Perceptions of Psychological Injury in the Workplace

Work-related psychological injury has not only increased as a percentage of all injuries but also accounts for the greatest cost, both in duration of lost time and financially (National Occupational Health & Safety Commission [NOHSC], 2001; NOHSC, 2002). There arc two major explanations as to why this might be. One explanation is that stigmatisation of psychological injury has reduced, resulting in increased reporting (Manton, 2004). The other ma.ior explanation is that workplaces arc becoming more stressful environments, resulting in increased levels of psychological injury to employees (Kenny & Cooper, 2003 ). This revi_w will investigate those potentially influential factors that relate to perceptions of workplace psychological injury, in particular whether reduced negative perceptio11s have led to an increase in reporting of psychological injury or whether psychological injury has actually increased. This will provide clarification on the role of perceptions of psychological injury in the workplace and will provide direction for Jlnurc research in this area. Author: Richard Merrett Supervisors: Dr D. Drake Dr D. McKillop Submitted: August 2004 Perceptions of Psychological Injury 3 Perceptions of Psychological Injury in the Workplace Whilst nonRpsychological workplace injuries continue to decline, employees are reporting a greater percentage ofworkRrelated psychological injury than at any time previously (Cooper, Dewe, & O'Driscoll, 2001). The National Occupational Health and Safety Commission (NOHSC, 2002), classifies the causes of psychological injury as the result of work pressure, exposure to violence, exposure to a traumatic event, harassment and other workRrelated mental stress factors. The term 'stress' is the most commonly used explanatory mechanism to describe general psychological injury (Cassidy, 1999). Although there may be many reasons as to why psychological injury is being reported at increasing levels, this paper will consider two major explanations. One explanation is that the rate of workplace psychological injury is not actually increasing but rather, because perceptions are becoming less negative, it is reported more. The other major explanation is that the workplace is becoming a more stressful environment, resulting in increased levels of psychological injury to employees. There have been many changes over the years to the workplace, which could indicate why psychological injury is actually increasing. Globalisation and the emergence of new technologies have led to increasing pressures in the workplace. These changes have resulted in restructures, downsizing and mergers, creating increasing instability in the workforce. Staff numbers have reduced or have changed from permanent fullRtime to part-time casual and the introduction of technology such as the Internet has led to a drive for increased response times and a 7 day, 24 hour work requirement (Kenny & Cooper, 2003). Competition not only between companies but also between individuals for reduced position~ adds to the pressures. Perceptions of Psychological Injury 4 An example of this is that the number of full-time employees working longer hours is increasing with many of these extra hours being unpaid (Deery, Plowman, & Walsh, 1998). To mediate the effects of the ,;;hanging work environment and to minimise the compensable claims for psychological injury, employee assistance programs (EAPs) that offer counselling, advice and assistance have increased considerably over the last 20 years (Kendall, Murphy, O'Neill, & Bursnall, 2000; Mcleod & Henderson, 2003). Although a number of studies on employee assistance programs have shown them to be successful in reducing levels of workplace stress (e.g., Rahe et al., 2002), overall their introduction into the workplace has had very little effect on the levels of reported psychological injury (Kenny & Cooper, 2003). This may be because the number of employees experiencing psychological injury is growing faster than those that can be treated, it may also be because employees are hesitant to use the service. The following study is interesting as it demonstrates that employees are experiencing psychological injury but they are not necessarily seeking treatment and hence, reporting it. Laposa, Alden, and Fullerton (2003), looked at emergency department personnel (predominantly nurses), and their experiences of traumatic work events. Although many had suffered symptoms of post traumatic stress disorder (PTSD), only 18% had attended critical stress debriefing provided by their employer and none of them had sought outside professional assistance. This was despite the fact that almost 30% of them had reduced their hours due to stress reasons and 20% had considered changing jobs due to the critical incident they had experienced. Therefore, even when psychological assistance is offered to employees, it is not necessarily utilised. This could indicate that employees perceive this type of Perceptions of Psychological Injury 5 injury negatively and therefore are hesitant to report it. This would not support the argument that negative perceptions of psychological injury are reducing and hence, being reported more. Rather it suggests that actual cases of psychological injury could be under-reported. Either way it is impossible to assess the amount of empirical support for these suggestions as despite the body of work on stress, very little research has been conducted on the perceptions of employees towards workrelated psychological injury. Additionally, the research that is available on perceptions, stigma and stereotyping is predominantly in the mental health arena and may not be relevant to the workplace. Nevertheless, understanding employee perceptions of psychological injury can only be beneficial. As our body of knowledge on psychological injury increases there will be an increased likelihood that improvements in the control and management of this condition will emerge. This review will seck to understand those potentially influential factors related to whether stigma of workplace psychological injury has reduced, resulting in increased reporting, or whether the level of psychological injury is actually increasing. This will provide clarification on the role of perceptions of psychological injury in the workplace and will provide direction for future research in this area. Furthermore, this paper will define psychological injury, workers' compensation and associated costs. However with limited research available on perceptions of psychological injury in the workplace this review will draw on research from the occupational health and safety domain, the workers' compensation field, work. related legislative decisions and research that has been conducted on the mentally ill. Perceptions of Psychological Injury 6 Definition of Work-Related Psychologica/Jnjury Work-related psychological injury is classified by the National Occupational Health and Safety Commission (NOHSC, 2002) as Mental Stress and identifies such causes as work pressure, exposure to violence, exposure to a traumatic event, harassment, and other mental stress factors. Essentially anything that is considered non-physical is classified under ihe psychological injury classification, including