The National Mental Health Commission’s National Report on Mental Health and Suicide Prevention.
This report provides a high‑level summary of the reform journey in Australia’s mental health and suicide prevention systems since the National Mental Health Commission (the Commission) presented Contributing Lives, Thriving Communities – Report of the National Review of Mental Health Programmes and Services2 (the Review) to the Australian Government at the end of 2014.
Since the delivery of that report, Australia has been undergoing significant changes to services, programs and policies in mental health and suicide prevention, as well as in primary health care, disability, housing and social services. These changes have not only been at the national level, but also at the jurisdictional and local levels, through state and territory governments and many local initiatives. Acknowledging the considerable work being undertaken at all levels, this report focuses on the initiatives being announced and progressed at the national level.
Part 1 outlines the key recommendations of the Review, the Australian Government’s response, areas of subsequent progress and where further work is
Part 2 provides more detail about some of the issues in monitoring and reporting mental health and suicide prevention, and the Commission’s ongoing role and plans for further work in this area throughout 2017. This is supported by a snapshot of currently available data for selected indicators of mental health consumer and carer outcomes in Appendix A.
Part 3 sets out where our work the Commission be taking us during the implementation stage of the reforms.
This report is also supported by a compilation of personal stories and case studies from mental health consumers, carers and service providers.
Republished under Creative Commons www.mentalhealthcommission.gov.au
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Why we need a new science of safety
It is often said that our approach to health and safety has gone mad. But the truth is that it needs to go scientific. Managing risk is ultimately linked to questions of engineering and economics. Can something be made safer? How much will that safety cost? Is it worth that cost?
Decisions under uncertainty can be explained using utility, a concept introduced by Swiss mathematician Daniel Bernoulli 300 years ago, to measure the amount of reward received by an individual. But the element of risk will still be there. And where there is risk, there is risk aversion.
Risk aversion itself is a complex phenomenon, as illustrated by psychologist John W. Atkinson’s 1950s experiment, in which five-year-old children played a game of throwing wooden hoops around pegs, with rewards based on successful throws and the varying distances the children chose to stand from the pegs.
The risk-confident stood a challenging but realistic distance away, but the risk averse children fell into two camps. Either they stood so close to the peg that success was almost guaranteed or, more perplexingly, positioned themselves so far away that failure was almost certain. Thus some risk averse children were choosing to increase, not decrease, their chance of failure.
So clearly high aversion to risk can induce some strange effects. These might be unsafe in the real world, as testified by author Robert Kelsey, who said that during his time as a City trader, “bad fear” in the financial world led to either “paralysis… or nonsensical leaps”. Utility theory predicts a similar effect, akin to panic, in a large organisation if the decision maker’s aversion to risk gets too high. At some point it is not possible to distinguish the benefits of implementing a protection system from those of doing nothing at all.
So when it comes to human lives, how much money should we spend on making them safe? Some people prefer not to think about the question, but those responsible for industrial safety or health services do not have that luxury. They have to ask themselves the question: what benefit is conferred when a safety measure “saves” a person’s life?
The answer is that the saved person is simply left to pursue their life as normal, so the actual benefit is the restoration of that person’s future existence. Since we cannot know how long any particular person is going to live, we do the next best thing and use measured historical averages, as published annually by the Office of National Statistics. The gain in life expectancy that the safety measure brings about can be weighed against the cost of that safety measure using the Judgement value, which mediates the balance using risk-aversion.
The Judgement (J) value is the ratio of the actual expenditure to the maximum reasonable expenditure. A J-value of two suggests that twice as much is being spent as is reasonably justified, while a J-value of 0.5 implies that safety spend could be doubled and still be acceptable. It is a ratio that throws some past safety decisions into sharp relief.
For example, a few years ago energy firm BNFL authorised a nuclear clean-up plant with a J-value of over 100, while at roughly the same time the medical quango NICE was asked to review the economic case for three breast cancer drugs found to have J-values of less than 0.05.
Risky business. Shutterstock
The Government of the time seemed happy to sanction spending on a plant that might just prevent a cancer, but wanted to think long and hard about helping many women actually suffering from the disease. A new and objective science of safety is clearly needed to provide the level playing field that has so far proved elusive.
Putting a price on life
Current safety methods are based on the “value of a prevented fatality” or VPF. It is the maximum amount of money considered reasonable to pay for a safety measure that will reduce by one the expected number of preventable premature deaths in a large population. In 2010, that value was calculated at £1.65m.
This figure simplistically applies equally to a 20-year-old and a 90-year-old, and is in widespread use in the road, rail, nuclear and chemical industries. Some (myself included) argue that the method used to reach this figure is fundamentally flawed.
In the modern industrial world, however, we are all exposed to dangers at work and at home, on the move and at rest. We need to feel safe, and this comes at a cost. The problems and confusions associated with current methods reinforce the urgent need to develop a new science of safety. Not to do so would be too much of a risk.
