As mental health in the workplace rises on the corporate agenda, it is increasingly important for organisations to consider the well-being of their mobile workforce. From short-term travel to longer term expatriate assignments, on- or offshore, or even getting caught in a security incident, pressures can be particularly acute for this business critical workforce.
In the UK, an estimated 11.5million working days were lost due to work related stress, depression or anxiety in 2015-16 and accounted for 37% of all work relations ill health cases and 45% of all working days lost.
When you consider that the mobile workforce accounts for over 38% of the total global workforce, absenteeism and impact on productivity due to mental health issues is a potentially significant threat to UK business continuity and effectiveness.
Organisations are at differing stages in recognising and managing mental health, and even those with established operational health programmes in place don’t always have an appropriate way of dealing with these issues.
From SMEs to global conglomerates, the benefits of implementing stronger procedures outweigh the costs of implementation. Along with the fact that, in many jurisdictions, health & safety regulators are now requiring employers to assess and manage stress in the workplace, it is becoming crucial that organisations start to address this important area of health.
Stress Factors
The very nature of the working life of a business traveller intrinsically incurs some of the most common and well documented work-related stress factors, such as sudden and unexpected workload, fast changing events and blurred reporting lines and responsibilities. These are consolidated with a number of stress factors specific to the mobile workforce, including:
• Jet lag
• Poor sleep and diet
• Diminished peer support
• Severance from home and family
• Trepidation to speak about concerns or issues in case it negatively impacts the perception of their ability to carry out their job
And the list doesn’t stop there.
In the current global environment, business travellers are also faced with a perception of heightened travel and security risk. While this is something that impacts everyone, the business traveller may be required to more often pass through territories that are uncommon to them or work in a higher risk environment as firms increasingly look to expand global footprints and trading relationships.
Long-Term
Organisations sending employees on long-term assignments should be mindful, and have in place, emotional and wellbeing support that is appropriate to the region.
In order to identify the level of support that may be needed it is important to consider barriers such as distance and time difference, diminished family network support and in-country medical support.
For instance, counselling is not readily available in some Asian and Middle East countries, and mental illness is stigmatised in some countries and therefore there are little or no medical facilities in the mainstream medical system.
Moving to a foreign country can be an incredibly stressful experience and a significant number of assignments can be impacted each year due to the mental health of the employee or a member of their family.
Expatriate families can often experience stress related to social isolation and strongly differing culture and if a family member becomes unwell, then from a business perspective a whole assignment may have to be cancelled because an ill spouse or child cannot return and live alone at home.
Duty of Care
Identifying stress factors and implementing strategies to manage potential mental health issues in a mobile workforce may be difficult, but employers have a duty of care to ensure the safety and well-being of their employees working and travelling abroad – this applies both to physical and emotional health problems.
It’s important not to underestimate the impact a mental health issue may have on an individual and could potentially have on an organisation from a legal, as well as business continuity, perspective. For example, some employees who succumb to depression may never return to full time work. If such an eventuality was foreseeable: for example, an employee or spouse being sent abroad with a pre-existing mental health condition, then potentially an employer could be held liable.
Medical and confidentially screening employees and families prior to travel is advisable as well as having well communicated confidential support processes in place so that employees are able to easily seek help if they need it.
Symptoms
One of the most common questions we have from organisations is how to identify mental health issues, and specifically depression.
While the effects of stress and depression are unique to individuals, and can therefore be difficult to identify, there are some common signs which may be evident:
• Signs that a travelling employee may be succumbing to work place stress are varied. Typical patterns might be a fall-off in performance: failing deadlines or not making meetings, uncharacteristic emotional outbursts, complaints about sleep issues, possibly excessive alcohol consumption and resisting work or tasks.
• An employee who is chronically stressed may go on to develop early depression. The first sign of this is impaired performance because sleep disturbance and poor concentration are often a feature. The employee will be aware of this and reflect negatively on themselves for not performing and resolve to try harder. This will often serve to make the depression worse and so the tragic cycle continues.
• Depression is often not understood by employers or colleagues. Whilst low mood may be a feature of depression, it is not a reliable indicator as employees are often able to ‘mask’ this aspect.
More reliable indicators are restlessness, waking at 3am and then not dropping off again, loss of interest in enjoyable things (such as reading, sex, food and exercise), poor concentration, social withdrawal, emotional liability and a feeling of ‘hopelessness’.
However, organisations should ideally combine awareness and procedures to monitor the mental health of a mobile workforce with a well communicated confidential support service, where employees feel comfortable to proactively discuss any issues.
Ways to support
Organisations need to start putting stronger risk management procedures in place to help employees deal with workplace stress. This is particularly necessary for the business traveller and expatriate community, which is more vulnerable to stress-related health issues.
If there is lingering doubt about the continuing fitness of an employee to travel, then an opinion can be sought from an occupational health physician who will be experienced in the field of mental health in the workplace.
HR departments should ensure all employees take a pre-placement medical assessment prior to travelling and working abroad to make sure they are not at risk of becoming depressed or developing a chronic anxiety state or another medical condition.
Workplace stress is now a well understood science: organisations can implement inexpensive programs to assess and manage stress in the workplace and, indeed, demonstrate to regulators that they are doing so.
Employee resilience training, assistance programs and regular surveys can be implemented to mitigate stress. Supporting workers abroad with regular ‘catchup’ calls with no specific agenda can be
helpful as is allowing adequate rest between assignments.
Julian Eyears is medical director of occupational health at International SOS
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