Stress Management Framework

Stress is not an illness, it is to some extent, a preventable cause of distress and suffering that can lead to ill health and, in some extreme cases, morbidity and mortality. It is the primary cause of occupational ill health, accounting for around half of all days lost to work-related ill health. Stress in one or two people can impact on others, for example, losing one colleague for an extended period with a stress-related illness can have a dramatic impact on the workload and morale of the rest of the team; the objective should be to prevent stress within the workplace.

To offer a sector-focussed tool to assist approaches for stress management as part of fulfilling the respective duties of care. This toolkit presents a range of information and guidance which aims to assist organisations and staff in managing work-relevant mental health. It is not a definitive document, but rather endeavours to be a useful and comprehensive resource providing an evidenced-based approach to supporting mental health in the workplace. The toolkit’s objective is to offer focused and practical solutions to reduce, or eliminate, problems which contribute to work-relevant mental ill health.

What is Stress?

The Health & Safety Executive (HSE) defines Work-related Stress as “the adverse reaction people have to excessive pressures or other types of demand placed on them”. Stress is associated with a wide variety of physiological and psychological symptoms, which may be severe in nature, and which occur when people perceive an imbalance between the combined levels of demand placed upon them, both at home and/or at work, and their capacity to meet those demands. However, HSE also makes a clear distinction between stress and pressure, recognising that pressure does not always lead to stress and is often motivational, providing the positive drive to achieve objectives at work.  

The relationship between Stress and Mental Health

It is often the negative impact on mental health that cause the greatest distress and ill-health with subsequent disruption for work and home-life. Employers are only expected to take steps to reduce work-related stress, but it is important to appreciate that it is rarely the case that there is a single causal factor. For this reason it is helpful to understand the relationship between stress and mental health in general, and that individual cases of stress are often complex and multi-causal in nature.

Mental health problems, such as anxiety and stress are common and wide-reaching, affecting individuals, their families and carers, co-workers and the broader community. Poor mental health, including that attributable to work-related stress. As a manager or supervisor the objective should be to prevent stress within the workplace;

• Minimise stressors for the individual and support for employees suffering from stress.
• Risk assess to identify the potential causes and improve or eliminate these where possible.
• Deal with problems as they arise, to promote openness and a ‘blame free’ culture.

Stress results in decreased productivity and increased human error, with the potential for higher number of accidents at work. Stress is the primary cause of employee sickness absence in the UK and is estimated to result in 91 million lost days each year.  Most people with mental health problems are in work, and employers can expect to find that, at any one time, nearly one in six of their employees will be dealing with poor mental health.

There is increasing evidence that both the content and context of work can play a role in the development of mental health problems, including stress. This has resulted in a growing awareness of the importance of addressing mental health problems in the workplace, at local, national and worldwide levels. As a result many employers now link their management of work-related stress to an over-arching mental health strategy.

Impact of Stress on an Organisation

Stress can cause adverse effects on the organisation, including;

• Reduced staff performance and productivity
• Poor decision making
• Increase in mistakes which may lead to increased "customer" complaints
• Poor commitment to work
• Increased sickness absence
• High staff turnover
• Poor work relations

Stress and the Law

The key pieces of legislation which place duties on Employers in relation to Stress are:

• The Health & Safety at Work etc. Act 1974 (HASAWA)
• Human Rights Act 1998 (HRA)
• Management of Health & Safety at Work Regulations 1999 (Management Regulations)
• Equality Act 2010 (EA)

Whilst HASAWA places general duties on employers to protect the health of employees and others from workplace hazards, through a variety of measures, including provision of suitable information, instruction, training and supervision, the Management Regulations give the more specific duty to risk assess. As those suffering from work-related stress may go on to develop conditions that fall under the definition of a disability, the HRA and EA protect employees from any discrimination on the grounds of those health conditions. The Public Sector Equality Duty, enacted under the HRA, also requires HEIs, as public authorities, to prioritise action to address the most significant inequalities within their remit, including disability, and take actions that are likely to deliver the best equality outcomes.

There are examples of court cases where employers have been prosecuted under Criminal Law, more commonly, cases are pursued under Civil Law compensation claims, frequently involving bullying and harassment allegations due to an employer’s breach of their common law duty of care. Both can result in substantial penalties/ compensation awards, court and other costs, as well as the undesirable publicity and its potential impact on reputation.

Useful Resources:

Equality & Human Rights Commission - Mental health is your business

Sample policy

HSE guidance on work related stress

Detailed advice and support is also available from the Scottish Centre for Healthy Working Lives.

