17 May 2017 Vikki Holloway, MA, Dip.SM, FCMI

1 17 May 2017 Vikki Holloway, MA, Dip.SM, FCMIStress Awar...
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1 17 May 2017 Vikki Holloway, MA, Dip.SM, FCMIStress Awareness 17 May 2017 Vikki Holloway, MA, Dip.SM, FCMI

2 What we will cover What is stress? Landmark caseHSE view and statistics How to recognise stress Some tools for managing stress

3 The discovery of stressHans Selye 1920’s – 1940’s extensive research into stress, starting as a medical student Later concentrated on patients termed as ‘being sick’ without a specific cause Found that ‘strain’ on the individual plays a significant role in the development of all diseases and illnesses In his view ‘stress is the non-specific response of the human body to any demand placed up on it’ He defined distress (bad) and eustress (good) 1n 1956 his book ‘The Stress of Life’ was published

4 “Stress occurs when pressure exceeds your personal ability to cope”What is Stress? Professor Stephen Palmer stated that : “Stress occurs when pressure exceeds your personal ability to cope” Lazarus defines stress as: “a condition or feeling experienced when a person perceives that the demands placed on them exceed the resources the individual has available"

5 HSE Definition Stress is the adverse reaction people have to excessive pressure or other types of demands placed on them. The HSE make a distinction between pressure and stress saying that pressure can be a motivating factor and stress occurs when the pressure becomes excessive This definition is also used by ISMA (International Stress Management Association) Go to

6 Information from Aviva 201445-54 year olds have highest levels of stress - triggered by money and work worries Unhappiness peaks in middle years with 45% of year olds unhappy with life 41% of people in this age group have suffered stress in the last year, compared to a UK average of 34%. 55-64 year olds have lowest rates of good health Over two fifths (45%) of year olds are unhappy with their lives, based on a survey of 2,000 UK adults, 

7 Some statistics – LFS 2016 The total number of cases of work related stress, depression or anxiety in 2015/16 was 488,000 cases The number of new cases was 224,000 The total number of working days lost in 2015/16 was 11.7 million. In 2015/16 stress accounted for 37% of all work related ill health cases and 45% of all working days lost due to ill health. Stress is more prevalent in public service industries The main work factors cited by respondents: workload pressures, including tight deadlines/too much responsibility lack of managerial support

8 Happy at work? John Ruskin in 1849 identified three things needed for people to be happy in their work: they must be fit for it they must not do too much of it they must have a sense of success in it

9 Employer Responsibility

10 Employer ResponsibilityBoard level – Governance Define the Culture Monitor high level KPI’s Polices Organisational change HR Managers and H&S Managers Role in proactively addressing work related stress and its prevention Up to date best practice Conducting / reviewing risk assessments Reporting issues of concern to Exec team/board Provide information to employees about stress and employee obligations

11 Employer ResponsibilityLine Manager Determine how stress / long term or frequent absence is connected How they will monitor and address potential sources of stress Consider implications of the Disability Discrimination Act Report their concerns to appropriate senior personnel while maintaining any obligations of confidentiality. Employees Tell someone! Make suggestions for improvement Inform their employer - long term medical condition that affects day to day Discuss any reasonable adjustments

12 Employer responsibilityThe Management Standards approach is a key component of the HSE’s ‘stress toolbox.’ Management of Health and Safety at Work Regulation 1999 dictate that if an organisation has > than 5 people they must assess the risk of stress related ill health arising from work related activities Under Health and Safety at Work 1974 organisations must take measure to control the risks HSE / CIPD recommend a Stress Policy is best practice

13 HSE Management Standards

14 John Walker vs Northumberland County CouncilSenior social worker managing staff teams and an increasing number of child abuse cases In 1986 he suffered a breakdown and was absent for 5 months GP noted that the levels of anxiety and stress were due to work He had no previous mental health issues Extra support was agreed – but it didn’t help Second breakdown in the autumn He was dismissed for permanent ill health

15 John Walker continued….Mr Justice Colman said: "Given that professional work is intrinsically demanding and stressful, at what point is the employer's duty to take protective steps engaged?" He also stated, "there is no logical reason why risk of psychiatric damage should be excluded from the scope of an employer's duty of care or from the co- extensive implied term in the contract of employment.“ The employers could have foreseen the second mental breakdown as the situation had not basically altered on his return to work (Mays and Gregor, 1995).

16 CIPD ‘Work related stress; what the law says’2010 document that summarises the legal duties that employers have to prevent work related stress A starting point Four-step guide to the law on work-related stress Suggested actions that you can take to comply with the law A checklist of key questions to check your compliance A list of resources, references and links to more detailed information on the law.

