinking, emotional, or social abilities and may require intervention. It is “any clinically significant behavioural or psychological syndrome characterised by the presence of distressing symptoms or significant impairment of functioning”.

It can cause disruption to a person’s behaviour, emotions, or thoughts that may last weeks, months, or years. People can and do recover from mental illness, but the treatment that works will vary from person to person.

The exact causes of mental illness are unclear, although it is thought that there may be a number of influences, including psychosocial, stress-related, biochemical, and genetic factors. Many things may also contribute to the onset of mental illness, such as trauma, conflict, alcohol or drug use, and unresolved or increased stressors and demands.

People with experience of mental health issues are often given a medical diagnosis – a medical explanation of the problem. It is important when working with a person that we continue to remember that our friend or employee is a person first – he is not a diagnosis.

For some individuals, receiving a diagnosis is a relief, providing explanation and logic to their experiences, and providing a way forward. For others, the label is not that important – everyone is different. If you are unsure of your employee’s/colleague’s views, ask them directly; don’t assume.

Examples of mental health disorders include mood disorders, anxiety disorders, psychotic disorders, postnatal disorders, eating disorders, and alcohol and other drug disorders.

Stress in the workplace

Stress is defined as “the awareness of not being able to cope with the demands of one’s work environment with an associated negative emotional response”. While everyone’s tolerance level for stress is different, issues that can create stress at work include:

  • harassment at work i.e. bullying, violence, sexual, racial, disability
  • expectations of long working hours
  • lack of recognition, or positive feedback
  • uncertainty about what is expected or required in the job and the future of the organisation
  • accident hazards and dangers
  • poor management styles that do not include consultation or value diversity in the workplace
  • unresolved conflicts in the workplace
  • poor support for workers experiencing personal or professional difficulties

It is important to remember that there may be a combination of things happening in a person’s life affecting his mental health. The strengthening of the “stress and fatigue” amendments means that employers need to be proactive in addressing issues of stress in the workplace.

Whilst people are entitled to keep their personal lives to themselves, if this is affecting their work performance, an employer may need to check things out and offer support around issues such as:

  • work/life balance
  • relationship issues
  • financial issues
  • family issues, such as childcare or elderly parents
  • health issues, including alcohol and other drug issues

Legal rights and responsibilities

Discrimination can be seen as the systematic unfair treatment of people because they are different. It occurs when a person is treated unfairly or less favourably than another person in the same or similar circumstances.

It is unlawful to discriminate against someone because they have a mental illness on the basis of disability, which includes mental illness and can include mental health issues, when in employment or looking for a job.

Employers have to make reasonable accomodations (RAs) for employees with disabilities, including people with an experience of mental illness, unless it would be unreasonable for them to do so. Possible RAs could be:

  • restructuring jobs so that some tasks that a person has difficulty with are swapped for tasks they are able to do
  • adjusting work schedules so that people can work at their best times; some people feel better in the mornings and want to start earlier and others may feel worse in mornings due to medications, or some people may request time off for counseling or medical appointments
  • providing part-time work if suitable; this may be on a temporary or a more permanent basis
  • having flexible sick leave provision, including leave without pay if appropriate
  • providing some private space to work, or modifying open offices, so people have some form of privacy, especially if noise aggravates their mental health

What can employers do?

Communicating with a staff member who has experience of mental illness is not difficult. It requires principles of good management, including:

  • knowing your staff
  • talking to them openly and honestly
  • being able to catch things early
  • having a good overview of what support and assistance you or your company can provide

If you have concerns about a staff member, it is important to discuss your concerns with them directly. Talk to your human resource advisor or department head about your concerns, after letting your employee know you are doing so. Remember, this is about supporting your employee, not creating more stress by trying to figure out his situation without his involvement.

What can employees do?

As an employee, you need to be honest with yourself and with your employers. No one can expect support and help if they don’t discuss their situation directly and honestly. If you realise you are not well, begin by exploring some of the resources available to you within the organisation. You may like to consider the following options.

  • Is there an EAP – Employee Assistance Programme – in place?
  • Do you have any sick leave balance owed to you?
  • What or who are your main supports at work, at home, in the community?

If you find that work is continuing to be a struggle, you need to talk with your manager about the situation. This may be difficult, especially when you want to be seen as a capable and committed employee, but honesty and openness is often the best way to sorting out work demands before they get more difficult.