The Management of Health and Safety at Work Regulations 1999 require employers to assess health and safety risks, including stress, and to introduce suitable control measures based on such risk assessment. Priority should be given to assessing the causes of stress at work and introducing measures to reduce or, where reasonably practicable, prevent it. Risk Assessments should be carried out whenever new work activities are introduced, or changes made to existing activities, which could give rise to new or increased workplace stressors.

Identifying hazards which could give rise to stress

When considering the likelihood that a work activity could result in employees becoming stressed, it is necessary to first identify the potential hazards.

Identify the Hazard:

Identify all the common organisational stressors (hazards) relating to the work activities; evaluate the risks (low / medium / high); describe all existing control measures and identify any further measures required.

Specific hazards assessments are available for hazardous substances, lone working etc. and should be assessed on a separate risk assessment form and cross-referenced with this document where appropriate.

Guidance on risk assessment from the Health and Safety Department of the University

https://www.ed.ac.uk/health-safety/online-resources

https://www.ed.ac.uk/health-safety/online-resources/risk-assessments

http://www.docs.csg.ed.ac.uk/Safety/health/Stress_Managers_RA_checklist.pdf

Common organisational stressors include:

• Unrealistic targets and workloads
• Insufficient resources
• Long working hours
• Rapid change
• Conflicting priorities
• Uncertainty or insecurity
• Poor communication
• Lack of involvement
• Poor delegation
• Management style and conflict

Work performance alteration

• Reduction in output or productivity
• Uncharacteristic mistakes or errors of judgement
• Poor concentration or decision making
• Deterioration in planning and control of work
• Increased absence

Change in attitude and behaviour

• Loss of motivation or commitment
• Working longer hours with diminished returns
• Erratic or poor time keeping
• Rapid changes in emotional mood
• Increased use of alcohol and/or cigarettes

Alteration in relationships at work

• Tension and conflict between colleagues
• Poor relationships with clients
• Increase in employee relations or disciplinary problems

A variety of methods can be used to identify these including informal staff talks, focus groups, sickness/absence records, questionnaires and workplace inspections.

Causes of stress are referred to as stressors. There is rarely a single cause of stress and the causes may be interrelated, particularly the home / work interface. It is important to remember it is the individuals’ reaction / perception to a stressor that counts.

Environment both work and external;

• Poor working conditions,
• Too much / too little work,
• Repetitive or boring work,
• Task inappropriate to ability,
• Lone working / social isolation,
• inadequate pay,
• Job design,
• lack of control,
• lack of support or assistance,
• unclear or changing responsibilities / clarification of role / conflicting demands,
• poor communication,
• lack of security,
• lack of tolerance of mistakes,
• management style / conflict
• wider aspects of work such as assessment of job performance, reduced prospects of career progression and impending retirement.

Physical environment;

• Poor lighting,
• excessive noise, heat, cold or humidity,
• perceived threat or danger,
• excessive need to wear Personal Protective Equipment (PPE),
• poor work environment / poor housekeeping,
• overcrowding,
• poor transport, long journeys

Domestic;

• Marital breakdown,
• children leaving/returning home,
• family illness/ dependency,
• financial problems,
• poor housing,
• moving house,
• ill-health

Stress can cause adverse health effects on the individual, including;

Physical Effects

• Raised heart rate
• Gastrointestinal problems
• Skin conditions
• Headaches
• Nausea, aches and pains
• Lowering of resistance to infection

Behavioural Effects

• Tiredness and irritability
• Reduced quality of work, indecisiveness and poor judgement
• Reduced attention span and impaired memory
• Loss of sense of humour
• Poor sleep pattern, impaired concentration or excessively ‘jumpy’
• Increased sick leave
• Poor time keeping

Any member of staff may be affected by work-related stress. Some individuals may be more vulnerable than others, dependant on their job and domestic pressures. The focus is not merely on the individual but on the work and organisation as a whole. Know your staff. Individuals suffering from stress often display a range of outward signs that may be noticed by colleagues and other managers.

These signs include:

• Tiredness and irritability
• Reduced quality of work indecisiveness and poor judgement
• Loss of sense of humour
• Physical illness such as headache, nausea, aches and pains
• Poor sleep pattern or excessively ‘jumpy’
• Increased sick leave
• Poor time keeping
• Staff taking work home or staying late excessively

It is important that these individuals are made aware of the outcome of the risk assessment and informed of actions and control to minimise the risk.

Recording of Assessment Details: 

•  Record the significant findings of your risk assessment and set a review date;
• Ensure support is offered;
• Refer to the University's support services available for guidance where required;
• Refer to the HSE website for guidance.

