Supporting sustainable return to work

Dr Jo Yarker from the Department of Organizational Psychology shares her research into supporting employees who are returning to work following mental ill-health absence.

Around 15% of the working population suffer from common mental disorders (CMDs) such as depression, anxiety and adjustment disorder (OECD, 2014). For half of these, experience of mental ill-health will lead to a period of long-term sickness absence. In the UK alone, stress, anxiety or depression accounts for 57% of all working days lost to ill-health in 2017-2018 (HSE, 2018).

Sustainable return to work for workers with CMDs is therefore a major societal challenge in terms of scale and costs. A successful initial return to work is no guarantee for sustainable return to work, with research suggesting that approximately 19% of workers subsequently relapse and take further absence or exit the workforce (Koopmans, Bültmann, Roelen, Hoedeman, van der Klink, & Groothoff, 2011).

Relapse has significant consequences for sustaining work, with implications for employment prospects, productivity and wages (OECD, 2014). There is an urgent need to better understand how workers with CMDs can be better supported to return to, and stay in, productive work. Together with my colleague Professor Karina Nielsen from the University of Sheffield, I sought to find out how to support employees returning to work following mental ill-health absence.

Understanding the barriers to sustainable return to work

Our study was the first to our knowledge to follow workers post-return using a qualitative approach. We used the recently developed IGLOO framework in our research: examining the Individual, Group, Leader, Organisational and Overarching (IGLOO) contextual factors (Nielsen, Yarker, Munir & Bültmann, 2018) that influence workers with CMDs’ ability to remain in employment throughout working life.

We conducted interviews with 38 workers who had returned from long-term sick leave due to CMDs, the majority of whom we spoke to at multiple points following their return.  We’d originally planned to follow workers in the first months after return, however, after being contacted by workers who still experienced challenges long after return, we decided to include these too. We also spoke to twenty line managers with experience managing returning workers.

Our findings

Participants reported a number of resources, in and outside of work, that helped them stay and be productive at work.

Resources at work across the five IGLOO levels help employees stay and be productive at work:

  • Individual: Creating structure within their working day to help maintain focus and concentration.
  • Group: Gaining feedback on tasks from colleagues, help with challenging tasks and being treated as before, not as someone with a CMD.
  • Leader: Agreement of communication to colleagues, continued support and access to work adjustments, and signaling (and being) available but not intrusive.
  • Organisational: Flexible working practices and leave policies, accommodating absenteeism policies, work-focused counselling, and demonstrating care through support.
  • Overarching context: This level was not applicable as we only examined UK workplaces.

Resources at home across the five IGLOO levels help employees stay and be productive at work:

  • Individual: Prioritising self-care and the establishment of clear boundaries between work and leisure.
  • Group: Understanding and non-judgmental support from friends and family.
  • Links to services: Consistent point of contact and facilitation of links to external services and treatment.
  • Organisational: Access to work-focused counselling.
  • Overarching context: Those who were financially independent were able to make choices that better suited their needs; the majority reported the positive media attention around mental health enabled them to ask for help.

The main results of our study point to important avenues for future research and practice. Within the workplace, the findings highlight the need to:

  • Consider resources at all IGLOO levels and implement multi-level interventions.
  • Train returned workers in how to structure their day.
  • Train and support line managers, both in having difficult situations but also on how to support workers creating structure and support them manage their workload.
  • Develop more information about appropriate work adjustments that can be implemented and how these can be accessed.
  • Offer flexibility to the returning employee, in relation to work schedule, ad hoc flexibility when depleted to prevent further decline and aid recovery, and flexibility in tasks.
  • Adopt an individual approach as there is no off-shelf-style that works for all.
  • Adopt a long term approach, ensuring that employees are able to access adjustments in the months and years that follow.
  • Conduct further research to enable us to understand the contribution of these features and their synergistic effect on enabling returned employees to remain productive at work.

Outside the workplace, the findings highlight the need to:

  • Conduct further research to better model the impact of support received from friends and family, GP services and those within the voluntary sector.
  • Equip GP services with the skills and knowledge to support return to work.

