Workplace stress is something millions live with, but few truly understand. We have all heard that stress kills, but something less publicized is that stress costs. According to the American Institute of Stress, stress in the workplace affects four out of five American workers and costs U.S. businesses an estimated $300 billion a year from accidents on the job, absenteeism, employee turnover, diminished productivity, medical expenses, increased insurance premiums, workers compensation awards and lawsuits.
Researchers concede that stress is difficult to define because it is an inherently subjective experience. We all react differently. And differentiating "work stress" from the general, day-to-day stress that everyone experiences can be even more problematic because there is rarely an exact demarcation between the two.
To help clarify things, the National Institute for Occupational Safety and Health (NIOSH) has defined job stress as "the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources or needs of the worker." The European Agency for Safety and Health at Work offers a similar, yet perhaps clearer, interpretation: "people experience stress when they perceive an imbalance between the demands made of them and the resources they have available to cope with those demands." More importantly, the agency also notes that although the experience of stress is psychological, stress affects people's physical health.
But while clearly detrimental to the business world, workplace stress rarely enters public or political discourse on either side of the Atlantic. Researchers-and, on occasion, managers-talk about "good stress," which is sometimes referred to as "eustress" to distinguish it from harmful stress. Preparing to run a race, for example, might be stressful, but may lead to improved performance. "Pressure might be good for performance, but stress is not," said Eusebio Real Gonzalez, Ph.D., head of the European Risk Observatory in Bilbao, Spain. He worries that managers who allow for-or even embrace-"good stress" can create a slippery slope that inevitably leads to harmful stress. Gonzalez says that a good way to tell the difference between stress and eustress is duration; stress that is chronic will likely be harmful.
The subjectivity surrounding stress, however, has not deterred researchers from studying its causes and health effects. Dr. Steven Sauter, coordinator for the research program on work organization and stress-related disorders at the NIOSH, has seen an explosion in the scientific study of workplace stress in recent years.
To Sauter, this awakening can be largely credited to the massive downsizing and outsourcing trends of the 1990s that have created a climate of job insecurity in the workplace. Similar factors include more flexible employment practices, the use of temporary or contract workers and the growth of new operating systems, such as "lean production," that make employees constantly fearful that their next work day could be their last. Furthermore, experts also see stress rising due to the burdens facing two-income families, the aging workforce, a faster pace of work, poor work/life balance and the longer work hours many employers now demand in the modern business world. The fact that the United States now has a more service-oriented economy that requires more personal interactions than ever may be another factor.
Regardless of the cause, NIOSH researchers have found that 35% of the working population experiences high levels of stress on the job, while 13% say they "always" find work stressful. And there are numerous ways in which this is having direct financial effects on corporate bottom lines.
Among the one-third of workers who report high levels of stress, there is a 50% increase in health care utilization costs to their companies, resulting in an average additional cost of $600 per worker per company per year.
If depression is a factor then costs can rise even higher. Depression touches at least 7% to 11% of the workforce, and Sauter believes it is even more prevalent than these numbers suggest because the continuing stigma of the disease causes it to go under-reported. And employees suffering from depression have been found to use their health care plans 70% more than the average worker, which costs employers an additional $950 per employee in direct costs. If depression and stress are present together, costs go through the roof-amounting to an additional $2,000 per worker per year.
Sauter emphasized that this data refers to stress in general and is not necessarily limited to workplace stress by itself, but he also notes that a recent review of the literature found that psychosocial demands in the workplace were associated with a doubling of the risks of depression. Moreover, the costs to employers are the same regardless of the genesis of the stress.
An Awakening to the Problem
Traditionally, the business world has never paid much attention to stress. "It's a source of permanent frustration," said Gonzalez. And Gonzalez is not alone.
"We've tried to engage our client base in it, but we've been relatively unsuccessful," said Sydney Robertson, executive vice president at ORC Worldwide, a New York-based consulting firm specializing in human resource management and workplace safety.
That may be changing. The evident connections between workplace stress and soaring health costs-not to mention the rigors of competing in a global marketplace-have piqued the interest of many companies. Employers are also realizing that the new service-based economy often demands healthier, more engaged employees than an industrial economy does. Stress may lower the productivity of someone manning a conveyor belt or pushing the levers on a machine, but it can lead to the direct loss of business if it affects the client-based, person-to-person interactions required in customer service.
So now, many companies are attempting to develop programs that can cut the long-term costs of stress while boosting morale, productivity and profits in the near term. And keenly aware of the connection between stress and illness, a legion of governmental and nonprofit agencies devoted to occupational safety and health are encouraging this process in hopes that the corporate world's incentive to deal with the problem can lead to a healthier population.
But regardless of macro trends, the process still comes down to a simple choice. When confronted with a worker complaining of job stress, an employer has two basic options. The first is to view the reported stress as a personal disorder that has nothing at all to do with the workplace. In this case, if the employer decides to respond at all, the effort will likely go no further than encouraging him or her to exercise, consult a psycho-therapist or utilize the employee assistance program (EAP).
