Shifting the Dial on the regulation of mental health at work

I'm Janene Hillhouse, and today I'm joined by Yasmin Cox. We're both executive directors with different regulatory roles for injury prevention and management in the Office of Industrial relations. Before we start, we'd like to acknowledge the traditional custodians on the many lands in which we meet today and pay our respects to their elders past, present, and emerging. We'd like to extend that respect to Aboriginal and Torres Strait Island peoples here with us today. We are here because today more than ever before, we are aware of the importance of our, our families, and our community's mental health. One in two of us will experience a mental health condition in our lifetime. One in five of us will experience a mental health condition in any year, and work related stress is estimated to effect around a third of us. And we are here because as employers, regulators, and leaders, we are being called to shift the dial and to explore and share new ways to promote, prevent, intervene early, and support recovery of workers with mental injuries.

In this session, we will tell you a little bit about us and why it is so important that we are shifting the dial for mental health. We will explore two ways that we are shifting the dial. The first is by putting people at the heart of the work that we do, and the second is through making the real and inherent connection between our regulatory functions for work, health and safety and workers' compensation. We will show you how it has impacted the ways that we prevent and support workers with mental injuries, and we will challenge you to think about what you can do as leaders in your workplace or in the delivery of your services to apply what we have learned to make a real difference in your work.

Who are we? The Office of Industrial Relations. We are a diverse but connected group in the Queensland government that regulate and provide government services across the work continuum. We deliver a range of policy, advisory, compliance, dispute resolution and specialist technical services and initiatives across work, health and safety, electrical safety, industrial relations, and workers' compensation. My role is in Work Health and Safety Queensland, our work health and safety regulator. And I'm responsible for looking after our specialized health and safety services, including our team of experts in all things mental health. Janene's role, my colleague is in workers' compensation regulatory services and looks after the scheme, strategic legislative policy as well as the workers' compensation, dispute resolution, compliance, licensing, prosecution, and engagement functions. While we take on many different roles and responsibilities, the connection we have across our organization comes from a shared vision and purpose for Queenslanders.

At the heart of our work, our why is that Queensland workers, industry and communities are healthy, safe, fair, and productive. And when it comes to mental health, we are all being called to take action to make a real difference to Queenslander's working lives and health. As regulators, national reviews and surveys have asked us the following questions, Are we doing enough to educate on psychological injury and illness, identification and prevention? And when a worker is injured, do worker's compensation schemes support workers with mental injuries recovery or do they make them worse? And we have taken answering these questions very seriously. In answering these questions, we started with understanding our why and we looked at the research to start applying the how. The research told us, taking a person-centered approach would have the most impact and help us understand a workers' and a workplace's unique risk factors and circumstances that lead to injury and how the design of work or the work environment may be controlled to prevent the risk of future psychological injury, illness, and lessen the human impact of an injury of a worker's and their family's life, as well as the many costs of an injury.

When we looked at our why and put people in the center, we realized across our different roles that we're all grappling with the same challenges. We are impacting the same people at different and sometimes the same points. And not only do we share a why, we have similar purposes in the context of responding to emerging and re-emerging injuries and heightened regulations and massive disruption. We are both focused on systems connecting together behavior and holistic management culture. A traditional siloed approach hasn't always resulted in the best outcomes, and we know that we can combine our forces to greater effect. This led us to build on the learnings from successful initiatives, work health and safety and worker's compensation, working in partnerships, including initiatives for managing dust diseases, and taking a person-centered integrated systems approach. Working with and building upon the primary secondary tertiary prevention model, the how we are shifting the dial. This comprehensive integrated approach will incorporate and does incorporate four elements, promote, prevent, intervene early, and support recovery.

So what does person-centered mean? Being person-centered means people's values, their beliefs, circumstances and needs are used to guide how their experience, their services and supports are designed. It is also about enabling people to participate meaningfully in the decisions that impact them. So how do you do it? In the simplest of terms, you are curious. You listen and you engage. You find out what a person really cares about, what motivates them, and what you discover sits at the heart of your response. As regulators this means that when we are developing a new policy, a code or fact sheet or tools, the people who are impacted are around the table when we're making decisions. This means we engage with workers, employers, pcbs insurers, lawyers, and medical and allied health providers, and it means that we listen to every point of view. Sometimes it also means that we dive even deeper and map a worker's journey through the claims process from pre-injury to post-injury to understand what it felt like and meant to them and their family. Now the outcomes can be confronting because you don't always hear what you want to hear. I know that when we used journey mapping to look at how we could make a real difference to the experience of first responders who had trauma related injuries, it was hard because sadly, it told us a story of fear, a sense of isolation and disconnection, attack, shame and uncertainty. And when we really listened, it pointed us into the right direction for what we needed to do next to support their experience at a systemic level.

We have designed and delivered a number of initiatives and as an outcome of understanding the worker's journey and unique perspective, these include from a work health and safety perspective our upcoming new code of practice on managing the risk of psychosocial hazards at work. The purpose of this code is to provide practical guidance for duty holders about their existing obligations to eliminate or minimize risks to psychological health and safety. Under the Work Health and Safety Act 2011, it will provide practical guidance on how to achieve minimum safety standards. It does this through providing clear, accessible and useful information. For PCBU's and other duty holders about psychosocial hazards. The code does not create a new work, health, safety duty, or expand existing duties. We've designed hazard specific guidance such as prevention and managing risks to work related psychological health, preventing and managing fatigue related risks in the workplace, prevention and management of work related and aggression in health services, work related violence and aggression in residential age, disability, and youth care, and a guide to working safely in people's homes.

