This document summarizes strategies that workplaces can implement to support the mental health and wellbeing of employees, with a focus on anaesthetists. It discusses how work can impact mental health and identifies anaesthetists as being at high risk of suicide. Barriers to help-seeking are outlined. The document then covers approaches workplaces can take, including promoting mental health, preventing issues, early intervention, and supporting recovery. Specific strategies are provided, like developing policies, creating supportive environments, and building resilience in employees from students to experienced practitioners. Factors for successful workplace mental health programs are also presented.

1. Supporting the mental health
and wellbeing of Anaesthetists.
What can the workplace do?
Jaelea Skehan, Director

2. • Setting the scene
• Impact of work on our mental health
• A workplace approach to mental health and wellbeing
• Modern theories of suicide prevention
• Considerations for the workplace in suicide prevention
Presentation overview

3. • Suicide rates in female doctors higher than in general
population;
• Female, Indigenous and young doctors (transition from study
to work) appear to be most vulnerable to mental health
problems;
• Specialities such as psychiatry, ENT and anaesthesiology
amongst the highest suicide rates.
• Rates of suicide for anaesthetists estimated at 44.0 per
100,000 (Elliot et al, 2010).
Why is this an issue for anaesthetists?

4. Barriers to seeking support (Hawton et al, 2001):
- lack of confidentiality or privacy (52.5%),
- embarrassment (37.4%),
- impact on registration and right to practice (34.3%),
- preference to rely on self or not seek help (30.5%),
- lack of time (28.5%),
- concerns about career development or progress (27.5%).
Barriers to help-seeking:

5. Let’s explore resilience…
Which of these is most likely to ‘bounce’ back?

6. What if this was the surface they were
bouncing off?

7. Approaches need to focus on
The individual The environment

8. Mental health and wellbeing?
• State of wellbeing, where we can realise our
potential, cope with normal stressors, live and
work fruitfully, and make a contribution to
society.
• More than the absence of illness.

9. Influences on mental health?
• Structural: e.g. safe and healthy working conditions,
employment security, inclusive workplaces etc.
• Community: e.g. sense of belonging, access to social
support, freedom from bullying etc.
• Individual: ability to deal with thoughts, manage life and
cope, good physical wellbeing

10. Can work contribute to mental ill-health?
• Generally working is good for our mental health.
• But, many work factors can contribute to mental health
problems or make existing problems worse.
• When work related stress is high and ongoing it can be a
risk factor for mental illness.
• It is important to PREVENT issues where possible and
mitigate risk where it is not possible.

11. An introduction to the promotion of
mental health and wellbeing and the
prevention of mental ill-health in the
workplace.

12. Prevention First: workplaces

13. Actions to prevent the onset of mental ill-health in the whole
workplace population (including families & community)
Action Area 1
Actions to prevent the onset of mental ill-health in groups at higher
risk within the workplace and community
Action Area 2
Actions to identify and intervene early with individuals showing
early signs of mental ill-health in the workplace
Action Area 3
Actions to support referrals to appropriate treatment & return to
work plans for those experiencing acute periods of mental ill-health
Action Area 4
Actions to reduce the ongoing impact of mental ill-health on
individuals entering or returning to work
Action Area 5
Actions to promote mental health and wellbeing in individuals
experiencing or recovering from a diagnosed mental illness in the
workplace
Action Area 6
Actions to promote mental health and wellbeing in the whole
workplace population (including families & community)
Action Area 7

14. Mental Health Promotion
• Mental health promotion is about enhancing social and
emotional wellbeing and quality of life.
• Initiatives can occur:
– with whole populations (e.g. the whole workplace), selected
groups (e.g managers, female staff, young staff) or
individuals
– in any setting (e.g. workplaces, the home, schools,
communities, health settings)
• Mental health promotion is relevant to all people, whether they
have a diagnosed illness or not.

15. Platforms for Action
1. Healthy workplace policy – e.g. stigma reduction, social
inclusion, OH&S policies, HR policies.
2. Creating supportive environments – e.g. anti-bullying
programs, strengthening families, healthy work initiatives.
3. Strengthening workplace & communities to take action –
peer support, worker-led initiatives.
4. Developing personal skills– e.g. life skills training, mental
illness literacy, parenting skills, financial management.
5. Reorienting OH&S services to a promotion and prevention
approach – e.g inclusion of mental health and wellbeing

16. Prevention of mental ill-health
Prevention interventions work by focussing on reducing risk
factors and enhancing protective factors. Activities may work
at three main levels and seek to:
• primary prevention - prevent the onset or development of a
problem or illness: types = the whole workplace & groups at
higher risk.
• secondary prevention - lower the severity and duration of an
illness through early detection and referral to appropriate
treatment;
• tertiary prevention - reduce the impact of an illness through
rehabilitation back into the workplace.

