Presentation irene houtman

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  • 1. Psychosocial risk management: The Dutch case Irene Houtman
  • 2. This presentation
    • Psychosocial risk exposure in the Netherlands
    • Active policies in the last two decades and their results
    • The policy shift: from managing risks towards reducing absenteeism & disability and increasing participation
    • Towards sustainable employability & an all inclusive labour market
  • 3. Working conditions profile NL against EU
  • 4. Trends in EU-data on psychosocial risks covering 1990-2005 Source: EWCS
  • 5. Period of 1990 - 1998
    • 1990 National legislation on OSH was implemented with specific attention to well being at work
    • 1990-1998
    • Handbook(s) on management of work-related stress
    • Description of good practices
    • Guidelines for maintenance (objective, expert opinion: WEBA method)
    • Research:
      • Monitor on Stress and Physical Load
      • Priority program on mental fatigue
  • 6. Some findings of the Monitor on Stress and Physical Load linked survey on + 1000 companies-
    • Companies who are active in Psychosocial RIsk MAnagement
    • (PRIMA) characterize themselves by (multivariate):
    • Employers: OR
    • Work-related stress recognized as a problem 3.1
    • Large size 2.1
    • Employees:
    • Low on autonomy 1.8
    • Many short cycled work 1.5
    • Low physical load 2.1
  • 7. 1998 2007: Work and Health Covenants
    • Characteristics & aim:
    • Sector wise approach
    • Ministry subsidizes (50%)
    • Large scale OSH interventions:
      • psychosocial risks in NL highly prevalent
      • so psychosocial risk management often core
    • Aim: 10 % risk reduction in three years
    • Proper (quantitative) evaluation
  • 8. An example: the police favourable unfavourable
  • 9. Changes in risk exposure High quantitative demands - 12% Problems with time autonomy - 11% Problems with opportunity for contact - 12% Problems with feedback - 17% Problems with emotional load - 10% Problems with supervisor and colleagues - 20% High emotional exhaustion - 11% High depersonalisation - 20% Dissatisfaction with work - 20%
  • 10. Effectiveness of the measures I (imputation)
  • 11. Effectiveness of measures II (imputation)
  • 12. After the Work and Health Covenants
    • In 2007 the Working Conditions Act was updated
      • Employers obligated to make a risk assessment (RIE)
      • Well being as specific issue was skipped from the act .
      • Companies 30 days in Europe Source: EWCS
      • 14. Sickness absence trend in the Netherlands
      • 15. Absolute figures on disability in The Netherlands until 2004 steady rise 100.000 a year -> legislative change Source: NEA 2009 Source: UWV
      • 16. Disability inflow by diagnosis
      • 17. Estimated costs of work-related drop out (for 2001)
        • Costs of drop out from work Euro % of total
        • x1000)
          • Work-related costs of absence 3.785 29,8
          • Work-related costs of disability 4.371 34,4
        • Costs on operational management unknown
        • Costs of health care,
        • Legislation & enforcement 2.869 35,8
        • Total (work-related costs) 12.690 100
        • For work-related mental health: 5.457 43%
        Source: Zwinkels et al, 2004)
      • 18. Research directed at determinants of, and intervening effectively in drop out because of ill mental health
        • Lessons learned from that research:
        • Early contact occupational health physician facilitates return to work
        • Partial work resumption is instrumental to return to work
        • Employers who facilitate partial return to work obtain a lot higher (up to 9 times higher) return to work after drom out from mental health reasons
        • In NL depression appears to be a major factor prehibiting return to work
      • 19. Final conclusions for the Netherlands -1
        • In NL there were relatively high levels of psychosocial risks and drop out for reasons of mental health Costs were high.
        • The high work pace appears to have been addressed quite effectively Work & Health Covenants?
        • The Work and Health Covenants have stopped. Now the Work and Safety Catalogue (is hoped to) maintain the gains and experiences from these Covenants no explicit monitoring
        • Attention shifted to counteract the high drop out (for large part) due to mental health problems this is mirrorred by legislative changes
        • Now the policy attention is mainly directed at participation and inclusion, particularly of specific groups at risk (e.g. elderly, women) towards an all inclusive labour market
      • 20. Take home message
        • Conditions for psychosocial risk management to be effective:
        • Participative approach (both employer AND employee involvement)
        • Use a stepwise approach (inventory passive-active-, plan, act, evaluate)
        • Employer has to ackowledge psychosocial risks to be a problem
        • Acknowledge workers/employees as experts
        • Management has to act on changes in the organizational structure
        • If many companies are small, try to organize sector wise
        • When employees become absent: individual approach necessary :
        • Early contact with (occupational health) physician discussing R2W
        • Partial work resumption is instrumental to a full return to work
        • Employer should temporarily and activily lower the threshold for (partial) return to work (adjustment in tasks, working times etc).
      • 21. Results: RTW per country (Time 2) Percentages after excluding full RTW at Time 1
      • 22. Results (continued): RTW and social security system