Category Archives: Mental Health

Stress at Work: Individuals or Structures?

Source: A C L Davies, Industrial Law Journal, Advance Access, April 23, 2021
(subscription required)

From the abstract:
Stress is a significant practical problem in modern workplaces. According to the Health and Safety Executive (HSE), more than half of all working days lost to ill health each year are attributed to stress, depression or anxiety. This article offers an overview of the occupational psychology literature on workplace stress, focusing on the job demands–resources or JD-R model, developed by Demerouti et al., and highlighting two important points: first, that stress at work is not just about excessive job ‘demands’ but also about inadequate ‘resources’ to cope with those demands; second, that stress-related ill-health is not just a matter of vulnerability on the part of the individual worker, but is also about the way in which the workplace is organized. The article then draws on these insights to offer a critique of the way in which health and safety law and tort law approach workplace stress, arguing that both bodies of law are overly focused on treating stress as a matter of individual vulnerability. It concludes by drawing out some broader implications of the occupational psychology literature for areas of employment law less obviously related to workplace stress, and for casual or platform working.

Does Going Back Into the Office Freak You Out?

Source: Amy Silver, Harvard Business Review, April 23, 2021
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With companies considering redesigning physical office spaces to better accommodate hybrid work environments, chances are, depending on your job, your sector, and your leadership team, at some point you’ll need to go in to work. And this might be making you anxious. As we try to socialize and adjust to yet another “new normal” by engaging with people at work like we did in a pre-pandemic world, the exact focus of our worries and fears will vary. To manage your fears, there’s a few things you can do.

  • Understand what impact fear can have on your work. When our fear system is activated, we go into fight-or-flight mode. This means we can become distracted, our thoughts become more muddled, and decision making becomes more biased as our brain tries to make short cuts and we are more likely to make bad decisions.
  • Learn how to manage your fear. Be compassionate to yourself and know that it’s okay to feel this way. Then recognize your triggers and reactions. Does being in a crowded elevator scare you? Or running into coworkers when you go to fetch your coffee?
  • Separate your “fear” voice from what you want to do. Fear’s job is to keep us safe, and it does that by pushing us to choose short-term, protective behaviors (like running away, or avoidance) in a given situation rather than behaviors that will serve us in the longer term (facing something more rationally).

The Retention of Educators of Color Amidst Institutionalized Racism

Source: Ain A. Grooms, Duhita Mahatmya, Eboneé T. Johnson, Educational Policy, Vol 35, Issue 2, 2021
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From the abstract:
Representing approximately 20% of the workforce, educators of color (EOC) leave the field at a rate 25% higher than their White counterparts. Despite workforce diversification efforts, few studies investigate the psychosocial consequences of navigating racialized school climate as reasons EOC may leave the workforce. This study relies on survey data collected from educators of color (paraprofessionals through superintendents) across the state of Iowa. Applying a critical quantitative research design, we examined factors that link racialized school climate to their job satisfaction and psychological well-being. Findings indicate that a racialized school climate has a significant, direct effect on EOC’s race-based stress and professional racial self-efficacy. We argue that solely focusing on the retention of educations of color acts as a distraction from dismantling the institutionalized racism that continues to permeate our school systems.

Related:
How race-related stress could be driving educators of color away from the job
Source: Ain Grooms, The Conversation, April 13, 2021

When teachers of color experience high levels of race-based stress in schools, they can also have an increasingly negative sense of belonging, according to new research.

For the study, we analyzed survey data from educators of color across Iowa. To get at whether they were experiencing race-based stress, we asked whether the educators felt supported raising concerns with their peers about racism in schools or if they felt the need to ignore or avoid it. I conducted this research along with my colleagues – education researcher Duhita Mahatmya and community and behavioral health professor Eboneé Johnson.

Teachers reported less support from colleagues than did principals. Over 75% of the teachers in our sample (175 out of 229) reported a negative sense of belonging, especially when they thought school districts would not devise policies to actively address equity and racism.

Opinion: A Shift in Nursing Home Residents to Younger Psychiatric Patients

Source: Don Martin, Undark, March 9, 2021

The pandemic’s toll on nursing homes has opened up beds that younger people, often with mental illnesses, are filling.

