Well-Being

Work can make you sick — and work can make you happy. Which one happens depends on who you are, what you do and how you are treated at work. Work that is rewarding, involving good relationships with colleagues and opportunities to feel a sense of achievement on a regular basis is a key factor in psychological well-being (PWB). Good PWB, as we shall see later in this chapter, is linked to good physical heath. Dull and monotonous work, difficult relationships with others and work that is impossibly demanding ‘or lacks meaning’ damages resilience, PWB and physical health. Later chapters will explain how PWB can be damaged or enhanced by work and will also cover the key workplace factors that influence PWB. This chapter sets the scene for what follows by explaining why PWB at work matters and how it is linked to overall sickness and health.

As Chapter 1 of this book has shown, PWB is important for individual employees in many different ways. Higher PWB is linked to life success, better health, career success, better relationships with others and more. This chapter concentrates on the benefits that high levels of PWB bring to the organization. Let’s begin by looking at a few examples in specific sectors.

This chapter explains how the important ideas of employee engagement and PWB can be drawn together to provide a powerful combination to benefit employees and organizations alike. Around the world there is currently a great deal of interest in the concepts of employee engagement and employee well-being. The statistics of engagement are interesting and show that improving employee engagement leads to a range of positive outcomes for organizations — they also show that in many organizations the levels of engagement are actually quite low. On a global basis just 21 percent of the employees surveyed around the world are engaged in their work (Towers Perrin, 2007), meaning they’re willing to go the extra mile to help their companies succeed, 38 percent are partly or fully disengaged. The relatively low levels of engagement appear to stretch across very different societies and economies. For example, in mainland China, 33 percent of people are reported to be partly or fully disengaged (Towers Perrin, 2007). Engagement levels in the Western economies also appear to be relatively low, with fewer than 20 percent of employees in the United Kingdom reported to be fully engaged and over 40 percent either disengaged or at least “disenchanted” (Towers Perrin, 2007).

How we feel changes over time? Obviously if something bad happens, such as being made redundant or having an accident it will affect how we feel for a while but eventually we will probably recover. Every now and then we seem to “get out of the wrong side of the bed” and start the day in a low and irritable mood for no obvious reason. A disagreement with a colleague or a difficult time with a customer can also affect how we feel.

It’s clear from elsewhere in this book that improving the PWB of people at work brings a wide range of benefits, to them as individuals, to their organizations — and of course to wider society. Later chapters look at how the PWB of a workforce can be influenced and enhanced. A prerequisite for changing anything, in a systematic way, is being able to measure it. If you can’t measure, it’s impossible to know whether things have changed or not. In fact, being able to measure is important, not just for understanding what might change after an intervention but, in the case of PWB, accurate measurement is even more important in deciding what needs to happen to improve things. As well as measuring current levels of PWB, an assessment of the factors that are influencing PWB, the “drivers” of well-being, is an essential measurement prerequisite. A full explanation of the drivers of well-being is covered in a later chapter (Chapter 7) but in this chapter, as well as discussing the measurement of PWB itself, we also discuss some of the core workplace drivers of PWB and how they too can be measured.

In a remarkable article, published in 1989 (see Arvey et al., 1991), Richard Arvey and his colleagues produced results that appeared to show that job satisfaction is inherited! At face value this is a very peculiar result indeed because, as we saw in Chapter 3, job satisfaction is supposed to be an appraisal of how we feel about our job. How can this be inherited? Arvey and his colleagues carried out a classic type of study that is used by researchers who are interested in inherited characteristics — a kinship study (see also Chapter 2 of this book). In these studies researchers focus on naturally occurring examples of people who vary from being very closely related, such as identical (monozygotic) twins who are from the same fertilized egg and hence genetically identical, through to unrelated pairs of people. They also take into account whether the people shared a common environment or were brought up apart — as in the case of twins separated from each other at birth and raised separately. This provides an array of people who have varying degrees of genetic and environmental similarity. At one extreme there are identical twins reared together who have common genes and environment. At the other extreme there are unrelated people reared apart who do not share a common environment or genetic background.

