LRQA Podcast:ISO 45003 - The rising significance of psychological health

We hear a lot of mention these days of ISO 45003, can you tell us something about this standard and why it’s important for organizations?

ISO 45003 is the first international standard addressing psychological health
safety and wellbeing at work. Previously a few countries including Canada had national standards addressing this topic but there wasn’t an international document. For us, as the ISO technical committee for Occupational Health & Safety the development of this standard has been a priority - one of the two projects we initiated immediately our committee was formed in 2018.

At that time, we had no idea that we would end up publishing our document three years later it would be in the middle of a global pandemic, an event which has itself had a significant effect on many people’s psychological health and wellbeing.

During the pandemic, in many parts of the world, there has been a huge change in people’s attitude to psychological health, and their willingness to openly discuss what was previously something of a taboo subject for many. And that has included recognising and discussing the extent to which that their psychological health and wellbeing is being affected by their work, or the environment in which they work.

That’s why ISO 45003 has attracted so much attention and interest, and why its publication was so important. And it helped that ISO made the text of the standard freely available to read via its website, as part of its response to the pandemic.

ISO 45003 is a guidance standard providing recommendations as to how an organization should manage psychological health safety and wellbeing at work. It is a standard that can be used by any organization regardless of whether they or not they adopt ISO 45001. For organizations that do use ISO 45001 it provides guidance on how to meet the ISO 45001 requirement that the organization manages the psychological health and safety of its workers.

So, you’ll notice that I used the term “guidance standard”, and I think I should just take a moment to explain that, and introduce another term, “requirements specification” to help me clarify one of the differences between ISO 45003 and ISO 45001. These terms describe two distinct and different types of management system standard.

ISO 45001 is what is termed a “requirements specification” – as it describes the requirements for an organization’s Occupational Health and Safety Management System. It uses the word “shall” , throughout, to describe requirements that any organization must achieve if it to claim conformance to the standard. In this respect it’s the same as the very familiar ISO 9001 standards for quality management and the ISO 14001 standard for environmental management.

In contrast in ISO 45003 which is a guidance standard, the work “shall” is never used because the standard contains no requirements; just recommendations, so instead the word “should” is used throughout.

But from what you say, work started on this standard long before the pandemic, so why was it seen as so important back in 2018, and what’s its relevance today given the signs the pandemic is abating?

The impact of work on peoples’ psychological health was a significant issue long before the pandemic. It was already causing significant harm - and causing significant costs for organizations – and it was already on an upward trend. So, the pandemic may have caused a spike in the number of people suffering psychological harm due to their work or work environment, but unless we act effectively, we will, at best, simply return to that upward trend, as the pandemic abates – with a huge cost both to people and to the economy.

Historically, many organizations have been hesitant to address the psychological health and wellbeing, due in part to the taboos and the stigma associated with mental ill-health. But psychosocial risk has become an ever more important part of the risk to which many workers are exposed. That’s partly because we’ve become better at managing the risks from physical hazards, and we haven’t made equivalent progress dealing with psychological hazards. It’s also due to the shift in some economies from manufacturing industries to service industries; in the service sector physical risks can be quite low, whereas the nature of the work in some service environments such as call centres means that psychosocial risks can dominate. And there are jobs that have particular vulnerability to psychological harm, such as the emergency services.

So that’s really why the ISO technical committee prioritised guidance in this area back in 2018.

But I think there’s another factor which makes the standard even more relevant for organizations today, and that the fact that, since the pandemic many workers are more aware of their psychological health and expect their organizations to support their psychological health and wellbeing. So, in terms of motivating and engaging workers, retaining and recruiting staff, organizations need to step up to meet these expectations, if they’re not to put the sustainability and reputation of their business at risk.

Perhaps the other thing to say, is that it fairly well established that workers subject to psychological risks such as stress, insecurity or trauma are more likely to make mistakes, including errors that lead to accidents causing physical harm either to themselves or to others.

What exactly do we mean by psychosocial risks, and can you give us some examples?
In ISO 45003, psychosocial risk is defined as the combination of the likelihood of occurrence of exposure to work-related hazard(s) of a psychosocial nature and the severity of injury and ill-health that can be caused by these hazards. So very much a standard definition of risk - but linked specifically to work-related hazards of a psychosocial nature.

So, what are those “work-related hazards of a psychosocial nature”? Well, the standard describes hazards of a psychosocial nature as falling into three categories, namely (i) aspects of work organization, (ii) social factors at work, and (iii) work environment, equipment and hazardous tasks.

• Aspects of work organization include: role ambiguity or conflict; limited input to decision-making; shift work/long or unsociable hours; inflexible or unpredictable hours; working far from home, family, friends; working without social interaction; exposure to traumatic situations; and concerns about job security

• Examples of social factors at work include: poor communication/information sharing; interpersonal conflict, unequal power relationships; harassment, bullying, victimization, workplace violence; abuse or misuse of power, lack of trust, honesty or fairness; failing to listen to/act on complaints and suggestions; inconsistent and/or poor decision-making; workers needing to work in their own time; conflicting demands of work and home; work that impacts the workers’ ability to recover from illness.

