Stress Interventions

Along with musculoskeletal disorders, work-related stress remains to be one of highest causes of work-related ill health.

It’s not only the individual who experiences impacts from work related stress. It is estimated that it costs UK employers between £42-45 bn each year. This is made up of absence costs of around £7 bn, presenteeism costs between £27 and £29 bn, and turnover costs of around £9 bn, although the scale of the problem may be much larger due to inconsistencies in the approaches of such studies and surveys.

There are steps that employers can take to eliminate, reduce, or mitigate the effects of work-related stress.

Such interventions can be categorised as primary, secondary, and tertiary. Each category targets different stages of stress: causes, reactions, and consequences.

What are primary, secondary, and tertiary interventions?

1. Primary interventions aim to eliminate organisational causes of stress at their source, and can be further broken down into two sub-groups:

• Sociotechnical interventions which are concerned with changes to aspects of work design which can create stress such as staffing levels, work schedules and work patterns.
• Psychosocial interventions are concerned with adjusting employees’ perceptions of the work environment. Typical responses include health and wellbeing communications and promotions.

2. Secondary interventions aim to target the reactive stages of stress in individuals. Such interventions help employees and managers better identify and manage stressors and associated symptoms as they occur. These intervention types can be both active and passive:

• Active interventions include interventions which encourage employees to identify negative thoughts and replace them with positive ones or give them the tools to reduce their exposure to them.
• Passive interventions are focused on minimising the consequences of reactions by reducing tension and anxiety, through stress management techniques.

3. Tertiary interventions focus on treating the consequences of stress in individuals. These interventions typically include Employee Assistance Programmes, occupational health services and counselling.

Not one intervention fits all

Following a risk-based approach to stress, the general principles of prevention (Schedule 1 of The Management of Health and Safety at Work Regulations, 1999) state that where risks cannot be avoided, they should be evaluated and combatted at their source. Therefore, employers should consider starting with primary interventions, where possible, as they focus on the root causes of stress.

Work-related stress initiatives, however, should not focus on one type of intervention, and employers should avoid implementing a blanket approach.

Employers who incorporate elements from all three intervention categories will ensure support can be tailored as required, not only to suit individuals but to suit organisations, such as during periods of change or particularly busy seasons.

Some occupations such as roles in front line services (Police, Fire Services, or healthcare) can face stress at work every day (trauma or violence), and due to the nature of those roles, it is unlikely it would be possible to remove primary sources of stress altogether; therefore secondary or tertiary interventions can be used to provide both coping strategies and post-event therapeutic treatment.

Employers should also recognise that secondary and tertiary interventions can support employees who aren’t in front line services – particularly when hazards which were not foreseeable or regularly realised cause harm.

On a very topical note, this could include stress and anxiety caused by the current Coronavirus outbreak, or the death of a colleague or perhaps physical harm/violence experienced when travelling for work.

Employers should also realise there may be instances where non-work related stress could affect work. For example, the loss of a family member or diagnosis of a medical condition. In such cases secondary or tertiary interventions could support individuals and help them back to work.

Are employers doing enough?

There are many reasons why employers should take care of their employees; it’s the right thing to do, keeps employees in work, reduces any absence related burden on society, and keeps employers on the right side of the law. Employers with good health and wellbeing initiatives are also likely to be an employer of choice for top talent.

Deciding if an employer is doing enough could start with looking at the psychosocial safety climate within an organisation. In other words, understanding how well an employer is currently protecting employees and managing stress. This can be done by looking at areas such as leadership, policies, communication and consultation, fair work, and wages etc.

Employers can also evaluate current interventions used and how successful they are. This can be determined by consulting with employees, completing staff surveys, setting up focus groups, collecting health and wellbeing data and carrying out audits.

Employers wishing to design their own or try new interventions should look at the results of their current performance and create an improvement action plan, if necessary.

Before an employer invests in any new interventions, they should be piloted with groups of employees across the organisation. Hence, there are opportunities to gain feedback from users and check the intervention was successful and effective before launching it across the organisation or finding an alternative to pilot which might be more suitable.