Danielle Mik:

Hi, everyone. Welcome to the pearls of wisdom today. Very excited to talk to Dr. Mary Wyatt about the challenge of developing mental healthy workplaces and the implications for people who are injured at work within those workplaces, Dr. Wyatt’s occupational physician and specialist in work health and work injury. She’s worked extensively with complex planes across a range of industries and participates in extensive research and return to work. Dr. Wyatt’s a strong advocate for better work injury management systems and is working with an advisors work injury management schemes, regulators, and government in this space. So, your research, Dr. Wyatt’s, indicates that the workplace’s approach is a key influence on return to work outcomes, and that they have a major influence over health, wellbeing, and productivity of their staff. So obviously, it’s very important for them to have a mentally healthy workplace to prevent those secondary psych injuries, developing for people that have a physical injury.

Danielle Mik:

So, from your research, we can see you’re well credentialed to talk in this space, and we are privileged to have you here today to share your pearls of wisdom with us on this topic. I guess overall, just looking at mental health, we know it’s a major issue for us as a culture overall and as a country, a fifth of OSEs are experiencing mental health conditions and no doubt the recent sort COVID situation has had a significant impact on that. But three quarters say mental health is actually a significant issue when they look to choose an employer, for example, if employers want to get and retain for good staff, then having a mentally healthy workplace will obviously be an imperative for that. PWC research shows that the return on investment is $2 30 for every dollar that’s spent.

Danielle Mik:

So, certainly, the fiscal indications are there and support employers doing it. Obviously, it’s also about developing culture and having a positive, happy workplace, which is obviously important to the people that work there. So, we know that mental health claims cost probably two and a half times more than physical claims and have people with mental health injuries have two and a half times more time off work. So, it certainly has a significant impact on people. I’d love to hear your thoughts about that and why that develops and why the mental health culture of a workplace is so important to injured workers.

Dr. Mary Wyatt:

Well, first of all, thanks for the opportunity to talk about this. It’s such an important issue for workers and for workplaces, my area is post work injury. And what we know is that how an organization deals with a work injury or return to work is really a microcosm of how they generally deal with the workplace and the workplace culture. Good research show there’s one tool to measure workplace culture, the psychosocial safety climate. And that has good correlation with the extent of time off work and claims costs following the work injury. And that’s one objective measure of the influence of the workplace on return to work. More direct measures, we know that when workers or employees with an injury say that their employer has responded constructively following their report of injury, they’re way more likely to be back at work than if they feel they’ve had a negative response from the workplace. So, that initial response makes a big difference. And that initial response is a reflection generally of how workplaces continue to respond.

Dr. Mary Wyatt:

The workplace is probably the greatest influence on return to work. And that impacts both the wellbeing of the work and the wellbeing of the workplace, both in terms of the culture and of the finances, as you’ve talked about work cover premiums, the direct costs reflect very much the workplace attitude and the workplace approach, and those claims costs will also have a direct impact on the premium and the indirect costs, staff replacement, casual staff to perhaps build somebody’s position, onboarding costs, et cetera, the time taken for supervisors and return to work coordinators in HR. Those indirect costs are estimated to being forwarded 10 times the direct premium costs. So, a lot of potential savings for workplaces and potential improvements in people’s wellbeing when workplaces get it right.

Danielle Mik:

Mary, has there any of your research been about how do employers take on that sort of information that you’ve just talked about, or how do you get employers to take on that information to make the changes necessary to create that positive environment?

Dr. Mary Wyatt:

Yeah. There’s not a lot of research about how you influence workplaces to become more proactive. We know that when they get their work cover premium notice, and particularly when there’s been a significant increase, the interest is peaked. And I know from talking with senior managers, when you talk about the wellbeing of their workplace and the wellbeing of their workers, they’re interested, but when you talk about the financial savings, their interests are often even more peaked because obviously, that’s one of their key performance matters is the financial bottom line. And of course, as you said, it’s beyond work injuries, absenteeism, staff, turnover, productivity, all of those things are significantly improved when there’s a good workplace culture. I repeatedly talk about reciprocity. Reciprocity is that notion that we respond in kind, the thing your mum taught you, do unto others.