• Risks associated with work environment, equipment and hazardous tasks include: inadequate suitability, reliability, maintenance or repair of equipment; lack of necessary tools, equipment or other resources; lack of space, poor lighting, excessive noise; very high or low temperatures; work at height, unstable environments, such as conflict zones.

Some of the factors I’ve mentioned are really only prevalent with certain types of work. For example, exposure to traumatic situations is a significant factor for members of the emergency services, but this would rarely if ever be experienced by workers in some other sectors. Factors more likely to be experienced across a wide variety of sectors and roles include workers needing to work in their own time; conflicting demands of work and home; poor communication/information sharing; lack of trust, honesty or fairness

What are the key messages from the standard about what organizations should be doing to address psychosocial risks?
One of the key messages is that organizations should be applying the same “hierarchy of controls” that they apply throughout the rest of the OH&S management system. By that I mean that they should always start with trying to eliminate the risk, or reduce the likelihood or severity of harm.

In other words, it’s important not to focus all the efforts on rehabilitating people after harm has occurred – although some provision for that is important too. But, certainly don’t start by accepting the current level of risk, and just thinking we need to be able to rehabilitate people who suffer harm, or even think that we just need to make people able to survive or withstand it. Resilience training can have its place, but it’s not the place to start.

So very much like physical safety, where we take steps to eliminate hazards where we can, and where we can’t we reduce risks, but we still prepare for the fact that harm may occur – by providing first aid facilities etc.

Well we should take very much the same blended approach with psychological health – eliminate the hazard where we can, reduce exposure to risk to the extent we can, help minimise the harm done if people are exposed to the risk (that where resilience training fits in, and where mental health first aiders can contribute), and then put in place arrangements to support people of harm does occur, in terms of rehabilitation and return to work support.

Another important message from the standard is to recognise that people are individuals and need to be treated as such. Conditions that don’t cause harm to one individual, may cause harm to another. For example, limited social interaction at work, will more adversely affect some people than others – for some people it really may not be an issue. Some people will be uncomfortable with even a small degree of role ambiguity when taking on a new role, where other people will be far less uncomfortable and be happy to explore the ambiguities as they settle into the role. And people’s personal circumstances differ and therefore may, for example, be quite differently affected by a degree of job insecurity. So it’s important for leaders and managers to remember that psychosocial risks may affect individual team members quite differently, and that their own reactions to these risks may not be a good indicator of now others may react.

If organizations haven’t really tackled these risks before, where should they start?

Most organizations will have dealt reactively to instances of psychological ill-health, but I’m sure there are more which haven’t tackled it proactively.

As with almost any significant initiative, it’s really important that there is visible and active top management support for any initiative to better support workers’ psychological health and wellbeing. That includes providing any necessary resources and personally setting an example. Just one very small example of that - we’ve seen a few instances recently where an organization’s top management have taken action to counter the so-called “always on” culture, namely the expectation has developed that any emails sent out of working hours should be replied to immediately. And personal example from those top managers is key to this - which means they should themselves stop sending messages to people outside working hours.

Another key to success is worker consultation and participation. Organizations should provide opportunities for workers to feedback on psychosocial risks and the effectiveness with which they are being managed. And they should encourage participation and engagement, e.g. in health and safety committees or in smaller organizations directly with workers. That dialogue and involvement provides the opportunity to address any concerns due to the sensitive nature of the impact of psychosocial hazards.

But once we have top management support to proceed, the starting point really is to understand which psychosocial hazards exist in the organization. And that’s where worker input is essential. Employee surveys can be helpful here, providing anonymised feedback. Encouraging and gathering feedback from team discussions can also contribute. Just like physical hazard identification and risk assessment, there needs to be a systematic approach which considers all parts and all activities of the organization, to identify psychological hazards and assess the risks.

And again, just like physical safety, we should review available data to see what that tells us about the occurrence of psychological harm - for example, sickness absence records, potentially complaints by workers or grievance cases, comments made in exit interviews with workers who resign from the organization. And similarly incident investigations – have they identified psychosocial factors as having contributed to incidents and accidents? All of these sources can help indicate where psychological factors are affecting performance.

How can an organization measure its progress in addressing these risks?

Measuring progress usually involves a blend of leading and lagging indicators.

Leading indicators help measure the proactive steps the organization is taking to improve workers’ psychological health and wellbeing,

Lagging indicators looking for the evidence that an actual improvement has taken place.

So our leading indicators might include things like, the progress in assessing psychosocial risks across the organization, progress in the actions arising from those risk assessment, take-up of any support measures we’ve put in place, whether that’s resilience training, or MHFAs in the workplace, or access to any on-line platforms or remote support.

Our lagging indicators would typically include sickness absence due to psychological ill-health, employee feedback on the effectiveness with which psychological health and wellbeing are managed, and maybe data on, and from, incident investigations

And I hope that in this conversation I’ve managed to bring out the strong parallels between the steps needed to manage worker psychological health and wellbeing, and those with which we’re already so familiar for the management of physical health and safety. I believe that seeing those parallels really helps us overcome any unease or trepidation about how to manage psychological health and wellbeing. It isn’t intangible, it isn’t un-measurable. It is something all organizations can deal with, and it's something all organizations need to address.