Suffering caused by work remains taboo

According to the WHO, every employee should have access to a health consultation service at work Keystone

Chronic stress affects one third of workers in Switzerland and the situation has continued to worsen in recent years. Despite alarm bells ringing, the problem remains largely ignored by employers.

With an unemployment rate of 3.4 per cent, an enviable position as one of the world’s most competitive nations and virtually non-existent public debt, Switzerland stands out as Europe struggles. The country has a reputation for being hardworking and diligent and it’s an economic model the Swiss want to preserve.

But there is a downside: between 26.6 and 34.4 per cent of Swiss workers say they are overburdened at work, a figure which has gone up by seven per cent in ten years, according to the State Secretariat for Economic Affairs (Seco).

Chronic stress and its effects on health such as depression, burn out and cardio-vascular or muscular-skeletal problems have led to higher absenteeism and lower productivity.

According to estimates published by Seco, the related costs could reach SFr10 billion ($11 billion) per year for businesses and society. In a report published in 2010, the Federal Statistics Office highlighted the exposure of workers to psychosocial risks: 41 per cent of those interviewed said they were under strong psychological pressure at work.

Worsening situation

However these studies do not reflect the true extent of the problem, specialists point out. “The situation has been critical for the past ten years or so but it has got worse again since 2008,” said Brigitta Danuser, of Lausanne University’s Institute of Work and Health.  

A Geneva psychiatrist specialising in occupational medicine, Davor Komplita, is not short of work.

“The situation is getting worse in terms of quantity and quality,” he admitted. “The clinical condition of the people who come for consultation is often very bad. My colleagues, specialists and general practitioners have also noted this.”

The pressure to perform and compete, the spread of casual work contracts, open plan offices, conflicts between colleagues, as well as bosses expecting around-the-clock availability that goes hand-in-hand with technological innovations are just a few of the reasons given for heightened stress. 

Almost half of the working population also suffers from an emotional overinvestment in their work, as a recent international study revealed.

“Our society is entirely organised around work. It has become an obligation. However contrary to what employers claim, just ten to 20 per cent of jobs are actually permanent positions,” Danuser said.

A situation which can lead to frustration, disappointment and professional exhaustion or even so-called “burn out”.  

Psychiatrists believe that work organisation itself can lead to health problems.

“In just one or two generations, we have obtained unprecedented individual liberty and recognition of human rights. But paradoxically relations at work have become more and more vertical and authoritarian. You see that in the private sector but also in public services,” Komplita pointed out.

Lagging behind

Whatever causes discontent in the workplace, Switzerland is not really equipped to deal with  the problem.

“Our country has a total of 150 occupational doctors, most of whom are specialised in risks such as poisoning or cancer. According to the WHO [World Health Organization] global action plan, every employee should have access to a health consultation service at work. We are far from that goal in Switzerland,” Danuser told swissinfo.ch.

To compensate somewhat, the Institute of Work and Health in Lausanne opened a consultation centre last year, along the model of what France has been doing for decades.

”We already have waiting lists. That proves that we are responding to a real need,” Danuser said.

Although French-speaking Switzerland is more aware of the problem, partly because of the widespread media coverage of a spate of suicides at France Telecom, Danuser doesn’t think there are significant cultural differences within Switzerland. “This is a Swiss problem. Germany for example has a very advanced structure for occupational medicine.”

She said it was down to the very liberal working culture in Switzerland in which “suffering belongs to the private sphere and is taboo in public”.

Parliamentary interventions on the subject over the past decade have been few and far between. “In France, it was the national parliament which decided to create an occupational medical body,” Komplita explained.

“It is a purely political act. Unfortunately when it comes to public health, Switzerland thinks uniquely in individual and budgetary terms. However health is an asset and a source of profit for companies,” he added.

Federal regulations virtually ignore psychosocial risks, which are not recognised as occupational illnesses by the main Swiss occupational health insurer Suva. “We have dealt with the problem by simply assuming that it does not exist,” said Komplita.

Companies in the dock

The treatment of suffering at work is being delegated instead to an increasing number of clinics specialising in looking after burned-out patients.

“It is very good to treat people, to help them get back their taste for life. But when someone is a victim of a war trauma, we try to tackle the root of the problem and not simply suggest walks in the forest. The same thing applies to work,” Danuser said.

Health specialists are not convinced by the efforts made in recent years by companies either. Motivational seminars, team building or personnel coaching are flourishing but to what end?

“The effects do not last and the camaraderie is quickly forgotten when it comes to deciding who should get a position,” Danuser said.

Komplita reckons that modern management methods, based on competition and insecurity will work against companies in the medium term.

“They will get an apparent increase in productivity but will lose out in the end. People will stay quiet, will no longer care about the overall quality of the production and will change jobs quickly, which will mean a considerable loss of skills,” he predicted.

“To make more and more detailed, but often difficult, procedures work, you have to mobilise people’s sense of solidarity, their zeal, creativity and convince them to make an investment. But nowadays many workers have just thrown in the towel.”

Psychosocial problems

Work-related psychosocial problems can manifest themselves in several ways:

Chronic stress results from an imbalance between the demands perceived by an individual as being placed on them and the resources he or she has to meet those demands. Constant requests and interruptions, the quantity of information to manage and new technologies are stress factors.

Burn out follows a prolonged situation of stress and manifests itself in physical, mental and emotional exhaustion. A so-called bore-out is a syndrome of professional exhaustion caused by boredom resulting from a lack of work, boredom and the absence of professional satisfaction.

Presenteeism is a term which describes an employee, afraid of losing his or her job, coming to work at any cost. According to some specialists the loss of productivity linked to this syndrome is more than that caused by absenteeism.

Neurobiologists recognise emotional overinvestment as an obsessional tendency which qualifies as a behavioural addiction. Sufferers display an intense desire to succeed and an excessive fear of failure in situations where not that much is at stake.

People affected by these problems may suffer from insomnia, pronounced fatigue, high irritability, repressed anger, a cynical view of work and society. Physical symptoms are varied: cardio-vascular problems, backache or headache, digestive or sexual problems, allergic reactions, cancer, and throat, ear or respiratory infections.

Stress in figures

Between 2000 and 2010, the proportion of the working population suffering from chronic stress rose from 26.6% to 34.4% according to a Seco study. The proportion of workers who never feel stressed, or only slightly stressed fell from 17.45% to 12.2%.

No differences emerged between economic sector, professional group or sex. However age was a factor with the rate of stressed younger workers (between 15 and 34) higher than the average.

Experts estimate that the vast majority (90%)of consultations with general practitioners are stress-related.

According to a study by Health Promotion Switzerland, stressed employees are less productive which can cost businesses up to SFr8,000 per year. 

(Adapted from French by Clare O’Dea)