Working conditions, exposure to trauma and the mental health of firefighters

Dr Kevin Teoh from the Department of Organizational Psychology shares the findings so far from the Firefighter Longitudinal Health Study.

Firefighters working on the Brumadinho Dam Disaster in 2019

Firefighters play a crucial role in the emergency response system, taking on a myriad of roles that range from the firefighting to responding to car crashes, delivering emergency care and raising safety awareness. They also perform rescue services and are involved in disaster relief.

The nature of this work is often physically, mentally and emotionally challenging, and firefighters can be exposed to traumatic situations such as the destruction of property, burn victims, serious injuries and death. All this can eventually take a toll on the mental health of this occupational group, and it is not surprising that firefighters report high levels of burnout, posttraumatic stress and common mental health disorders (Katsavouni et al., 2016; Lima & Assunção, 2011; Noor et al, 2019).

An international partnership

To better understand what, and how, different factors lead to the development of poor mental health in firefighters, in 2018 two psychologists from Brazil – Dr Eduardo de Paula Lima and Dr Alina Gomide Vasconcelos – visited the Birkbeck Centre for Sustainable Working Life for a six-month Fellowship. More specifically, they came from the Minas Gerais Fire Department, whose firefighters received international media coverage when the Brumadinho dam collapsed in 2019, leading to the loss of at least 256 lives.

The cornerstone of our international collaboration is the ongoing Firefighter Longitudinal Health Study (FLOHS), which aims to better understand the dynamic relationships among individual, operational (traumatic) and organisational risk factors in the development of post-traumatic symptoms and other mental health problems in firefighters. Recruits are assessed in their first week of training with follow up data collected every two years.

The role of working conditions

A simplistic take on the poor mental health of firefighters is that this is the product of the challenging work that they do. However, this ignores the fact that there is consistent research showing that psychosocial working conditions can have a beneficial and detrimental impact on our mental health (Harvey et al., 2017). Within the field of organizational psychology, psychosocial working conditions refer to how work is designed, organised and managed. Here in the Department of Organizational Psychology, we have studied this in a range of different occupations, including doctors (Teoh, Hassard, & Cox, 2018), teachers (Hassard, Teoh, & Cox, 2016) and performing artists (McDowall et al., 2019).

The current study

As psychologists, we were not only interested in whether exposure to traumatic events had a link to firefighters’ mental health, but whether psychosocial working conditions had a similar effect. In our first published study from the FLOHS project, we examined the data from 312 firefighters that were part of the first batch of participants. Three types of psychosocial working conditions were measured: how demanding the job is (i.e. job demands), how much influence one has on their work environment (i.e. job control) and how supported one is (i.e. social support). This was in addition to measuring firefighters’ exposure to traumatic events. The findings were quite clear:

  • 13% of firefighters reported a level of poor mental health that warrants psychological intervention.
  • Higher levels of exposure to trauma and higher levels of job demands were associated with poorer mental health.
  • Higher levels of job control and social support were associated with better mental health.
  • The strength of the relationship that job demands had on poor mental health reduced when firefighters reported high levels of either job control or social support.

What does this all mean? What if I’m not a firefighter?

The findings show that to support the mental health of firefighters, fire departments should focus on reducing the levels of job demands while increasing the levels of social support and job control. Given the inherently difficult nature of firefighting that will be very difficult to remove or reduce, the very least that firefighters deserve is to work in an organisation where the psychosocial working conditions are not another contributing factor to poor mental health.

This message has direct relevance to workers in other occupations within the emergency services, including healthcare workers, the police and the armed forces. In addition, more generally, our findings emphasise that supporting the mental health of workers requires improvements to their psychosocial working conditions and needs to focus on the organisation itself – not through individual interventions such as resilience or mindfulness training (Kinman & Teoh, 2018).

