UK 
United States
Daniela Masters, Head of Global Health and Wellbeing Programmes at Generali Employee Benefits (GEB) interviews Jason van Schie - Psychologist and Co-Founder of People Diagnostix, the company behind FlourishDx
GEB partnered with FlourishDx early last year, before the ISO 45003:2021 management standard for psychological health and safety at work was introduced. GEB’s healthcare dashboard data was indicating a need for multinational employers to address health and wellbeing strategically and holistically and, underpinning this, we identified a need for cross-departmental collaboration; particularly across HR and Health & Safety or Risk Management.
Our medical claims data suggested a potential increase in co-morbidities between physical and mental illness in 2020. In the last two years the agenda for a strategic approach to mental health in the workplace has been pushed forward by several years. Individuals and organisation have all been affected by the drastic changes the pandemic brought to our working and private life.
The partnership with FlourishDx was established with a view to helping clients access the support they need to look under the bonnet of their organisations; to get to grips with the root causes of work-related stress and, in the process, help prevent psychological injuries and promote positive mental health in the workplace. The underlying idea of the ISO45003 is a shared responsibility for employee and employer. The employee is asked to look after their personal coping strategies for stress, while the employer will need to address organisational mental health hazards.
A recent survey showed that only a fifth (21%) of UK organisations have carried out a stress risk assessment.1 At a time when organisations aspire to get much more strategic around mental health and wellbeing support, ISO45003 adoption could help greatly.
Daniela: There might be many reasons for the seemingly low percentage of organisations carrying out stress risk assessments, from siloed people departments to confusing concepts and terminology. We discuss all of this during our podcast interview.* But knowing how to approach stress risk assessments might also represent a key issue. Can you the please explain the difference between the UK’s HSE Management Standards and the ISO 45003 psychological health & Safety guidelines?
Jason: Yes, sure. The HSE Management Standards came out in 2004 and it was a guidance document; a voluntary thing that workplaces could take on board to help them meet their obligations under workplace health and safety legislation. It’s specifically related to psychosocial hazards but really it was about taking the ‘plan, do, check, act’ approach to some of the main stressors. The HSE focuses on six psychosocial hazards in particular: demands, control, support, relationships, role and change. The guidance can be followed on a standalone basis and applied in any industry or size of organisation.
ISO 45003, on the other hand, was only published last year so it’s a lot more recent and it’s a lot more rigorous. Basically, we’ve learnt a lot over the past 17 years when the HSE Management Standards were developed. But really this is a child standard of ISO 45001, which is the standard for Occupational Health and Safety Management Systems. So, it’s supposed to fit within a company’s overall safety management system.
It's about looking at how the whole risk management and return to work approach fits under existing systems and structures. In that way, it’s really integrated into how you do work, as opposed to a standalone activity on the side.
Daniela: How can the ISO 45003 guidelines help identify risk factors or psychological hazards for problem stress or even burnout within the organisation?
Jason: While the ISO guidelines talk about what a risk assessment approach looks like, it doesn’t necessarily dictate how a company does that. Whereas the HSE Management Standards refer to a tool called the stress indicator tool, which is available from the HSE. It’s like an employee perception survey, focused on the 6 specific hazards mentioned earlier. The ISO standard includes a lot more psychosocial hazards – around 30+. But it doesn’t dictate to an employer how they assess those risks.
The problem that we’ve observed is that the employee perception style survey approach for understanding psychosocial risk is actually pretty incomplete; it doesn’t give us very good information and is very one-sided.
A risk assessment should give you likelihood and consequence of harm. So, based on the exposure that people within our organisation have to psychosocial hazards, what’s the likelihood that we’re going to have people experience distress, burnout, have to take time of work due to work related stress etc.
What you typically get from employee perception surveys is a score, say out of 7, and a benchmark. For ‘workload’ you might get 5.1 against a benchmark of 5.2, for example. What does that tell you? It doesn’t tell you about likelihood or consequence of harm. It just tells you where you rank against a benchmark. Also, the style of questions doesn’t take into account individual preferences for things like workload and work design; what’s stressful for one individual or team might not be for another.
We’d argue employee perception style surveys are only really good for hazard identification. But you can do that with a 30-second check in, using something like our wellbeing check-in tool, ideally on a one- to two- month cadence, so you can respond to hazards in a very agile manner.
Daniela: OK, so that’s how you identify the hazards, but where do you go from there to better understand risk?
Jason: To really understand risk, we need to understand the severity of stress experienced due to hazard exposure, and the frequency and duration of that stress.
It’s similar to the way Occupational Hygienists might assess the risk of hearing damage. To understand that in an occupational context, we need to understand how loud the noise is that people are experiencing at work (the severity) but also the frequency and duration of that hazard exposure to understand the true risk of hearing loss.
So, what we’ve done at FlourishDx – probably our biggest innovation – is to come up with a whole new form of psychosocial risk assessment, which is more about occupational hygiene exposure assessment. This looks at that severity, frequency and duration of hazard exposure, with employees rating their level of wellbeing impact, rather than us just assuming that all work design factors will affect employees in the same way.
Daniela: In the work that our team does with multinational clients on their health & wellbeing strategy, we’ve observed a shift from the approach at the start of the pandemic of “We need to quickly do something to support our people’s mental health” and “fill coverage gaps” or “ensure access to care”, to now getting more strategic, especially considering new ways of working. Are you noticing this?
Jason: Yes, we are noticing this too. A lot of short-term initiatives were put in place during the height of the pandemic to help support employee mental health, such as extra days off. Employers were just trying to swim and stay afloat.
But now people have realised that things are changing all the time. This is the new normal: we have to start thinking strategically about mental health, and we have to do this now. ISO 45003 gives us a really solid framework to think strategically and not just what’s the hot thing that everyone else is doing at the moment.
Taking a risk management continuous improvement approach will help organisations grow and gradually improve their working conditions to support positive mental health year on year, also in line with new ways of working.
*To listen to the full 45-min Generali UK / GEB Wellbeing360 podcast interview with Jason van Schie, which includes tips on how HR can better support their Line Managers to help keep the workplace psychological hazard free, please click here https://www.generali.co.uk/Media/Podcasts.html
Also, to access a range of free resources from GEB and FlourishDx to help you get started on aligning with the ISO45003 guidelines, go to https://geb.mentalhealthaudit.com. All of Generali UK’s group income protection clients are also offered a free one-to-one workshop via GEB and FlourishDx, ideally with their cross-functional colleagues; HR, Health & Safety, Reward & Benefits.
1 Aon Benefits & Trends Survey 2022, https://www.aon.com/unitedkingdom/employee-benefits/resources/benefits-and-trends/default.jsp
