It's You, Not Us

The Rise of Medicalized Public Workplaces
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A soldier / first responder tells his buddy that he is not sleeping and that he is just fed up with things.  The friend suggests he may be depressed and that he should come forward and talk to a professional. At first glance, a reasonable suggestion but missing from these cryptic interactions are the contexts. The soldier does not bother to mention that he is not sleeping because he was promised a low tempo posting by his supervisor for agreeing to take on a tough tasking that nobody wanted. His supervisor has reneged on the promise and instead has told him that he is needed for an upcoming deployment and if he refuses he can say good-bye to his career. The soldier’s marriage is already rocky because he has not really been home for the past several years and he does not know what to do. Career or marriage?

These types of scenarios are not unusual. What is new is that any mention of upset/distress in work settings of the 21st century is the rush to medicalize members' problems as part of institutional risk management. Anyone displaying unusual behaviour is a potential liability for organizations. This focus on individual mental health can be helpful to people for sure but we have also come to the realization that many of the ‘evidence-based treatments’ and workplace interventions like mental health first aid, and adoptions of the military’s road to mental readiness (R2MR) initiatives are not producing the expected outcomes of reduced workplace mental health problems (See Carleton et al., 2018). I believe that something fundamental is missing.

What is missing is context. According to the Standing Committee on Veterans Affairs (SCOVA, 2018), 28 percent, nearly one-third of military members, are released annually because of physical and mental health problems. We could attribute these rates to reduced stigma, better detection, and better care for soldiers and maybe even due to leftovers from the Afghanistan War. But, we also must wonder about this seeming upsurge in the numbers of injured men and women. What else has changed?

For starters, beginning in the 1990s most of organizations and public workplaces went through massive downsizing – doing more with less – because of budgetary constraints. Since that time there has been a continual scrutiny for savings and trimming needless fat. This focus on financial bottom lines has impacted personnel and human resource management fronts. In many places, among other demands, this has also meant personnel shortages requiring members to take on multiple roles, time pressures, reduced time away from work settings, and 24-hour access through telephones and social media. Members are required to over-invest to ever-demanding work settings.  

A recent investigation of Canadian public safety workplaces showed that a staggering 45 percent of members reported mental health difficulties (See Carleton et al., 2017). Surprisingly, the many public reports of supervisory abuses, sexualized and harassing workplaces, and unreasonable demands are somehow forgotten in efforts to understand worker distress. Instead, there is a predictable call for better resiliency training to address these problems. In our study of resiliency among veteran families (Submitted for publication), we found that resiliency is not an individual quality like hardiness or ‘digging deep’ but a range of problem-solving responses dependent on tangible direct support from the institution and from broader social contexts.

Strikingly, none of our current explanations or interventions into workplace mental health acknowledges or addresses institutional causes of mental distress among members. We are left with the unspoken presumption that our current workforce is somehow lacking in self-management skills or fortitude to meet job demands. We have forgotten the wealth of research from the 1970s to 1990s on occupational  burnout (See Maslach). We may have created pressure cooker workplaces and have ended up blaming people for not being able to maintain unreasonable expectations.

If we are intent on creating healthier workplaces, then we must get serious about tackling institutional policies and practices and enshrine employee protections for speaking out about things like supervisory and institutional practices and inconsistencies.
 

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