The citation for the study is: Teoh, K. R. H., Lima, E., Vasconcelos, A., Nascimento, E., & Cox, T. (2019). Trauma and work factors as predictors of firefighters’ psychiatric distress. Occupational Medicine. doi: 10.1093/occmed/kqz168

Further information:

References

Harvey, S. B., Modini, M., Joyce, S., S, M.-S. J., Tan, L., Mykletun, A., … Mitchell, P. B. (2017). Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems. Occupational and Environmental Medicine, oemed-2016-104015. https://doi.org/10.1136/oemed-2016-104015

Hassard, J., Teoh, K. R.-H., & Cox, T. (2016). Organizational uncertainty and stress among teachers in Hong Kong: work characteristics and organizational justice. Health Promotion International, daw018. https://doi.org/10.1093/heapro/daw018

Katsavouni, F., Bebetsos, E., Malliou, P., & Beneka, A. (2016). The relationship between burnout, PTSD symptoms and injuries in firefighters. Occupational Medicine, 66(1), 32–37. https://doi.org/10.1093/occmed/kqv144

Kinman, G., & Teoh, K. R.-H. (2018). What could make a difference to the mental health of UK doctors? A review of the research evidence. London, UK, UK. Retrieved from https://www.som.org.uk/sites/som.org.uk/files/What_could_make_a_difference_to_the_mental_health_of_UK_doctors_LTF_SOM.pdf

Lima, E. de P., & Assunção, A. Á. (2011). Prevalência e fatores associados ao Transtorno de Estresse Pós-Traumático (TEPT) em profissionais de emergência: uma revisão sistemática da literatura. Revista Brasileira de Epidemiologia, 14(2), 217–230. https://doi.org/10.1590/S1415-790X2011000200004

McDowall, A., Gamblin, D., Teoh, K. R.-H., Raine, C., & Ehnold-Danailov, A. (2019). Balancing Act: The Impact of Caring Responsibilities on Career Progression in the Performing Arts. London. Retrieved from http://www.pipacampaign.com/wp-content/uploads/2019/04/BA-Final.pdf

Noor, N., Pao, C., Dragomir-Davis, M., Tran, J., & Arbona, C. (2019). PTSD symptoms and suicidal ideation in US female firefighters. Occupational Medicine. https://doi.org/10.1093/occmed/kqz057

Teoh, K. R.-H., Hassard, J., & Cox, T. (2018). Individual and organizational psychosocial predictors of hospital doctors’ work-related well-being. Health Care Management Review, 1. https://doi.org/10.1097/HMR.0000000000000207

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Meet our academics: Dr Manto Gotsi

Meet our Academics: Dr Manto Gotsi

Dr Manto Gotsi is a Senior Lecturer in Marketing in Birkbeck’s Department of Management. She is Programme Director for the new online MSc Marketing and Module Convenor for Consumer Behaviour.

Manto GotsiQ: What is your #BBKStory?

My academic career to date could have been entitled “A Greek’s adventure around the UK”, if only Northern Ireland featured in my appointments. Born in Athens, I travelled to Glasgow to study a BA(Hons) in Marketing at the University of Strathclyde. I’ve always loved writing, so my 18-year old self thought that a degree in Marketing would help secure a job as a copywriter. While studying, I worked in the Marketing department of a bank and in a PR agency, only to realise that writing marketing material was not the creative endeavour I envisaged. So, I decided to embark on a PhD in Marketing at Strathclyde – and join the creative freedom of the academic community.

Since then, I’ve held Lectureships at the University of Aberdeen and Brunel University, a Senior Lectureship at Cardiff University and a Readership at the University of Westminster. I’ve always been looking for an opening at Birkbeck. I strongly believe in the transformative power of education, to open horizons, improve job prospects and trigger new careers – and Birkbeck seems to be the perfect ambassador.

Q: What are you currently working on?

My research focuses on the management of paradoxes – how organizations, teams and individuals respond to competing demands and resulting tensions. At the moment, I am working on two exciting research projects. The first has been an eye opener. It is an exploratory study of the formalisation of informal entrepreneurs – waste pickers in Colombia – which has recently been funded by a British Academy/Leverhulme Small Research Grant. Findings reveal the struggles that waste pickers experience in disengaging from their informal role and transitioning into a formal entrepreneurial identity. The study ultimately argues that formalisation is a process rather than a destination. The second is in the corporate realm, exploring how different types of team goal orientation are linked to radical innovation outcomes in a corporate research lab in the USA.

