Helping your organization address staff wellness
Lisa McKay, Headington Institute
Lynne Cripe, USAID
Sharon Forrence, Counselor/Consultant
The pressures (I)
1. Violence and threat Intentional violence is the leading cause of
death among aid workers in complex emergencies (Cardozo & Salama, 2002).
Humanitarian workers in many areas facing increasing risk of being threatened, assaulted, and killed.
2. Social, cultural and/or spiritual dislocation
The pressures (II)
3. Poverty and deprivation “I’ve seen people dying, had bullets flying by,
walked in mine fields. They never freaked me out. But where do we stand? I’m from a modern democracy, they’re from a developing country; I’m paid a good salary, they earn zip; you go, they stay. Those are the things I would have liked to see a psychologist about” (Abric, 2002).
4. Moral dilemmas
5. The work environment
The reactions (I)
Trauma reactions Between 5% and 10% diagnosable post-
traumatic stress disorder (PTSD) (Cardozo & Salama, 2002; Eriksson et al., 2001, 2003; Holtz et al., 2002)
20% “partial” PTSD (Eriksson et al., 2001)
General distress Between 30% - 50% moderate to severe
levels of emotional distress (Cardozo & Salama, 2002; Eriksson et al., 2003)
40% at high risk of burnout (Eriksson et al., 2003)
The reactions (II)
Depression 10% - 15% elevated levels of depression
symptoms (Cardozo & Salama, 2002; Eriksson et al., 2003; Holtz et al., 2002)
Anxiety 10%-17% elevated levels of anxiety
symptoms (Cardozo & Salama, 2002; Holtz, 2002)
Substance Abuse 15% drink more than 3 standard drinks per
day (Cardozo & Salama, 2002)
So What?
Workplace stress affects you and your staff whether acknowledged or not
Staff retention and morale Employee health and absenteeism Compromised judgment Efficiency and productivity Liability
Creating Organizational Buy-in
Talk about it Understand what is happening with staff
in YOUR organization Recognize what you are already doing and
build on it Learn from other professions Identify key allies; informal and formal
leaders Grasp the teachable moments
Supporting your staff
Pick suitable staff members
Prepare them for the challenges
Provide ongoing support during field work
Process the assignment with them upon completion
PICK
Assessing “goodness of fit” Legal and ethical cautions Assessing risk factors that
increase vulnerability to traumatic stress
Assessing personality and coping mechanisms
Assessing ideals and motives
PREPARE
Candid description of environment Safety and security concerns Physical (health) care Cultural and political issues relevant to
assignment Stress management
Inform, anticipate and plan
Arrival Orientation
Security protocols Local customs Access to medical care, other resources Stress factors Stress reduction resources
Methods
Mentoring Experiential training CD-Rom, videos, web-based training One on one tutorials Co-mentoring among international,
national, and new staff Manuals, handbooks, workbooks
PROVIDE
High level of stressful experiences is inevitable in most assignments.
Stress can be chronic, traumatic, or secondary
Support is a on-going process, not a single event
Support needs to be culturally appropriate
Staff are responsible for acting in
ways to reduce adverse effects of stress.
Provide
What agency practices may increase stress?
Develop clear, written policies Clarify role of managers Include stress management, teambuilding,
conflict management training Consider peer support, mentoring
Critical Incident
• Establish protocol – physical safety, medical attention, support, evacuation resources
• Roles and Responsibilities• Managers/supervisors trained to respond• Coordination with HQ• Identify trauma counseling resources
PROCESS
Relief and Rehabilitation Network, ODI survey (1995)• Difficulty readjusting - 75% • Feelings of disorientation - 33% • Problems with getting a job - 24 %• Depression/lack of understanding - 17%
Returned Peace Corps Volunteers (1996)• 55% of described having a “very difficult” or “somewhat difficult”
time readjusting• 56% described feelings of not belonging
Journal of Traumatic Stress ( 2001) survey of returned staff from 5 agencies
• 30 % of returning relief workers surveyed reported stress symptoms
• 10 % could have been diagnosed with PTSD.
PROCESS
Process of preparation begins early on Allow adequate time to physically and
emotionally prepare Exit/handover process established Access to mental health resources Provide information on re-entry/transition
process Follow up after 1-2 months Applied to all staff!
Staff care on a shoestring budget…
What are practical, low-cost, steps you can take to start building a culture of staff-care in your organization?
10 ways to start…
1) Recognize and appreciate colleague’s good work, extra efforts, etc.2) Managers model good self care, demonstrate work-life balance.3) Celebrate special occasions, holidays and acknowledge transitions in
people’s lives (e.g., births, deaths, birthdays, promotions, new jobs). This doesn’t have to be elaborate or expensive!
4) During times of high stress, be mindful of each other’s well being. Spend time checking in with each other and actively listen to responses
5) In a high threat environment, provide information a timely, accurate and consistent manner.
6) Turn on the music and dance! It’s good exercise and can be a great form of non-verbal expression.
7) Use newsletters, emails, meetings to provide information about stress and resilience. This helps normalize people’s experiences and may expand their repertoire of coping strategies.
8) Host a party or social event that includes family members.9) Encourage staff to take mini-breaks during the day. And managers, set a
good example and take them yourself.10) After work-related travel—especially if intense, encourage staff to take
some down-time.11) Prepare organizational handbook (eg, relocation details)
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