Most of us spend at least one third of our life at work. Add travel to and from work, overtime, weekend work, and the complexities of shift work and its effect on sleep, and it is not unreasonable to estimate that half of our productive years are spent in work-related activities.
For some it may be more and for others it can be less. Whatever the time spent, it is reasonable to expect the workplace to be supportive, happy and rewarding emotionally as well as financially.
Sadly, this is often not the case. Increasingly, workplaces are engendering stress. This is not helped by the advent of technology and social media which provide a platform for 24-hour communication and an expectation that a query raised at any time of day or night will be met with an immediate response.
Professional burnout and its consequences are now ubiquitous.
In the medical profession it manifests itself in poor patient communication, threats to patient safety and mental health issues affecting health professionals resulting in self medication, misuse of alcohol and drugs, professional impairment as well as depression and suicide.
But stress and burnout also affects many other professions and vocations.
Teachers are under increasing stress, as are those working in the IT industry, the financial sector and academia, not to mention the pressures in the building industry, where failure to meet deadlines may result in multi-million dollar penalties.
Short cuts may reduce costs but this is often at the expense of workplace safety or public safety, as we have witnessed with the recent disasters caused by inflammable cladding.
Working in general practice we commonly see patients requesting certificates for time off work due to a minor aliment in the absence of any physical signs, or more honestly, simply needing a day off due to work-related stress.
I recently saw a patient, let’s call him John, in a distressed state. He was aged 45, tall, athletic-looking, well-dressed but tearful requesting a certificate for time off work. He was married to a school teacher and they had three teenage children.
John was an expert on cybersecurity having spent the past five years of a 20-year career in the IT industry specialising in cybersecurity. His reputation nationally and internationally had landed him a job with a multinational firm with offices in Melbourne and Sydney. Twelve months ago the organisation underwent a restructure and appointed a new operations manager, whose background was in banking, as John’s supervisor.
The manager was constantly harassing John about his failure to rapidly answer emails, for not responding to emails on the weekend, for not spending sufficient time at the Sydney office and for spending insufficient time in international teleconferences.
In the past 12 months, three other staff had left this organisation with claims of bullying and harassment against this manager.
John was not sleeping well at night, he had lost weight, lost self esteem and found himself irritable at home and constantly anxious at work. By any objective measure his performance had been outstanding.
He had complained to the HR manager about his treatment, but so far nothing had changed. He was clinically depressed and needed help, as well as time off work. He had never had time off work on medical grounds throughout his 20-year career.
We as GPs are well aware of the relationship between job stress and mental illness. So are some companies that provide stress management and mindfulness training to their employees, often without removing the source of stress.
There is now incontrovertible evidence of the relationship between job strain and common midlife mental disorders, such as the publication in the May 10 edition of the Lancet Psychiatry,1 based on a study by Harvey et al, which analysed data from the National Child Development Study ( n=6870).
Using multivariate logistic regression, the researchers investigated the relationship between job strain variables at age 45 and the risk of common mental disorders at age 50. The analysis controlled for non-workplace factors such as financial problems, divorce, housing instability, death in family, illness and workers personality.
High job demand, job-related strain and low job control emerged as significant independent variables predicting the future onset of common mental disorders, particularly depression and anxiety.
Providing mindfulness or stress-management programs does not remove the toxic culture that exists in some organisations that lead to the very problems that these programs are meant to fix. It is analogous to providing workers with masks and protective clothing to work in an asbestos-filled environment without removing the asbestos.
Organisations that do not deal with stress caused by their environment may find themselves facing hefty legal settlements. This also applies to the health sector which employs almost 700,000 workers in this country.
In the meantime, in addition to counselling, I have given John a certificate for 10 days off work. That is 10 days of productivity lost due to an insensitive supervisor.
1. Harvey SB, Sellahewa DA, Wang MJ et al Lancet DOI https//doi.org/10.1016/S2215-0366(18)30137-8
Dr Leon Piterman is Professor of General Practice at Monash University and has been in clinical practice for almost 40 years
Do you have any similar professional experiences you would like to share? Please email: [email protected]