1
Willing To Work Australian Human Rights
Commission Part 1 General overview of issues

• Ms Ingrid Ozols, B.Sc, Grad Dip Bus Mgmt, Grad
  Dip Comm MH Master MHSc, GradDipMHRecovery
  Social Inclusion (UK),
• Master of Suicidology
• Managing Director of Mental Health At Work
  (mh_at_work)
• redacted

2
General Issues presented

• mh_at_work will consider the following
• (a) evidence of the low rate of workforce
  participation of people with mental illness, the
  social and economic costs involved
• (b) identification of the barriers that people
  with mental illness experience in gaining and
  retaining employment
• (c) the respective roles of, and collaboration
  between, local, state and Commonwealth
  governments, business and community organisations
  in supporting the workforce participation of
  people with mental illness
• (d) the effectiveness of programs that aim to
  improve the workforce participation of people
  with mental illness, including best practice
  models
• (e) opportunities for tailoring education and
  vocational training for the needs of people with
  mental illness
• (f) effective measures to support employers to
  recruit, employ and retain people with mental
  illness and
• (g) the role of mental health services, and
  general health and community services in
  improving the workforce participation of people
  with mental illness

3
Case 1 A Personal Story

• Ingrid Ozols A journey back to work and life
• RTW graduated process
• Kindness, compassion, humaness_at_work
• Importance of work to wellness

4
Case Study - 2 Michael An Employee perspective

• Married male, late 30s. Worked in a demanding
  senior government role for many years
  experienced years of unexplained aches and pains,
  irregular heart palpitations, chest pain,
  perspiration, shortness of breath, high levels of
  anxiety and frustration. Relief came through
  drinking high levels of alcohol.
• Endless physical tests for a range of health
  symptoms. Doctor prescribed anti inflammatory
  medications, sleeping tablets.
• No- one looked for a psychological/emotional
  cause or illness.
• Michael wore his disguise that all was well at
  work home so that no one would know his inner
  torment and shame.

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Case Study 2 (cont)Michael - An Employee
perspective

• Lessons learnt
• Educate workers in basic mental health literacy.
• How to identify early warning signs and provide
  assistance
• How to listen non-judgmentally
• Where to refer someone for help
• Understanding and empathy towards those who may
  have an issue
• What some of the triggers may be
• The dos and donts regarding someone with a
  mental health illness.
• Make seeking help easy and available. Make sure
  everyone is aware that help is easily accessible
  and available in a private and respectful
  environment.
• Make help available outside of the immediate work
  area.

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Case Study 3Ms. M An Employer perspective

• Ms. M had been with a professional service
  organisation for approx 3 months. Ms M
  successfully completed her probation period. She
  worked successfully for a further 8 months.
• Ms M was not meeting the standards required, not
  was she meeting the agreed performance measures.
• Ms M was showing tardiness, absenteeism, a lack
  of communication, was often absent from meetings
  or work, and often without notification.

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Case Study 3 (cont) Ms. M An Employer
perspective

• Employer engaged in confidential discussions with
  team leader. Ms. M claimed she was struggling
  with serious family issues, compounded by her own
  health concerns.
• Oneonone counselling by manager over 1 2
  months showed no improvement, behaviour remained
  erratic, with mood swings.
• Manager followed company performance management
  process with a formalised, appropriately
  documented process.
• Employer offered EAP (Employee Assistance
  Program).

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Case Study 3 (cont)Ms M. An Employer
perspective

• Did workplace help?
• Employer had EAP, but this relies on employee
  seeing help voluntarily. Employer does NOT
  receive feedback on individual cases in order to
  protect privacy. So how does employer, EAP or
  employee know if it is effective?
• EAP included up to 3 visits without cost to
  employee.
• Using flexible working arrangements, employer
  arranged for Ms M. to have time off from work to
  attend counselling without penalty. Ms M chose
  to access pay for ongoing counselling after
  initial allocation exhausted. Effectiveness?
• Medical certificate provided for sick leave
• No specific reason disclosed at discretion of
  employee. How does employer manage unknown health
  issue? Impact of non-disclosure?

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Case Study 3 (cont) Ms M. An Employer
perspective

• Eventually Ms M disclosed she suffered from
  depression. Ms M. was prescribed a
  change/adjustment to her medication which caused
  emotional symptoms an inability to concentrate.
  Ms M. reported that completing routine work tasks
  such as note taking reports became challenging.
• Employer explored flexible work
  arrangements/working from home.
• Outcome Ms M. eventually resigned.
• Team reaction/impact Disgruntled. Team felt they
  where picking up the pieces completing
  additional work. In the absence of any
  explanation, they saw person not doing job
  without understanding. Once team aware, more
  empathic but resources stretched so pressure to
  perform was felt by all.