It is also important that schools maintain records of risk assessments for inspection. Obtaining a signature from individuals to confirm that they have read and understood the information contained in the risk assessment is advised and should be implemented at the discretion of each school.

Managers can seek guidance on managing stress within the workplace from Human Resources, Health and Safety representatives and the Occupational Health Service.

Many staff within the wider University community have, in conjunction with their ‘normal’ roles, a health and safety function to perform, these responsibilities and lists of the available guidance and resources available from the Health and Safety Department to assist staff in carrying out those roles successfully are available at;

Safety Responsibilities

Occupational Health Service

Staff Counselling

Human Resources

Health and Wellbeing

The table below includes the factors identified by the Health & Safety Executive (HSE) as being most significant contributors to workplace stress, and also an eighth factor - external factors that can impact on ability to cope with work pressures – this latter factor becomes relevant when conducting a risk assessment for  a specific individual. The table also shows some examples of the stress-related hazards associated with each factor.

The HSE’s Management Standards includes a Stress Indicator Tool. HSE considers use of this tool to demonstrate a suitable and sufficient risk assessment of stress.  The tool includes 35 questions across the first seven factors in the table above.

HSE Stress Indicator Question Set

There are a variety of models available for stress risk assessment. Risk Assessment needs to happen at different levels within the university.

In order to give a full picture of the impact of stress on employees and the university, it is important to review other related data to identify potential hot spots where particular factors score poorly, indicating that stress levels are raising concern.

Higher level considerations usually in the remit of Human resources and Senior Management include;

• Sickness absence statistics (it may be helpful to include not only specific references to stress, but also to consider trends in wider symptoms that are commonly stress-related

• Occupational Health referral data – breakdown of referral reasons, management unit breakdowns

• Wider staff survey results and engagement levels
• Stress-related grievance, disciplinary or claims activity

• Counselling service uptake information – information about numbers and types of services requested and delivered, causal factors etc.
• Staff Survey outcomes and response rates
• Variety and number of grievances/ disciplinary actions and compensation claims which cite work-related stress has been cited as a contributory factor (this would include bullying/ harassment claims)
• Exit interview reports, where work-related stress is blamed for the decision to leave the university

This data can also be used at a more local level in order to help develop solutions and prioritise their implementation, such as:

• Stress Risk Assessments
• Audit findings and recommendations, whether internal, self-audits or delivered by external bodies (consultants or enforcement agencies)
• Performance reviews
• Performance review broad data – e.g. overall numbers found to be under-achieving, as this could be an indicator of over-demand or poor support.

For individual risk assessments, use of a hazard identification sheet, can be useful as part of a wider discussion with the employee to hear their concerns and develop a risk assessment with control measures to help temporarily alleviate some of the pressure until personal circumstances have improved to some extent, or an alternative course of action decided upon.

Work- Related Stress Hazard Identification Form (for use in individual cases)

Having identified potential stress-linked hazards, the next step is to consider what measures can and should be taken to reduce the risk to employees. The table below give some examples of common practices and support mechanisms that may already be in place, or could be considered.

Once suitable controls are identified, they must be incorporated into a prioritised University Stress Management Action Plan, which must be reviewed regularly.

All information and instructions should be clear, unambiguous and easily understandable, as well as readily accessible to all employees. This may require a variety of media, languages or other variations to accommodate the diversity of employees, their skill sets and roles.

Training is one of four educational elements required by the Health & Safety at Work Act, the other three being information, instruction and supervision. This section will be used to give examples of what might be meant by each of these terms in relation to good stress management.

It is important to remember that HSW places statutory requirements in relation to training and that it may therefore be helpful for certain training to be mandatory in order to demonstrate compliance. All of the training data will help inform the key considerations when planning stress-related training for employees, such as:

• Training might be specifically concerning stress e.g. raising awareness of what is meant by stress, rolling out stress management policy, teaching how to risk assess for stress, helping employees understand about resilience and how their own resilience profile influences their relationship with colleagues and or leadership style, managerial and supervisory specific roles and responsibilities in relation to stress management. However, it may be that some of the data gathered above has highlighted needs for other training – such as managing change or conflict, equality and diversity awareness, assertiveness, mindfulness or workload management.
• The target audience(s) – numbers,  role (leadership, management, research, teaching, administrative, operational, technical), knowledge base line, skill sets, abilities, specific needs, self-selecting or mandatory attendees etc.
• The delivery methods – internal or external provision, classroom or e-learning, bespoke or generic. This may be influenced by the target audience, their conflicting priorities and availability of time or learning media preferences.
• Status of training – mandatory, desirable, self-selecting

Supervision

Part of the training process is the reinforcement of what is learned when putting it into action. Good supervision enables the opportunity to praise good practice, point out poor practice and support improvement.