We developed guidance for employees, colleagues, line managers and HR professionals to support returned workers to thrive at work. This and our full report can be found on the Affinity Health at Work website.

Further Information

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Managing the ‘always on’ culture – a myth buster and agenda for better practice

Professor Almuth McDowall (Department of Organizational Psychology) shares her research into worklife balance and calls on employers to take responsibility for their organisation’s culture.

Break, Business, Business People, Businesswoman, Cafe

There is much being written and said about the ‘always on culture’ and how we are increasingly glued to our digital devices – whether at work or at home. Some of my own research has also concerned itself with this topic. My colleague and friend Gail Kinman and I had the results from a practice survey published in 2018 as we wanted to know what organisations are doing about the changing world of work, and the use of information and computer technology.

Well, precious little is the answer. Over half of our respondents said that their organisations don’t have a relevant policy in place and don’t offer any guidance or training. Somewhat worryingly over 40% thought that it should be up to individuals to manage the issue, rather than their line managers or human resources.

Why would people choose to be ‘always on’ outside formal working hours?

Working unpaid during leisure time does not make logical sense! We gift the UK economy billions in unpaid overtime year on year, as research by the Trade Unions Congress has revealed. Our systematic review with colleagues Svenja Schlachter, Ilke Inceoglu and Mark Cropley pointed to a complex picture.

People have different motivations, influenced by issues such as what everyone else does (social norms), what the expectations in the job are, how committed people feel to their job, how they value ‘switching off’ and recovery and whether this is supported in their environment. One key issue which came out of this review is the ‘empowerment enslavement paradox’. Our digital devices are both an enabler, as they afford flexibility, but also ‘digital leash’ as it’s difficult to say ‘enough is enough’ and switch off. As we all know, screen-time can be very seductive.

Is there any evidence that being ‘always on’ is bad for our health?

A recent econometric analysis shows that ICT infrastructure has a positive impact on population health (the authors measured general health outcomes such as infant mortality etc.). Regarding the impact of social media use, there is evidence that high use is linked to poor sleep quality, anxiety depression and low self-esteem. Of course, such studies cannot tell us whether teenagers who are highly anxious to start off with are more likely to be prolific users.

There is far less robust evidence on the exact effects from the world of work – what happens to you if you are on your phone, tablet or laptop near 24/7? We lack good research to tell us what the exact effects are.

What we do know though is that we need recovery and respite, our systems are simply not programmed to be on continuous overdrive. We also know that leisure activities which are quite different from our work tasks are better for our recovery than doing more of the same. I take this to heart. For instance, I find that reading at night doesn’t help me switch off as academics read rather a lot at work, so I take ballet classes online (and am known to teach the odd one myself!), knit and crochet.

What can organisations do?

Employers have a duty of care and should ensure that people are not overworked and can switch off. Worklife balance research tells us that those who live ‘enriched’ lives have better mental and physical health, important for them, and important for their employer. We should actively support employees by ensuring that:

  • A worklife balance policy is in place as a point of reference; then check processes and structures against this policy
  • Employers review job design and ensure that digital tasks (checking and responding to emails, synchronising devices, remote calls and conferences) are actually captured in people’s workload and tasks – these often fall off the radar
  • There is consultation to ask employees what they need – mutually negotiated boundaries and solutions work much better. Think creatively about flexible solutions!
  • Everyone, including senior leaders and managers, role models good behaviours. People need time to switch off, so don’t expect your staff to be available outside normal working hours
  • Staff are offered training and development. Managing in an increasingly digital workspace requires up-to-date management and leadership skills
  • Employees look out for implicit expectations and ‘rumours’. “I check my emails on holiday because this is what is expected of me”. Really? Question such assumptions as they can often take on a life of their own

Finally, if in doubt, ask a psychologist. The Department of Organizational Psychology is keen to work with organisations to establish, consolidate and evaluate best practice.

Further information:

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The proposed ‘right to disconnect’ after work hours is welcome, but not enough

This post was contributed by Professor Gillian Symon, member of the Digital Brain Switch project. Involving a multi-disciplinary team of UK researchers (including Birkbeck’s Dr Rebecca Whiting), the project explored the ways in which mobile communication technology  affects how we switch between different aspects of our lives. This article was originally posted on The Conversation on 23 March 2016.    

