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

Remember that organizational change

takes time

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)