Health and Safety
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Barriers to psychological health and safety

By Dr. Kate Toth, CHRL


Considerable recent efforts by mental health leaders in Canada have been successful in opening the conversation about mental health in the workplace.

Such conversations are vital to the reduction of stigma for people struggling with a mental disorder. However, there is still a long way to go and stigma acts as a barrier to psychological health and safety in our workplaces.

A research study on disclosure decision making at work (Toth & Dewa, 2014) found that employees diagnosed with a mental disorder perceived significant differences in disclosing a mental versus a physical health issue. They also discussed their fear of being stereotyped; employees were concerned about being perceived as incompetent to perform their job, that they could just “get over it” if they “pulled up their socks” and that they were manipulating the system for their own benefit. Moreover, participants feared being viewed or treated differently following disclosure of the mental disorder (e.g., being the subject of gossip, concerns about job security and loss of opportunities for advancement).

These research findings highlight the vulnerability of a group of people in the workplace, a position that is protected through adoption of a default position of nondisclosure due to fear of being stigmatized. While the study discussed here is related to mental disorders, it can be argued that the same processes are likely to be at play for any individual with a concealable stigmatized identity.

The basis for psychological safety is on workplace practices that involve choices or decisions about how work is structured or performed. Research has found that damages awarded for mental injury have increased by 700 per cent since 2006, and that the greatest psychosocial risk factors are related to job demands, job control, rewards and recognition, fairness and support (Shain, Arnold, & GermAnn, 2011; Shain & Baynton, 2011). Most legal actions have been founded on workplace failures in three key areas: 1) reasonable and clear job demands, 2) safety for employees to voice concerns and 3) monitoring and responding to workplace conflict. Stigma in the workplace can be linked to all three of these areas for legal action.


Reasonable and clear job demands

Overwhelming job demands are linked to burnout and exhaustion, while a lack of job resources is associated with disengagement from work, resulting in reduced organizational commitment and increased absenteeism. Reasonable and clear job demands are important for psychological safety; however, the reasonableness of job demands may vary from individual to individual, making it challenging for employers to ensure fairness among employees and achieve necessary productivity.

Employees do need to disclose, at least to some extent, to access necessary or helpful workplace accommodations, but many choose not to do so. Research has found that employees who disclose do in fact receive more accommodations, and that supervisor and coworker supports are particularly important for increased job tenure for employees diagnosed with a mental disorder (Corbière et al., 2014).


Safety to voice concerns

Employees who fear stigmatization do not feel safe to voice concerns. In fact, they may spend considerable mental and emotional resources concealing the stigmatized attribute, resulting in fewer cognitive resources available for the work itself. Employees in this position are likely to feel less able to voice concerns related to workload, job demands and work-life balance for fear of being perceived as incompetent or trying to manipulate the system.


Workplace conflict

Once an employee discloses, through choice or accident, the information is out there and cannot be taken back. Employees may face responses that result in workplace conflict or harassment, such as being the subject of gossip, social exclusion, judgment and facing reduced opportunities for advancement. Employees may experience more limited psychological and social support, civility and respect and psychological protection. They may also have more limited involvement and influence through the discrediting process that accompanies stigmatization. In turn, such factors will have an impact on employee engagement, both for the individuals affected and for the broader organization.


Implications for organizations

Through reducing stigma in the workplace, employers can enhance inclusivity and psychological safety. Organizational culture is fundamental to this process and human resources has a key role to play in the achievement of the desired culture. Here are some recommendations for getting started:

Work towards implementation of the Standard on Psychological Health and Safety in the Workplace. The Standard identifies 13 risk factors for organizations, including those discussed above. Many resources exist to assist organizations – see the Mental Health Commission of Canada website to get started.

Review and enhance your organizational policies. Organizations need to have policies in place that support a psychologically healthy and safe workplace culture related to civility, respect, inclusivity, diversity, non-discrimination and accommodation of individuals with disabilities. These should be integrated into the existing health and safety policies and practices within the organization recognizing the health of the whole person, rather than creation of a stand-alone psychological safety policy. It is also critical that these policies are consistently enforced in all areas of the organization, as culture can vary quite significantly among units in the same organization.

Combat stigma in the workplace. Stigma involves cognitive, affective and behavioural responses from others. Reduction of stigma is challenging because it is often a result of deep-level attitudes that are resistant to change. Research suggests that interventions that include contact with an individual belonging to the stigmatized group, particularly where people work together towards a shared goal, are more effective in achieving lasting attitude change than interventions that simply provide accurate information and challenge stereotypes.

Minimize relational conflict. Substantive conflict or conflict related to tasks, issues, different points of view and the like can result in better decision making and a moderate level should be encouraged within organizations to promote full consideration of options and avoid groupthink. On the other hand, relational conflict is personal in nature and refers to personal attacks, gossip, interpersonal disharmony, harassment, social exclusion and other such practices. A conflict management strategy sets boundaries for substantive conflict, creates processes for respectfully disagreeing with colleagues while working together to achieve organizational outcomes and emphasizes a zero-tolerance policy for relational conflict (Rahim, 2002).

Taking these steps will enhance the psychological health and safety for all employees within your organization, but particularly for those who face increased vulnerability due to stigma.

Dr. Kate Toth is a professor of human resources at Conestoga College.



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