Work-related mental disorders (also known as psychological injuries) have become a major concern in Australian workplaces due to the negative impact on individual employees, and the costs associated with the long periods away from work that are typical of these claims. Each year:
- 7,500 Australians are compensated for work-related mental disorders, equating to around 6% of workers’ compensation claims
- approximately $480 million is paid in workers’ compensation for work-related mental disorders.
Mental health in the workplace
Mental health can be adversely affected by exposure to a range of factors in the workplace, including, for example:
- a poorly designed or managed work environment
- mentally, physically or emotionally demanding work
- excessive or prolonged work pressures
- bullying or harassment
- a traumatic event
- workplace violence.
Exposure to these factors can lead to work-related stress. When stress is very high and or prolonged it can in turn lead to work-related psychological or physical injury.
Work-related stress has been linked with high levels of:
- unplanned absences including sick leave
- staff turnover
- withdrawal and presenteeism
- poor work and poor product quality.
Work-related stress may also lead to depression and anxiety in the long term.
Snapshot of claims for mental disorders
Claims involving mental disorders are usually associated with an above average time off work and higher than average claim costs. Findings from our Work-related Mental Disorders Profile 2015 report showed:
- Over the five years between 2008–09 and 2012–13, one out of every 1,100 full-time employees claimed for a mental disorder every year.
Other yearly averages for work-related mental disorders over this period included:
- typical compensation payment per claim was $23,600 compared to $8,700 for all claims
- typical time off work was 14.8 weeks compared to 5.3 weeks for all claims
- 39% of claims caused by harassment, bullying or exposure to violence
- 90% of claims attributed to mental stress (see below)
- 65% of claims awarded to workers aged 40 and over.
Between 2008–09 and 2012–13, around 90% of workers’ compensation claims involving a mental disorder were linked to work-related stress or mental stress—mental stress refers to the mechanism of injury describing work-related stress in claims data. The most common mechanisms causing mental stress were:
- work pressure (32%)
- work-related harassment and/or bullying (24%)
- exposure to workplace or occupational violence (15%)
- other mental stress (11%)
- exposure to a traumatic event (6%)
- vehicle accident (5%)
- being assaulted (3%)
- sexual/racial harassment (3%).
Most at risk occupations
Over the five-year period reviewed by SWA, the occupations with the highest rate of claims for mental disorders were:
- defence force members, fire fighters and police (6 claims per million hours), specifically police (7.2)
- automobile, bus and rail drivers (6 claims per million hours), specifically train and tram drivers (21.5)
- health and welfare support workers (3.3 claims per million hours), specifically indigenous health workers (6.1)
- prison and security officers (2.5 claims per million hours), specifically prison officers (5.7)
- social and welfare professionals (1.8 claims per million hours).
The highest occupation unit groups were:
- train and tram drivers (21.5 claims per million hours)
- police (7.2 claims per million hours)
- Indigenous health workers (6.1 claims per million hours)
- special care workers (6.0 claims per million hours)
- prison officers (5.7 claims per million hours)
- ambulance officers and paramedics (5.2 claims per million hours).
The overall rate of claims for mental disorders (all occupations) was 0.62 claims per million hours, and the frequency rate fell from 0.76 in 2002–03 to 0.47 in 2014–15.
The nature of these occupation groups suggests that workers who receive compensation for a work-related mental disorder tend to be those who have high levels of interaction with other people, are often providing a public service and often doing their job in difficult and challenging circumstances.
Work health and safety duties
In Australia, all jurisdictions are covered by WHS legislation, of which the general principle is that employers, so far as is reasonably practicable, are required to provide and maintain a working environment that is safe and without risks to health, including psychological health.
It also makes good business sense to prevent or minimise risks to psychological health. Work environments that do not adequately manage these risks can incur significant human and financial costs.
- Under the model WHS Act, PCBUs have a duty to protect workers from psychological hazards as well as physical hazards.
- The best way to do this is design work, work systems and processes, as well as workplaces that protect workers from harm to their psychological health and safety; monitor the health of workers and workplace disorders and consult with workers.
- Employers also have a duty to make sure that work is safe for those returning after a workplace illness or injury.
Workers have a duty to take reasonable care of their health and safety and not adversely affect others’ health and safety. They must also cooperate and comply with reasonable instructions on health and safety matters. This might include working to job descriptions to avoid role conflict or following workplace policies to prevent bullying.
Employers can intervene to manage a work situation whenever signs of stress are first noticed. Early signs may include increased unplanned absences, withdrawal or deteriorating work performance.
