Navigating the Impact of Stress

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Navigating the Impact of Stress Depression
in the WorkplaceSue Covey, LCSW, CEAPAPS
HealthcareEmployee Assistance Program

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Agenda

• Introduction
• Depression Overview
• Impact of Depression in the Workplace
• Contributing Factors
• Stress Overview
• Stress in the Workplace
• Definition of Stress
• Contributing Factors
• Stress versus Depression Which is it?
• Performance Decline
• Role of Supervisor
• Role of EAP

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Depression and its Impact in the Workplace

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Depression

• One of the most common illnesses affecting
  working adults
• Up to two-thirds go untreated/dont recognize
• Clinical depression vs. feeling down.

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Depression

• 10 of Americans can be expected to experience a
  depression in a 12-month period and 17 in life
  time prevalence
• 70 are part of the workforce

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Depression in the Workplace

• Depression is the leading cause of disability
  worldwide
• Affects job performance and productivity
• Results in high absenteeism

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Annual Economic Impactof Depression
Cost43.7 Billion
Annually
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Annual Economic Burden of Depression
Absenteeism and Lost Productivity
Treatment and Rehabilitation
Loss of earnings due to depression-induced
suicides
Source Greenberg et al, The economic burden of
depression in 1990. Journal of Clinical
Psychiatry, 54 (11) 1-14.
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Economic Impact

• Greenberg (1993) estimated total annual cost of
  depression in US to be 43.7B (in 1990 dollars)
• Goetzel (1998) reported healthcare costs as much
  as 70 higher for depressed employees
• Goldberg (2001) found health care expenditures
  for depressed individuals to be 4 times higher
  than non-depressed

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Economic Impact (cont.)

• Behavioral health related long and short-term
  disability claims climbing.
• Depression ranks consistently in Aetnas top 10
  diagnoses for disability claims nationally
• Estimated 200 million days annually lost from work

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Workplace Impact

• Lost productive work time due to depression
  (Stewart 2003)
• 5.6 hours per worker per week in lost productive
  work time, versus expected of 1.5
• 81 of LPT due to reduced performance while at
  work
• Translates to 44B annually
• 31B more than for non-depressed workers only
  14B lost
• Depressed workers lost 1.5 to 3.2 days more than
  non-depressed workers in a 30-day period (Kessler
  1999)
• Again, Aetna 200 million in a year

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Depression Workplace Contributing Factors

• Time Compression
• In last 2 decades the work year for prime-age
  working couples has increased by nearly 700 hours
• High levels of emotional exhaustion at the end of
  the workday are the norm for 25-30 of workforce
• 26 take no vacation
• Dual-income couples chat an average of just 12
  minutes a day!
• Job Loss or Fear of Job Loss
• Three million jobs were lost between 2000 and
  2004
• People paid less in their new jobs

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Stress in the Workplace

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Stress in Workplace

• One in three adults suffers from moderate to
  extreme stress
• World Health Organization lists stress at work as
  one of the top ten key determinants of poor
  health
• Stress-related compensation claim costs continue
  to rise
• Work-related-stress accounts for long stretches
  of absenteeism

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Stress in Todays Workplace Costs Money

• Cost is realized in
• Reduced productivity
• Increased absenteeism
• Employee turnover

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Work-related Stress

• Excessive and prolonged stress
• No single cause
• Some become so used to symptoms of excessive
  stress that it goes unnoticed

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Most Work Stress Related to

• Sudden unexpected pressures
• Combination of stressful factors accumulate over
  time
• Whether feel you have power and control in work

• Management of work
• Relationships at work
• Organizational set-up

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Symptoms of Work-Related Stress

• Can manifest itself as physical and emotional
  health problems
• Also, as altered ways of behaving at work and at
  home

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WHAT IS STRESS?
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STRESS

• Reaction of your body to the demand(s) that are
  placed on it

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STRESS MANAGEMENT

• Inside job
• Eustress vs. Distress
• Effects on stress level
• Intensity
• Duration
• short-term
• prolonged
• Number of stressors
• Coping style and skills

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• Fight or Flight

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STRESS RESPONSE

• EVENT -
• ANXIETY/TENSION
• HYPOTHALAMUS
• PITUITARY GLAND
• ADRENAL GLANDS
• SYMPATHETIC RESPONSE
• MAJOR ORGANS (lungs, liver, heart)
• INCREASE BLOOD to BRAIN MUSCLES
• INCREASE ADRENALIN
• STAGES ALARM RESISTANCE EXHAUSTION

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STRESS
EXTERNAL INTERNAL

• Have you labeled a problem at work (external) as
  a crisis when it is only slightly
  uncomfortable? (thoughts/internal)
• Is a family/relationship issue causing you
  headaches or taxing you emotionally or causing
  difficulties at work?