When approaching your manager, you might like to consider:

  • taking a support person with you to discuss issues – there is no weakness or shame in doing this and your support person may be able to help you to explain things more clearly
  • being prepared – write down what you want to say and what you think might help you at this time, not what might help the company
  • talking to your doctor or counsellor about their suggestions and whether they would be prepared to discuss any issues that arise with your manager

Don’t be afraid to ask for the support you require.

Staying connected

If the employee does take time off work, consider how he can stay connected in some way to the organisation and his team. Be guided by the person, or if necessary by his support people – both family and health professionals.

Some companies have set procedures and policies in place to do this when someone is away sick for whatever reason. For example you may find it useful to:

  • keep in touch – this may be through a family or friend if the person wishes
  • let your colleague know about any significant work issues, such as organisational changes, management changes, etc
  • don’t withhold information that will affect him directly
  • do not lie about a situation if your employee/colleague asks about something
  • respect the person’s needs/wishes for privacy or contact – don’t have the manager or whole team visit unannounced
  • send flowers if that’s what happens when people are unwell – just because it’s a mental illness not a physical illness doesn’t mean they won’t appreciate them
  • try not to pressure for a return date, this may increase their anxiety and delay return

Returning to work

It is common that returning to work (RTW) after a period of being unwell can be a very frightening prospect. Often, a person’s self esteem and confidence have been affected and he sometimes doesn’t feel he has the competence to return.

There may be fear that he is going back too soon, and will have to take on too much, not be able to cope and become unwell again.

This can create a snowball effect of growing fears and worries. There is also the fear of what other people will think and what impact a person’s absence has had on the rest of the team.

Fears and concerns about returning to the workplace are normal and being able to talk them through will help. Think about what support you would like to have on returning to work and who you might like as support people. Identifying what causes additional pressure and stress, and what assists you, can help create a positive RTW plan. Being prepared in this way can help ensure a RTW that meets your needs.

A RTW plan needs to be responsive to both the needs of the person and the organisation. It is important from an employer’s perspective to be realistic about what RAs your workplace can make.

Employers need to consider, in consultation with the person and any appropriate support people the:

  • type of work the person is doing
  • severity of the situation for the person
  • other factors specific to the person, i.e. general state of health, age, access to support and treatment, adjustment to the situation, etc.
  • other factors specific to the workplace, i.e. levels of flexibility to accommodate changes, sick leave, RTW policies, etc.

Looking at all the options

As with any other significant health issue, the employee and the employer may need to consider whether permanent full time employment is the best option or whether part time or contract work might be more suitable.

Sometimes, other roles in the company or using a supported employment service may be an option. However, if options are very limited, and there are no appropriate alternatives, it may be necessary to discuss terminating employment.

It is really important to have a clear written plan so that strategies and support options are outlined. This needs to be reviewed and directed by the person returning. Discuss how feedback will be given from both the employee’s and employer’s perspective. Involve someone as additional support if desired.

Set another review date for about one month after it seems everything is back to usual, as you would with physical conditions – there can be a “settling in period” when people first return and it’s important to have planned follow-up to ensure progress is being made.

Mentally healthy workplaces

If an organisation hasn’t already looked at overall wellness in the workplace, this is a perfect opportunity to do so. For many people, there will be work-related stressors that may have contributed to their mental health issues. Involving all staff in promoting wellbeing and health is an important part of health and safety policy. Anyone can become stressed in the workplace environment, so looking at policy and action can be really helpful.

When the time is right, a person returning from work after experiencing mental illness or other mental health issues could be a great asset or guide in this process.

Source: Article from the Star Online, 6 December 2009

 

Dr Raminder Kaur is a consultant psychiatrist. This article is contributed by The Star Health & Ageing Panel, which comprises a group of panellists who are not just opinion leaders in their respective fields of medical expertise, but have wide experience in medical health education for the public. The members of the panel include: Datuk Prof Dr Tan Hui Meng, consultant urologist; Dr Yap Piang Kian, consultant endocrinologist; Datuk Dr Azhari Rosman, consultant cardiologist; A/Prof Dr Philip Poi, consultant geriatrician; Dr Hew Fen Lee, consultant endocrinologist; Prof Dr Low Wah Yun, psychologist; Datuk Dr Nor Ashikin Mokhtar, consultant obstetrician and gynaecologist; Dr Lee Moon Keen, consultant neurologist; Dr Ting Hoon Chin, consultant dermatologist; Prof Khoo Ee Ming, primary care physician; Dr Ng Soo Chin, consultant haematologist. For more information, e-mailstarhealth@thestar.com.my.

 





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