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Work stress and its impact on mental health is an infinite problem in capitalist societies. This is because under capitalism there is a constant struggle between management and labour. For management the goal is profits and productivity; for workers it is decent, meaningful and well-paid work.
For workers to meet the demands for profits and productivity, resources are required; and within a capitalist system investment in resources for workers is continually reigned in as they are a cost to company profits and productivity. The problem is that work stress and mental health issues arise when work lacks meaning, and job demands exceed the resources workers have to manage them.
In recent decades, unprecedented attention has been given to the issue of worker mental health and wellbeing by policy makers, tripartite agencies, social partners (workers, governments and employers), and academics, largely in developed economies. Major stakeholders such as the WHO, ILO and the OECD have called for policy responses by drawing attention to the link between poor quality work and the parlous state of worker mental health.
If we are to seriously consider the prognosis of mental health in future work we must come to grips with the crisis of mental health that has accelerated in the modern work environment over the past few decades. The crisis must be conceptualised as not based on the development of new industry or technology, but in the way that work is organised within a capitalist context by an unequal employer-employee relationship.
Understanding the precise factors that influence the individual experience of poor mental health stemming from work is not a simple process. In fact, there are many reasons, micro and macro, for the decline in workers’ mental health.
At a direct micro level the relationship between poor work conditions and poor mental health is borne out by significant evidence. Research demonstrates a clear link between psychosocial determinants — such as level of control over work, work autonomy, work pressure, power imbalances, bullying, a profound lack of meaning, alienation, and dehumanisation — and work stress, burnout, physical health problems and death. How jobs are designed (the amount and type of resources allocated to manage demands), the organisation and management of work, and the workplace social context are all aspects that potentially affect worker mental health.
In Australia the main reasons for mental health workers’ compensation claims are work pressure, work-related harassment and/or bullying, and workplace violence. In the UK, the main reasons cited for work-related stress are workload, lack of managerial support and organisational change.
Although not featured in these statistics, the increasingly insecure nature of work is also damaging. Danish research shows that when healthcare workers perceive insecurity through exposure to organisational changes such as mergers, employee lay-offs, budget cuts and changes in management, rates of prescriptions for psychotropic drugs such as antidepressants were 1.14 times higher in the following 12 months compared to those not experiencing change.
Yet poor work quality is not immutable. Decisions made by management about work design impact on worker mental health. Therefore there is scope, looking forward, to influence or otherwise force a change to how work is constructed and managed.
Our research yields a useful explanation of work design by exploring what we call Psychosocial Safety Climate (PSC) – reflecting the corporate climate for worker mental health. PSC levels assessed by workers are indicative of the priority that management gives to worker mental health versus productivity, evident in policies, practices, procedures, and systems for the protection of worker mental health.
PSC is formulated as a “cause of the causes” of work stress – a precursor to work stress in a given job. PSC reveals management methodology and predicts the quality of work on offer – the level of demands (work pressure, stressful exposures), the levels of resources (autonomy, wages, job flexibility) and the social relational aspects of work (harassment, bullying, social support). The link from PSC to work conditions to mental health is shown in many studies.
But at a macro-level, managers operate in a capitalist political economy, which requires and values competition, productivity, and profits. Corporate boards and shareholders demand profits. But these foundational aspects, and the attendant work conditions, that they give rise to (insecure work, work pressure, monitoring, lean resourcing, low power) are the very elements of work that create work stress which can cause or exacerbate mental health concerns. Therefore, we see work stress as a recursive and growing problem in a capitalist political economy which relies on resource acquisition, competition, profits and productivity growth by employers and society.
Management decisions are influenced, boosted and constrained in broader economic and political circumstances. For instance, across the EU, at a national level union density is positively related to workplace PSC levels. Yet the era of neoliberalism has progressively attacked and eroded union membership across the globe. Hence the macro power to influence work conditions and industrial protection in workers’ interests has eroded. Wages which could be used to access mental health care are restrained, and social services pared back. This era, captured succinctly by an ILO sourced graph (see Figure 1), is characterised by business growth predicated on reducing the costs of labour relative to productivity. At the same time executive salaries have been exorbitantly ratcheted up. UK top executives earn 133 times more than the average UK worker – within 4 days the average executive earns the average annual salary of a worker (High Pay Centre). Resources are clearly flowing upwards contributing to global income and wealth inequality – “the richest 1% own half the world’s wealth” (Credit Suisse).
Figure 1. Productivity and wage Index (G20 advanced economies)
If the trends embodied by neoliberal economics are to continue, then there is a bleak outlook for addressing the causes of mental health crises via future work arrangements. The material contradiction is that allocating more job resources, more services, and better conditions for workers, to increase worker mental health is a cost to productivity. Ironically, as mental health becomes an increasing focus for its impact on worker output, any productivity-driven framework will come up against its own limits (i.e. profit margins) and will be unable to positively impact the core causes of mental distress.
Decisions to increase worker mental health therefore need to be based on humanitarian grounds. Because the improvements required to do this threaten net productivity, a new kind of economy is required that values humanity and measures value in terms other than company profitability and GDP.
In essence, the warning signs are already here in modern industries. Amazon’s Fulfilment Centres and Tesla’s car production lines – technologically advanced, highly mechanised and touted as a vision for the future of work – simply demonstrate some of the most advanced examples of trajectories already present in modern working life. That is, increased precariousness, low pay, lack of meaning, high job demands, extreme hostility to unionisation and collective resistance, and surveillance, vigorously guided by intensive productivity management through various means (just-in-time Fordism or excessive managerialism) – all the while generating huge annual company profits. The levels of burnout among Silicon Valley’s tech workers are extremely high in cutting edge skilled work on precarious piece-rates.
No doubt new technologies such as robotics, 3D and 4D printing, artificial intelligence, virtual reality, augmented reality and autonomous vehicles will change the nature of work, but the stress fundamentals remain. Social policy shifts such as a basic universal income seems promising, to enable life quality without reliance on the labour market, and may drive up the demand for quality and meaningful work (not just any kind of work). Increases to wages need to be a priority for any meaningful change in working conditions.
With our understanding of PSC we argue that an immediate reallocation of resources and power is required to swing the balance towards prioritising humanity and quality working conditions. Substantive changes in work conditions can improve PSC. For example, a NZ company recently trialled a 4 day working week with no reduction in salary which increased PSC, reduced job stress and increased job satisfaction. With sound knowledge of PSC evidence, workers, unions and advocates can more effectively articulate the impact of corporate climate in their efforts to better mentally healthy conditions for workers.
In the here and now, if PSC (which can be measured and has benchmarks that predict future job strain and worker depression) is normalised as a lead indicator of psychological health and safety (as a safety key performance indicators, for instance), it could act as a fulcrum, helping to improve and protect worker mental health through increased provision of ‘decent work.’
If we are to avoid a serious epidemic of mental illness in our workplaces, we need to consider the overall trajectory of how and why we produce, question the existing focus on productivity, and rapidly move to change it. What matters for mental health is not so much the industry and its particulars, but how workers are treated and how highly their humanity is valued and centred in their work. Otherwise we are heading for an increasingly and permanently mentally unhealthy world of work, with flow on effects to families and communities around the world.