It is impossible to understand the full impact of the last 30 years of changes in human service delivery without understanding the impact of acute and chronic stress on workers at every level of the system. In this chapter, we review what we know so far about the magnitude of stress impacting daily existence with a specific focus on workplace stressors. The issue of workplace stress is a public health problem of enormous proportion, not dissimilar to what existed 200 years ago before we understood that microbes cause disease—only now the infectious agent is violence in all of its forms.
The National Institute for Occupational Safety and Health (NIOSH) defines job stress as the “harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker”(p.6) . Workplace stress is created by uncertainty along with a lack of control over important factors at work . The job demands for human service workers are significant, particularly when there is a mismatch between the work that is often difficult and uncertain, and the individual’s resources. Exposure to childhood adversity and to other traumatic experience complicates and compounds normal workplace stress and workplace stress itself can become toxic.
The ways in which individuals respond to workplace stress is multi-determined by sources specific to the individual, the job, and the organization . There are many indicators of individual stress including: an increase in unexplained absences or sick leave, poor performance, poor time-keeping, increased consumption of alcohol, tobacco or caffeine, frequent headaches or backaches, withdrawal from social contact, poor judgment/indecisiveness, technical errors, constant tiredness or low energy, and unusual displays of emotion .
A large body of research has accumulated about the impact of stress on the individual. In general, it has been found that too much stress is bad for our psychological well-being , hurts our bodies , and our mental health , decreases job commitment , increases a sense of threat and anxiety at work , lowers non-work satisfaction  and reduces job involvement . Workplace stress contributes to a threefold risk for heart and cardiovascular problems while stressed employees are two to three times more likely to suffer from anxiety, back pain, substance abuse, injuries, infections, cancers, and obesity . A recent study found that 54 percent of workers leave work feeling fatigued and at least 10% percent of workers are too tired to even enjoy their leisure time. The result is that one out of five workers is at risk for stress-related health problems – and all of this research was performed before the economic downturn of 2008.
And let’s look more closely at that issue of substance abuse. Alcoholism alone causes 500 million lost work days annually. Absenteeism among alcoholics or problem drinkers is 4 to 8 times greater than for non-alcoholics and up to 16 times greater among all employees with alcohol and other drug-related problems. Family members of alcoholics and substance users use ten times as much sick leave and have higher than average health care claims than family members of non-alcoholic and other substance-using families .
According to NIOSH job stress has become a common and costly problem in the American workplace, leaving few workers untouched while 40% of workers report that their jobs are very or extremely stressful. In fact, one-fourth of employees view their jobs as the number one stressor in their lives; three-fourths of employees believe the worker has more on-the-job stress than a generation ago. Problems at work are more strongly associated with health complaints than are any other life stressor, more so than even financial problems or family problems .
As for the cost of workplace stress, one authority has estimated that 60-90% of medical problems are associated with stress and one large insurance company estimates that 45% of corporate after tax profits are spent on health benefits . But that only reflects a portion of the actual cost. A true analysis must include absenteeism, job turnover, replacement cost for employees who leave the job, accidents, workplace injuries (and in the worst cases, death), the long-term health and social consequences of tobacco, alcohol and drugs as well as the costs of quality control, administration, and customer service problems related to stress. The American Institute of Stress claims that chronic stress actually adds over $300 billion each year to cover associated health care costs and absentee rates. That represents a cost of over $600 to every “stressed” worker – an investment of dollars that gives no return on investment. Meanwhile, the cost for health insurance of a single employee doubled over the last few years and is still rising .
Excerpt from Bloom, S. L. and Farragher, B. (2010) Destroying Sanctuary: The Crisis in Human Service Delivery Systems. New York: Oxford University Press.
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