As Chapter 6 explained, PWB at work is influenced by many factors that are not directly work-related. These factors are important and it is crucial to recognize that what goes on at work is not the only thing that influences PWB at work. It is equally important to recognize that what actually goes on at work is generally the most important factor in how people feel at work. Work-related factors are the most important contributors to PWB at work partly because they have a direct impact on PWB but also because it is easier for organizations to change and improve work-related factors. Improving someone’s relationships with members of their family is not something that an organization might normally expect to be able to do — but improving relationships with someone’s manager or colleagues is a different matter.

Two people can be working in very similar situations, with equally similar personal and family circumstances, yet one seems to be positive, resilient and psychologically healthy, the other doesn’t. How can this be and what does it imply? Essentially, this can happen because there are two main sets of factors that exert an influence on people’s PWB. The first set of factors relates to the situation — especially the work situation. Much of the material in this book has concentrated on the impact that these situational factors (management, type of work, access to resources, levels of control and autonomy, personal circumstances etc.) can have on PWB. There is no doubt that “situation” factors can have a major impact on PWB but it is very important to recognize that the impact of the situation on PWB can be significantly moderated by “person” factors — qualities such as optimism, resilience or positive thinking that are related to the individual himself or herself. These “person” factors help to explain the differences in PWB experienced by two people who are working in essentially the same situation (see Figure 8.1).

Earlier chapters in this book have focused on research and evidence. This chapter is more practical and rather than reviewing research findings and introducing new ideas and concepts, it provides guidance on how to take a strategic and practical approach to improving and sustaining PWB in an organization.

Mersey Care NHS Trust partnered with Robertson Cooper to design and implement an integrated leadership development and employee well-being program. This was introduced at a time during which the Trust was going through a major change and restructuring process, having recently begun their application to attain status as Foundation Trust equivalent. A priority of the program was to ensure that employees felt involved and supported throughout the restructure and felt good about coming to work. In light of this Robertson Cooper designed a program to measure the levels of Psychological Well-Being (PWB), engagement and perceived productivity of employees, using the ASSET framework (see Chapter 5). The leadership development process was then designed to incorporate ASSET results so that action plans could be made to improve well-being and engagement in the priority areas, as well as informing managers about how to become more effective leaders. Of the senior managers and clinicians who Completed the evaluation, 83 percent agreed that the content of the development centers met their expectations. Subsequent monitoring of performance of the Clinical Business Units has seen an improvement in key performance indicators and some measures have significantly exceeded original targets. There are now plans to re-use ASSET to assess the impact of the change, which will lead to further evaluation and progress toward the full objectives of the program.

Given that Johnson & Johnson is the largest health care company in the world, it stands to reason that it would extend the same level of excellence it is known to have for its health and wellness products, to the health and wellness of its own employees. By adopting the philosophies of “caring for the world one person at a time”, the Johnson & Johnson health and wellness programs reach around the globe, and touch employees’ homes. The programs aim at prevention, but are also constructed to respond without judgment, and treat the individual throughout the health continuum. It has strived for — and achieved — a “culture of health” throughout the corporation that is spreading into the communities in which employees live and work. This case study focuses on the components of Johnson & Johnson’s “Health and Wellness Program”.

Whilst the case may be strong for the role of well-being in personal happiness and for increased productivity, the challenge faced by many organizations and health promoters is how to get people engaged in health and well-being. Sadly, many people only engage in their health once things start to go wrong; yet, there is extensive evidence^{2, 3, 4} that a healthy lifestyle can increase life expectancy and substantially reduce the risks of a raft of medical conditions.

This case study describes the process of introducing and sustaining a comprehensive corporate health management system in a company in the chemical industry.

The company, Evonik Degussa GmbH, is an international industrial group operating within the Chemical, Energy and Real Estate sectors. The starting point for the intervention was the setting up of an interdisciplinary steering group for the management, the implementation of measures and for the evaluation of the whole process. Besides the top management of the company, representatives of HR (human resources), OSH (occupational safety and health), OD (organizational development), the works council and different production departments were all involved in the steering group. The Chairperson of the steering group was a representative of occupational medicine (medical service). The steering group was supported permanently by external representatives of two different statutory health insurers. During the past 15 years, this steering group initiated a great many projects promoting and enabling the health, engagement and well-being of employees. The activities focused on the prevention of musculo-keletal disorders, lifestyle changes and the promotion of strategies for coping with an ageing workforce. This case study deals with the problem of how all the implemented measures can be sustained, and how the activities can be implemented within the structures and processes of the enterprise. The case study could be used as a blueprint for other companies on how well-being initiatives can be integrated in continuous action-orientated projects.

