In this issue of Occupational Medicine
Honorary Editor
In this issue almost half the original research concerns mental health in the workplace. Four research papers deal with the entire life cycle of work-related mental health problems, starting with the autonomic response to stress, moving to the impact of behaviour and perception on developing mental health problems, then to the reporting of work-related mental ill-health and finally to whether work-related mental ill-health can be prevented through the implementation of management standards.
For most occupational physicians, mental health problems will be the commonest cause of their referrals and work-related mental health problems will be the most frequent reason for completing their Occupational Physicians Reporting Activity (OPRA) card (more than 40% of reported cases). The Health and Occupational Reporting (THOR) network at the University of Manchester has now provided high-quality data about work-related mental health problems for over 10 years. Work-related cases of mental ill-health are reported either by occupational physicians through OPRA or by psychiatrists through the Surveillance of Occupational Stress and Mental Ill-health (SOSMI) scheme. About 600 doctors report into each scheme and these have now been joined by general practitioners who report into THOR-GP since 2005. Carder and colleagues [1] report analysis of the OPRA and SOSMI schemes between 2002 and 2005. Compared to the analysis for 1996–2001, rates for psychiatrists appear to have fallen to about 90 cases of work-related mental ill-health per million workforce whereas rates for occupational physicians have increased to about 1600 per million, although these changes may not reflect actual changes in incidence. Anxiety and depression continued to be the most common diagnoses, and workload and relationships the commonest causes, but with possibly important differences in cause between employment sectors. Workload or factors intrinsic to the job appeared to differ significantly between different employment sectors and the authors note that whilst this might be addressed through changes in work practice such as additional recruitment, training, or increased delegation, less than half of organizations have taken steps to reduce stress in the workplace. This is where the Health and Safety Executive (HSE) Management Standards come in, having been introduced to help reduce the levels of work-related stress reported by British workers. This approach highlights six key areas of work design that, if not properly managed, are associated with poor health and well-being, lower productivity and increased sickness absence. But is there any evidence that implementation of the management standards can bring about a benefit? Kerr and colleagues [2] believe there is. They carried out a questionnaire study of over 700 employees, asking them to complete the HSE Indicator Tool as a measure of the Management Standards as well as measures of job-related anxiety and depression, job satisfaction and safety. Whilst the response rate was low (29%), HSE Management Standards were positively associated with job satisfaction and negatively associated with job-related anxiety and depression, and poor safety. Whilst this is encouraging and hopefully suggests the HSE are on the right track, in order for THOR reporting rates to fall, the proportion of organizations implementing the standards will need to increase significantly.
The other research on work-related mental ill-health in this issue concerns offshore oil platform workers and the effects of job demands and control on the autonomic nervous system in media workers. In their study of almost 600 offshore workers, Chen and colleagues [3] found that perceived occupational stress increased the risk of mental illness and that avoidant or negative behaviour coping styles significantly worsened mental health. In their study of almost 900 broadcasting workers, Lindholm and colleagues [4] showed that those with high job control had better vagal recovery than those with moderate or low control, but this only applied to middle aged employees and not those in the younger and older age groups.
Continuing this particular theme, Peter Verow [5] bravely explains why he became a part-time occupational physician and Frank Gallagher [6] reviews Manage Your Mind: The Mental Fitness Guide. On a separate theme we also have four original papers concerning sickness absence and certification, another issue of huge importance to practising occupational physicians. Occupational Medicine remains committed to publishing practical research relevant to practising occupational physicians, which is our mission. Satisfyingly, our impact factor, the measure of how often the research we publish is cited elsewhere, has doubled in the last 5 years, and thus exceeded the relative increase of any other occupational medicine journal in that time. The journal and its success are only possible thanks to the efforts of many people, some of whom are mentioned in this issue at the end. Thank you.
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- Carder M, Turner S, McNamee R, Agius R. Work-related mental ill-health and ‘stress’ in the UK (2002–05). Occup Med (Lond) (2009) 59:539–544.
- Kerr R, McHugh M, McCrory M. HSE Management Standards and stress-related work outcomes. Occup Med (Lond) (2009) 59:574–579.
- Chen WQ, Wong TW, Yu TS. Mental health issues in Chinese offshore oil workers. Occup Med (Lond) (2009) 59:545–549.
- Lindholm H, Sinisalo J, Ahlberg J, et al. High job control enhances vagal recovery in media work. Occup Med (Lond) (2009) 59:570–573.
- Verow P. Why I became a part time occupational physician. Occup Med (Lond) (2009) 59:569.
- Gallagher F. Manage Your Mind: The Mental Fitness Guide. Occup Med (Lond) (2009) 59:593.
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