ASSE: Coping Strategies for Unseen Human Disorders

When an employer conducts an accident investigation, the root cause often boils down to either an ineffective work process, a breakdown in management systems, a workers lack of skills and knowledge or a workers poor attitudes toward safety or some combination of the above. August Spector, Ed.D., senior consultant at Potomac, Md.-based Workplace Learning Systems, suggests adding one more potential root cause to that list: unseen human disorders.

"I feel it's an emerging issue," Spector told a crowd of about 100 safety professionals and stakeholders at the American Society of Safety Engineers' Professional Development Conference and Exposition in Seattle.

Often mistaken for a worker having a bad attitude toward safety or disrespect for the safety culture, unseen human disorders can cause behaviors that lead to unsafe work practices, Spector said.

Types of unseen human disorders that can affect workplace safety include:

  • Physically based disorders Such as trouble with hearing, eyesight, speech or musculoskeletal function;
  • Psychologically/neurologically based disorders Such as attention deficit hyperactivity disorder (ADHD), learning disorders, panic disorders, anxiety disorders, depressive disorders and obsessive compulsive disorder; and
  • Shadow syndromes Milder forms of the serious disorders listed above. For example, a worker might not be clinically depressed but still might experience some low-grade depression after the death of a loved one or some other traumatic event in their personal life. Spector also noted that shadow syndromes often are co-morbid to (have common symptoms with) a particular disorder. For example, according to Spector, research has shown that individuals with ADHD often have shadow syndromes such as learning disorders, oppositional defiant, conduct disorders, depressive disorders and anxiety disorders.

How can any one of these unseen disorders impact the safety and health of your workplace? According to Spector, those with unseen disorders might have trouble focusing on a single work task, concentrating for extended periods of time or screening out distractions. They might not finish a project in a timely manner, might not appear to be listening, might frequently interrupt during conversations or meetings and might act impulsively.

Spector gave a simple example of a how an unseen human disorder could impact workplace safety: A worker finds out that his or her neighbor a good friend has died. The employee comes to work feeling a little down for several days. Because the worker's mind is elsewhere, he or she has trouble concentrating and, consequently, does not follow a critical procedure correctly, causing the worker to suffer an injury.

"People Feel They're Doomed to Failure"

Spector noted that there are some general characteristics that are common to unseen human disorders. According to Spector, those characteristics include:

  • Poor self-image;
  • Feeling of being lost, in a cage, etc.;
  • Feeling of not being appreciated;
  • Uncertainty of the future;
  • Being "mixed up," forgetful, mind on other activities;
  • Tiredness, lack of sleep;
  • Mistake-prone, impulse-prone;
  • Fear, unexplained anxiety; and
  • Possible tantrums and rage.

Of these characteristics, Spector said that low self-esteem is the one that's most pervasive.

"People feel they're doomed to failure," Spector said. "We have to help people with their self-esteem."

Coping Strategies

Spector outlined a number of coping strategies for the challenges typically presented by unseen human disorders.

He discussed strategies for dealing with:

Low self-esteem Instill meaningful hope by pointing out the employee's strengths and communicating a belief that success is possible. Periodically provide the employee with meaningful praise and recognition during work activities. Quickly recognize accomplishment of short-term goals, especially safety goals. (It can be as simple as telling the worker, "I think you completed that assignment very well and in a very safe manner. Keep up the great work.")

Depressive disorders These disorders make people feel exhausted, worthless, helpless and hopeless. Spector recommends that safety professionals and supervisors:

  • Help the employee set realistic goals and help him or her assume a reasonable amount of responsibility to achieve these goals.
  • Break large tasks into small ones, set some priorities and provide positive feedback as the employee completes tasks.
  • Offer emotional support. This involves understanding, patience, affection, encouragement and attentive listening.
  • Encourage the employee to participate in activities with other crew members that might make him or her feel increased self-worth.
  • Do not accuse the depressed person of faking illness or of laziness or expect him or her to "snap out of it." Eventually, with help and understanding, most people get better.
  • Rather than asking the crew members to make immediate important decisions, postpone (if possible) such decision-making until the period of depression has been reduced. For example, before assigning the employee to a significant job transition, discuss it with him or her, demonstrating positive results to the change process.