Support

Support is identified within in the HSE Management Standards as a key element in workplace stress reduction.

The standard required is that:

• Employees indicate that they receive adequate information and support from their colleagues and superiors;
• Systems are in place locally to respond to any individual concerns;

To achieve this within a university, it is expected that:

• The organisation has policies and procedures to adequately support employees;
• Systems are in place to enable and encourage managers to support their staff;
• Systems are in place to enable and encourage employees to support their colleagues;
• Employees know what support is available and how and when to access it;
• Employees know how to access the required resources to do their job; and
• Employees receive regular and constructive feedback.

Effective support is best achieved through a combination of Organisational Systems cascading through the institution, providing building blocks for Individual Support Systems that are readily identified and implemented.

Organisational Systems

This includes the encouragement, sponsorship and resources provided by the Institution, managers and working culture. Higher Education Institutions should have a range of wellbeing related policies and services that are key in providing support to staff and include;

• An established and effective system for organisation communications.
• Policy (Safety/ Health/ Wellbeing) that clearly identifies commitment and procedures detailing support available.
• List of other related policies and procedures implemented equally across all levels e.g. Sickness Absence policy, Equality and Diversity, Respect at Work, Stress Management, etc.
• Wellbeing Web page signposting employees to support to aid stress management.
• Access to Occupational Health Services.
• Counselling or similar.
• Staff Development opportunities to access training and improve workplace skills.
• Management training programmes to provide managers with awareness about their responsibilities, legal obligations and skills required for their role, including people management skills.
• Wellbeing and Health promotion events and opportunities at work to engage staff in physical and social activity. 

Individual Support Systems 

Usually found at a local level and dependent on the skills and knowledge of line managers and staff and the prevailing working culture. Main features include:

• Regular and effective communications – staff meetings, performance reviews, return to work interviews, etc.
• General awareness of availability of and easy confidential access to the above support services.
• Familiarity with policies and confidence they are implemented fairly.
• Knowledge of referral systems to support services including Dignity and Respect   Advisors, Trade Unions etc.
• Personal Development and training opportunities offered and encouraged.
• Individual stress risk assessment.
• Consideration given to recommendations from Occupational Health Services.
• Consideration of a wide range of reasonable adjustments to support those suffering from stress whether at work or off sick.
• Time given for engagement in lifestyle health promotion activities and social events.

Some of the data sources indicating risk that could be included in considerations.(link to ‘sources’ indicating risk above)

In order to ensure the effectiveness of any mechanisms to manage stress, it is important to identify data that shows how well those measures are performing, and to then review it at regular intervals, ensuring emerging trends and other findings are suitably highlighted and acted upon and brought to associated committees, such as the university’s safety committee.

Summary of Roles and Responsibilities in the Management of Stress - LINK

Managers should refer employees to Occupational Health in all cases of sickness absences that last for a period greater than four weeks, or in relation to shorter periods where a possible health issue is likely to have an ongoing effect on work attendance or performance.

Individuals can also be referred whilst they are attending work, if work appears to be affected by a health or mental wellbeing issue. Stress risk assessments should be considered and implemented prior to referral to the Occupational Health Service where possible and factors identified as causative should be managed.

Management referral

Mental Wellbeing

Stress and mental wellbeing resources for Higher Education Institutions

Containing links to Health and Safety Executive (HSE), Advisory Conciliation and Arbitration Service (ACAS), Chartered Institute for Personnel and Development (CIPD) and HE sector resources

https://www.ucea.ac.uk/library/publications/Stress-and-mental-wellbeing-resources-for-Higher-Education-Institutions/

HSE’s management competency indicator tool 

What are the Management Standards?

Tackling work-related stress using the Management Standards approach

A step-bystep workbook  

Talking Toolkit: Preventing Work-Related Stress

Stress risk assessment

How to tackle work-related stress: A guide for employers on making the Management Standards work

Working together to reduce stress at work: A guide for employees

Line Manager Competency Indicator Tool

https://www.hse.gov.uk/stress/mcit.htm

https://www.hse.gov.uk/stress/mcit.xls

https://www.hse.gov.uk/stress/mcit.pdf

A practical guide to managing and supporting people with mental health problems in the workplace

Caught in the Middle: 10 Tips for Managers Leading From Home

Finding Balance: Evidence-Based Strategies for Employers

For Work-Family Balance, Give Policy a Personal Touch 

Supporting mental health in the workplace

Workplace well-being tool