According to the German Social Code V §20 health promotion activities are an obligation for health insurance funds in Germany. They have the opportunity to invest in, and influence, health promotion activities. In 2000, the Associations of Health Insurance Funds developed quality guidelines for workplace health promotion, which were modified and enlarged during the following years. These guidelines assure quality management of health promotion activities, documentation of all activities in this field and proper and systematic evaluation. There are clear guidelines for the qualification of providers of health promotion activities. There is a difference between individual approaches to change behavior (physical activity, nutrition, stress reduction, drug abuse, etc.) and building organizational change in a variety of settings (i.e. for schools, municipalities/local activities, companies and workplaces). The AOK Rhinland, a regional health insurance in Northshine-Westfalia, has its own institute (BGF Institut) for workplace health promotion, with experts in various fields to support enterprises in undertaking health promotion activities. This Institute was actively involved in the case study described below.

This case study presents one higher education institution’s (HEI’s) ongoing journey over a 10-year timeline, which began, in 2005, with the need to improve health and safety management, and evolved, by 2010, to integrate well-being and the ethos of a “Well University”, based on a holistic settings approach. We present an incomplete journey, moving toward building organizational resilience by 2015, and take readers through the thinking that influenced and shaped the wellbeing direction and some of the subsequent actions that were taken.

The London Fire Brigade (LFB) is the largest fire and rescue service in the United Kingdom. It exists to make London a safer city. The organization’s vision is to be a world-class fire and rescue service for London, Londoners and visitors. LFB employs approximately 7000 staff, of which 5800 are operational fire fighters and officers. It is part of a group of organizations under the “umbrella” of the Greater London Authority (GLA) and is the third largest fire-fighting organization in the world: protecting people and property from fire within the 1587 square kilometres of Greater London. Providing Londoners with 24/7 coverage, the LFB has 113 fire stations, plus the river station, which are crewed by four different watches, operating on a two-two-four watch system (two days on, two nights on, four days off). In meeting the needs of London, LFB is the only UK fire service to have a predominantly whole time (full-time) work force. Other brigades across the United Kingdom use a combination of full- and part-time staff, and “retained” fire fighters who carry out fire-fighting duties in addition to their usual employment.

Nowadays, worksite health promotion interventions are increasingly being delivered through the Internet. Advantages of Internet-delivered interventions are — among other things — accessibility, anonymity and interactivity. Accessibility means that employees can use the intervention at their own convenience, 24/7, in the comfort of their own home or during lunch break at work. This is connected to the second advantage, anonymity. Use of Internet-delivered interventions can be completely anonymous, without colleagues knowing that the employee is, for example, stressed or wants to decrease his/her drinking behavior. If the employee has, for example, a shared office space or is not able to use the Internet-delivered intervention at work, the accessibility of the Internet makes it possible to use the intervention elsewhere (e.g., at home). Finally, through its interactive character, the Internet is an appropriate medium to deliver tailored health promotion interventions; interventions that offer only content that is relevant for the specific employee. The way in which this is usually done is by letting employees fill out a health risk assessment and subsequently offering intervention content that is related to the behaviors at risk and their related determinants.

BT has a well-developed mental health framework which seeks to support employees at their different stages of need as well as helping managers deal with mental health issues. The framework has three elements — primary prevention, secondary intervention and tertiary rehabilitation. Products and services have been developed that address the issues of education and training, assessment and practical support for each of these elements. The resultant suite of interventions is known as the company’s “mental health toolkit” and is available for deployment by individuals, managers or operational units as required. The toolkit is kept under constant review and is revised and supplemented in the light of both developments in good practice and business requirements.

The subject of this case study is a leadership and well-being theme that was developed as a core component of the National Health Service (NHS) West Midlands Executive Leadership Development (Aspiring Chief Executives) and Aspiring Directors programs. The theme, entitled “Keeping Pressure Positive” (KPP), was designed to challenge participants to raise their game in managing pressure and performance for themselves and others, and to provide developmental support to help them achieve this.