Send Your People Home Safe –

and Sane – Every Day!

Carolinas AGC Convention 2016

Nancy Spangler, PhD, OTR/L President, Spangler Associates Inc. Consultant, Partnership for Workplace Mental Health

SPANGLER ASSOCIATES, INC:

• Individual health (and safety)

• Workplace performance

• Brain research on thinking, emotions, social connectedness

SPANGLER ASSOCIATES, INC:

What:

Collaborate with employers to advance

effective approaches to mental health.

How:

• Share business case for quality

mental health care, including early

recognition, access to care and

effective treatment.

• Provide supportive tools at

www.workplacementalhealth.org • Mental Health Works

• Employer Case Examples

• E-updates

• Research Works issue briefs

• Promote employer case examples

and facilitate peer-to-peer dialogue.

Partnership for Workplace Mental Health

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Best qualifications. . . .

I grew up in the culture: • Hard working

• Hard playing

• Sarcastic

• Tough guys

The Tough Facts:

• Suicide = 2nd leading cause of death in men

• Construction is among top 10 industries for suicide

• Heavy construction equipment operators especially at risk

• People with lower formal education are more at risk for suicide (as well as substance abuse, obesity, and heavy smoking)

http://www.nxtbook.com/naylor/NGCS/NGCS0116/index.php#/2

http://www.carsonjspencer.org/programs/working-

minds/construction-industry-blueprint/

Why? • More education increases insight, social-emotional

interaction, problem-solving, and skill development

• Hard and dangerous work, financial and time pressures, lots of room for conflicts

• Seasonal employees at off-site locations

– Isolation from family and friends

– Disruption of routines

• Tough guy, stoic culture makes getting help unlikely

• Sleep difficulties and chronic pain

– Self medication with alcohol, sleeping pills, and pain medications

Mental health concerns are highly prevalent for all:

• 1 in 5 adults in the U.S (18.6%) experiences mental illness in a given year. – 18.1% of adults in the U.S. experiences an anxiety disorder, such as

posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias.

– 6.7% of adults aged 18 or older (15.7 million people) had at least one major depressive episode

• Mental illness frequently occurs with other medical conditions, especially diabetes and heart disease, and mental distress worsens the course of both illnesses.

• Work and life stress (such as trauma) can be risk factors for developing depression.

Percentages of Adults with Mental Disorders and/or

Medical Conditions

National Comorbidity Survey Replication, 2001-2003

STRESS =

• Distress = negative emotional state due to harmful stimuli or excessive demand

• Eustress = euphoric effect of positive adaptation to demands or challenges

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“The nonspecific response

of the body to any demand

made on it.” (Selye, 1956)

Stress Response = multisystem response

to a demand, threat, or perceived challenge

Brain’s limbic system

and cortex set off the

hypothalamic-pituitary-

adrenal (HPA) axis

response to prepare the

individual to:

-Fight

-Flight

-Freeze

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Distress is costly to workplaces:

• May result in emotional fatigue and poor impulse control

• People may eat, drink, and/or smoke too much

• Distressed workers have difficulty focusing on work or personal goals

• 120,000 deaths and nearly $190 billion in health care costs each year (Goh, Pfeffer & Zenios, 2015)

Stress isn’t all bad: • Distress = negative emotional state

due to harmful stimuli or excessive demand

• Eustress = euphoric effect of positive adaptation to demands or challenges

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Stress Can Stimulate Growth and Resilience:

Stress Adaptation Growth Dynamic (Kim, Y.J., 2005)

Adaptation = Resilience

• Term with multiple applications

– Physical (engineering, cellular, ecological systems)

– Social/psychological (child development, individual, organizational, community disaster recovery)

• “A process linking a set of adaptive capacities to a positive trajectory of functioning and adaptation after a disturbance.”*

• The ability to bounce back, to grow, to bend rather than break.

* Norris, F.H. et al. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127-150.

