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Send Your People Home Safe –
and Sane – Every Day!
Carolinas AGC Convention 2016
Nancy Spangler, PhD, OTR/L President, Spangler Associates Inc. Consultant, Partnership for Workplace Mental Health
SPANGLER ASSOCIATES, INC:
• Individual health (and safety)
• Workplace performance
• Brain research on thinking, emotions, social connectedness
SPANGLER ASSOCIATES, INC:
What:
Collaborate with employers to advance
effective approaches to mental health.
How:
• Share business case for quality
mental health care, including early
recognition, access to care and
effective treatment.
• Provide supportive tools at
www.workplacementalhealth.org • Mental Health Works
• Employer Case Examples
• E-updates
• Research Works issue briefs
• Promote employer case examples
and facilitate peer-to-peer dialogue.
Partnership for Workplace Mental Health
3
Best qualifications. . . .
I grew up in the culture: • Hard working
• Hard playing
• Sarcastic
• Tough guys
The Tough Facts:
• Suicide = 2nd leading cause of death in men
• Construction is among top 10 industries for suicide
• Heavy construction equipment operators especially at risk
• People with lower formal education are more at risk for suicide (as well as substance abuse, obesity, and heavy smoking)
http://www.nxtbook.com/naylor/NGCS/NGCS0116/index.php#/2
http://www.carsonjspencer.org/programs/working-
minds/construction-industry-blueprint/
Why? • More education increases insight, social-emotional
interaction, problem-solving, and skill development
• Hard and dangerous work, financial and time pressures, lots of room for conflicts
• Seasonal employees at off-site locations
– Isolation from family and friends
– Disruption of routines
• Tough guy, stoic culture makes getting help unlikely
• Sleep difficulties and chronic pain
– Self medication with alcohol, sleeping pills, and pain medications
Mental health concerns are highly prevalent for all:
• 1 in 5 adults in the U.S (18.6%) experiences mental illness in a given year. – 18.1% of adults in the U.S. experiences an anxiety disorder, such as
posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias.
– 6.7% of adults aged 18 or older (15.7 million people) had at least one major depressive episode
• Mental illness frequently occurs with other medical conditions, especially diabetes and heart disease, and mental distress worsens the course of both illnesses.
• Work and life stress (such as trauma) can be risk factors for developing depression.
Percentages of Adults with Mental Disorders and/or
Medical Conditions
National Comorbidity Survey Replication, 2001-2003
STRESS =
• Distress = negative emotional state due to harmful stimuli or excessive demand
• Eustress = euphoric effect of positive adaptation to demands or challenges
9
“The nonspecific response
of the body to any demand
made on it.” (Selye, 1956)
Stress Response = multisystem response
to a demand, threat, or perceived challenge
Brain’s limbic system
and cortex set off the
hypothalamic-pituitary-
adrenal (HPA) axis
response to prepare the
individual to:
-Fight
-Flight
-Freeze
10
Distress is costly to workplaces:
• May result in emotional fatigue and poor impulse control
• People may eat, drink, and/or smoke too much
• Distressed workers have difficulty focusing on work or personal goals
• 120,000 deaths and nearly $190 billion in health care costs each year (Goh, Pfeffer & Zenios, 2015)
Stress isn’t all bad: • Distress = negative emotional state
due to harmful stimuli or excessive demand
• Eustress = euphoric effect of positive adaptation to demands or challenges
12
Stress Can Stimulate Growth and Resilience:
Stress Adaptation Growth Dynamic (Kim, Y.J., 2005)
Adaptation = Resilience
• Term with multiple applications
– Physical (engineering, cellular, ecological systems)
– Social/psychological (child development, individual, organizational, community disaster recovery)
• “A process linking a set of adaptive capacities to a positive trajectory of functioning and adaptation after a disturbance.”*
• The ability to bounce back, to grow, to bend rather than break.
* Norris, F.H. et al. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127-150.