Dr. Mary Wyatt:

Reciprocity has been studied across societies and across history, and it’s a fundamental operating principles of human beings. So, you look after me, I am way more likely to look after you. You treat me badly and I don’t trust you. I’m going to respond in kind and both positive reciprocity and that negative reciprocity are increased. So, you do something for me, I’m more likely to do something nice back to you, but I’ll increase the level of it. Treat me badly, I’ll probably increase my level of negative response to you, this is just the way we are as human beings. I think nothing unusual about workers, we’re all that way. And it’s just a fundamental operating principle, if we look after each other, we’ll do better.

Danielle Mik:

In workers that I’ve talked to about this issue, I often call it that upward spiral, all the downward spiral. If the employer starts doing the right thing, the worker will build on that, the employer will build on that and you go upwards. But you have the reverse, the negative employer does something that the worker perceives as inappropriate or dishonest or shady or whatever, and they don’t trust them. And so then they’re not as compliant or easy to get along with. And then the employer doesn’t, and it just goes the other way.

Dr. Mary Wyatt:

Absolutely. We did a webinar yesterday, and one of the colleague experienced case managers would ask the supervisor, “Where would you rate your worker on a scale of one to 10 or zero to 10?” And get a sense of the relationship and what the supervisor’s view is. Low view of the worker, then that’s a red flag for problems. And you’ve seen this many times over and I have as well, the worker is not the best performer in the workplace. The supervisor feels justified, then giving them a bit of a hard, or perhaps having a bit of a negative response. And as you say, [inaudible] viral.

Danielle Mik:

So, with the research that you’ve done, what are the common mental health conditions that injured workers develop from workplaces where it’s not a positive culture to return to work?

Dr. Mary Wyatt:

Look, I might focus on secondary psychological problems. As an occupational physician, mostly I deal with physical injuries, shoulders backs, necks, knees, et cetera, and a range of other health issues. And what we do know is that when people with a physical problem develop secondary mental health, anxiety, or depression of a typical adjustment disorder, they actually do worse than people with a primary mental health problem. So prevention is better than cure, as you would say, Danielle Mik. And the important situation is to prevent people developing those secondary mental health problems. And I would also add in their chronic pain. The simple way of thinking about chronic pain is acute pain plus distress makes you much more likely to develop a chronic pain disorder. And if you can prevent that distress, you can minimize the chances of chronic pain.

Dr. Mary Wyatt:

I was involved with an intervention 15 years ago, where we worked with medium to large employers, a large number of case and we worked. We’d had day one model of early care and we got in and helped people. It was a very supportive model and maintained that employee-employer relationship, influenced supervisors to look after people. And we didn’t have any cases where people develop chronic pain and this is out of thousands of cases. And I would attribute that to minimizing distress.

Danielle Mik:

It really gets back to that brain body link, doesn’t it? That is there and becoming more accepted is there and the interplay with that in the development of chronic pain?

Dr. Mary Wyatt:

Absolutely. And so, you can not only minimize the chance of people developing chronic pain, but minimize the chance of developing anxiety and depression. Now, the wise study, for those of you who haven’t heard of it, was a major study in New South Wales public hospitals. And the model for the wise study, and I’m happy to provide you with references,

Danielle Mik:

Sure. That would be great. Thank you.

Dr. Mary Wyatt:

Was to do psychosocial screening on all people with the physical injuries within the intervention public hospitals. So, people would get a shoulder problem or a back problem, and they’d be screened using the short form Orebro musculoskeletal pain questionnaire. Those at high risk were given extra support. First thing, they were offered extra support by a psychologist who was trained in management of psychosocial factors. And they had their return to work coordinator provide extra visits. They saw an injury management consultant in New South Wales at six weeks if they were still off work.