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• Optimism/beliefs

• Emotions

• Purpose/meaning

• Self reliance

• Connections

• Help - give/receive

• Replenishment

Resilience

Stress/rest/recovery cycle:

Power of Beliefs & Mindsets:

• Effect of stress on health depends on beliefs • People reporting high levels of stress plus belief that stress

impacts health had 43% higher risk of death (Keller, Litzelman,

Wisk, et al., 2012)

• Helping others reduces mortality • Stressful life events buffered by giving help to family and

friends reduced 5-year mortality risk (Poulin, Brown, Dillard &

Smith, 2013)

• Changing mindsets • “You must be smart.” vs “You worked hard.” (Dweck, 2006)

Smiling reduces mortality: • Baseball players with full (Duchenne) smiles lived

seven years longer (Able & Kruger, 2010)

Skill Practice:

• Smiling

• Gratitude

• Body posture

• Meditation

Intensive . . . . . .

Targeted. . . . . . .

Universal . . . . .

Get people back to work

Reduce risks

Keep healthy people healthy

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Employer Practices:

• Active, outbound intervention

• Screenings, information, resources, & benefits

• Organizational leadership, culture, & management practices

• Disease management/ Case management

• Disability management (Return-to-work)

• HRAs/Screenings & coaching

• Information, webinars, education

• Medical benefits

• Employee Assistance Program (EAP) & behavioral health benefits

• Values, ethics, & mission/role alignment

• Communication (face-to-face, at multiple levels,

conflict resolution, predictable structure)

• Career & life development/balance

• Training (Manager/supervisor & employee)

• Health champions

• Connectedness, meaning, belonging 21

Employer Practices:

New Program on Depression:

Right Direction

• In partnership with

Ohio-based coalition, Employers Health

• Designed to help motivate employees and their families to seek help when needed, and to provide employers with appropriate support, tools and resources.

http://www.rightdirectionforme.com/DepressionatWork.html

“Emotional Ergonomics” Program called ICU:

• Identify the signs

• Connect with the person

• Understand the way forward together

Built on DuPont’s core values: – Safety and Health

– Environmental Stewardship

– Highest Ethical Behavior

– Respect for People

http://www.esibethesda.com/ADSmediafiles/_video/ImprovingEmotionalHealth/player.html

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Man Therapy

• Information to help men understand that mental health disorders are not “unmanly signs of weakness”

• Resources and tools for (learning and laughing)

Case Examples and Resources:

• H-E-B (San Antonio)

• RK (Denver)

• Tarlton Corp (St. Louis)

• Toolbox talks with construction workers at jobsites

• Suicide prevention training for managers;

• Mental health resources through the RK Wellness

Program, including an in-house wellness coach and

1:1 counseling

• Trusting, collegial culture • Diversity of thought and talent • “Project First” win-win mentality – reduces

client/subcontractor conflicts • Superintendent training on conflict

resolution

• EAP/Behavioral health outreach for ALL disability claims • Disabilities with primary mental/behavioral health

diagnosis are treated by specialists or claims not paid

Systemic Effects:

Values-based leadership –

builds trust

Culture of health

Culture of high performance

Positive individual health and

organizational performance

outcomes

Questions?

Nancy Spangler

816-820-1870

nspangler@kc.rr.com

(Please contact me or leave your

business card if you would like to

receive our e-mailings – or if you have

an employer case example to share)

SPANGLER ASSOCIATES, INC:

Bonde, J. P. E. (2008). Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occupational and environmental medicine, 65(7), 438-445.

Katon, W. J. (2011). Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues in clinical neuroscience, 13(1), 7.

Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.

McGonigal, K. Stress is your friend. Retrieved from http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend

Selye, H. (1956). The Stress of Life. New York: McGraw-Hill Book Co. Selye, H. (1976). Forty years of stress research – Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1878603/pdf/canmedaj01483-0055.pdf

Spangler, N.W. (First Quarter, 2012). H-E-B Emphasizes Health for Partners and Communities. Mental Health Works. Retrieved from http://www.workplacementalhealth.org/mhw12012

References & Resources:

Spangler, N.W., Koesten, J., Fox, M.H., & Radel, J. (2012). Employer perceptions of stress and resilience intervention. Journal of Occupational and Environmental Medicine, 54 (11), 1421-1429. Retrieved from http://www.workplacementalhealth.org/Publications-Surveys/Study-Examines-Employer-Perceptions-of-Stress-and-Resilience-Intervention.aspx

Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. Retrieved from http://www.samhsa.gov/data/sites/default/files/NSDUHmhfr2013/NSDUHmhfr2013.pdf