Monitor - September 2013

42 MONITOR ON PSYCHOLOGY • SEPTEMBER 2013

Total Worker Health” — illustrated this broader view of occupational health. In fact, NIOSH coined the term “Total Worker Health” to advance the idea that factors both inside and outside the workplace contribute to the health and safety of today’s workforce.

“Work and health, because they’re such important components of our lives, cannot be separated,” said L. Casey Chosewood, MD, senior medical officer at NIOSH, who chaired a session on Total Worker Health TM. “What happens at work doesn’t stay at work, and what happens at home doesn’t stay at home.” Traditionally, workplace health and safety measures haven’t been well integrated with general health-promotion programs. That’s finally changing, Chosewood said. Today’s companies aren’t just working to make their physical spaces safe for workers, he said. They’re also encouraging employees to make healthy choices when they’re off the clock, by providing opportunities for health education or medical screenings, for example.

“The workplace is an ideal venue for advancing health,” Chosewood added. “People come to work with an understanding that they are going to follow directions, take instruction, be part of a team and learn new skills. It’s really a perfect place for health interventions.” While Total Worker Health was the theme of this year’s conference, presenters discussed a wide range of topics at the event. Following are just a few of the many highlights.

Promoting mental health in the workplace

In the opening session plenary presentation, Anthony LaMontagne, ScD, of the University of Melbourne’s School of Population and Global Health, discussed an integrated intervention approach to work and mental health. Anxiety, depression and other mental health problems are prevalent in working populations, he said, and some of those problems are attributable to working conditions. Any intervention to improve mental health in the workplace needs to combine three components, he argues.

First, he said, mental health interventions should reduce work-related risk factors for mental health problems, such as bullying, job insecurity, long working hours or poor social support at work.

Second, interventions should promote the positive elements of work. “Most people derive some meaning or satisfaction from work,” LaMontagne said. While those elements may be more obvious in some jobs than in others, people in all sorts of jobs can draw self-esteem and self-efficacy from their work. “We don’t do a good enough job trying to build up the positives,” he said.

Finally, LaMontagne said, employers must address mental health problems among working people, regardless of their underlying cause. In the end it doesn’t matter whether a person is depressed because of factors at work or at home, he notes.

Either way, employers must address the issue in the workplace.

Assisting affected employees to seek professional help will benefit the organization as well as the individual worker.

LaMontagne said that employers have been fairly accepting of workplace mental health promotion programs, driven mostly by concerns about absenteeism and productivity. But they’ve been less successful addressing job stress issues. “Employers are basically saying, ‘Come in and fix the workers,’ but aren’t making sure the workplace is optimal,” he said. While that’s frustrating for people concerned about mental health, he adds, it’s also an opportunity. “To some extent, this is an opportunity to ride on the coattails of mental health promotion, to get job-stress prevention into the mainstream.”

Job insecurity and accident under-reporting

Tahira Probst, PhD, from Washington State University, studies both job insecurity and the safety climate of organizations. She presented results of a recent study investigating the intersection of those two interests. Three million work-related injuries and illnesses are reported in the United States each year, Probst said, but some studies have found more than three-quarters of workplace injuries go unreported. She hypothesized that when workers feel their jobs are insecure, they are less likely to report accidents and injuries.

She surveyed 1,265 workers in 27 organizations from a variety of sectors, such as hospitality, manufacturing, construction and health care. She confirmed that as job security went down, the number of unreported injuries climbed. On the other hand, organizations with a positive safety climate — those that reward safe behaviors, enact good safety training systems and make employees feel comfortable raising issues to managers, for instance — had lower rates of under-reporting.

Encouragingly, a positive safety climate could overcome the effect of high job insecurity on under-reporting.

Job security can’t always be improved, Probst said, but organizations can protect workers by taking steps to improve the company’s overall commitment to safety. “What goes unreported goes unfixed,” she said. “The issue of under-reporting is extremely critical to the health and safety of employees.”