In 2020, OIR as the lead agency across Australia, launched the People at Work Digital platform to help those organizations with more than 20 staff with undertaking a psychosocial risk assessment. People at Work is more than just a survey. There are a suite of resources that will assist businesses in not only running the survey, but also in breaking down the results and understanding their particular issues. Based on the survey, it is one of Australia's only validated and evidence based psychosocial risk assessment survey tool with benchmarking a five step process to identify, assess, and control risks to psychological health. At work, it's suitable for businesses with more than 20 workers and based on current data, there has been over 25,000 total respondents. To date, Queensland represents 24% of the total proportion of survey respondents across the country. Public administration and safety, healthcare and social assistance, education and training have the highest number of responses across industry. This integrated approach has required us to also tackle this from the workplace level. With mentally healthy workplaces workshops for managers and supervisors, mentally healthy workplaces toolkit, and the People at work tool through to scheme wide initiatives that focus on early intervention and supporting a worker's recovery. This toolkit provides all the current guidance and information in one place and is available as a free online resource on work safe.qld.gov.au. Centralizes existing and new resources, easy to use and adopt, includes tips for small businesses who may have different challenges than those larger corporations.

The mentally healthy workplaces workshops, managers and supervisors promotes the integrated approach and comprises of two modules. Module one, psychological health and safety, and module two, Early Intervention and Supporting Recovery. We started workshops to support the toolkit from 2017, and these workshops are being offered by OIR to all industry sectors to provide an opportunity for different industries to connect in and learn from each other, something that has been identified as a vital component to success of these workshops. The feedback that we receive from these workshops is overwhelmingly and incredibly positive. Organizations also have a responsibility to ensure their workers feel supported and are able to return to work. We have been working to ensure that these tools are available to make their role a little bit easier, including risk assessment templates, investigation

Tools, workers surveys, and checks, just to name a few. From a workers' compensation perspective, a person-centered approach has led to us taking a different approach across three different areas. First, it has led to scheme design changes that reduce stigma and improve early intervention, including presumptive legislation for first responders with post-traumatic stress disorder and providing earliest possible access to treatment and support for workers. This means the scheme will support you getting the treatment that you need while your claim is being decided. And it means that if you're a police officer, child support officer, ambulance officer, corrections officer, or firefighter, whose role it is to protect us. And in doing that, you are diagnosed with ptsd. It is presumed that your PTSD will be work related when you make a claim. Recently I was in Townsville and I was talking to an ex ambulance officer, and I was reminded of the power of this change and of listening.

It was with tears in their eyes that they expressed thanks for this amendment and for making their experience, taking their experiences seriously for what they described as saving lives. Secondly, it has led us to introducing a service that is a little unusual in a worker's compensation scheme because it has one focus, which is providing workers with free, confidential, and independent support. Our Worker's psychological support service has supported more than 2000 workers since it was introduced, and it was through that service that a worker whose psychological injuries had flowed over into physical injuries impacting on their heart, was able to connect with a number of support options, including a counselor from their hospital bed. Finally, it has led us to taking responsibility for our part of the scheme, which means prioritizing investing in our own people to make sure that they understand how to support workers who have a complaint or a dispute, as well as prioritizing our own staff's wellbeing because mental injuries are hard for everyone involved.

As we step forward, our focus remains on being curious, listening, engaging, and responding. We're listening to the environment around us, the trends we are seeing, and most importantly taught the people who sit at the heart of our work are telling us. So the next steps for us looks like finalizing and supporting the implementation of the code of practice and accompanying regulations that enhance duty holders understanding of their obligations to manage the risks to psychological health. Under the Work Health and Safety Act, continued promotion of people at work, mentally healthy workplaces, workshops, mental health work events. We're finalizing the review of the Work Health and Safety Act in early 2023 and commencing the five year review of the workers' compensation scheme in 2023. We're also developing a proposed code of practice for the management of psychological injury claims in the workers' compensation scheme. Internally, we are continuing to engage with our people to understand what support they need to perform their roles and be the best versions of themselves. And we're identifying opportunities for efficiency, for the benefit of our staff, as well as scheme stakeholders

To make a real difference in the mental health of Queenslanders. At Work, we know we cannot do it by ourselves. You as leaders, employers, insurers, or service providers play a key role, and we challenge you to look at how you can take action and look for new ways and take a person-centered approach. Take a big picture view and ask yourself the following, Do you understand your role and what difference can you make? Are you looking at approaching old problems in new ways? How can you be person-centered? Do you engage with your workforce and individual staff to understand what they need? Do you know where your people are at and what they need to be to be the best version of themselves? Do you engage outside and within your organization? Have you reached out to explore what resources are available to help? Are you working with your insurer, WorkCover Queensland, to support rehabilitation and return to work?

Here's what you can do. Take an integrated approach in your workplace to raise your safety and return to work systems maturity, understand, review, share, and visit. Firstly, understand your role and obligations for promotion, prevention, early intervention, and supporting recovery. Second, review your existing safety and in injury management systems and consider using people at work to gain a snapshot of current psychosocial hazards. Thirdly, consult with your workers to understand their experience, your workplace and design system level solutions. Fourth, share information on goddess materials that relate to specific psychosocial hazards such as work-related violence and aggression, and the mentally healthy workplaces toolkit and how workers can be supported. And last but not least, visit work save dot q ld.gov.au.

We're being called to shift the dial and to explore and share new ways to promote, prevent, intervene early, and recover for mental injuries for ourselves, for our families, and for our community.

How can you help us shift the dial, help your workplace, help your work colleagues, help your community and your families? We need to be doing something differently, so let's do it together. Work safe, home safe.