“The Duty of Care is fundamental. How do we expect
to care for affected populations if we’re not taking care of our own?” IVCA / CHS
alliance, 2021 p7
In her article on burnout, Huffington describes the phenomena as a
‘workplace crisis’, now with its own definition from the World Health
Organisation:
“A syndrome conceptualized as resulting from
chronic workplace stress that has not been successfully managed. It is
characterized by three key factors: feelings of energy depletion or exhaustion;
increased mental distance from one’s job, or feelings of negativism or cynicism
related to one’s job; and reduced professional efficacy.” Huffington (2019)
This article is not specifically focused on the international aid sector and research suggests that burnout rates in the sector may be two to three times higher than the general population. While this may not sound surprising, given the challenging nature
of much of the work in the sector, what might be more surprising is the extent to which organisational factors contribute to this burnout.
Activity 1.7 Stress and the role of organisations
Listen to the following audio which is part of an interview with Dr Liza Jachens who has researched this topic and consider the relevance of her conclusions to your organisation. Note any ideas in your learning journal.
DR LIZA JACHENS: So, in my research, I've consistently found humanitarians to be a lot more at risk than the general public. The risk can be double. Sometimes it's triple the risk for negative health outcomes. So, I can give you some
examples. So, for anxiety, the humanitarians are around 30% at risk. Compared to the European population, it would be around 8%. And to compare it to another human services profession, like the police, that would be sitting at
around 10%. So, and I think for depression, it's fairly similar percentages actually, and then for PTSD, humanitarians around 25% at risk, European population around 6% and the police around 14%. So sometimes humanitarians are
even more at risk than the police in some cases, not all cases, but sometimes they are. And the obvious clue as to why that is the case is because they work in these challenging contexts. And that's why people automatically start
thinking about these operational or occupational risks, this witnessing to distressing events, exposure to trauma suffering. But there is quite a bit of variability in those percentages that I've just given you. There's a lot of
variability across regions. So, in the Middle East, North Africa, for example, there would be much sort of higher for PTSD. Switzerland might be a little bit more at risk for burnout and heavy drinking. We have to take that into
consideration. Women and men, there are lots of differences, international and national workers. I should probably stop there. So, these are challenging contexts, is only half the story. Humanitarians, like any employee, are also
exposed to organisational stresses. And as you were saying, it's about the design and management of work. So, it would be things like having a high workload, how much support are you getting at work from your colleagues, from your
managers, recognition at work, job security, how much influence or job control you might have. Change is a big one at the moment, being exposed to a lot of change. So, these are all organisational stresses. And these are the factors
that I've really been sort of investigating quite deeply. I've been looking at some stress models that incorporate some of these organisational factors. And what we found has been, I think quite extraordinary, because they're just
such good predictors. So, we found that those who were classified as having a high number of these organisational stressors were between 3 and 10 times more likely to be at risk for a negative health outcome. And you know, I think
-- stop me if I'm going on too long here, Melissa, but I think what's particularly interesting is that these organisational stresses are also important for trauma, trauma-related health outcomes, like PTSD. And we don't typically
think of organisational stressors when we're thinking about PTSD. Our immediate assumption is it's all about trauma. So, what am I talking about? What could this mean? And just to give you an example here is that the level of workplace
stress that an individual is experiencing before or after a traumatic event actually affects the extent to which they will develop a poor mental health outcome. So, if you've got somebody experiencing many of these organisational
stressors, which I've been talking about, maybe they're hiding their emotions. They've got work overload and so on at the time of the traumatic event. So, you can imagine how that would affect their level of resilience. And it
may affect how they heal from a trauma. So, it seems like the work context can make quite a big difference on the pathway from trauma to recovery or from trauma to PTSD. So, I think that's an interesting thing to think about, because
the dialogue about PTSD has mostly been about trauma. And, of course, it is about trauma, of course it is, we can't take that away from it, but I think there are more things that we need to start thinking about.
Listen to the second part of the audio, in which Dr Jachens also talks briefly about how organisations might respond to issues of mental health in their workforce, for example, being proactive not just reactive and challenging stigma.
MELISSA: I mentioned that you are really looking forward to opportunities to put your findings and your learnings to use so that organisations can have better mental health outcomes for their staff. I'm curious what could this look
like from your perspective? DR LIZA JACHENS: Yes. So, I didn't work in the humanitarian organisation. So, I am kind of limited to recommendations, but I can tell you some of my observations of what I've seen been going on. So,
a lot of the time I've noticed that they're using the research as a tool to leverage resources for mental health. So, to give you some examples, I've seen more counsellors, more psychologists being employed. I've seen mental health
insurance being improved. So, people have more affordable access to external services. I've seen some funding for specific interventions, like that heavy drinking in particular contexts, but what you'll notice about all of these
interventions is that they fall into one category. They are responding or reacting to existing mental health problems. And so, a lot of the recommendations that I'm trying to do now is to actually do more of an integrated approach,
where you start looking at protecting mental health, promoting mental health. And the protecting of the mental health would be looking at how to reduce those work-related risk factors. So, looking at those organisational stressors
that we were talking about earlier, how do we reduce those? And looking at how do we promote mental health? how do we reduce stigma? Developing positive aspects of work, what are the resources? What are workers strengths, looking
at some of the positive capacities as well. And, of course, we have to and must respond to mental health problems as they occur and make services as accessible as possible. That's not -- that's just as important. Yeah, I kind of
hoping for a more integrated approach. One of the things that I think we need to look at quite carefully is addressing stigma, because what I've noticed is that it seems to be seriously impacting access to mental health services.
So, I noticed on looking at the data from the surveys, just as an example, you know you've got a quarter of a staff who don't really want to share with staff health, because they're scared of professional consequences, sharing
personal information, worried about discrimination, and that type of thing. So not everyone's comfortable asking for help. And so, there's quite a bit that can be done around that, maybe refreshing communication strategies around
health services, maybe implementing something like mental health first aid. So, I think knowledge and awareness of mental health in itself does reduce stigma.
