Book Reviews
Mental health and work: Issues and perspectives
Lou Morrow, Irene Verins, Eileen Willis (eds)
ISBN: 0 958 72285 4 2002 349 pp pages Adelaide: Auseinet (The Australian Network for Promotion, Prevention and Early Intervention for Mental Health)
Ken Bridge
Centre for Labour Research, University of Adelaide, SA
As the editors of this volume point out in their introduction, discussion and research on the issue of mental health tends to focus on individuals to the neglect of wider structural and societal factors. This collection of readings redresses this imbalance, providing a sociological perspective based on the assumption that factors related to economic, democratic and social participation are central to mental health and wellbeing. The book was commissioned by Auseinet (the Australian Network for Promotion, Prevention and Early Intervention for Mental Health based at Flinders University of South Australia) and developed in collaboration with VicHealth (the Victorian health promotion unit).
The book focuses on people's working lives on the grounds that access to 'decent, meaningful work' is a crucial factor in the determination of mental health. However, as the editors go on to argue, the workplace can also have a negative impact, with extra demands on employees due to restructuring, downsizing, 'flexible working', longer hours and the intensification of work practices. Nevertheless, they maintain, the workplace remains a site for the prevention of mental ill-health.
What strikes the reader first is the carefully crafted layout of this volume, with its logical structure and clear presentation of the ideas. The book is divided into five sections: an introduction to the context and issues; a study of work and identity; work and safety; work and emotions; and workplace case studies with a focus on training. Each section has a brief editorial introduction, and most chapters begin with a helpful abstract. The collection includes three moving poems about working life by Peter Waterhouse, and a number of apposite cartoons by Simon Kneebone interspersed throughout the text.
The various chapters incorporate a variety of styles, including academic research and descriptions of practical mental health programs. The research methodologies include both qualitative and qualitative approaches, and range from the interpretation of interview transcripts to statistical analysis.
In a key introductory chapter Maureen Dollard and Tony Winefield (from the Work and Stress Research Group at the University of South Australia) explore the links between mental health and 'over-employment' (for example, long hours or faster pace of work), 'underemployment' and unemployment. They provide an overview of the issues from a psychological standpoint, outlining the connections between work and mental wellbeing in terms of workplace stress, personal control and social connectedness. The breadth of their analysis is refreshing, their discussion of psychological factors and physiological effects being complemented by a critical social perspective on the issues, with close attention to changes in the workplace and labour market, as well as to unpaid emotional (caring) work. The chapter also incorporates an outline of psychological theories regarding the impact of unemployment and concludes with suggestions for a research program and policies to improve mental health and wellbeing at work.
The next section explores the relationship of work and identity. Suzette Dyer and Maria Humphries offer a Foucauldian critique of a career and self-help discourse which transforms real people into 'neutered chameleons' who must continually remake themselves into marketable employees or face unemployment. Meanwhile Rosemary Hoban outlines the mental health implications of the blurred distinction between the roles of worker and family or community member in the case of Indigenous community workers. Thea O'Connor promotes a social model of health for working women, while Alison Rosser explores issues to do with the combining of caring work and paid employment. Bernadette Fallon explores issues and strategies for older workers in the context of the Victorian government's Working for Ages project, a focus shared by Troy Speirs and Martyn Wilson in their investigation of pre-retirement strategies for older men. Finally, Stephen Pavis et al discuss the need for satisfying and meaningful work amongst young people in rural Scotland, raising the question: Is any work better than no work?
The third section deals with issues of work and safety, with a focus on covert forms of violence such as bullying, racism and other forms of discrimination. Lyn Turney explains how workplace bullying can become institutionalised as part of professional socialisation, while Charmaine Hockley describes the impact of workplace bullying on third parties.
In a broader context, Melissa Corkum outlines VicHealth's Together We do Better community health promotion campaign while Cath Roper describes the incorporation of mental health care 'consumers' as paid consultants in monitoring the psychiatric service system.
The fourth section is concerned with the general area of work and emotions with a particular focus on the issue of emotional labour and the commodification of workers' feelings. Chapters by Sue Stack and Vanda Zammuner et al show how health professionals risk burnout or alienation when their emotional labour is 'appropriated' in the interest of profit or efficiency' (p186). Two other chapters deal with the impact of emotional stress, Monica Leon explaining how a permanent state of fear and anxiety can cause illness, especially amongst staff whose work role is that of 'toxic-handler'. Meanwhile Peter Hosie et al show how highly pressured work regimes whereby 'half as many people are being paid twice as much to produce three times more' can lead to emotional exhaustion.
The final section explores mental health issues in a variety of workplace and community settings. The earlier chapters focus on training/education programs. Trevor Waring describes the development of a training video to assist hairdressers in their role as confidante and information gatekeeper. Daniel Nicholls and Bee Mitchell-Dawson explain how the neglect of core interactive skills amongst mental health nurses can be addressed through clinical supervision. Anne Boscutti explores wellbeing amongst service staff especially those dealing with high-risk populations such as homeless young people. Finally Barrie Thomas and John Murphy discuss the difficulties of recognising the importance of the meaning of work in the commercial setting of The Body Shop.
Other chapters in this last section discuss positive programs which tackle the problems described elsewhere in the book. John Shephard shows how the internet-because of its very anonymity-can be a powerful tool to combat workplace stress. Karen Field et al discuss the relevance for the workplace of beyondblue the National Depression Initiative, and Shandell Blythe et al show how holistic workplace health is promoted in a project sponsored by the Upper Hume Community Health Service. Meanwhile Stephen McKernon et al explain the development of a NZ toolkit for mentally healthy workplaces and Leanne Luxford and James Nichol describe a trial project for developing a mental wellness program in a NZ aged care facility.
This book of readings is most welcome for its interpretation of workplace mental health from a sociological perspective which also takes into account changes in the workplace that have occurred in the wake of globalisation and the deregulation of finance, trade and the labour market. The various chapters provide a rich resource for the exploration of mental health in the workplace at several levels-a sharper awareness of the lived experience of workers; a better understanding of the context of the problems; and a clearer outline of positive programs to address the issues. Moreover the volume is exceptional for the clarity of its structure and presentation, and the breadth of its scope. Despite the appearance of 'mental health' in the title the book would be a very appropriate text for those interested in the general study of workplaces from a range of perspectives including human resources, industrial relations and organisational policy and practice.
eContent Home