Intervening at this early stage to provide appropriate support and identify and address workplace issues that may be causing or contributing to stress, can often prevent a situation deteriorating and a worker developing a mental disorder or psychological injury.
Managing psychological hazards
Psychological hazards can be managed using the same risk management process applied to physical hazards, as set out in the model Code of Practice: How to manage work health and safety risks. The process involves:
Hazards are things or situations that have the potential to cause harm including psychological injury. Psychological hazards can be identified by:
- reviewing incident reports, workers’ compensation claims, patterns of absenteeism, sick leave, staff turnover and staff complaints
- getting feedback from workers through one-on-one discussions, surveys and focus groups
- observations, such as deteriorating work performance or how workers interact with others.
While hazards will vary between workplaces and jobs, work-related factors known to contribute to the risk of psychological injury are listed below.
Exposure to some physical hazards in the work environment can influence a worker’s comfort and performance and may contribute to feeling stressed.
- For example, non-compliance with WHS requirements such as exposure to poor air quality, high levels of noise, extreme temperatures and unsafe machinery.
- Job demands—the level of physical, mental and emotional effort required to do a job.
- Job control—the level of control a worker has over aspects of their work including how or when a job is done.
- Support—the level of support from supervisors and co-workers, information, equipment and resources available to allow work to be done.
- Workplace relationships—the nature of relationships between workers, managers, supervisors, co-workers and clients.
- Role clarity—the overall scope or responsibilities of the job, clarity about the objectives, key accountabilities and management expectations of workers.
- Organisational change management—how change in the organisation, structure or job is communicated and the extent of worker involvement during these changes.
- Recognition and reward—the nature of feedback on task performance, performance reviews, opportunities for skills development, formal and informal rewards.
- Organisational justice—perceptions of unfairness, consistency, bias and respect for workers.
These factors are interrelated so should not be considered in isolation. A combination of these may increase the likelihood of psychological injury.
People respond to stress at work in different ways. Individual differences may mean that some workers are more susceptible to harm from the hazard, for example a worker with a disability or illness, new and young workers.
To work out if harm may result from exposure to psychological hazards in the workplace, you need to carry out a risk assessment. This involves examining the identified risk factors in more detail to determine the level of risk and prioritise the order control measures are implemented in.
You can assess the level of risk by considering:
- The nature of the hazard—the capacity the hazard has to cause harm, for example exposure to low levels of conflict may be unpleasant without causing a health and safety risk whereas high levels of unmanaged conflict can escalate into workplace bullying, increase stress and cause incidents.
- The extent of exposure to the hazard—the duration, frequency and intensity of exposure, for example work-related stress may increase if workers are constantly under time pressure.
- Individual differences—how workers deal with exposure to a particular psychological hazard may vary.
Controlling the risks
Businesses must eliminate risks to workers’ health and safety as far as is reasonably practicable, or minimise them, by implementing effective control measures that address the work environment and systems of work. Control measures aimed at individuals are usually less effective.
- Your aim should be to achieve the best fit between the working environment, the systems of work and the needs and capabilities of workers.
Control measures to consider include:
When it comes to the work environment, implement the hierarchy of controls, which might include:
- placing a barrier between customers and bank tellers where there is a risk of workplace violence
- having higher partitions between workstations to reduce noise.
Systems of work and the design of work and work processes include:
- Workforce planning to make sure there is a balance between work demands/time pressure and workers capacity to meet those demands.
- Defining job roles so work activities and the scope of the work are clear.
- Making time frames for completing work that are reasonable and achievable.
- Giving workers more control over how the work is done by consulting and agreeing to work procedures before work starts. Giving workers autonomy to make decisions about their work load, rate and pace of work, may minimise the risk of injury from work demands.
- Consulting workers when setting performance targets.
- Flexible work arrangements where possible, by allowing a degree of freedom in how work is done.
- Suitable planning, management and communication processes for organisational change.
- Providing support systems, for example buddying and mentoring for new workers.
- Rewarding workers’ efforts.
- Providing regular feedback on worker performance.
- Engaging workers in decision making.
- Providing systems for workers to raise concerns and report unreasonable behaviour.
Training and education
Workers need to understand their role and have the relevant skills to do the job. Providing information, instruction, training and supervision can help protect them from psychological health risks.
Training, instruction and information should include:
- Workplace practices concerning psychological health and organisational values.
- Induction information on expected workplace behaviour and conduct including all relevant policies and procedures, for example the prevention of bullying, harassment and violence at work.
- Management training to help managers and supervisors support workers, identify hazards and risks at work, and manage conflict.
