Mental stress at work
Mental stress and promoting resilience.
In a recent conversation with the manager of a care facility, the question arose as to the origin of the phenomenon whereby employees start blaming each other and making each other responsible for mistakes. In difficult situations, someone is promptly named as being responsible because they have done or failed to do something. When employees call in sick, it is often always the same people. The same employees politely and silently take on the extra work on site, because when someone is sick, you are not supposed to say anything bad about him or her. When the colleague who has recovered returns to work, he or she still feels the cold, hears the odd pointed remark like: ‘… well? Finally back too?’
When the atmosphere turns frosty, it seems that scapegoats are needed. The supposedly weakest in the system are picked on, so that the stress in the work system degenerates into strain. A tendency can arise in which the wave of sick notes does not stop. The next employee drops out as soon as another has resumed work. What can be done about it and where can those affected find help and support?
Conflict is human
Even in the Old Testament, scapegoats were needed to discharge culpable omissions and unresolved tensions by throwing stones, and to be able to return to a regulated everyday life. What remains is the desire for people to find a prompt explanation for various forms of unease and to quickly dissipate it. This is especially true where much is left unsaid and supposedly empathic, where demarcation is equated with a lack of teamwork.
What to do with cackling chickens and black sheep?
Sheep farming is proving difficult in today’s companies, but finding scapegoats is a little easier. And there are now legal requirements for keeping chickens, just as there are for employees. Since 1996, the Occupational Safety and Health Act has applied to companies. Among other things, it states that a cause study should be carried out and that a functioning protection system should be in place. In 2013, it was expanded to include the factor of ‘psychological stress’. The resulting counselling and training opportunities do not always deliver what they promise. The question often remains: ‘How do I recognise whether my employees are under psychological stress and how do I make the factor measurable and my measures controllable?’
The statutory accident insurance institutions provide valuable, cost-effective structural assistance that managers can use to intervene at various levels… before the hacking or stone-throwing begins. The simple structural model, which is divided into the levels of ‘technical’, ‘organisational’ and ‘personnel’, provides an initial systemic insight.
The technical level
At the technical level, the following questions can be addressed:
- How are the workplaces and rooms equipped?
- Is there an opportunity to retreat to an appropriate place for breaks?
- What about the room temperature, the noise level, the lighting?
- Are the work tools of good quality, available in sufficient numbers and in a well-maintained condition?
- What about the equipment for initial measures in the event of fire or accidents?
The organisational level
At the organisational level, the following considerations can be used to get started:
- When do peaks in stress occur, for example, because too many employees are in a room at the same time, limiting each other’s actions (have to)?
- Are responsibilities clearly and bindingly defined?
- (How) is an uneven distribution of tasks addressed: dual roles versus ‘shirking’?
- What happens when something happens? Are there bindingly named contact persons, for example ‘collegial contact persons’, so that information from employees can be taken up at an early stage?
The personal level
The personal level is the busiest and at the same time the least sustainable, simply because people are forgetful. Criteria for observation and assessment can be:
- How is demarcation dealt with when employees say ‘no’?
- Do they have adequate freedom to act and opportunities for further development?
- Are there times and, above all, spaces for exchanging ideas with colleagues and talking to management?
- Is the entire corporate culture more problem-oriented or solution-oriented?
- Do managers and employees have the courage to address conflicts openly and constructively, or are they avoided for fear of emotions?
When psychological stress becomes extreme
Psychological stress usually arises from the sum of all stresses and only rarely occurs in isolation. Systems decompensate seemingly unexpectedly at their weakest point. Particular attention is required in transitional situations and during peak periods, in times when no one is particularly attentive because they are fully occupied with day-to-day business. A functioning system for the protection of employees is put to the test when an emergency situation occurs. These include, for example, first-aid measures, fires, evacuations and escalations.
Post-traumatic stress symptoms only become apparent months later, when the affected company has long since returned to business as usual. It is right and important to resume as much normality and everyday life as possible after extreme events. At the same time, however, changes in team dynamics, an increase in the rate of absenteeism due to illness and fluctuation must be expected in the following months. Old conflicts, even those that have already been resolved, are present again. The scapegoat principle and the pecking order can take on a new dynamic. Existing stresses are intensified by an additional one.
Strengthening bonds and connections
Not only colleagues who are obviously in need of help, but also, and especially, employees who have helped to cope with an extreme situation in a matter-of-fact and professional manner need to receive positive feedback from the company in the period that follows, feedback in which their concerns are heard by their superiors. In addition, the statutory accident insurance funds provide support, for example, hotlines through which a ‘psychosocial rescue chain’ can be activated, similar to the regular emergency numbers.
In the company, the situation of employees who were involved in an extreme event should be documented in the first-aid book immediately, because the mental repression of such an event also begins immediately. If an employee visits their GP as a result of the extreme event in order to get a sick note, the GP will refer them to a ‘D-Arzt’ (a medical specialist for occupational accidents). This specialist is the first point of contact for the accident insurance company, which will then arrange further steps and measures.
Employees should be informed in the annual compulsory training sessions that stress reactions following an extreme in-house event are a case for the D-doctor, not for the GP. If more than three days of work are lost as a result of the event, managers must report the accident to the statutory accident insurance. If the employee concerned has been brought into contact with the statutory accident insurance system, he or she will receive professional support immediately and without red tape.
Conclusion
The impulses described above are important clues for tracking down the cause. The planning of measures should always be systemic, taking into account ALL stresses and strains. The most important resource in human interaction is the ability to form bonds. Recognising this ability, giving it space, promoting it and strengthening it is the key to stable working relationships.
Notes (mainly in German):
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Further reading: Fach-Information Psychosoziale Notfallversorgung der BGHM: https://www.bghm.de/fileadmin/user_upload/Arbeitsschuetzer/Fachinformationen/Fachinformationen/FI-0027_Psychosoziale-Notfallversorgung.pdf (Stand 07/2018)
Hanne Sha and Thomas Weber: Trauer und Trauma. Die Hilflosigkeit der Betroffenen und der Helfer und warum es so schwer ist, die jeweils andere Seite zu verstehen. Asanger-Verlag , 2015
Ina Maria Tristl
Ina Maria Tristl, born in 1971, has been working with people for 30 years. Since 2015, she has been advising and supporting small and medium-sized companies in the healthcare sector in her capacity as a healthcare specialist and occupational safety specialist. She teaches at vocational schools and independent educational institutions, and advises teachers and managers. She is also an honorary crisis intervention worker for the Red Cross.