This book is one of a series exploring the relationship between work and health. My worry is that it may struggle in its message to its intended audience: a mixture of employers, employees and health professionals. It may fail to satisfy all.
The key message is that mental health in the workplace matters as it affects productivity and there are things one can do to improve this. Few would disagree with such admirable sentiments from the authors, psychologists practising in Canada.
It is unfortunate that the book was published just before the arrival of DSM-5 and so relies on DSM-IV-TR. It fails, therefore, to take into account some of the changes to, for example, post-traumatic stress disorder (PTSD) within DSM-5. This may not matter to health professionals, but will make a difference to employers and employees who might well seek to rely on some of its detail. There are sections that deal with the common mental disorders, which I fear may be too brief for health professionals but still confusing for employers and employees. This book may struggle from too wide a target audience.
Notwithstanding its faults, it achieves some notable successes. It emphasises some of the at-risk populations that can be easily forgotten, such as bank employees who are prone to PTSD after a robbery. It points out that the rigorous suppression of sickness absence encourages presenteeism, which in turn impairs productivity and suppresses openness about health issues. Employees with mental health problems can all too readily fall foul of an over-rigorous sickness absence policy. The book is rightly critical of the ‘one size fits all’ approach to assessing health problems at work, for example, the over-reliance on risk assessment tools in the UK. Above all, however, it explores in considerable and useful detail what it describes as a ‘ work environment’ and how this can arise in organisations obsessed with outcome data, where employees experience little decision-making latitude, are subject to increasing demands for productivity and where power struggles can all too readily thrive. Such an environment serves to foster workplace bullying. Stark parallels in the National Health Service are all too obvious and these concerns have been expressed more recently by the former president of the Royal College of General Practitioners and head of the London-based Practitioner Health Programme, Claire Gerada. The book justifies itself on this point alone, although it is in general more focused towards an American audience and its research and evidence base reflect that emphasis. The lack of UK data may also limit its appeal within this country, for example it says little of the useful work by the King’s College Group on the British Military and PTSD from recent conflicts, which is disappointing.
Overall, this book explores some useful points and encourages an approach based on building resilience in individuals and promoting a positive work environment. These are important principles, but I suspect easier to prescribe and write about than to achieve. I also suspect that, rather like a cohesive family, much depends on the calibre of senior management who set the tone.
I enjoyed reading this book, but I came away with the thought that it would be of most use to those who wish to explore the scourge of workplace bullying and that it may struggle to provide what it seeks to: a stand-alone textbook of mental illness in the workplace for a wide audience of employers, employees and health professionals.
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