Stressed out

Some believe stress is a good thing but, as Andy Whittington explains, it can be a bigger problem for companies and their insurers than just a couple of days off sick

The case for rehabilitation and return-to-work initiatives is overwhelming as partnerships between employers, rehabilitation providers and support agencies enable employees to recover from illness or injury and return to work faster. The rehabilitation process is reactive, however, and employers that take the time to analyse the cause of absence and address these factors are often more successful in reducing the number of sick days taken.

The two main causes of sickness absence are musculoskeletal disorders and stress. Musculoskeletal conditions are often identified and addressed through health and safety risk assessments, job rotation and training - such as moving and handling instruction. Employers that are committed to reducing the risk of musculoskeletal injury in this way are largely effective.

Stress-related absence is more complex. Strategies such as employee assistance programmes - which attempt to prevent stress-related absence - are only effective when the employee is actually experiencing stress.

Indeed, claims for incapacity benefits citing stress-related illness, anxiety and depression have risen by more than a third since 1997. Women are statistically more likely to be diagnosed with depression, although experts are divided over why - whether it affects women more or whether they just more readily admit they have the symptoms.

Stress has overtaken physical injury as the primary cause of absence in the UK, which been the driver behind insurers researching how to prevent stress-related illness. If unchecked, acute cases of mental health can develop into chronic conditions - stress can lead to anxiety, prolonged anxiety leads to depression, and depression can develop into chronic mental illness.

For example, in one case, an employee received no occupational health assistance or notable management support, and a fairly straightforward case of stress-related sickness developed into an absence of almost a year. After the insurer's involvement, however, the case was resolved and the employee returned to work in a few weeks.

Employers appear to be reluctant to consider stress-related absence as a credible reason for sickness. Some employers are unsympathetic to the problems that people with genuine mental ill-health face and are unsure of the ways in which these needs can be met.

Body talk

Although some stress is thought to be good for focusing people, continued pressure can have a detrimental effect on the body. Good health is a result of a good balance - obesity, smoking or excessive and prolonged pressure at home or at work are factors that can alter the balance of a person's nervous system and place their body under stress. Factors such as regular exercise, good diet and adequate sleep helps address this balance.

Cardiologists acknowledge that the autonomic nervous system monitors the health of the body, encouraging internal balance. The system has two main components - one responding to challenge, which increases the heart rate; the other managing recovery and slowing the heart rate down. It is the ability of this system to effectively co-ordinate these two activities and keep the body 'in balance' that ultimately determines an individual's state of health.

The effectiveness of the ANS can be analysed through the heart rate variability measurement. It is, therefore, possible to assess how well an individual's nervous system is coping with stress and the risk to their general health and well-being.

A new service - Stresserve - has been developed that scientifically measures this balance and advises individuals whether their body is at risk of developing stress-related illness. For the first time, individuals are being provided with information relating to whether their body is showing signs of stress. This will enable insurers to work with individuals to prevent a stress-related absence. This is an invaluable step towards proactively managing stress, as opposed to reacting to it.

The test analyses the ANS, using a wireless ECG monitor to measure heart rate variability. The results show how well a person is coping with stress so that they may avoid stress-related sickness by altering their lifestyle appropriately. A health assessment such as this has two main benefits. Firstly, it can alert individuals as to whether their body is coping with the stress they are under; and, secondly, it enables employers and rehabilitation companies to identify and address the reasons for the stress and provide help and support to individuals.

Assessing stress

Employers that organise assessments for employees can be provided with an anonymous report that details the health of their workforce so that changes can be made if stress levels are too high. An assessment such as this offers employers the means to measure the stress that employees are under and, by providing advice and assistance to re-address any imbalance, can reduce the risk of absence and associated costs.

A proactive and innovative assessment could revolutionise the way employers view stress at work by providing a system to prevent illness and absenteeism, rather than simply reacting to it. The impact could extend to reducing the number of UK sick days.

Furthermore, employees will feel that their health is important to their employer and the benefits of such a feel-good factor relate to increased motivation, better productivity and greater commitment to the business.

- Andy Whittington is a business development officer at AIG Medical and Rehabilitation.

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