Changes proposed to France’s famously inflexible employment laws by French president François Hollande have prompted an outcry among students and unionists and even the barricading of schools by pupils. But among the raft of changes to working practices is the liberating notion that employees should have the right to disconnect: to ignore emails from employers during evenings and weekends so that time with friends and family is not affected by work distractions or feelings of guilt.

Limited interventions of this sort have been put forward in Germany and France before, but this is the first proposal that the right be enshrined in law.

There is much to like about it. First, it recognises the massive impact the widespread use of smartphones and tablets, Wi-Fi and high-speed mobile internet has had on our working lives. In as much as work emails, diaries and contacts are on a smartphone in our pocket, to some extent we are never truly “out of the office”. The proposal seeks to counter this in legislation, not to leave it to corporate custom and practice.

Second, the proposed legislation acknowledges the considerable research that suggests that we need to psychologically detach from work regularly, or risk becoming exhausted and losing our creativity.

Third and most importantly, it makes the employer at least partly responsible for managing this intrusive technology and its effects on employees. There is a recognised paradox, whereby technology allows flexibility over when and where we work, but at the same time acts as a leash that chains us to our (virtual) desks. For too long this has been seen as something employees themselves should manage.

The research into work-life balance my colleagues and I have conducted suggests that achieving the right balance has become another “life crisis”. It is one that is fed by endless media articles and self-help books, and one that is almost certainly unresolvable by the individual as so much of the pressure comes from bosses and colleagues at work. What we’ve found is that there needs to be respect for individuals’ chosen work-life boundaries at all levels within organisations.

So congratulations to the French for taking this particular taureau by the cornes. But is their proposed approach through new legislation the right answer?

It’s not easy, and often employers don’t make it any easier. wongstock/shutterstock.com

As far as it goes

There are three ways digital media and mobile technology have affected our lives that isn’t acknowledged by legislation, which is concerned only with time spent connected to work. In our research we’ve sought to highlight the creeping effects of “digi-housekeeping”: those endless technology maintenance tasks that we engage in – updating software, syncing devices, fighting technical problems – which often takes place outside of office hours and doesn’t appear on time sheets. None of this is accounted for by legislative approaches.

Nor does legislation address the way in which the use of social media for work may intrude into our privacy. When we blog and tweet for our employers, are we exploiting our personal identities for their ends? Are these additional tasks, and the need to maintain our digital presence online, causing us anxiety and increasing our workload without any formal recognition of the effort involved? These sorts of activities go beyond a concern with just maintaining a time boundary between work and life. They represent new tasks required to maintain our digital work lives.

What’s more, because the French legislation presumes an employee-employer relationship, it entirely ignores the anxieties of the self-employed, as those taking part in our research told us. While those working for themselves have always had to work hard, social media has put added pressure on them to be constantly online and accessible to maintain their business. We need more imaginative interventions that will address the needs of specific groups such as these.

What are 21st century working lives like?

The French legislation is important primarily because it makes clear the responsibilities of employers and organisations. However, it’s also rather a blunt-edged tool that doesn’t appreciate the intricacies of our online lives. Legislation like this enforces a strict work-life boundary that may be a thing of the past.

Read the original post on The Conversation

Read the original post on The Conversation

Our research collaborators kept video diaries that captured the complex circumstances of today’s workers in a more revealing way than traditional surveys can do. These video diaries suggest we might be making sense of our lives in radically different ways in the 21st century. We distinguish between online and offline lives rather than work and non-work hours, and we think more about how we prioritise time, rather than how we divide it.

To support flexible working, we may need flexible legislation that is based on other considerations than time alone, including where and how we work best. It’s very unlikely there will be a one-size-fits-all solution; researchers and policymakers are going to have to find more creative 21st century solutions for this very 21st century problem.

So the French government’s move to formally recognise the distraction caused by unfettered technology is welcome, but limited. To improve upon it, we need to understand much more fully the complexities of contemporary digital online lives, what boundaries people now find important, and how the law can best support them.

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