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.

Further Information:

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Hair, power and politics

Professor Joanna Bourke from Birkbeck’s Department of History, Classics and Archaeology explores the cultural and political significance of hair.

This is a summary of a free public lecture Joanna Bourke will be giving at Gresham College (30 Holborn EC1N) on 31 October 2019 between 18.00 and 19.00. It is part of a lecture series she will be presenting as the Gresham Professor of Rhetoric. Other topics include: Eye, Breast, Stomach, Clitoris/Penis, Foot.

Then NAACP President Rachel Dolezal speaking at a rally in downtown Spokane, Washington. Credit: Aaron Robert Kathman

 

In June 2015, Rachel Dolezal was exposed for having lied about being of African American heritage. Dolezal was head of her local branch of the National Association for the Advancement of Colored People (NAACP); she had given talks at the Eastern Washington University on African American politics, including a class on the role of hairstyles in the Black Power Movement; she was active in the African American community. The problem was: she was not African American. In making the transition, spray tans were never enough. Crucial to her “passing” as Black was the way she styled her hair in long dreadlocks, weaves, and box braids. Even one of her critics had to admit that she “definitely nailed the hair, I’ll give her that”.

In May 2019, Anna Sorokin (alias Anna Delvey) was imprisoned for scamming her way to the top of New York High Society by pretending to be a German heiress with a £60 million fortune. She may have worn Alexander Wang outfits but her “ratty” hair with split ends betrayed her. In the words of one commentator, “No real heiress would be seen dead without immaculately coiffured hair”.

These two cases illustrate the importance of hair to the staging of the self. Numerous historians, anthropologists, and sociologists have observed that the body is a site for the cultural production and staging of the self. Hair is one of the most visible of these social markers. Hair can be cut, coloured, curled, braided, knotted, crimped, twisted, straightened, backcombed, teased, moisturized, oiled, gelled, sprayed, shaved, and wrapped. People wear wigs, weaves, hairpieces, and extensions; they cover their hair with scarfs and hijabs, taqiyahs and yarmulkes.

Hair signals gender, class, status, age, generation, marital status, religion, group membership, familial ties, politics, social norms. It is personal, but it is also a highly visible cultural artifact. In Victorian society, it was taken for granted that a hair conveyed social and emotional messages. Indeed, it is difficult to find a Victorian novel that does not linger on the hair of its characters. Hair shows a character’s inner character. Thus, in Wuthering Heights, Isabella Linton had artfully arranged curls until, when upset, “her hair uncurled: some locks hanging lankly down, and some carelessly twisted round her head”. In contrast, Dracula had “hair growing scantily round the temples, but profusely elsewhere. His eyebrows were very massive, almost meeting over the nose”. Hair was also a major part of relic culture in Victorian culture, particularly between the 1850s and the 1880s. The Great Exhibition showcased at least 11 displays of hair art. A lock of hair encased in a locket or ring was a powerful relic, creating binding connections between lovers.

Aesthetic judgements about hair are fundamentally political. Slave-traders, prisoners of war, and female collaborators are routinely shaved as a form of dehumanisation. In 1905, Madam C. J. Walker became the wealthiest self-made female millionaire in America by marketing hair softeners to African American women; decades later, the “Black is Beautiful” movement repudiated such products. As Marcus Garvey (the Jamaican activist who, incidentally, came to Birkbeck in the year immediately before he co-established the Negro Universal Improvement Association) proudly proclaimed: “Don’t remove the kinks from your hair! Remove them from your brain!”. During the 1968 protests against the Miss American pageant, feminists not only threw bras and girdles into the Freedom Trash Can, but wigs, hair-curlers, and false eyelashes as well.

Today, schools routinely apply rules that stigmatise Black hair styles. It was only in July this year that California became the first US state to ban discrimination over natural hairstyles. Hair remains a system of power.

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Examining the class system in British museum employment

Sam Evans, a PhD researcher at the Department for Organizational Psychology, is leading a series of focus groups which will ask participants to reveal what it takes to get in and get on in the museum sector, and how social class shapes career chances and experiences.

I’m interested in how inequality is reinforced in the workplace. Class, until recently, has been surprisingly absent from the debate. Research into diversity or equality, often overlooks class, as does occupational psychology in general. Part of the reason for this absence is that class is not a legally protected characteristic, like age or gender, but also it is argued that there has been a more fundamental ‘individualisation’ of Western culture.

Class identities have become more difficult to see or express in the workplace. Our careers are thus seen as our responsibility, and we don’t often think or talk about the structural inequalities that might frame this. However, there is research suggesting inequality at work is increasing, professions are becoming more not less exclusive, and social mobility is declining.