17 CIPD ‘Work related stress; what the law says’Identifying a problem Monitoring working conditions to spot signs of stress Being aware of working conditions that could cause ill-health Consulting with employees to get their views on the workplace Giving consideration to employees with specific health needs or disabilities

18 CIPD ‘Work related stress; what the law says’Preventing harm Assessing the potential impact of workplace stressors Identifying measures that could prevent ill-health Ensuring employees are aware of preventative measures

19 CIPD ‘Work related stress; what the law says’Protecting individuals Taking action where harm to individuals is foreseeable Considering the needs of individuals Making reasonable adjustments to meet specific health needs or disabilities

20 CIPD ‘Work related stress; what the law says’Managing the workplace Monitoring the ongoing impact of work on vulnerable individuals Avoiding discriminating against individuals because of their health needs or disability Preventing workplace bullying and harassment

21 CIPD ‘Work related stress; what the law says’https://www.cipd.co.uk/knowledge/fundamentals/emp- law/health-safety/work-related-stress

22 The Stress Response

23 The Stress Response

24 The Stress Response A physiological response to a perceived or actual threat The body is unable to determine between something actual and something vividly imagined When a threat is recognised the stress response is triggered The sympathetic nervous system is activated Sends stimulatory impulses to target organs to speed them up Adrenaline and noradrenaline – primary stress hormones

25 The Stress Response

26 The role of Cortisol Also a stress hormone – inappropriate exposure can damage health: Cognitive performance Dampen thyroid function Blood sugar imbalances Decreased bone density Sleep disruption Decreased muscle mass Elevated blood pressure Lowered immune function Slow wound healing Decreased muscle mass Increased abdominal fat

27 Symptoms of stress Long term Short term Mental/emotional healthFeeling emotional Negative thoughts Becoming more anxious Disturbed sleep Physical health Increased ‘palpitations’ Sweating, blushing Headaches Muscle tension Butterflies in the stomach Feeling of nausea Loss of appetite Mental/emotional health Anxiety Depression Physical health High blood pressure Heart disease Insulin resistance Appetite suppression Dysfunction of the gut e.g., IBS Eventual immune suppression Increased susceptibility to some infectious diseases

28 Signs of Stress Individuals Groups/Teams Mood swingsDisappointment with self Increased emotional reactions Withdrawn Loss of motivation and confidence Confusion, inability to concentrate Poor memory Changes in patterns, e.g., arriving late Changes in eating habits Increased smoking/drinking/drug taking Feeling tired/twitchy/nervous Disputes and disaffection within the group Increase in staff turnover Increased sickness absence Increase in complaints & grievances Increased reports of stress Difficulty in attracting new staff Poor performance Customer dissatisfaction or complaints

29 Strategies Avoiding the stressor (including a situation which brings back memories of a stressful event) Working through events and the consequences Coming to terms with events Talking with supportive friends Humour Exercise Relaxation Therapy

30 Strategies In the WorkplaceTell your line manager/welfare department if you are feeling under too much pressure Take a techy break! Get up and walk away from your computer every 45 minutes Drink tea in your tea break – research shows that the theannine counteracts the affects of caffeine and actually calms you down. Give yourself a 5 minute hand massage Take 3 deep breaths in and long breaths out At lunchtime listen to some music – even better get outside and listen to it on a personal player

31 Be clever with your timeKnow who/what wastes your time Prioritise – not everything has an equal value – what are the consequences of non-compliance? Stop procrastination and do today what you normally put off until tomorrow Be prepared and organised Pareto Principle 80/20 rule: 80% of effects come from 20% of causes

32 Strategies Look after your bodySit and walk with good posture, stand tall and look up often Its hard to feel down when you’re looking up! Posture affects the way we feel. Eat healthily and get enough sleep Take care not to rush eating and speaking Take regular exercise Be wary of maladaptive coping strategies

33 Strategies Relax the chatter in your mindTake a few moments each day to be quiet and calm without being disturbed Think frequently about the good things in life and allow yourself to smile more often Take up some form of focused relaxation either individually at home, such as self hypnosis or in a group such as autogenic training or yoga/tai chi Spend more time in the present moment

34 Mindfulness ‘…receptive attention to and awareness of, present events and experience’ (Brown and Ryan 2003) ‘Consciously bringing awareness to you’re here-and-now experience, with openness, interest and receptiveness’ (Harris, 2007)

35 Mindfulness – Being vs DoingBrings us into the present moment – being mode. In doing mode we look for actions that will produce solutions which can lead to knee jerk reactions We are often on automatic pilot In being mode we let go of trying to fix everything and simply look at things as they are: It gives us the space to deal with emotions The space between the stimulus and the response The space to gain a different perspective Chance to Redress the Balance

36 Mindfulness benefits Mental health General benefits Depression StressAnxiety Addictive behaviour Chronic pain Insomnia Greater calm and relaxation Improved well-being Improved relationships Improved physical health Easier pregnancy and birth (see MBCP programme) Brain changes

37 Thank you! Vikki Holloway 07989 937719 [email protected]If you have any questions please contact: Vikki Holloway