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Safety, mental health and the safety paradox

Currently, RUOK day and Mates in Construction dominate health and safety social media (and quite rightly and importantly so). This is part of broader conversation in health and safety about mental health and well-being, with increasing calls to address mental health and well-being more explicitly in health and safety legislation.

But as the health and safety industry turns its mind to the very important issue of mental health in the workplace, perhaps we need to take a step back and reconsider the role that health and safety has in mental health – not necessarily improving it but contributing to psychological harm at work.

Something I have often observed over the years I have been commenting on health and safety management, is the Safety Paradox. The Safety Paradox supposes initiatives for health and safety have the capacity to improve safety outcomes, but also the unintended potential to undermine safety.

These days, it seems stress and other forms of psychological harm are at the forefront of human resources and health and safety management. I cannot go a day, it seems, without seeing an article about workplace stress and what we should be doing about it.

All of the Australian health and safety regulators have adopted programs and publish guidance material on workplace stress and what employers should be doing about it.

However, what I do not see, is a self critical reflection by the health and safety industry, questioning the extent to which our health and safety practices contribute to psychological harm in the workplace.

Could health and safety be doing harm?

What has emerged, at least to my mind, is the extent to which our policy, procedure and policing approach to safety and health, far from alleviating psychological harm in the workplace, might be contributing to it.

Safety management might be part of the problem.

In a Western Australian inquiry into the possible impact of fly in/fly out work on "mental health" the Australian Medical Association identified the way health and safety is managed can contribute to a "distinct sense of entrapment" (page 43):

The AMA also expressed its concerns about this issue, noting that "[o]nerous rules, safety procedures and focus on achievement of production levels have been shown to create a distinct sense of entrapment in FIFO workers."

The inquiry drew, in some measure, on an earlier report, the Lifeline WA FIFO/DIDO Mental Health Research Report 2013 which also appeared to note the adverse impact of safety and health management on psychological well-being. For example "[a]dhering to on-site safety rules" was identified as a workplace stress (page 77). Interestingly, the Lifeline report noted a sense of "intimidation" brought on by the number of rules and regulations associated with work on a mine, and:

This sense of intimidation was further mirrored in the outcomes of mining safety regulations which in theory were designed to care for workers but in practice led to inflexible regulation over genuine safety concerns (page 81).

Examples from the Lifeline report include:

... a participant recalled a situation in which a worker handling heavy loads required an adhesive bandage but was unable to ask someone to get them for him because he had to fill out an accident report first (which he was unable to do mid-job); hence he had to carry on working without attending to his cuts. Alternatively, another example of the application of safety rules in an inflexible manner was illustrated when a group of workers were reprimanded for not wearing safety glasses on a 40 degree day even though they could not see from them due to excessive sweating. Hence, safety rules themselves were accepted as a necessary part of work but their implementation in an inflexible uniform manner created stress as workers felt their impact hindered their ability to conduct basic work tasks safely and/or without attracting rebuke. Hence, site rules and regulations could translate into arbitrary and punitive forms of punishment, which undermined participants’ ability to fulfil jobs to their satisfaction and left them feeling insecure with their positions (page 81).

It seems, then, we need to think beyond our own perceptions of what might contribute to workplace stress and understand the impact that our efforts to manage health and safety might actually be having. Again, as the Lifeline research noted:

... although past research has shown that site conditions and cultures, such as isolation and excessive drinking are problematic, this research shows that the regimented nature of working and living on-site also takes a toll on mental health and wellbeing. From the responses of many participants, it was apparent that following site safety rules (either under pressure of internal monitoring or in the perceived absence of adequate safety precautions by co-workers and supervisors) was a significant stressor. Participants felt unable to apply self-perceived common-sense judgments and also reported feeling vulnerable to intensive scrutinising, intimidation and threats of job loss (page 82) [my emphasis added].

The common criticisms of safety management and its emphasis on process, controlling behaviour and discipline seem to go directly to factors identified as contributing to psychological harm in the workplace. The pressure to comply with rules, fear about reporting incidents, the inability to exercise individual judgement on how to manage risk and the inflexible application of process are all side-effects of process driven safety.

It is also going to be interesting to see how health and safety regulators, often the champions of paperwork and process, oversee potential impacts of systems on psychological harm in the workplace. Indeed, it would be very useful to see what risk assessments, research or other measures are taken by regulators prior to issuing improvement notices, or giving instructions to workplaces about how to manage risks.

Does the health and safety industry understand the potential effects of their interventions, or undertake any research to understand the potential harm our health and safety intervention may cause?

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