I want to explore these issues in-depth in my research project, The Museum of Them and Us; I am interested not just in how people are classed, but also occupations, roles and organisations. I am particularly interested in why some careers and types of work favour some groups of people and not others. We assume anyone can get in and get on, no matter how tough, given they have the right personal qualities. But what is this really like for people from different backgrounds? I have chosen to look at museums, partly because I am familiar with the field, but also because visiting and working in museums is described as middle class. But why is this, does this account for all types of work, and what does this mean for people who might not be from middle-class backgrounds.

I don’t have a fixed definition of the term ‘class’ (this is a subject that has been debated for 150 years and most researchers recognise there is no one single definition), but am using Pierre Bourdieu’s concept of capital of class. This involves looking at the types of economic, social or cultural capital that are valued within different types of museum work and how this relates to the type of capital people actually have, or are able to acquire. Cultural capital is particularly important as this relates to accent, dress, education and knowledge of particular types of culture, and is often highly valued in cultural work.

I have already conducted interviews with representative bodies, trade unions and membership bodies as well as analysing reports and websites to look at how ‘getting and getting on is described’. I have found that, as with other research, museum work has become less secure and more competitive. The onus seems to be on the person to develop themselves as specialist and professional, and yet also flexible and versatile. This potentially makes it riskier and less beneficial for anyone entering the field. Class was talked about but was often described as difficult to see or measure, and most diversity initiatives were aimed at developing the individual to fit the required ways of working, rather than look more closely at how ways of working might be creating inequalities.

With the focus groups and interviews, on the one hand, I am asking people to talk about their work – what it takes to get in and on, how this might have changed, how this might be different for different roles, are some roles held in higher esteem than others and why. On the other hand, I want to talk about social class – what does it mean to people, do they think class matters and if so, how? I am also asking people to contribute images or photos that they think represent their work.

Take part in the focus groups:

If you have worked or volunteered for a museum you can take part in a focus group or an interview. If people think that class has mattered to them in particular, I am also conducting private interviews.

Taking part is confidential, enjoyable and you will be helping the sector. To take part in a focus group or an interview and for further information, please contact me or visit my website.

Thursday 5 April
6PM – 7.30PM, Birkbeck Main Building, Room MAL 420, Malet Street, WC1E 7HZ  

Wednesday 11 April
6.30PM – 8PM, Birkbeck Main Building, Room MAL 420, Malet Street, WC1E 7HZ.

Thursday 26 April
6PM – 7.30PM, Museums Association Offices, 42 Clerkenwell Close, London, EC1R 0AZ

Friday 18 May
2.30PM – 4PM, Birmingham Museum and Art Gallery, Chamberlain Square, Birmingham B3 3DH

Wednesday 23 May
6PM – 7.30PM, Museums Association Offices, 42 Clerkenwell Close, London, EC1R 0AZ

Thursday 7 June
4PM – 5.30PM, Whitworth Gallery, The University of Manchester, Oxford Road, Manchester, M15 6ER

Thursday 14 June
5.30PM – 7PM, M Shed, Princes Wharf, Wapping Road, Bristol, BS1 4RN

Or schedule an interview:
If you think social class has mattered to you personally in your work or career then you can take in part in an individual interview, by email, Skype or face to face (depending on your location).

If you are interested in finding out more, please contact Sam directly.

About Sam:

I studied History originally, and then spent about 25 years working in marketing in the museum, cultural and public sectors. A lot of my work was really about understanding people and organisational cultures as much as ‘doing’ marketing, hence my interest in studying organisational psychology.  I started studying part time about 8 years ago, first obtaining a degree in psychology at OU, then moving on to the MSc in Organisational Psychology at Birkbeck.

About the same time as graduating, I was made redundant, which forced a decision – stick to the marketing “battleship” I knew, or jump onto the less stable “raft” of psychology. I had already met some PhD students and Dr Rebecca Whiting who became my supervisor, and thought I would really like to study for a PhD here. So when I was offered a studentship, I took the leap. It’s been one of the best decisions I’ve ever made!

From Dr Rebecca Whiting, a lecturer in the Department of Organisational Psychology and Sam’s PhD supervisor:

Sam brings a wealth of experience to her research from working in this sector and an intellectual rigour from her academic training. Class is a challenging concept to research because of the many and sometimes conflicting ways in which its conceptualised and measured.

Many definitions reflect the relationship between class and socio-economic and cultural status. However, since class is not a ‘protected characteristic’ under the Equality Act 2010, it doesn’t always appear as an aspect of diversity in organizations, so is ripe for critical investigation. Museums are key locations of our socio-cultural heritage but are an under-researched context in organizational and occupational research.

This highlights the importance of Sam’s research which brings together this topic and context to explore how class impacts on museum work.

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