One year ago, a nursing home in Kirkland, Washington, became an early battleground for the U.S. coronavirus outbreak. The disease has since decimated nursing home populations — more than one-third of the Covid-19-related deaths in the U.S. have been nursing home residents and staff. Virtually unnoticed is what has followed: In some nursing homes, a shift has occurred in the type of residents who live there, and Covid-19 is one of the reasons.

As older residents die from the pandemic and as more families choose to keep elderly relatives at home, some of these facilities are accepting more younger patients, including some with drug addictions and mental illness. Some patients have schizophrenia. Some have psychosis. This change in clientele can have a dramatic impact on the daily functioning of nursing homes, a change that administrators and staff may be unprepared to handle.

Job Stress and Health of Elementary and Secondary School Educators in the United States

Source: Paul A. Landsbergis, Elina Shtridler, Amy Bahruth, Darryl Alexander, NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy, Volume 30 Issue 3, November 2020
(subscription required)

From the abstract:
Elementary and secondary school educators face many work stressors, which appear to be increasing due to economic, political, and social trends. Therefore, we analyzed data from a 2017 national American Federation of Teachers survey of U.S. education staff, including data from two New York School districts that have adopted collaborative labor-management practices. The national American Federation of Teachers sample of educators reported significantly higher prevalences of several work stressors and poorer physical and mental health compared to the U.S. workers overall, adjusted for age, gender, and race/ethnicity. Compared with educators nationally, educators in districts with collaborative labor-management practices did not have a consistently higher or lower prevalence of work stressors or poorer health. Findings suggest the importance of reducing work stressors among U.S. educators. Results should be interpreted with caution due to the low educator survey response rate.

Sustaining Behavioral Health Services Through the Pandemic

Source: Karmen Hanson, LegisBrief, Vol. 28, No. 31, August 2020

….At any given time, approximately 20% of Americans live with a mental health disorder. Because of the potential for people to develop a psychological disorder due to pandemics like COVID-19, state legislatures, health departments and the federal government are implementing a variety of approaches to help…..

Preventing Suicide Within Your Workforce: Five Steps to Take

Source: Maureen Minehan, Employment Alert, Vol. 37 no. 3. February 5, 2020
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The suicide statistics in the United States are alarming. According to the U.S. Centers for Disease Control (CDC), 45,000 lives have been lost to suicide since 2016. In the past two decades, suicide rates have risen by 30% or more in 23 states, with North Dakota (58%), Vermont (49%), New Hampshire (48%) and Utah (47%), experiencing the highest increases. The CDC says employers have a role to play in reducing suicide rates by promoting employee health and well-being, supporting employees at risk, and putting plans in place to respond to people showing warning signs. ….

Solidarity and disparity: Declining labor union density and changing racial and educational mortality inequities in the United States

Source: Jerzy Eisenberg‐Guyot, Stephen J. Mooney, Amy Hagopian, Wendy E. Barrington, Anjum Hajat, American Journal of Industrial Medicine, Early View, December 17, 2019
(subscription required)

From the abstract:
Background:
Recently, United States life expectancy has stagnated or declined for the poor and working class and risen for the middle and upper classes. Declining labor‐union density—the percent of workers who are unionized—has precipitated burgeoning income inequity. We examined whether it has also exacerbated racial and educational mortality inequities.

Methods:
From CDC, we obtained state‐level all‐cause and overdose/suicide mortality overall and by gender, gender‐race, and gender‐education from 1986–2016. State‐level union density and demographic and economic confounders came from the Current Population Survey. State‐level policy confounders included the minimum wage, the generosity of Aid to Families with Dependent Children or Temporary Assistance for Needy Families, and the generosity of unemployment insurance. To model the exposure‐outcome relationship, we used marginal structural modeling. Using state‐level inverse probability of treatment‐weighted Poisson models, we estimated 3‐year moving average union density’s effects on the following year’s mortality rates. Then, we tested for gender, gender‐race, and gender‐education effect‐modification. Finally, we estimated how racial and educational all‐cause mortality inequities would change if union density increased to 1985 or 1988 levels, respectively.