17. Mental health
problems,
mental illness
Support
recovery
from illness
Support for
mental
health
problems
Identify and
respond
early
Reduce
individual
risk factors
Support
good health
Managing mental health at work
Reducing risk Promoting Recovery
Reduce
environ-
mental risk
factors
*Note – colours align sections to the relevant parts of the Prevention First Framework

18. • Ensuring a good fit between the job and the person doing the job;
• Preparing people well for the work they need to do (consider pre-
service as well as in-service training);
• Creating a culture of high expectations along with support;
• Having a culture of fairness and equity;
• Promoting mental health literacy (how to stay mentally healthy –
particularly adapted for the profession);
• Good communication between managers and staff;
• Increasing social connection and opportunities for peer-support
across the profession.
Support
good health

19. • Reducing drug and alcohol misuse;
• Support healthy diet and physical fitness;
• Develop individual skills – stress management,
communication skills, conflict resolution;
• Management of physical injury and/or pain;
• Options to support workers managing ill-health in family;
• Provide support and flexibility for staff exposed to traumatic
events at work or experiencing difficult life events.
Reduce
individual
risk factors

20. • Reduce or manage occupational risks
– Fatigue
– Excessive stress
– Bullying and harassment
– Disharmony
Reduce
environ-
mental risk
factors

21. Mental health
problems,
mental illness
Support
recovery
from illness
Support for
mental
health
problems
Identify and
respond
early
Reduce
individual
risk factors
Support
good health
Managing mental health at work
Reducing risk Promoting Recovery
Reduce
environ-
mental risk
factors
*Note – colours align sections to the relevant parts of the Prevention First Framework

22. • Promote awareness of mental illness, signs, symptoms etc;
• Support early identification (self or others):
– Self-identification, peer-identification and support;
Identification by supervisors or mentors;
• Promote culture of acceptance of mental health problems;
• Promote culture that help-seeking is a positive thing;
• Promote a culture of offering support, expressing concern for
work colleagues;
• Supervisor/mentor training to increase skills in raising difficult,
personal issues with staff in a helpful, non-threatening way.
Identify and
respond
early

23. • Promote use of EAP for early support;
• Provide immediate first aid for staff experiencing a
mental health crisis at work;
• Reassurance of support for staff receiving treatment for
mental illness;
• Partnerships and referral pathways to mental health
providers that staff will accept and trust;
• Provide or facilitate access to peer-support models
and/or online treatment modalities.
Support for
mental
health
problems

24. • Take a positive optimistic approach;
• Manage absences well;
• Identify and address any workplace contributing factors;
• Manage return to work well;
• Make reasonable adjustments to the work environment;
• Facilitate access to support options for family and friends;
• Address stigma in the workplace.
Support
recovery
from illness

25. What do we know about why people die by
suicide?
Traditional approach of risk and protective factors
Modern theory by Thomas Joiner

26. Summary – risk factors

27. Serious Attempt or Death by Suicide
Those Who
Desire Suicide
Those Who Are
Capable of Suicide
Perceived
Burdensomeness
Thwarted
Belongingness
Sketch of the Theory by
Thomas Joiner

28. Prevention Implications
(Joiner)
• The model’s logic is that prevention of
“acquired ability” OR of “burdensomeness”
OR of “thwarted belongingness” will
prevent serious suicidality.
• Belongingness may be the most malleable
and most powerful.

29. Suicide prevention for the
medical profession
Primary Prevention Building stronger more resilient doctors
Secondary
prevention
Recognise and seek additional support when
risk factors and warning signs emerge and
reduce access to means
Early Intervention Seek support and help when critical events
occur
Intervention
(suicidal)
Seek specialist help; increase social
connection; remove means of suicide
Postvention Support those affected by the suicide of a
peer (or other).

30. Evidence for public health approaches
Activity Evidence rating
Means restriction (incl barriers) good
Media reporting guidelines good
Multi-faceted programs good
Community based programs promising
School based programs good (immediate)
Workplace programs limited
Emergency Dept brief interventions promising
Child welfare/detention programs limited
Prison-based programs limited

31. Evidence for public health approaches (cont)
Activity Evidence rating
Programs for veterans/defence forces good
Programs for substance use problems limited
e-therapies good
Gatekeeper training and peer education promising
Education and support for GPs good
Telephone services promising
Support to family friends of those at risk good
Postvention support limited*
Screening promising
(youth/ older)

32. Evidence for mental health approaches
Activity Evidence rating
Intensive care plus outreach good
Hospital admission poor
CBT good
Inpatient-based therapies poor
Outpatient-based therapies poor
Psychosocial interventions good
Ongoing contact good
Crisis cards poor

33. Summary - What can
workplaces (and/or
professional bodies) do?
Workplace responses

34. Things to address
1. Promote mental health and wellbeing and build
resilience;
2. Address individual and environmental risk factors for
mental ill-health and suicide;
3. Create a culture that accepts that mental health
challenges will occur and promote early pathways to
support.
4. Take a comprehensive approach thinking about
undergraduates, early career and experiences
practitioners.

35. Factors for success
1. Commitment from senior leaders;
2. Employee participation;
3. Develop and implement policies;
4. Allocated resources for success;
5. Ongoing effort for a sustainable approach
6. Plan and evaluate outcomes
From PwC report

36. Contact Us:
Email:
Jaelea.Skehan@hnehealth.nsw.gov.au
Twitter:
@jaeleaskehan
@HInstMH
Websites:
www.himh.org.au