Protecting workers from workplace conflict, bullying, harassment and discrimination, for example:
- Develop policies and procedures that set the standard of workplace behaviour and help workers to raise concerns and report unreasonable behaviour.
- Provide access to Employee Assistance Programs or counsellors.
The least effective approach is to try to change workers’ behavioural responses as this does nothing to change the inherent risks. Health and wellbeing programs and worker resilience training may still be a useful supporting approach, when combined with higher order controls including work design and management.
Review control measures
You should regularly review control measures to make sure they are effective. Reviewing controls may identify a worker is not coping with the work or particular task and is showing warning signs of stress. Intervening at this early stage may prevent a psychological injury.
You should review control measures:
- before making changes in the organisation or to work procedures
- if new information becomes available to indicate a control measure may no longer be the most effective
- a psychological injury occurs.
Consulting your workers
You must consult with your workers on health and safety matters that will impact them. Doing this at each stage of the risk management process can help identify and control psychological hazards and risks in the workplace.
Consultation involves sharing information, giving workers a reasonable opportunity to express their views and taking those into account before making a decision on health and safety matters. Consultation is required on specific matters, for example:
- Decisions about the most effective controls for the identified hazards and risks.
- Policies and procedures—conflict resolution, preventing and responding to workplace bullying, aggression and violence in the workplace and managing work-related fatigue.
- Workplace changes—reasonable workplace adjustments for a worker returning to work, changes to organisational structure, for example when downsizing.
Further information on consultation is in the model Code of Practice: Work health and safety consultation, cooperation and coordination.
Best practice for managing psychological claims
Making a workers’ compensation claim can be a confusing and stressful experience, especially for someone with a psychological injury. If the process is managed well, it can support the injured worker to recover and return to work.
Best practice claims management begins with recognising the complexity and unique challenges often seen with psychological injuries, and ensuring an injured worker is empowered and supported throughout the claims process.
We worked with SuperFriend and other key stakeholders to develop Taking Action: A best practice framework for the management of psychological claims in the Australian workers’ compensation sector. The framework aims to assist insurers and claims managers to better support workers with a psychological injury or who are at risk of developing one.
Return to work
When workers return after suffering a psychological injury, you need to help them recover at work by providing suitable duties, and detailing them in a return to work plan.
A return to work plan involves the employer, worker and other relevant parties such as rehabilitation providers, working together to get the injured worker back to work in a timely, safe and durable fashion.
It usually includes clear objectives, a list of actions to be taken to enable return to work, and the person responsible for each action. It may include:
- suitable duties being offered including modified or alternative duties
- hours of work including work breaks
- support, aids or modifications to the workplace
- relevant contact details
- time frames
- processes to monitor progress.
Suitable and alternative duties
Suitable duties refer to work that is suited to the worker’s current capacity taking account of their medical condition, age, skills, work experience and pre-injury employment. They may involve reasonable adjustment, for example:
- Flexible working arrangements—varying start and finish times or allowing extra or longer work breaks.
- Modifying some aspect of the job or work tasks—simplifying tasks, providing greater support; writing down instructions, developing standard operating procedures, using diagrams.
- Modifying the workstation or work area—relocating the workstation to a quieter location or using privacy screens.
Suitable duties must be meaningful. An injured worker should not be discriminated against because of their injury, including when being offered suitable duties.
Psychosocial risk assessment tool for businesses
A psychosocial risk assessment tool that includes resources to help organisations identify, manage and evaluate injury prevention and management interventions, is available from People at Work.
Developed by Safe Work Australia, the University of Queensland, the Australian National University, Queensland Government and WorkSafe Victoria, the free assessment tool called People at Work, helps employers identify workplace risks and focus on prevention.
People at Work provides organisations with access to:
- A free, reliable and valid psychosocial risk assessment tool.
- Resources to help implement a psychosocial risk management approach and evaluate the effectiveness of chosen interventions.
Benefits of implementing People at Work
Benefits of implementing People at Work include:
- A focus on managing work-related psychosocial risk and prevention of psychological injury.
- Communicating a clear message to workers that their organisation values their health and wellbeing.
- Taking positive steps towards complying with health and safety laws in relation to psychological health.
Additional information for workers and PCBUs is available at HeadsUp.
There are a number of services available to people who are feeling depressed, stressed or anxious. They include:
Safe Work Australia is not a regulator and cannot advise you about work health and safety compliance. If you need help, please contact your state or territory work health and safety authority.
This framework provides practical and evidence-based guidance to assist workers’ compensation insurers and claims managers to better support workers with a psychological injury.