Results:
Overall, a 10% increase in union density was associated with a 17% relative decrease in overdose/suicide mortality (95% confidence interval [CI]: 0.70, 0.98), or 5.7 lives saved per 100 000 person‐years (95% CI: −10.7, −0.7). Union density’s absolute (lives‐saved) effects on overdose/suicide mortality were stronger for men than women, but its relative effects were similar across genders. Union density had little effect on all‐cause mortality overall or across subgroups, and modeling suggested union‐density increases would not affect mortality inequities.

Conclusions:
Declining union density (as operationalized in this study) may not explain all‐cause mortality inequities, although increases in union density may reduce overdose/suicide mortality.

Behavioral Health Provider Participation in Medicaid Value-Based Payment Models: An Environmental Scan and Policy Considerations

Source: Melissa Bailey, Rachael Matulis, Kelsey Brykman, Center for Health Care Strategies, September 2019

From the abstract:
Health care payers are increasingly shifting from fee-for-service payment systems that reward volume to adopt value-based payment (VBP) models that promote high-quality, cost-effective care. While increased access to and coordination of behavioral health services is a policy priority for federal and state policymakers, the extent that the behavioral health system is engaged in VBP is less well understood than its physical health counterpart. In partnership with the National Council for Behavioral Health, the Center for Health Care Strategies (CHCS) conducted interviews with representatives from behavioral health associations, community-based behavioral health providers, state agencies, Medicaid managed care organizations (MCOs), and other subject matter experts to understand the successes and challenges associated with implementing VBP in Medicaid behavioral health care.

Informed by these interviews and a review of state program guidelines, quality measures, and MCO contracts, this report provides: (1) an overview of the behavioral health system’s engagement in VBP in the U.S., with a focus on 11 states; (2) lessons on implementing VBP from the perspective of behavioral health providers; and (3) policy recommendations for how state and federal policymakers, MCOs, and other stakeholders can support the adoption of VBP within behavioral health care. It also identifies nine key themes that support successful behavioral health VBP design and implementation to inform efforts in states across the country.

After The Fall: Safeguarding Employees’ Mental Health After Workplace Injuries

Source: Maureen Minehan, Employment Alert, Volume 36, Issue 18, September 4, 2019
(subscription required)

An employee trips and falls at work and sustains a significant knee injury. She needs surgery and misses months of work while recovering. You know she’s receiving good care for her physical injuries, but do you need to also be concerned about her mental health?

Related:
Suicide and drug‐related mortality following occupational injury
Source: Katie M. Applebaum, Abay Asfaw, Paul K. O’Leary, Andrew Busey, Yorghos Tripodis, Leslie I. Boden, American Journal of Industrial Medicine, Volume 62 Issue 9, September 2019
(subscription required)

From the abstract:
Background:
Drug overdoses and suicides have been rising since 2000 and are major contributors to a 3‐year decline in US life expectancy. Studies suggest that injured workers have elevated rates of depression and opioid use, but no studies have measured excess mortality related to these risks.

Materials and methods:
We linked New Mexico workers’ compensation data for 100 806 workers injured in 1994 through 2000 with Social Security Administration earnings and mortality data through 2013 and National Death Index cause of death data. We then estimated the association between receiving lost‐time workers’ compensation benefits and mortality hazard ratios (HRs) and 95% confidence intervals (CIs) based on Fine and Gray cause‐specific subdistribution hazards for common causes of death and for drug‐related, suicide, and alcohol‐related mortality.

Results:
There was almost a 3‐fold increase in combined drug‐related and suicide mortality hazard among women (HR = 2.63, 95% CI = 1.91‐3.64) and a substantial increase among men (HR = 1.42, 95% CI = 1.13‐1.79). Circulatory disease mortality hazard was elevated for men (HR = 1.25, 95% CI = 1.05‐1.50).

Conclusion:
Workplace injuries severe enough to require more than a week off work may impair workers’ long‐term health and well‐being. Drug‐related deaths and suicides may be important contributors to the long‐term excess mortality of injured workers. Improved workplace conditions, improved pain treatment, better treatment of substance use disorders, and treatment of postinjury depression may substantially reduce mortality consequent to workplace injuries.