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Case Study 3 (Ms M An Employers perspective)

• How was team managed?
• Manager was professional, understanding with
  good interpersonal skills. Org had increased
  focus on management coaching of performance,
  service to customer was being affected
  negatively, action was required.
• Lessons learnt for both parties
• Employees need confidence/trust that they can
  be honest about what is happening in their lives
• Employers cant be supportive if they are not
  aware of the individuals situation. Humanness
  can work alongside policies and procedures but
  employers must still operate within bounds of
  policy and legal obligations balance issues
  such as duty of care and privacy rights of
  individuals

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Case Study - 4 Mr. T A positive outcome

• 30 professional male, recent appointment to
  role. Disclosed bipolar disorder, advised
  treatment medication changes may impact
  ability to perform role at the same high level he
  had been used to.
• Mr, T showed anxiety in meeting project
  deadlines.
• Employer/manager held regular discussions,
  communication channels remained open and flexible
  work practices were introduced.
• Mr. T took some sick leave as required.
• Mr. T was able to fulfil role requirements and
  satisfy his role requirements, thus keeping his
  job.
• Situation regarded treated as confidential.
  Privacy was maintained. The team leader was
  supportive, informed and tolerant.

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Case Study 5Return to work Not that easy for
Ms. E

• Ms. E, mid 40s middle manager, state government
  department. Has been on Workcare for 2 years for
  psychological injury (major depression, allegedly
  a result of workplace bullying (note that the
  claim was accepted)
• Ms E. has now been certified as fit to work, and
  remains willing and able to return to her
  pre-existing injury duties, effective
  5/3/2012.Medical certificates also declare fit to
  work from this date.
• Medical professionals case manager recommend
  two basic agreed return to work adjustments for
  Ms E. for her to return to work. These were
• Sitting away from alleged bully
• Direct head welcomes her back to work the team
  on her return to work.

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Case Study 5 (cont)Return to work Not that
easy for Ms. E

• We are advised the employer has since informed Ms
  E. she is not welcome to return to work as the
  required accommodations could not be met.
• Distressed, Ms E. indicated she was well enough
  to return to work, has the ability and right to
  work, needs to work to earn an income and feels
  the accommodations are not that difficult as the
  office is large and that sitting arrangements can
  be changed relatively easily so as the 2 parties
  can be seated apart
• Ms E. has since sought advice from both WorkSafe
  Victoria and Legal Aid. Despite the significant
  distress this response has caused her, Ms E has
  every intention of going to work this week. She
  remains committed to returning and to performing
  to the best of her ability.
• Outcome is awaited.

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Setting the Scene

• 1 in 5 Australians will experience a mental
  illness within any one year
• (1997 2007 Nat Health Wellbeing Survey)
• 20 billion a year cost to community through
  mental ill-health
• 6million workdays each year lost to depression
  alone
• Increased stress claims varies amongst
  workplaces
• By 2020 the World Health Organisation estimates
  that Depression will be the 2nd highest burden of
  disease disability in the world

07/03/2012
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Setting the Scene (contd)

• More than 2000 suicides in Australia each year
• 7 people every day, 1 every 3 hrs in a day
• Lifeline takes 1500 calls per day every day
• Weekend waiting time can be 40 mins
• Can strike at any stage of lifespan from
  childhood to old age
• Impacts on a persons ability to function in
  life, work relationships

07/03/2012
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Setting the Scene contd

• Medibank 2008 study
• Cost of work place stress to Aust 14,8
  billion per year Absenteeism presenteeism,
  costing 10.11 billion/yr
• 3.2 days/worker lost/ yr due to workplace
  stress
• Comcare Research last 12 months
• 54 increase in mental health stress claims
  since 2006-2007
• Other injuries are decreasing
• 22 of all serious claims stress related
• Workplace Stress fast becoming 1 of
• the BIGGEST THREATS TO WORKPLACE OHS

07/03/2012
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Setting the Scene (cont)

• American Psychological Association (2011)
• 1/3 surveyed felt stress or tense DURING WORKDAY,
• 40 Heavy job load caused stress,
• 43 lack of opportunity for growth within
  workplace.
• Workplaces need to consider what mental health
  friendly ERGONOMIC ADJUSTMENTS /or
  ACCOMMODATIONS are needed

07/03/2012
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Setting the Scene The Price of Severe Mental
Illness

