Presentation T P30

T P30 (Poster Presentation):
Informalized respite in worker mental health

Presented by: Cindy Malachowski

Authors

Malachowski C1, Sawchuk P2,3, Boydell K4,5,6, Kirsh B1,5,7

  1. Graduate Department of Rehabilitation Science, University of Toronto, Ontario
  2. Leadership, Higher and Adult Education, Ontario Institute for Studies in Education, University of Toronto, Ontario
  3. Centre for Industrial Relations and Human Resources, University of Toronto, Ontario
  4. Health Systems Resource Group, The Hospital for Sick Children, Toronto, Ontario
  5. Department of Psychiatry, University of Toronto, Toronto, Ontario
  6. Dalla Lana School of Public Health, University of Toronto, Ontario
  7. Department of Occupational Science and Occupational Therapy, University of Toronto, Ontario, Canada

Abstract

Background

As a result of the growing awareness of the relationship between employment and mental health problems, the workplace has become a site for mental health promotion, illness prevention and intervention. A key concern in intervention attempts has been effective access to, and use of available supports for those experiencing mental health problems. It is within this context that many questions arise: How does an employee navigate support systems in the workplace? What types of challenges emerge for workers experiencing a mental disability? In essence, what social relations and institutional practices contribute to the workplace experience of people living with mental disability? To explore these questions, our research takes up an ontological shift from traditional qualitative and quantitative research in order to investigate social relations in which the workplace is situated. In order to do this, we employ Smith’s (1997, 2004, 2005) institutional ethnography to understand how the experience of the employee with mental health problems is shaped and coordinated within the workplace setting. Institutional ethnography starts in the everyday lives of people, and explores the forms of organization and relations that produce their experiences. Making these coordinating relations visible provides opportunity to investigate them, and describe analytically how they operate.

Methods

This study reports on data that was collected from an institutional ethnographic study conducted in a large industrial manufacturing facility in Ontario between Sept/2012-Oct/2013. The primary author engaged in over 140 hours of ethnographic observations, and 17 interviews with various informants. Data were analyzed with the aim of locating and describing how people coordinated their work across settings and time. First, we read and re-read transcripts from interviews with employees working with mental health problems in order to identify common work activities. This analysis elucidated several institutional coordinating practices, policies and procedures; we were able to trace a sequence of socially coordinated activity, which was mediated by the employees’ engagement with texts. We then used a mapping process to trace how various informants, such as managers, healthcare staff, and physicians, were drawn into the coordination of work practices that support employees experiencing mental health problems. Mapping involves situating a text back into the action and activities in which it was produced, circulated, and read. It is a process that allowed us to identify how texts enter into, and consequently coordinates sequences of action, thus identifying determinants of life conditions.

Results

We uncover how workers with mental health problems come to know their illness in two different ways: from an experiential and a ruling perspective. In order to navigate these two ways of knowing, workers would engage in informalized respite from work; and those workers experiencing a greater disjuncture between these two ways of knowing were less likely to engage in accessing or coordinating formalized services and supports.

Conclusions

Workplace supports need to be positioned to either reduce, or address the disjuncture between the worker’s experience of mental health problems from an experiential perspective (feeling too unwell to work) versus a ruling perspective (the textual practices that coordinate ‘sick time’). Dominant discourses tend to construct depression as a standing illness state, around which a series of coordinations revolve. The informant accounts shed light on the work processes required to effectively manage exacerbations in their condition. The concept of ‘hiding’ was indexed in numerous ways, including ‘hiding’ the expression of emotions, physically ‘hiding’ from coworkers, and ‘hiding’ the need for respite. Indeed, this concept of ‘hiding’ was shaped and coordinated by various texts that hooked the worker into broader organizing relations such as the collective agreement, formal job descriptions, and work reporting duties/requirements. Therefore, as some job types afford greater freedom to cope with unpredictable states that require immediate (typically informalized) respite, this autonomy often sets the stage for a more resilient and ongoing pattern of coping.With this in mind, we argue for increased attention toward the active accomplishment of institutional coordination of periodic unwellness at work as an under-appreciated starting point for organizational change.

Schedule Details

Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Mental disorders