Psychosocial risks and health effects of restructuring: The empirical evidence

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Psychosocial risks and health effects of restructuring: The empirical evidence Background Document to the High Level Conference Investing in well-being at work: Addressing psychosocial risks in times of change Prof. Dr. Thomas Kieselbach, University of Bremen Co-ordinator of European Expert Group on Health in Restructuring (HIRES) Board Member of International Commission on Occupational Health (ICOH) EU Commission and Belgian EU Presidency Brussels, 22-24 November 2010

Stress potential of transitions Characteristics of transitions: disruption of routines loss of security and predictability confrontation with inadequate resources to fulfil the required tasks fear of the future loss of social integration risk of social exclusion

3 lines of considerations The potential of this background document was to bring together 3 different lines of considerations: Health effects of unemployed: the direct victims of restructuring Health effects of survivors: survivor sickness (survivor syndrome) The role of middle or line management as drivers and role models of change (but also: health effects in this group)

Psychosocial impact of restructuring Increase of job insecurity Specific stressors: unpredictability of the future uncontrollability: rumours uncertainty new task design increase of competitivity among employees: work climate lack of anticipation period restructuring and downsizing often handled and perceived as accident

Health impact of restructuring: direct victims Effects of job loss and continuing unemployment: Increased likelihood of morbidity and mortality Increased risk of poor MH and para-suicides Higher rates of all cause and specific causes of mortality Self-reported health and limiting long-term illness Loss of control: Depressive feelings, lower self-esteem Reduction of capacity to react, Lower belief in self-efficacy Emotional instability

Health impact of restructuring: direct victims Increase of Passivity Prescription of drugs Higher prevalence of risky health behaviours incl alcohol use and smoking, poorer diet, physical inactivity, poor standard of sleep (esp young men) Drug and medical consumption Extension of effects to victims-by-proxy and wider community Explanations: Financial hardship and blaming experiences Risk of a downward spiral Hysteresis effect of persistent unemployment

Health impact of restructuring: survivors strain-fatigue long-term sickness absence (2.3 higher 10-town) disability pensions use of psychotropic drugs (sleeping pills and tranquilizers) nicotine and alcohol consumption complaints of health impairments emotional exhaustion Increased work intensity as major source of stress and burnout higher physical strain: Musculosceletal problems increase in occupational accidents Main contributing factors: Lowered self-efficacy and lack of social support, perception of unfairness

Health impact of restructuring: middle managers The executors of change: Middle or line managers The central nervous system of the organization Caught in the middle (due to their sandwich position) Drivers and role models of change Individual effects of restructuring: Increased stress and burnout levels Physical and psychological health complaints Emotional instability Disturbed sleep Increased alcohol consumption Contamination effect with problems of their subordinates

Role of trust and fairness in organizations Explicit contribution of fair procedures regarding the distribution of burdens (distributive justice): sharing the burden in hard times? Procedures how to come to such conclusions (procedural justice): transparency, impartiality, timeliness way how it is communicated and interacted (interactional justice): e.g., avoidance of rumours

Protective factors for healthier restructuring Middle or line managers: The executors of change Social support (from supervisors or/and external coaches) Availability of tools and instruments Helpful, supportive and accepting environment facilitates coping Acceptance of change Perceptions of justice in all dimensions

Socially Responsible Restructuring An enlightened management should include these health considerations into the concept of socially responsible restructuring, which will not only lead to higher competitiveness but also, through the protection of the health of workers, to a smoothing of the process of organizational and social change. A healthy workforce is in the interest of all stakeholders and social institutions if a competitive European workforce is to be maintained.