The amazing advances we have made in keeping people safe in all workplaces started in the ‘70s with the Health and Safety at Work Act 1974 (United Kingdom), and Health and Safety at Work (NI) Order 1978,(Northern Ireland) and has resulted in reducing the number of injuries and fatalities that happen in the workplace. A great example of this is that in the UK in the period 2022/23, 135 work-related fatalities were reported. (135 too many) However, in that period, more than 6000 people died through accidents at home according to Royal Society for Prevention of Accidents (ROSPA) The workplace is a controlled environment, where laws place absolute duties on employers and employees. At home, we tend to be more reckless. 

Did you know that above laws apply to mental health also? However, where the enforcing authorities prosecute employers who do not meet the legal standards for physical safety, they simply offer guidance with regards to psychological safety. 

Let’s apply this logic to similar legislation ‘The Road Traffic Act – imagine, instead of risk of prosecution for road traffic breaches, we were just advised; not to drive over 30 mph, not to drive through red lights, to stop at zebra crossings!  How many road-related injuries and fatalities would be recorded if this were the case?  Apart from the moral implications of not wishing to harm anyone else on the road or footpath, the fear of enforcement is definitely a motivation to drive safely and within the legal boundaries provided by the Road Traffic Act.

The reporting of work-related deaths and injuries falls under R.I.D.D.O.R. legislation.  The legislation places a duty on employers to report specified work-related injuries and diseases and dangerous occurrences. Obviously, any work-related fatality must be reported immediately and specified injuries also are reported. 

Specified work-related diseases must be reported, however work-related stress, anxiety and depression are not included. Have we stumbled? Have we underestimated the affect the workplace can have on mental health, if not understood and managed effectively?

Under R.I.D.D.O.R. specified ‘diseases’ where these are likely to have been caused or made worse by their work include:

• Carpal tunnel syndrome (neurological disorder)
• Severe cramp of the hand or forearm (debilitating condition)
• Occupational dermatitis
• Hand-arm vibration syndrome (debilitating condition)
• Occupational asthma
• Tendonitis of the hand or forearm (disorder of tendons without sheaths)
• Any occupational cancer
• Any disease attributed to an occupational exposure to a biological agent.

However, conspicuous by its absence, work related stress, anxiety or depression is not specified and goes unreported and has the highest prevalence in the UK and Northern Ireland.

Evidence shows that stress, anxiety and depression are the greatest cause of work-related illness in the UK.  (In the UK 1.8 million working people are suffering from a work-related illness of which more than half (914,000) due to work-related stress, anxiety and depression. (a rise of 92,000 since last year).

In order to determine how the workplace might be negatively contributing to harmful stress, anxiety or depression, it would be vital that G.P's asked the right questions when their patients requested a 'fit note' because they felt they were suffering from stress. The HSE Management Standards provides excellent guidance on this. Asking questions such as:

• Do you feel confident you can meet the demands of your job?
• Do you have some say on how you carry out your work?
• Do you feel you have accessible support if you feel overwhelmed or worried?
• Do you feel that you are singled out for unfair treatment and how is that managed?
• Do you have a clear and not conflicted role?
• Are you frightened of changes that may be happening soon or in the future?

Having this important work related information would enable the G.P. to provide a clear indication on if and how the workplace may be causing stress, thus giving the employer an opportunity to address these issues and put in place controls to mitigate harm. This will also provide evidence to the Enforcing Authorities determining whether the organisation met their legal duty.

I honestly believe that the government need to step in and raise the bar on enforcement for employers not meeting the legal standard of care for psychological safety at work. If evidence exists that an employer has not provided a psychologically safe workplace and because of this breach a person, or persons have been harmed by work-related stress, then this should be included in the specified diseases. (let’s remember, carpal tunnel, hand arm vibration, severe cramp in hand or forearm are conditions/disorders, not diseases and are included). Stress, if it becomes too excessive or prolonged, can develop into a mental or physical illness.  The fact that more than half of those suffering from a work-related illness is due to stress, anxiety or depression, I suggest that the likelihood that many of these people have been exposed to prolonged or excessive work related-stress is extremely high.

So, what could be in it for the Government if they choose to address this?

• Less financial impact on the public purse due to long-term absenteeism.
• More financial contribution, because if addressed, potentially more people would be well enough to work and pay Income Tax and National Insurance.
• There would be a greater likelihood of workers returning to work after long term absence rather than adding to the number of people who never return.
• Potentially there would be less negative impact on the National Health Service if the numbers of those suffering from stress, anxiety or depression reduced rather than increased.

Because of the laws in place, accidents, fatalities and injuries have been reduced. However, there is still a lot of work to be done with regards to the health aspect. I know that the HSE are working hard to reduce the risk of people being exposed to dusts, chemicals, musculoskeletal injury, machinery use related conditions etc., and that is fantastic, however, I feel that unless work related stress is addressed and enforced, the numbers are going to get higher and higher. There is not time to dither, we need to start right now.

In Northern Ireland and indeed the rest of the UK, we are all over-exposed to stressors all of the time such as the health crisis, financial challenges, job insecurity, lack of leadership, climate change, family strife etc. and some of us can deal with that and not become mentally ill.  It is the same with the workplace, some people can cope with over exposure to stress, others can’t. There may be times, when life changes, and the very strongest of people become overwhelmed and at risk of mental ill-health. However, in the workplace there are laws in place to protect us from the work causing us physical or mental ill-health. If those laws are enforced, then the workplace will be a less harmful place.

I feel that if a great number of health and safety professionals, the media and trade unions got on board and raised awareness of all of this, then organisations could be motivated to make the changes necessary to provide psychologically safe working environments where people and commerce thrive together.