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Workplace bullying and harassment harms health

    Workplace bullying and harassment (WBH) is bad for people’s health, and this negative health impact can manifest in a variety of ways and be long-lasting.

    Over a decade ago the UK government initiated the Fair Treatment at Work survey, aiming to ‘place the issue of bullying at work on employers’ agendas’, yet there has been no major initiative since.

    Using data from the 2014 Adult Psychiatric Morbidity Survey, VISION researchers Annie Bunce, Ladan Hashemi and Sally McManus, along with Carrie Myers and Charlotte Clark from City St George’s, University of London and Stephen Stansfeld from Queen Mary, University of London, examined the prevalence and nature of WBH among workers in England, and associations with mental health.

    A clear picture of the severity of the problem of WBH in England is painted by four key findings.

    1. One in ten people in paid work reported having experienced WBH in the past year. This is likely to be an underestimate due to underreporting for various reasons;
    2. Those who reported bullying were more likely to be in a financially disadvantaged position;
    3. Over half of people who reported having been bullied at work identified the perpetrator as a line manager; and
    4. Clinically diagnosed common mental disorder was more than twice as likely in employees with experience of WBH compared with those without, and those exposed to WBH were also twice as likely as others in paid work to screen positive for PTSD.

    Taken together these findings demonstrate that WBH is common in UK workplaces, it may be driven and exacerbated by issues of inequality, power and hierarchical organisational structures, and it is associated with depressive and anxiety disorders severe enough to warrant health service intervention and treatment.

    This power dynamic should not be forgotten when addressing issues in the workplace, but the complexity of workplace environments creates challenges for identifying, understanding and addressing bullying. Reports of WBH can coincide with performance concerns from managers, and, whilst behaviours intended as legitimate performance management activities might be misinterpreted as bullying by the employee, it is also possible that HR practitioners attribute managerial bullying behaviours to legitimate performance management practice to exonerate mangers and protect the organisation.

    This links to a recently published piece for The Conversation by Sally McManus and Kat Ford (Bangor University), which sets out how companies can influence and perpetuate violence in society, including via employment practices that conceal the extent of bullying, sexual harassment and other forms of workplace violence (for further information see Six ways companies fuel violence (theconversation.com).

    Also, structural issues in the workplace can create pressure for managers which they then take out on those they manage, managers can be victims of WBH themselves, and organisational culture may perpetuate WBH.

    Given such complex power dynamics, it is recommended that organisations involve employees at all levels in the development of policies, and collaboratively review the implementation and performance of policies regularly to ensure they are working for the people they are intended to protect. Rather than prescribed ‘tick box’ policies and responses, creative methods incorporating employees’ perspectives may more likely lead to meaningful change.

    Crucially, managers and HRs might not be the most approachable people for victims of WBH. For example, other VISION research has found this to be the case for victims of intimate partner violence and abuse (see VISION Policy Series: The impact of intimate partner violence on job loss and time off work in the UK – City Vision).  Therefore, alternative sources of support need to be available within organisations, such as unions and counselling services.

    For further information please see the full paper available at: Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey | BMC Public Health (springer.com)

    Or please contact Dr Annie Bunce at annie.bunce@city.ac.uk

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    Dr Annie Bunce receives award at Lancet Public Health Science conference

      Dr Annie Bunce

      Dr Annie Bunce, VISION Research Fellow, was awarded Best Oral Presentation at the Lancet Public Health Science conference in London this November. She presented on the Prevalence, nature and associations of workplace bullying and harassment with mental health conditions in England: a cross-sectional probability sample survey.

      Annie’s research, conducted with VISION colleagues Ladan Hashemi, Sally McManus, and others, presents the first nationally representative findings on the prevalence of workplace bullying and harassment in England for over a decade. Annie analysed data from the 2014 Adult Psychiatric Morbidity Survey (APMS) to demonstrate: the prevalence of workplace bullying and harassment (WBH) in the working population in England; the nature of WBH experienced, who it was perpetrated by and the types of behaviour it involved; and associations between the experience of WBH and indicators of adverse mental health.

      The study is unique in that the APMS makes robust assessments of mental health – operationalising diagnostic criteria – which provides an accurate assessment of clinical need. Implications for employers, policymakers, health services and researchers are outlined.

      For the article, please see: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02066-4/fulltext

      Please contact Annie at annie.bunce@city.ac.uk for further information.

      Photo by Icons8 Team on Unsplash

      Causal discovery for studying sexual abuse and psychotic phenomena

         Dr Giusi Moffa

        Sexual abuse and bullying are associated with poor mental health in adulthood. Elucidating putative causal relationships between affective and psychotic symptoms may inform the development of therapies. Causal diagrams can help gain insights, but how?

        Given a causal diagram, usually represented as a directed acyclic graph (DAG), and observational data from the variables on the graphs, many analytical methods (especially adjustment techniques) allow us to estimate the effect that intervening on a variable is expected to have on another.

        In real-world problems, we rarely have a complete picture of an underlying structural mechanism regulating the relationship among different variables. Causal discovery is a technique leveraging statistics and machine learning tools to uncover plausible causal relationships from data, with little to no prior knowledge of them. While learning causal structures from purely observational data relies on unrealistic assumptions (especially causal sufficiency and faithfulness), a causal discovery exercise may help us identify the most promising scenarios to prioritise when designing interventional studies.

        In a recent article, now available open access in Psychological Medicine, Dr Giusi Moffa, Statistician affiliated with the University of Basel, Switzerland and colleagues used state-of-the-art sampling methods for inference of directed acyclic graphs (DAGs) on data from the English Adult Psychiatric Morbidity Surveys, to investigate sexual abuse and psychotic phenomena.

        The analysis sought to model the interplay among 20 variables, including being a victim of bullying or sexual abuse and a range of psychotic (e.g. paranoia, hallucinations and depression) and affective symptoms (e.g. worry and mood instability) while accounting for the sex of the participant. To respect temporality, we imposed some prior constraints on the DAG structure: childhood sexual abuse and bullying referred to events that were temporally antecedent to the assessment of the psychological variables, and hence they only admit incoming edges from sex and each other.

        Contrary to expectations, the procedure favoured models placing paranoia early in the cascade of relationships, close to the abuse variables and generally upstream of affective symptoms. A possible implication is that paranoia follows from early abuse involving bullying or sexual exploitation as a direct consequence. Overall, the results were consistent with sexual abuse and bullying driving a range of affective symptoms via worry. As such, worry may be a salient target for intervention in psychosis.

        Check out the paper for a more thorough discussion of the findings (joint work with Jack Kuipers, Elizabeth Kuipers, Paul Bebbington and VISION member Sally McManus).

        This is a repost of a blog available on LinkedIn: https://www.linkedin.com/pulse/causal-discovery-studying-sexual-abuse-psychotic-phenomena-moffa

        Paper available open access: https://www.cambridge.org/core/journals/psychological-medicine/article/sexual-abuse-and-psychotic-phenomena-a-directed-acyclic-graph-analysis-of-affective-symptoms-using-english-national-psychiatric-survey-data-erratum/CF603075EBBD5D75E60F327CE01C4050

        For further information about the approach: giusi.moffa@unibas.ch