The second, emerging strategy of dealing with an employee who reports stress is to acknowledge the true nature of the problem and start to do something about it. "Just admitting there may be a problem is a big first step," said Robertson. In this vein, an increasing number of employers are now actively engaged in changing the workplace to reduce harmful work-related stress, with many embracing what is referred to as the "organization of work."
The Organization of Work
The organization of work has been defined by the NIOSH (in its publication "The Changing Organization of Work and the Safety and Health of Working People") as "the way jobs are designed and performed, and the organizational practices (management and production methods and accompanying human resource policies) that influence job design."
And it cannot be addressed in a one-size-fits-all manner, according to David Ballard, PsyD, MBA, assistant executive director for corporate relations and business strategy at the American Psychological Association (APA). Thus, he recommends asking employees throughout the organization what they need.
Communication is key, and this is something his organization weighs heavily when selecting the winners of its Psychologically Healthy Workplace Awards, which are given out after evaluating five categories: "employee involvement," "work/life balance," "employee growth and development," "health and safety" and "employee recognition."
"Communication is the hub of everything," said Ballard. "What we're seeing is that you simply can't be successful without employee involvement. Many companies think they are doing this well-and they aren't."
Most companies attempting to implement organization of work concepts, for example, survey their employees, but people never hear the results. Or worse, nothing is ever even done with the data to improve the organization of work. This can actually destroy trust-and trust can make the difference between success and failure in a program. "Don't ask them questions and then implement a plan without their full participation," said Ballard. "Employees must be involved in the design, implementation and evaluation of the program."
Letting employees have this much power over how work is done makes some managers nervous, according to Robertson. Most private sector managers tend to believe that the reason they are managers is that they know how to make decisions about how work is organized. "If you believe in the right to manage, then you don't accept the notion of a two-way dialogue between management and employees," said Robertson. "But if you believe in developing a more effective organization, then you'll want workers and managers to have a dialogue."
Nothing can disrupt the process as much as putting up a wall. "The question of whether to have a real dialogue with employees about the organization of work is one of the crucial points in the whole debate," said Robertson. "The participants in the debate about how to address workplace stress typically cannot reach agreement on whether to have a dialogue with employees."
The European Union is clear on this matter. Across the Atlantic, worker participation is an obligatory element in the employer's effort to address workplace stress. "For some, this is anathema," said Gonzalez. "In fact, that's part of the reason it's enshrined in EU legislation-we've found that worker participation in both identifying and resolving problems is essential for success."
From this participation, it is important to stay focused on working conditions because that usually tackles the root cause rather than symptoms. "Focus attention on work-related factors that are commonalities across your staff, not just individual judgments," said Gonzalez. "If I have 12 people in my unit and nine say I don't communicate well, I'd have to recognize I have a problem."
While there is a consensus that effective employee involvement is critical, the experts also agree there is no single "right" solution to the complex issue of workplace stress. Ultimately, Gonzalez believes that conducting the risk assessment is the easy part. The hard part is determining what to do once you understand what your people are saying about work stress.
"There's no matrix on what to do," said Gonzalez. Larger companies can buy consultant expertise to help. But at least in the European Union, the difficulty of knowing what to do does not relieve the employer of the obligation to assess and address psycho-social workplace risks.
The silos separating risk managers, human resources, and health and safety managers can also present huge challenges for companies trying to come to grips with workplace stress. If the HR, EHS and risk management functions are not integrated, it is difficult to make much progress.
"You can see in some companies there's a little bit of ping pong going on," said Gonzalez. "If only one department does it, it won't work. You need the support and vision of top management to integrate these departments."
As expected, companies are responding to this emerging challenge in a variety of ways. The best part, of course, is that many are now at least responding in some way, but some organizations remain wedded to the traditional view that stress is a purely individual problem and that management always knows best-but the risks of continuing down this familiar road appear to be growing.
And the most important thing for companies to remember is that addressing workplace stress through the organization of work need not be a huge undertaking at first. You can build the program piece by piece, engaging employees to determine what their top priorities are. A health risk and productivity assessment survey is exactly how the Toronto Police Service (TPS) began its process of reducing workplace stress, for example. Since TPS is the largest municipal police force in Canada, even this must have initially seemed a daunting task. But according to one insider, any difficulty at the beginning proved well worth the effort.
"The assessment revealed a number of health risks, including cardiovascular risks, and there were indications that employees were reporting high levels of job stress," said Carol Vipari, Ph.D., the corporate psychologist at TPS. Before the assessment, efforts were already underway to reduce stress through a typical employer-run wellness program, but the survey led TPS to address work stress more systematically, according to Vipari.
Not only have employees and managers widely endorsed the improvements, but TPS' efforts won it the APA's 2009 Best Practices Award for a Psychologically Healthy Workplace. And no matter how effective your organization of work program is, there is still nothing like being recognized for your efforts to take a load off.