Q & A with Dr Petter Cotton

Q & A with Dr Petter Cotton

by Dr Lindy Alexander

Dr Peter Cotton was a key contributor to the (Mis)behave with Dave series, created to encourage the early identification of factors contributing to psychological injuries in workplaces. Here Dr Cotton shares his insights into mental injury and what employers can do to support their staff.

What are the current trends in research around work related psychological or mental injury?

The numbers of psychological or mental injury seem be increasing across most jurisdictions. It’s a challenging space because the outcomes haven’t improved greatly in recent years.

It’s also complex because we have the impact of mental health programs such as beyondblue, which means there’s a lot of awareness about mental health issues now, so it’s hard to know if there are more people coming forward or if the incidence of mental injury is actually increasing.

What are some examples of things that can contribute to mental injury?

There’s occupational violence (that includes alcohol or drug-fuelled violence targeted at hospital staff in emergency departments or emergency workers), interpersonal conflict, bullying and performance management. Other risk factors include laissez-faire leadership and this is where managers tend to focus on technical job content rather than on people skills. For example, a nurse who has both clinical and leadership responsibilities may tend to focus on the technical aspects of the work if they’re in a stressful environment. The tolerance levels for incivility (e.g. inappropriate low intensity behaviour, interrupting, sarcasm) and poor behaviour is also something that can contribute to mental injury. Staff cliques, excess work demands, poor quality performance management processes and perceived low workplace support all can impact on an employee’s mental health.

What are some of the early warning signs of mental injury?

There are a number of generic early warning signs, for example, increased unplanned leave. If someone starts withdrawing and taking time off, that should always be a trigger to initiate a conversation and to try to determine whether something in the workplace is affecting that person or if it’s more a non-work related illness or issues.

If people change the way they are behaving in the workplace, if they exhibit disproportionate emotional responses to situations, are grumpier, upset or get fired up about issues that seem unwarranted, then that’s a trigger for managers to initiate a supportive conversation.

What’s a supportive conversation? What might that look like?

It’s where a manager initiates a conversation with an employee who doesn’t seem to be their usual self. There may be some early warning signs that prompt managers to have this conversation. These supportive conversations are best framed as a straightforward check in. You might say, “You don’t seem your usual self. I’ve noticed XYZ, can we have a chat about it” rather than “I think you have a mental health disorder.”

This is really about managers and employers responding as a people leader. No one is expecting a manager to become a diagnostician or counsellor. It’s about supporting people and trying to get access to relevant services for employees as early as possible. The outcome may be as simple as the person agreeing to go to the Employee Assistance Program (EAP) or their family doctor.

What are some of the barriers for managers in starting that conversation?

We still get a lot of avoidance behaviour in the workplace. Often managers may be scared to talk to employees because they are worried they will open Pandora’s box or they may not think it’s their role. There’s a real lack of clarity around this. As a people leader it’s absolutely appropriate to initiate a straightforward, supportive conversation. If someone has personal difficulties at home and they’re not getting much sleep maybe different duties need to be looked at, or tweaking their starting and ending times to accommodate them. Managers need to be open enough to initiate that conversation and then either refer employees onto an external support person or to explore how the work may be managed differently for them.

What might a psychologically healthy workplace look like?

A mentally healthy workplace is about validating early help seeking behaviour. We want people to feel comfortable that they can access assistance and help and won’t be treated differently. A practical example is that good managers in team meetings will promote wellbeing. They might say, “Wellbeing is an important part of the way we do our work so if anyone’s struggling come and chat to me.” Then they might also have a bit of discussion and reflection about how the team is travelling.

We know that when people believe that wellbeing is on the radar or that managers value peoples’ wellbeing, employees are more likely to come forward early, and you’re least likely to get resistance if you decide to initiate a supportive conversation.

So it’s crucial that wellbeing is part of ongoing work conversations and meetings?

Yes, it’s got to be integrated in the day-to-day way the organisation does business, and people know that if something happens or they’re struggling, they can go to the manager confidently, and they’ll be appropriately supported and steered in the right direction. People make judgments about how genuine a manager is and if the manager’s reading from a script and saying in a rote way “wellbeing is important”, then workers don’t perceive that it’s genuine. But if employees believe managers value wellbeing because of having conversations over time and they see things happening, then that builds the confidence in the team environment.

Everyone shares the responsibility for mental health in the workplace. Starting the conversation is the best thing you can do.

Peter is a clinical and organisational psychologist who has consulted with most Australian workers compensation authorities on the management and prevention of work-related psychological injuries. He held an appointment with the former National Occupational Safety and Health Commission as a subject matter expert in workplace mental health, and is currently involved with a number of jurisdictional prevention and clinical quality assurance initiatives.

To view more visit “Psychological injury in the workplace” by Peter Cotton