• In a 2010 report, Functioning of this cohort
  showed
• 51.2 with psychotic illness were assessed to be
  functioning well in work socially prior to
  onset of illness.
• 70.8 of the total had been in either paid or
  unpaid work or studying.
• 68.7 had good adjustment within these roles
• 63.9 reported good social functioning before
  the onset of first symptoms.
• Most people (90.4) reported deterioration of
  functioning after illness onset.
• 1/3 (32.3) were assessed as having a significant
  level of impairment to self -care in the previous
  4 weeks.
• ttp//www.health.gov.au/internet/main/publishing.n
  sf/Content/353E10EE88736E02CA2579500005C211/File/
  psyexe.pdf)

07/03/2012
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Setting the Scene (cont)The Price of Severe
Mental Illness

• Almost 1/5 (18.4) accessed were unable to
  complete a simple chore such as cleaning their
  room.
• 2/3s (63.2) were assessed as having a
  significant level of dysfunction in their
  capacity to socialise over the past year.
• People with psychotic illness experience very
  high rates of unemployment low rates of labour
  force participation.
• They are also at greater risk of homelessness.
• Factors contributing to these high rates include
  social isolation, family breakdown, stigma,
  discrimination need for acute care, including
  hospital admissions. Nature of illness is up and
  down can be well for long periods and then
  unwell. It is not a stable path.
• (http//www.health.gov.au/internet/main/publishing
  .nsf/Content/353E10EE88736E02CA2579500005C211/Fil
  e/psyexe.pdf)

07/03/2012
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Setting the Scene (contd) The Price of Severe
Mental Illness

• Government disability pensions were the main
  source
• of income for 85.0 of people.
• 1/3 (32.7) in paid employment, 30.5 full -
  time employment.
• 1/3 of participants (32.7) were in paid
  employment over the past year versus 72.4 of
  general working age population as _at_ July 2010.
• Workplaces do not know how to retain, support and
  manage a person with a psychotic illness and tend
  NOT to employ them because of this fear and
  stigma that they will be difficult to manage and
  may not be reliable and could potentially be
  violent.

(http//www.health.gov.au/internet/main/publishin
g.nsf/Content/353E10EE88736E02CA2579500005C211/Fi
le/psyexe.pdf)
07/03/2012
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Working Well....(1)

• WORK is IMPORTANT TO WELLBEING, but can also
  hinder with inappropriate practices
  organisations need to have advise, strategy and
  training to know what to do and what not to do.
• PROMOTION, PREVENTION, EARLY INTERVENTION
  APPROACH needs to be a the way we do business!
• PEOPLE with Mental Health issues Want to work,
  Need to Work, Can Work, have the Right to
  work....
• Work gives structure, belonging, purpose.
• Connection important for wellness...

07/03/2012
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Working Well....(2)

• Workplaces need to address manage Psychosocial
  hazards /or Risk factors
• Work culture -
• eg Bullying harassment intent versus impact,
• conflict, office politics, relationships, morale,
  turnover.
• Physical environment
• e.g. noise, lighting, overcrowding.
• Organisational practices
• e.g. leadership style, unclear roles
  responsibilities, unclear roles, poor
  communication, lack of autonomy, lack of control,
  outdated discriminating policies procedures,
  unreasonable work pressure/loads, demands, long
  hours, job designs, lack of training, lack of
  support, change management processes.

07/03/2012
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An Evidence Based Strategic Long-term Approach.

• Integrated sustainable long-term multi layered
  ongoing education using LIVED EXPERIENCE/QUALIFIED
  PEER SUPPORT with quality assurance.
• Encourage culture change, need leadership
  commitment engagement, internal champions
  constantly working at promoting PPEI
• Simple supportive/management approaches based on
  the lived experience.
• Incorporate adult learning principles
  interactive workshops education campaigns
  tools.
• Not about diagnosis (not our role).
• Prevention, early intervention.
• Recognising signs symptoms when not doing well,
  something isnt right with self or others, when
  resilience is slipping.
• Not about fixing or managing other peoples
  problems (we cant anyway).
• Providing tools for people to take responsibility
  for their own wellbeing.
• Work is important to wellness.
• Creating supportive understanding tolerant work
  environments.
• This is the way we do business.
• Embed humanness into policies practices.