I also lead the development of the new online MSc in Marketing to be launched in September 2020 in collaboration with the University of London. This is an exciting initiative for many reasons. Firstly, I strongly view online learning as part of the future of education – and I am delighted that Birkbeck plays a role in this new era. Secondly, I believe that online learning sits very closely to Birkbeck’s ethos and values of enhancing access to education. Beyond part-time learning in our on-the-ground programmes, online programmes thus seem like a natural extension. Lastly, on the personal front, this programme is an opportunity for me to learn new skills, which I am very much enjoying!

Q: What do you do in your spare time?

I have always enjoyed writing poetry and short stories and recently I’ve been flirting with the idea of publishing my work. Beyond writing, I adore travelling. I spend most of my disposable income travelling around the world with my family and friends. I love exploring new places, understanding how people live and trying out new cuisines.  I am an avid reader of novels and poetry, and also follow international news with a passion.  I also enjoy hanging out in the Victoria and Albert Museum and having endless coffees with my friends.

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BEI Research Year in Review

2019 was a busy year for the School of Business, Economics and Informatics. Here are some of our research highlights.

BEI Research Year in Review

Improving Diversity on Sport Boards

Improving diversity on sport boards

Dr Richard Tacon and Dr Geoff Walters from the Department of Management worked with Sport England to improve the diversity of board members in the sport and physical activity sector. The programme, unveiled in September, follows a series of studies demonstrating that sports governance lacks diversity, particularly with regards to ethnicity and disability.

Richard and Geoff have designed and implemented training materials as part of the initiative, which will identify and develop a pool of suitable candidates from under-represented groups. The intention is that sports organisations will then be able to turn to these people when recruiting for new board positions.

Diagnosing Gaming Disorder

Gaming

Researchers led by Bruno Schivinski, Lecturer in Marketing, developed the first psychological test to check for ‘gaming disorder’, a new type of mental illness now recognised by the World Health Organisation.

Now accessible online, the test provides participants with feedback on their video game habits in comparison with the rest of the population. Research is ongoing to understand the point at which gaming becomes a health problem and the factors which contribute to the development of gaming disorders to promote responsible gaming.

Sticking up for Parents in the Performing Arts

Paloma Faith is among those calling for better support for parents in the performing arts

Academics from the Department of Organizational Psychology developed a survey of workers and work-life balance in the performing arts in partnership with Parents and Carers in Performing Arts (PiPA).

Over 2500 UK workers from the performing arts, including 1000 parents and carers, took the survey. It found that 43% of performing artists who left their careers did so because they became parents. Carers pay a significant penalty in terms of well-being and remuneration in order to maintain a career in the performing arts and are far more likely to leave the industry than non-carers, leading to a drain in talent and reduced diversity in the arts. Professor Almuth McDowall, Head of Department, added her voice to the call for change alongside leading figures in the sector such as actor Cate Blanchett and singer Paloma Faith.

Understanding Text Data

Researchers from the Department of Computer Science and Information Systems developed a tool to simplify the process of understanding and using data from text. Called Samtla API, the new service can automatically annotate words and phrases from digital text documents with named entities and sentiments using machine learning and text mining technologies.

Spearheaded by Dr Mark LeveneDr Martyn Harris, and Dr Andrius Mudinus, the initiative grew in response to the growing need for easily understandable annotations on the large volumes of text data, generated by media, businesses and individuals all over the world.

A Prizewinning Contribution

Dr Alexey Pokrovskiy was awarded the European Prize in Combinatorics

In August, Dr Alexey Pokrovskiy from the Department of Economics, Mathematics and Statistics was awarded the European Prize in Combinatorics. The prestigious award is made once every two years, recognising excellent contributions in Combinatorics, Discrete Mathematics and their Applications by young European researchers aged 35 or under.

Adapting to Climate Change

Strategic management experts from the Department of Management and the Cass Business School at City, University of London found that greater collaboration between the insurance industry and state policy makers could improve society’s ability to recover from disasters linked to climate change.

Using insurance is a step away from crisis towards risk management, strengthening socio-economic resilience under a changing climate. Birkbeck’s Dr Konstantinos Chalkias, the Cass Business School’s Professor Paula Jarzabkowski and their co-authors put forward seven recommendations to the Global Commission on Adaptation to maximise the benefits of insurance for climate adaptation.