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Is it Depression, or Is it Stress?

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Work Related Risk Factors/Triggers To ?????

• Conflicting work demands
• Unclear job expectations
• Unclear responsibilities
• Lack of intrinsic rewards
• Negative job events

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Typical Triggers to______?????

• Lack of control over work
• Excessive time pressures
• Excessive/inflexible work hours
• Too much/too little work/responsibility
• Confusion re duties/responsibilities
• Lack of job variety/interest
• Inadequate training
• Poor work/life balance
• Difficult relationships at work
• Lack of support/contact with colleagues
• Organizational confusion

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Identifying a Depressed/Stressed Employee

• Key changes in
• Job performance or behavior

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Signs of _______ in the Workplace

• Decreased productivity
• Morale problems
• Lack of cooperation
• Safety problems, accidents
• Absenteeism
• Frequent complaints of fatigue
• Complaints of unexplained aches and pains
• Alcohol and drug abuse

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Changes That Could Signal ____________

• Marked decrease in ability to get job done
• Working slower than usual
• Frequently missed deadlines
• Making excuses for inability to complete
• Frequently calling in sick
• Appearing listless
• Decrease in concentration
• Looking distracted
• Irritable/withdrawal from coworkers

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NEGATIVE SIGNS

• Emotional
• Mood Swings
• Feeling cannot cope
• Anxiety
• Crying
• Anger
• Short fused at work/home
• Withdrawal From Friends Family
• Confusion and Forgetfulness
• Feeling achieved nothing at end of day

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NEGATIVE SIGNS

• PHYSICAL
• Nail biting
• Fidgeting
• Headaches
• Backaches
• Heartburn
• Clenched jaw
• Sleep Disturbance
• Low energy
• Hot flashes
• Finger tapping
• Loss/increase appetite

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NEGATIVE SIGNS

• MENTAL
• Disorganized
• Inability to plan concentrate
• Memory lapses
• Self doubt
• Panicky
• Feeling inferior
• Defensive
• Getting less work done
• Poor coworker relationships
• Decrease motivation

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How Do You Know an Employees Performance has
Declined?
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PERFORMANCE DECLINE

• Little patience
• Outbursts
• Lateness
• Complaints
• Co-worker relations
• Missed deadlines

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What Do You Do?
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What Do You Do?

• Do Nothing
• Become Over-involved

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WHY SUPERVISORS AVOID CONFRONTATION

• Nice guy syndrome
• Problem will go away
• Not my job/role
• Fear/intimidation
• Absence of skills
• Second guessing
• Critical self inventory

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ICEBERG CONCEPT
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TIP OF THE ICEBERG

• What the supervisor sees SYMPTOMS
• Absenteeism
• Complaints from public/other EEs
• Co-worker relationship issues
• Confusion/concentration
• ___________________________________
• What the professional sees ROOT ISSUE
• Drug/alcohol Emotional
• Family/relationship Physical Illness

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How You Can Help - Steps to Use

• Observe
• Document
• Discuss
• Monitor/Follow-up
• Refer

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General Signals to Observe

• Work performance is down from previous levels
• Inconsistent productivity
• Increased/patterned absenteeism
• Wide variation in work quality
• Chronic lateness
• Negligence toward responsibilities
• Avoidance of co-workers and supervisor
• Irritability, moodiness and/or anxiety

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Documentation

• Facts
• Objective not judgmental
• Date/Time
• Others involved
• Meetings/discussions with employee
• Balanced
• Action taken

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Meeting Preparation

• Choose time/place carefully
• Refer to personnel polices
• Have documentation available
• Have witness available when appropriate

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Employee Meeting
Judge Performance Only Stick to the Facts Dont
Accept Excuses Remain Calm Refer to the EAP when
appropriate Develop an Action Plan
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Some Common Responses

• Anger
• Tears
• Excuses
• Denial
• Agreement but no follow-through

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Your Response Remains

• Focused on the performance problem
• Sticking to the facts
• Helping the employee get the assistance they need

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Meeting Summary

• Issues
• Expectations
• Write out an action plan
• Recommend EAP
• Write down time and date of a follow-up meeting
  with employee
• Follow through

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Your Response Remains

• Formal versus Informal EAP Referrals

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Remember

• You are not responsible for the employees
  personal problems
• You are responsible for job performance
• Its not your job to diagnose or counsel!!
• It is important for a supervisor to recognize,
  identify and manage his or her feelings in order
  to objectively assess the situation

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EMPLOYEE ASSISTANCE PROGRAM

• Free
• Individual, couples and families
• Confidential
• Professional
• Counseling Legal Financial
• Employees, dependents,
  household
• Sessions/issue

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• Question and Answer
• Follow Up