Organization, procrastination and time management For workers with some unseen human disorders, managing time and organizing work activities can be difficult. For others, procrastination is a real problem. In these cases, Spector recommends that safety professionals and supervisors:

  • Provide structure in the work cycle and environment.
  • Break large tasks into short-term, doable activities.
  • Create reasonable timeframes/deadlines to complete a project.
  • Provide small rewards upon completion of key tasks to encourage task closure and improve self-esteem.
  • Use an understanding buddy or coach to help the employee stay on track.
  • Utilize the variety of low- and high-tech aids that can help employees stay organized and manage their time. Aids can be as simple as spiral-bound notebooks, post-it notes, safety tags, alarm wristwatches or hand-held tape recorders.

Social behavior and interpersonal conflict Temper and mood swings due in part to interruptions, intrusion upon another's space, forgetfulness, inattentiveness, hyperactivity and heightened levels of anxiety frequently can lead to major social problems at work, contributing to non-conformance with safety practices. Spector recommends that safety professionals and supervisors:

  • Provide immediate feedback for safe behavior.
  • Reduce too many high-pressure, short-term tasks.
  • Be open to and accept apologies for outbursts and poor behavior.
  • Before a boiling point is reached, temporarily remove the person from the frustrating situation, or vice versa.
  • Do not assume everyone knows what's going around the work site via the employee "grapevine."
  • Encourage teaming up with an emphatic co-worker who can coach/help.
  • Include all employees in information meetings, celebrations and events.
  • Recognize individual uniquenesses, especially positive ones.

Social behavior and interpersonal conflict Temper and mood swings due in part to interruptions, intrusion upon another's space, forgetfulness, inattentiveness, hyperactivity and heightened levels of anxiety frequently can lead to major social problems at work, contributing to non-conformance with safety practices. Spector recommends that safety professionals and supervisors:

  • Provide immediate feedback for safe behavior.
  • Reduce too many high-pressure, short-term tasks.
  • Be open to and accept apologies for outbursts and poor behavior.
  • Before a boiling point is reached, temporarily remove the person from the frustrating situation, or vice versa.
  • Do not assume everyone knows what's going around the work site via the employee "grapevine."
  • Encourage teaming up with an emphatic co-worker who can coach/help.
  • Include all employees in information meetings, celebrations and events.
  • Recognize individual uniquenesses, especially positive ones.

Distractibility, attention span, impulsivity and hyperactivity

  • Provide less distraction in the workplace structure/environment.
  • Break work tasks into smaller blocks of time or work flow.
  • Do not assume the employee has learned or retained verbal information. Provide easily understandable notes; use a variety of teaching approaches at safety meetings; use non-verbal signals (for example, eye contact or hand movements) to help control inappropriate behavior without calling attention to the individual; and utilize a support feedback loop.
  • Encourage inexpensive, easily used adaptive devices.
  • Provide period work breaks and work variety.

A "Delicate" Area

Spector, in an interview with Occupationalhazards.com, cautioned that his strategies are geared more for individuals with mild cases of physical and neurological disorders not necessarily those who have been clinically diagnosed.

He said that he specifically uses the term "disorder" to differentiate it from the term "disability" and the provisions of the Americans with Disabilities Act, because when a worker has a disability or condition that fits the definition of ADA, it becomes a more "delicate" situation. In other words, under ADA, a worker with a disability who believes he or she has been the object of discrimination perhaps because he or she was passed over for a promotion or re-assigned to a different department then the company could be facing legal action.

Spector's advice: "Know the law and your employees."

"And be knowledgeable of some of the coping techniques that are available," Spector added.

When faced with a worker who might have a human disorder, when should a safety professional move beyond coping strategies and refer the worker to employee assistance program counseling or to occupational health staff?

Spector answered that safety professionals should refer the employee to expert help when the employee's symptoms are "systemic" and consistent not occasional and when the employee's problems are "beyond your capacity" to handle. In those cases, a sit-down with the employee might be necessary to determine what's going on in the employee's life and how the company can help.

"You Have to Take a More In-Depth Look"

Spector's presentation hit home for safety professional Jack Schwab of General Mills in New Albany, Ind., where Schwab admitted that he has had to handle a number of "non-typical issues."

For example, when he dug deeper into an accident in which a worker lost four fingers, it was discovered that the worker was dealing with a serious illness in the family as well as several other high-stress personal issues.

"That was a major contributing factor" to the accident," Schwab said.

Such discoveries have brought Schwab to the conclusion that there are "a lot more issues" to the root causes of accidents than meet the eye.

"I've found a lot of times you have to take a more in-depth look," Schwab said. "It might not just be the physical hazards."

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