Dr. Mary Wyatt:

And so they had that extra support and they had a significant reduction in work disability in those cases. And there were control hospitals where people had usual care. And this really it was a award wedding study and pretty good evidence that you can get in early and identify people who are at risk of prolonged group disability, extra early studies from WorkCover Queensland and the recovery blueprint show that the major factors affecting work disability for physical claims are firstly, low coping ability and secondly workplace issues.

Dr. Mary Wyatt:

So, if you give those people extra support and manage the workplace, then you are halfway there to helping them and reducing long term workability. So, they had significant reduction in work disability days lost from work, but more importantly at 10 to 12 months post injury, a huge reduction in long term cases. So, it’ll slightly increase cost in the early stages, but longer term will be massive reduction in disability for the worker and the all of awful consequences and also significant financial savings.

Danielle Mik:

So, it seems then from what the research is showing what you’re suggesting is that providing that early individualized support for the person and making sure they feel connected and heard and validated really will lead to better outcomes for employers.

Dr. Mary Wyatt:

Absolutely.

Danielle Mik:

It’s the same thing that we talk about in creating overall a mentally healthy workplace environment. That’s what employees need. So they go hand in hand, don’t they?

Dr. Mary Wyatt:

Absolutely. And the research on how you actually manage psychological cases is not well formed. We can gather from indirect reviewing of the literature, how we should approach it. But the basic principles are to treat physical injury cases and psychological injury cases in same way. You can do psychological screening and identify social factors in those who lodged psychological injury claims will have psychological injuries with, or without a claim. And the same principle, as far as you’re getting early, you speak to the worker, often supervisors are worried and cautious and avoid communicating with their team members because they’re fearful. They might mark it up. How do I not understand what, do I do? But when they get in with the same approach for psychological cases, to physically cases, things work much more smoothly, says discuss return to work. What is the work in need in terms of return to work duties, communicate, look after them, same principles apply.

Danielle Mik:

So, just then wrapping up Doctor, there’s so much to take from that. Thank you. Are there any additional recommendations that you would like to make that you think important for employers, what they can do to create that positive culture and environment so that people that do have the physical injuries that doesn’t translate to the secondary mental health injuries?

Dr. Mary Wyatt:

There’s a lot of information around at the moment about what employers can and need to do, not only to create a really good environment, but also to meet their obligations. Yeah. The psychosocial hazards way of looking at this issue is coming or has come, it’s out from Safe Work Australia. Jurisdictions are picking it up. There are inspectors now looking at how workplaces are dealing with psychosocial hazards. So there’s a lot of information out there. I don’t think I need to repeat it, but it’s a matter of going through it. It’s not a difficult thing to do, but it does take time and effort. And I would commend workplaces to look around at workplaces that have done it.

Dr. Mary Wyatt:

A particular thing I like is Netflix’s HR policy, which is no high performing jerks. And the high perform who is a problem in terms of team members is a really big issue because companies rely on them because they get stuff done. But at the same time, they’re doing a great job individually. They can be very destructive if they have that bullying or whatever approach that affects team members. So, I would encourage workplaces to deal with those issues proactively. We hear about them all the time. It’s hard for workplaces to deal with it, but really important. And the best way to deal with those, is to set up an overall good culture and deal with those difficult team members as part of that overall culture.

Danielle Mik:

Well, thank you. That’s fantastic advice. Thank you, Dr. Wyatt. I really appreciate your time. It’s been lovely to interview you. We’d talk about this probably all day long. There’s so much drilling down you can do in specific areas, but thank you so much for that. Really appreciate your time and love to chat with you again at some point.

Dr. Mary Wyatt:

Delightful. Thanks again, Danielle Mik.

Danielle Mik:

Thank you for your time. Bye.