Supporting Sustainable Return to Work following Mental Ill-health Absence

Dr Jo Yarker from the Department of Organizational Psychology and Professor Karina Nielsen from the University of Sheffield have been researching how to support employees who are returning to work following mental ill-health absence.

In the UK alone, stress, anxiety or depression accounts for 57% of all working days lost to ill-health in 2017-18. Yarker and Nielsen developed a toolkit for employees, colleagues, line managers and HR professionals to support individuals to return to and stay in work.

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Informal entrepreneurs and formalisation: insights from a role identity transition lens

Dr Manto Gotsi from the Department of Management is exploring the barriers to entrepreneurship in developing economies. She explains her findings from research into the formalisation of waste pickers in Cali, Colombia.Entrepreneurship in Colombia

Entrepreneurial development is viewed as an engine for economic growth in developing economies. However, these same economies are faced with high numbers of informal entrepreneurs: choosing entrepreneurship out of necessity rather than opportunity, these individuals operate on a small scale, are low-skilled and often marginalised.

In many developing economies, informal entrepreneurship, that is, monetary transactions not declared to the state for tax benefit and/or labour law purposes, but which are legal in all other respects, accounts for up to 60% of GDP. Informal entrepreneurs are viewed as unfair competition to formalised entrepreneurs, with the risk of stifling economic growth. These workers also face a lack of protection and are at risk of exploitation, since they are operating outside of the law.

However, despite growing efforts to influence formalisation, informal entrepreneurs are exceptionally persistent. Alongside my colleagues Dr Maria Granados and Dr Ainurul Rosli, I wanted to find out why this is the case.

This missing micro focus

Prior to our research, studies on formalisation have focused predominantly on institutions; aiming to stimulate entrepreneurs to formalise through direct controls on their actions, alongside education and appeals to raise awareness of the benefits for the individual.

Formalisation has typically been conceived of as a destination rather than a journey (Burton, Sørensen and Dobrev, 2016). We took an alternative view, understanding the process as a continuum, whereby an informal entrepreneur undergoes a role identity transition.

For this transition to take place, an individual must adopt new skills, attitudes, behaviour and patterns of interpersonal interactions, while maintaining some sense of self-continuity. They may require external resource and validation from their peers in order to legitimize their position. A successful role identity transition will result in internalization of this new identity; an alternative outcome is role abandonment.

Our research

Our research took us to Cali, Colombia, where informal waste pickers have been carrying out recycling activities for over one hundred years. For the past thirty, they’ve been relying on the Navarro landfill; collecting recyclable materials to transport and sell to intermediary informal warehouses. When Navarro was closed due to environmental concerns, a new law prohibited waste pickers from working in sanitary landfills and from recuperating recyclables from trash bags and transporting them in non-motorized vehicles. Following an intervention from CIVISOL Foundation, the Colombian Constitutional Court recognized the marginalized status of these waste pickers and granted them formal entrepreneur status.

Surprisingly, despite this change in the law, by no means all waste pickers became and stayed formal entrepreneurs. Some became paid workers instead of entrepreneurs, while others chose to continue as renegades outside of the system. There was also evidence of individuals moving back and forth between these options, with many entry and exit points on the road to formal entrepreneurship.

Through our interviews with waste pickers in Cali, we found that those who had successfully transitioned to formal entrepreneurs in what we see as a ‘virtuous cycle’ had in common a high sense of calling that enabled them to adopt the formal entrepreneurial identity. In addition, they were comparatively less concerned about receiving validation from their peers and wider society.

Those who became renegade waste pickers also did not feel a strong need for external recognition, however they didn’t feel the same calling, so didn’t adopt the formal entrepreneur identity. Similarly, although those who became paid workers had access to information and resources, they couldn’t see themselves in the role of formal entrepreneur.

How to encourage virtuous cycles

Our research tells us that granting formal status to marginalized workers is necessary, but not sufficient for sustained formalisation. It is essential to take into consideration the norms, values, beliefs and struggles of informal entrepreneurs, and encourage role identity development through information initiatives and social network support. People who felt a calling and could visualise themselves in the role were more likely to remain in formalised status.

In order to create more external support, there should also be campaigns to motivate local government, local business communities and broader civil society to recognize and support the formalisation journey.

All this needs to take place before, during and after role transition to ensure more people stay in formalised roles.

Further Information:

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