Philip Thomas, Professor of Risk Management, University of Bristol
This article was originally published on The Conversation. Read the original article.
WorkLife: Why is work making us sick? (Audio)
Worker compensation claims have been decreasing over time but this masks all kinds of problems with our wellbeing at work.
Making our workplaces healthier and safer means we have to confront all those things causing us stress at work. And that’s not going to be solved by standing desks, complimentary massage or lunchtime yoga.
LISTEN NOW > to the ABC RadioNational podcast of ‘WorkLife: Why is work making us sick?”
These are the characteristics of people most likely to cut corners at work
Peter O’Connor, Queensland University of Technology and Peter Karl Jonason, Western Sydney University
In a newly published study, we found that employees who “cut corners” tend to be morally compromised, low in conscientiousness, self-focused and impulsive. This in addition to the potential for corner-cutting to increase risks.
Surveying more than 1,000 Australians and Americans, we found approximately one in four employees regularly cut corners. Men are slightly more likely to cut corners than women.
Cutting corners at work
Cutting corners is a workplace behaviour characterised by skipping or avoiding steps important to a task, in order to complete the task sooner. Corner-cutting is generally considered an undesirable behaviour, with research linking it to a range of negative outcomes such as low job performance, safety violations and serious injuries.
Although corner-cutting comes with a set of risks, it also comes with a clear possible benefit – cutting corners can possibly lead to greater productivity. Consistent with this, studies have shown that corner-cutting is more likely in jobs characterised by high demands and few resources. It is also more likely in organisations that prioritise efficiency over risks.
However, even in such organisations, corner-cutting is openly discouraged. Mistakes caused by employees cutting corners are typically met with harsh consequences.
To investigate whether corner-cutters can be identified, we surveyed employees from a range of industries including health care, education, hospitality, retail and construction. We looked at several demographic variables and personality traits to determine who is more or less likely to cut corners at work. We focused on both common personality traits (e.g., extraversion, conscientiousness) as well as “darker” personality traits (e.g., Machiavellianism, narcissism).
We didn’t just stop at a questionnaire. We also exposed employees to a hypothetical scenario where they could choose to cut corners or not. We conducted two variations of the study across Australia and the US.
The personality traits of corner-cutters
Across both studies, we found that both common and darker personality traits were associated with corner-cutting. Most significantly, corner-cutters were likely to be low in conscientiousness, low in honesty and high in psychopathy (i.e., impulsive, callous social attitudes). Corner-cutters also scored high in Machiavellianism (i.e., manipulation, self-interest) and narcissism (i.e., grandiosity, pride).
Age and gender were also factors in corner-cutting, such that employees who cut corners at work tended to be younger and male.
But there are also various contexts that play into the decision to cut corners. While a third of employees cut corners when it would likely save them time, they were less likely to do so if they could be reprimanded (only one in six employees cut corners in this situation), or if there was the potential for a poor-quality outcome (only one in four cut corners then).
These results paint a seemingly negative picture of workplace corner-cutters as individuals who are generally self-interested and low in conscientiousness. However, it is plausible that employees sometimes cut corners with noble intentions. For example, the related concept of “workarounds” refers to the more accepted behaviour of “clever methods for getting done what the system does not let you do easily”.
To explore this possibility, we investigated whether corner-cutters were more proactive than those who tend not to cut corners. Our results strongly suggested that this was generally not the case.
Proactive employees were not more likely to achieve their goals by cutting corners at work, even when their goal was to save time. In fact, we found that proactive individuals were slightly less likely to cut corners at work than non-proactive individuals.
We also found little relation between corner-cutting and career success. There was no relationship between corner-cutting and income. However, it was associated with higher income for those who scored high in psychopathy.
This indicates that while corner-cutting generally does not relate to career success, it can result in career benefits for impulsive, self-focused individuals. These individuals are likely to cut corners as a strategy to be more productive, despite possible costs to the organisation or co-workers.
Implications for managers
Overall, we found that corner-cutting is not a desirable workplace behaviour. Those most likely to cut corners are likely to be poor performers aiming to meet minimimal standards in contrast to good performers looking to excel. The possible exception is individuals high in psychopathy looking for short-cuts to get ahead.
Clearly, it makes sense to minimise the number of employees with corner-cutting tendencies. This is particularly true for jobs in which mistakes caused by cutting corners can lead to serious injury (e.g., jobs in mining, construction). At the very least, we suggest employers take into account certain characteristics of applicants (e.g., conscientiousness, psychopathy) when selecting for such positions.
Peter O’Connor, Senior Lecturer, Business and Management, Queensland University of Technology and Peter Karl Jonason, Senior Lecturer in Personality or Individual Differences, Western Sydney University
This article was originally published on The Conversation. Read the original article.