07/03/2012
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Creating A Mentally Healthy Supportive
Workplace

• Currently working on ebook version for WorkSafe
  Victoria
• gt100,000 copies distributed
• Co badged with clients CEO Sign off
• Other clients ANZ, Coles Group

07/03/2012
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mh_at_work clients learnings

• Program requires support from most senior
  management, internal champions, contemporary
  leadership
• Sustainable long term on going regular multi
  layered education campaign
• Evaluate evaluate evaluate
• I am so proud I work for a company who has the
  courage to bring us this program
• I wish I had this information years ago

07/03/2012
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Recommendations (1)

• Improve collaboration of different mental health
  sector stakeholders to work together with
  businesses/workplaces/corporate. mh_at_work has
  endeavoured to be a conduit
• One size DOES NOT FIT ALL! Schizophrenia is
  DIFFERENT to depression, sometimes they occur
  together, we need to educate workplaces about
  these differences.
• Provide employer assisted training around
  accommodations and adjustments workplaces need to
  recruit and retain persons with a mental
  illness.
• Increase incentive programs for training
  /education and ongoing support especially with
  the episodic nature of illness, peaks troughs,
  constant monitoring of knowing people.
• Social media/technology is not the be all and end
  all not the silver bullet, need high tech, high
  touch combination.
• Increase awareness in workplaces that long term
  strategic tailored programs need to drive
  behavioural culture change

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Recommendations (2)

• To gain engagement from insurers/workers
  compensation linkages as part of prevention,
  early intervention initiatives to provide
  financial incentives for their clients to
  implement appropriate evidenced based mental
  health interventions.
• GP Training to reconsider stress leave
  certificate approach of 6weeks away in
  crisis people cant work, but connection however
  small is key to RTW. Consistent messaging
  collaboration is required, better education about
  the importance of connection and work (graduated
  work, job redesign etc)
• E.A.P- Employee Assistance Programs, NOT A
  REGULATED INDUSTRY, NO QUALITY ASSURANCE,
  Services, quality of professionals ad hoc, hit
  miss expensive to employers, difficult to gain
  appts difficult to gauge effectiveness
  outcomes. Need tighter regulation

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Recommendations (3)

• Mental Health First Aid the beyondblue work
  place programs, headsup are good, however they
  are being perceived as the fix all and adequate
  solution to complex ongoing issues. Do not
  address disability or work towards culture
  change.
• Facilitator quality is a concern with MHFA No
  quality assurance, no record of messages being
  delievered or skill checking. Open to anyone to
  be a trainer. Quality inconsistent and varies
  from individual to individual trainers
• Suicide Prevention needs to be included teaching
  managers and employers skills competence to
  have brave conversations to approach, support
  manage these difficult issues.
• More data needs to be collected around Suicide
  Prevention in the Workplace its impact
  anecdotal evidence tells us this is a huge taboo
  in workplaces with no systems of support in
  place.
• More research in Prevention Promotion Early
  Intervention with respect to mental health,
  mental ill health, suicide prevention and
  resilience of persons, teams and organisations.
• Encourage businesses to go beyond tokenism, work
  to change culture.
• Developing a naturally mentally healthy,
  diversity welcoming philosophy to how work is
  done here.

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References

• The Conference Board of Canada 2011 Building
  Mentally Healthy Workplaces Perspectives of
  Canadian Workers and Front-Line Managers.
  Canada
• Comcare 2010 http//www.comcare.gov.au/data/asse
  ts/pdf_file/0004/103288/Submission_to_public_heari
  ng_on_mental_heatlh.pdf
• Comcare 2008, Working Well - An organisational
  approach to preventing psychological injury, A
  GUIDE FOR CORPORATE, HR AND OHS MANAGERS
  Canberra
• Comcare 2009 PUTTING YOU FIRST. BEYOND WORKING
  WELL A BETTER PRACTICE GUIDE. A practical
  approach to improving psychological injury
  prevention and management in the workplace
  Canberra
• http//www.workingforhealth.gov.uk/Carol-Blacks-Re
  view/
• http//www.health.gov.au/internet/main/publishing.
  nsf/Content/353E10EE88736E02CA2579500005C211/File
  /psy10.pdf
• Mental Health Council of Australia, 2007 Lets
  get together - A National Mental Health
  Employment Strategy for Australia Canberra
• Medibank Private 2008 The Cost of Workplace
  Stress in Australia
• http//www.hreoc.gov.au/disability_rights/publicat
  ions/workers_mental_illnessguide/workers_mental_il
  lness_guide.pdf 2010 Worker with Mental
  Illness a
• Practical Guide for Managers
• http//www.centreformentalhealth.org.uk/pdfs/menta
  l_health_at_work.pdf
• Ozols, I McNair, B (First edition 2003, tabled
  version 2007) Creating A Mentally Healthy and
  Supportive Workplace Canberra.

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• THANK YOU