A Healthy Approach? How the Rail Industry Can Improve its Management of Staff Illnesses

Mark Eastwood, Director of Staff Absence Solutions Ltd © Staff Absence Solutions Ltd

The Office of National Statistics estimates that 137.3 million working days were lost in the UK because of staff illness in 2016. This equates to approximately 4.3 days per worker and is actually the lowest rate of absence since the ONS started this series in 1993. 24.8% of these absences were caused by short-term minor ailments (coughs and colds etc.), but musculoskeletal conditions and mental health problems also represented high levels of long-term absences. One of the reasons for the general decline in absences is the increased awareness of and improved support for employees presenting with these conditions, but as general knowledge of these problems has increased so has the confusion and uncertainty in how to most effectively support them. In this article Mark Eastwood, Director of Staff Absence Solutions Ltd, a former conductor and station manager (1996–2011), tells Railway-News how organisations in the industry can optimise their approach to an issue which has a significant impact on the productivity of all industries across the globe.

“Past experience from my own railway career would show that long-term absence was caused by musculoskeletal conditions. Over the last few years, this trend has changed significantly and the cost of psychological absenteeism and presenteeism is now a major burden that affects the industry in terms of budget, but also performance and public perception.
The current wave of mental health awareness, whilst welcome, has become confusing and more importantly, inconsistent. The result is that many organisations are unable to make a clear decision about how they address the challenge and are prone to making ill-informed investments for little or no return.

Railway organisations have an opportunity to radically change their approach by addressing the stressors and triggers created by the unavoidable working practices of the railway industry, but to do this, they must work together with organisations such as the RSSB and CIRAS, to understand the factors involved and agree on a robust, consistent method of management.

Mental Health

As an example, they should consider the following:
PTSD, caused by trauma, can have a root cause in being involved in an incident of suicide/fatality. It can be caused by witnessing or being involved in any traumatic incident or by experiencing trauma throughout life, inside or outside of the workplace. It should also be considered that bringing PTSD into the workplace, having previously served in the armed forces or emergency services, or having been affected by previous trauma, could be a contributing factor. Add shift work, home/work-related stress, anxiety and depression, other triggers such as insomnia, bullying, harassment, peer-pressure, performance levels, workload, personal and financial issues and suddenly, mental health management would seem to be both complex and difficult.

With the introduction of new policies and a modern approach, the whole railway sector could address their collective responsibility under the Health and Safety at Work etc. Act 1974 (and other relevant mental health legislation), they could radically change their approach to assisting employees with mental health conditions and significantly reduce absence, whilst maximising performance. By investigating more cost-effective ways of educating their employees and with a more modern approach to treatment, a significant sea-change could be seen throughout the industry. Not only would a well-considered, end-to-end approach be cost-effective, it would see new levels of investment in employee wellbeing, a collective understanding of the mental health ‘triggers’ and a much greater return on investment.

Fundamental to all of this is the fact that the vast majority of mental health conditions, such as PTSD, ADHD, ADD, OCD, stress, anxiety and depression, to name but a few ‘modern’ conditions, are considered to be potential career threatening conditions with no solution available other than traditional therapies such as CBT, counselling and Eye-Movement Desensitisation and Reprocessing (EMDR), supported by long-term use of anti-depressants.

In reality, all of these conditions are simply labels invented by psychiatrists to enable themselves and others in the mental health fraternity to diagnose consistently. Whilst this was a positive step, people who have been labelled, believe that their diagnosis is for life and the only form of treatment is via their GP, the NHS and their Employee Assistance Provider (EAP). All of these approaches are limited to therapies accredited by the National Institute of Health and Care Excellence (N.I.C.E).

When these therapies are unable to deliver a solution, many employees are then left to consider retirement or contract termination, when they really should be given access to specialist help, support and assistance, not only via appropriate therapy, but with education about their condition and their symptoms. They should have a clear understanding that recovery is not only possible, it is probable. There are two definite types of mental health conditions. First are the organic, biologically proven conditions that can be demonstrated with brain scans or via blood tests.

The second type are the labels given to modern conditions and cannot be proven. Diagnosis is via the contents of two publications – The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) published in 2013 by the American Psychiatric Association and the ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th revision), published in 2016 by the World Health Organization. These list symptoms for each condition where diagnosis is delivered after a suitable period of time if symptoms are consistent.

With the exception of organically provable conditions such as dementia, Alzheimer’s, Parkinson’s, etc., all of the others are learned behaviours. If this is understood and accepted, then with appropriate specialised therapy, the learned behaviours can and will be un-learned, resulting in a full and long-term recovery.

It should also be considered that these conditions are not ‘fixed states’. By this I mean that someone who is depressed is not in a state of depression every minute of every day. They experience peaks and troughs. If we can accept this, then by identifying the root cause of the symptoms, treatment will provide coping strategies and facilitate a return to normal life and full employment.

It is clear that there is confusion and misinformation around employee mental health. So, what is the answer, what are the solutions? On a global scale, the industry must collaborate to create a solution that is fit for purpose and all-encompassing. This must be an end-to-end policy and a modern, innovative procedure. It must address all aspects of the roles and responsibilities, it must address the physiological and psychological contributors and deliver a robust cultural change, supported and delivered at all levels, throughout all areas of the industry, driven from director level and cascaded downwards with full engagement and inclusion.

From an individual perspective, the new approach must be innovative, must be positive, must be both proactive and reactive and must be available to all.

Whilst peer management is a positive step, why not educate all employees, regardless of their status and position? This would give everybody a consistent understanding of the role of both employer and employee where mental health management is concerned. It must empower individuals to be able to record and report contributing factors and most importantly, it must enable those who ask for help, support and assistance, to gain immediate access to appropriate, confidential, help, support and assistance.

If this initiative was undertaken and delivered successfully, the whole industry would see positive engagement, together with welcome return on their financial investment and a significant reduction in mental health absence, year on year.”

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