Presentation irene houtman

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<ul><li> 1. Psychosocial risk management: The Dutch case Irene Houtman </li> <li> 2. This presentation <ul><li>Psychosocial risk exposure in the Netherlands </li></ul><ul><li>Active policies in the last two decades and their results </li></ul><ul><li>The policy shift: from managing risks towards reducing absenteeism &amp; disability and increasing participation </li></ul><ul><li>Towards sustainable employability &amp; an all inclusive labour market </li></ul></li> <li> 3. Working conditions profile NL against EU </li> <li> 4. Trends in EU-data on psychosocial risks covering 1990-2005 Source: EWCS </li> <li> 5. Period of 1990 - 1998 <ul><li>1990 National legislation on OSH was implemented with specific attention to well being at work </li></ul><ul><li> 1990-1998 </li></ul><ul><li>Handbook(s) on management of work-related stress </li></ul><ul><li>Description of good practices </li></ul><ul><li>Guidelines for maintenance (objective, expert opinion: WEBA method) </li></ul><ul><li>Research: </li></ul><ul><li><ul><li>Monitor on Stress and Physical Load </li></ul></li></ul><ul><li><ul><li>Priority program on mental fatigue </li></ul></li></ul></li> <li> 6. Some findings of the Monitor on Stress and Physical Load linked survey on + 1000 companies- <ul><li>Companies who are active in Psychosocial RIsk MAnagement </li></ul><ul><li>(PRIMA) characterize themselves by (multivariate): </li></ul><ul><li>Employers: OR </li></ul><ul><li>Work-related stress recognized as a problem 3.1 </li></ul><ul><li>Large size 2.1 </li></ul><ul><li>Employees: </li></ul><ul><li>Low on autonomy 1.8 </li></ul><ul><li>Many short cycled work 1.5 </li></ul><ul><li>Low physical load 2.1 </li></ul></li> <li> 7. 1998 2007: Work and Health Covenants <ul><li>Characteristics &amp; aim: </li></ul><ul><li>Sector wise approach </li></ul><ul><li>Ministry subsidizes (50%) </li></ul><ul><li>Large scale OSH interventions: </li></ul><ul><li><ul><li>psychosocial risks in NL highly prevalent </li></ul></li></ul><ul><li><ul><li> so psychosocial risk management often core </li></ul></li></ul><ul><li>Aim: 10 % risk reduction in three years </li></ul><ul><li>Proper (quantitative) evaluation </li></ul></li> <li> 8. An example: the police favourable unfavourable </li> <li> 9. Changes in risk exposure High quantitative demands - 12% Problems with time autonomy - 11% Problems with opportunity for contact - 12% Problems with feedback - 17% Problems with emotional load - 10% Problems with supervisor and colleagues - 20% High emotional exhaustion - 11% High depersonalisation - 20% Dissatisfaction with work - 20% </li> <li> 10. Effectiveness of the measures I (imputation) </li> <li> 11. Effectiveness of measures II (imputation) </li> <li> 12. After the Work and Health Covenants <ul><li>In 2007 the Working Conditions Act was updated </li></ul><ul><li><ul><li>Employers obligated to make a risk assessment (RIE) </li></ul></li></ul><ul><li><ul><li>Well being as specific issue was skipped from the act . </li></ul></li></ul><ul><li><ul><li>Companies 30 days in Europe Source: EWCS </li> <li> 14. Sickness absence trend in the Netherlands </li> <li> 15. Absolute figures on disability in The Netherlands until 2004 steady rise 100.000 a year -&gt; legislative change Source: NEA 2009 Source: UWV </li> <li> 16. Disability inflow by diagnosis </li> <li> 17. Estimated costs of work-related drop out (for 2001) <ul><li>Costs of drop out from work Euro % of total </li></ul><ul><li>x1000) </li></ul><ul><li><ul><li>Work-related costs of absence 3.785 29,8 </li></ul></li></ul><ul><li><ul><li>Work-related costs of disability 4.371 34,4 </li></ul></li></ul><ul><li>Costs on operational management unknown </li></ul><ul><li>Costs of health care, </li></ul><ul><li>Legislation &amp; enforcement 2.869 35,8 </li></ul><ul><li>Total (work-related costs) 12.690 100 </li></ul><ul><li>For work-related mental health: 5.457 43% </li></ul>Source: Zwinkels et al, 2004) </li> <li> 18. Research directed at determinants of, and intervening effectively in drop out because of ill mental health <ul><li>Lessons learned from that research: </li></ul><ul><li>Early contact occupational health physician facilitates return to work </li></ul><ul><li>Partial work resumption is instrumental to return to work </li></ul><ul><li>Employers who facilitate partial return to work obtain a lot higher (up to 9 times higher) return to work after drom out from mental health reasons </li></ul><ul><li>In NL depression appears to be a major factor prehibiting return to work </li></ul></li> <li> 19. Final conclusions for the Netherlands -1 <ul><li>In NL there were relatively high levels of psychosocial risks and drop out for reasons of mental health Costs were high. </li></ul><ul><li>The high work pace appears to have been addressed quite effectively Work &amp; Health Covenants? </li></ul><ul><li>The Work and Health Covenants have stopped. Now the Work and Safety Catalogue (is hoped to) maintain the gains and experiences from these Covenants no explicit monitoring </li></ul><ul><li>Attention shifted to counteract the high drop out (for large part) due to mental health problems this is mirrorred by legislative changes </li></ul><ul><li>Now the policy attention is mainly directed at participation and inclusion, particularly of specific groups at risk (e.g. elderly, women) towards an all inclusive labour market </li></ul></li> <li> 20. Take home message <ul><li>Conditions for psychosocial risk management to be effective: </li></ul><ul><li>Participative approach (both employer AND employee involvement) </li></ul><ul><li>Use a stepwise approach (inventory passive-active-, plan, act, evaluate) </li></ul><ul><li>Employer has to ackowledge psychosocial risks to be a problem </li></ul><ul><li>Acknowledge workers/employees as experts </li></ul><ul><li>Management has to act on changes in the organizational structure </li></ul><ul><li>If many companies are small, try to organize sector wise </li></ul><ul><li>When employees become absent: individual approach necessary : </li></ul><ul><li>Early contact with (occupational health) physician discussing R2W </li></ul><ul><li>Partial work resumption is instrumental to a full return to work </li></ul><ul><li>Employer should temporarily and activily lower the threshold for (partial) return to work (adjustment in tasks, working times etc). </li></ul></li> <li> 21. Results: RTW per country (Time 2) Percentages after excluding full RTW at Time 1 </li> <li> 22. Results (continued): RTW and social security system </li> </ul></li></ul></li></ul>