15
• Optimism/beliefs
• Emotions
• Purpose/meaning
• Self reliance
• Connections
• Help - give/receive
• Replenishment
Resilience
Stress/rest/recovery cycle:
Power of Beliefs & Mindsets:
• Effect of stress on health depends on beliefs • People reporting high levels of stress plus belief that stress
impacts health had 43% higher risk of death (Keller, Litzelman,
Wisk, et al., 2012)
• Helping others reduces mortality • Stressful life events buffered by giving help to family and
friends reduced 5-year mortality risk (Poulin, Brown, Dillard &
Smith, 2013)
• Changing mindsets • “You must be smart.” vs “You worked hard.” (Dweck, 2006)
Smiling reduces mortality: • Baseball players with full (Duchenne) smiles lived
seven years longer (Able & Kruger, 2010)
Skill Practice:
• Smiling
• Gratitude
• Body posture
• Meditation
Intensive . . . . . .
Targeted. . . . . . .
Universal . . . . .
Get people back to work
Reduce risks
Keep healthy people healthy
20
Employer Practices:
• Active, outbound intervention
• Screenings, information, resources, & benefits
• Organizational leadership, culture, & management practices
• Disease management/ Case management
• Disability management (Return-to-work)
• HRAs/Screenings & coaching
• Information, webinars, education
• Medical benefits
• Employee Assistance Program (EAP) & behavioral health benefits
• Values, ethics, & mission/role alignment
• Communication (face-to-face, at multiple levels,
conflict resolution, predictable structure)
• Career & life development/balance
• Training (Manager/supervisor & employee)
• Health champions
• Connectedness, meaning, belonging 21
Employer Practices:
New Program on Depression:
Right Direction
• In partnership with
Ohio-based coalition, Employers Health
• Designed to help motivate employees and their families to seek help when needed, and to provide employers with appropriate support, tools and resources.
http://www.rightdirectionforme.com/DepressionatWork.html
“Emotional Ergonomics” Program called ICU:
• Identify the signs
• Connect with the person
• Understand the way forward together
Built on DuPont’s core values: – Safety and Health
– Environmental Stewardship
– Highest Ethical Behavior
– Respect for People
http://www.esibethesda.com/ADSmediafiles/_video/ImprovingEmotionalHealth/player.html
23
Man Therapy
• Information to help men understand that mental health disorders are not “unmanly signs of weakness”
• Resources and tools for (learning and laughing)
Case Examples and Resources:
• H-E-B (San Antonio)
• RK (Denver)
• Tarlton Corp (St. Louis)
• Toolbox talks with construction workers at jobsites
• Suicide prevention training for managers;
• Mental health resources through the RK Wellness
Program, including an in-house wellness coach and
1:1 counseling
• Trusting, collegial culture • Diversity of thought and talent • “Project First” win-win mentality – reduces
client/subcontractor conflicts • Superintendent training on conflict
resolution
• EAP/Behavioral health outreach for ALL disability claims • Disabilities with primary mental/behavioral health
diagnosis are treated by specialists or claims not paid
Systemic Effects:
Values-based leadership –
builds trust
Culture of health
Culture of high performance
Positive individual health and
organizational performance
outcomes
Questions?
Nancy Spangler
816-820-1870
(Please contact me or leave your
business card if you would like to
receive our e-mailings – or if you have
an employer case example to share)
SPANGLER ASSOCIATES, INC:
Bonde, J. P. E. (2008). Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occupational and environmental medicine, 65(7), 438-445.
Katon, W. J. (2011). Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues in clinical neuroscience, 13(1), 7.
Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.
McGonigal, K. Stress is your friend. Retrieved from http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend
Selye, H. (1956). The Stress of Life. New York: McGraw-Hill Book Co. Selye, H. (1976). Forty years of stress research – Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1878603/pdf/canmedaj01483-0055.pdf
Spangler, N.W. (First Quarter, 2012). H-E-B Emphasizes Health for Partners and Communities. Mental Health Works. Retrieved from http://www.workplacementalhealth.org/mhw12012
References & Resources:
Spangler, N.W., Koesten, J., Fox, M.H., & Radel, J. (2012). Employer perceptions of stress and resilience intervention. Journal of Occupational and Environmental Medicine, 54 (11), 1421-1429. Retrieved from http://www.workplacementalhealth.org/Publications-Surveys/Study-Examines-Employer-Perceptions-of-Stress-and-Resilience-Intervention.aspx
Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. Retrieved from http://www.samhsa.gov/data/sites/default/files/NSDUHmhfr2013/NSDUHmhfr2013.pdf