Mental Illness and Work-Related Limitations in Healthcare Workers: A Preliminary Retrospective Study.

This retrospective observational study investigated hospital staff requests for job fitness visits, addressed to occupational medicine. Specific objectives were to analyze: (1) health workers' requests, sociodemographic characteristics, psychiatric diagnoses, assigned doctor's fit notes, and (orthopedic, psychiatric) limitations; (2) associations between psychiatric diagnoses, sociodemographic (sex, age), and work-related (job, department) characteristics; (3) associations between the same psychiatric diagnoses/orthopedic limitations, fit notes, and/or psychiatric limitations. Data of St. Orsola-Malpighi Polyclinic health workers (N = 149; F = 73.8%; mean age = 48 ± 9.6 years), visited by both the occupational medicine physician and psychiatrist (January 2016−May 2019), were analyzed. 83.2% of the sample presented with at least one psychiatric diagnosis, including mood (47%), anxiety (13.4%), and anxious-depressive (10.7%) disorders. Significant differences between psychiatric diagnoses according to sex and fit notes (both p < 0.01) have been found, whereas no significant associations based on age and work-related characteristics have been observed. Analysis of frequencies of participants with the same psychiatric diagnosis (orthopedic limitation being equal), according to doctor's fit notes and psychiatric work limitations, showed a high heterogeneity of assignments. The current occupational medicine procedure for fit notes/job limitations assignments does not allow taking into consideration clinical factors possibly associated with more specific assignments. To standardize the procedure and translate the psychiatrist's clinical judgment into practice, further studies to test the usefulness of clinimetrics, which might represent a reliable approach in considering different fit notes and job limitations, are needed.

Age Diversity Climate Affecting Individual-Level Work-Related Outcomes.

The present study answers the call for more studies to investigate the age diversity climate's effect on individual-level outcomes. Building on the social identity approach and social exchange theory, we surveyed 110 Italian employees aged between 18 and 61 years old (M = 46.10, SD = 10.02) and investigated the role of age diversity climate in predicting intentions to quit (H1), job-related wellbeing (H2), and work engagement (H3). Our findings confirmed the hypotheses (H1 and H2), showing the added effect of age diversity climate over and above age, job tenure, role clarity, job demands, job control, perceived support, and perceived job and organizational fit. In fact, age diversity climate accounted for a significant increase in the variance explained for two of the three hypothesized models (i.e., intentions to quit and job-related wellbeing, but not work engagement). To conclude, this study contributes to the existing literature by showing the age diversity climate's predictive value for turnover intentions and job-related wellbeing, and corroborating the importance of supporting age diversity through a variety of Human Resources Management strategies.

Workaholism and the Enactment of Bullying Behavior at Work: A Prospective Analysis.

Despite the fact that workaholism and workplace aggressive behavior share many correlates, such as neuroticism, hostility, and negative affectivity, little is known about their relationship, with most evidence on both phenomena coming from cross-sectional studies. In the present study, we contributed to a better understanding of the antecedents of enacted workplace bullying behavior (i.e., perpetration of bullying), and the potential interpersonal implications of workaholism, by investigating their cross-lagged relationship. Data from a two-wave one-year panel study conducted with 235 employees in a national healthcare service organization showed substantial cross-sectional and cross-lagged positive relationships between workaholism and enacted workplace bullying. Whereas Time 1 workaholism was a significant predictor of Time 2 enacted workplace bullying, reversed causation was not supported. To shed light on the role of a potential mechanism explaining the link between workaholism and enactment of bullying, we examined whether job-related negative affect (e.g., anger) mediated their longitudinal relationship. However, whereas increased negative affect from T1 to T2 was positively associated with T2 enacted workplace bullying, the relationship between T1 workaholism and increased job-related negative affect was not significant, contrary to the hypothesized mediation. Taken together, our findings suggest that workaholism may be an important antecedent of enacted workplace bullying. Study limitations and future perspectives are discussed.

Rapid Review on COVID-19, Work-Related Aspects, and Age Differences.

The COVID-19 pandemic significantly impacted the labor market and multiple aspects of work and workers' life. The present rapid review analyzes this impact considering the effects that COVID-19 pandemic had on employment and work-related aspects across different age groups. A comprehensive literature search was performed on scientific contributions published between 2019 and March 2021, resulting in 36 papers pertinent to the scope of this review. Findings were grouped according to different topics, all linked to age: occupational risk, implications on the labor market (i.e., job loss and reemployment, job insecurity, turnover intentions and retirement, and healthcare workers' return-to-work phase), remote work, and key individual and organizational resources and strategies. Overall, the review revealed variability across age groups in the impact this pandemic had on employment and several work-related aspects (i.e., occupational risk, remote work). Findings supported an age-differential effect of normative history-graded events such as the current pandemic, highlighting different responses and consequences depending on workers' age.

Core Self-Evaluations Affecting Retirement-Related Outcomes.

This study addressed a gap in the literature by examining the role of core self-evaluations as a predictor of retirement preparation (i.e., attitudes, expectations, and goals), compared to other important aspects such as demographic, financial, health, and work-related variables. Based on the resource-based dynamic model for retirement adjustment and the core self-evaluations theory, the present study showed that core self-evaluations significantly and positively affected the social component of retirement adjustment (H1), the retirement expectations of new beginning (H2), the retirement expectations of continuity (H3), and retirement goals (H4). Additionally, core-self evaluations negatively affected the retirement expectations of imposed disruption (H5). All the analyses were controlled for age, gender, perceived health, financial situation, job centrality, and expected retirement age. In conclusion, core self-evaluations are valuable and supportive to workers across the work lifespan, and for dealing with the retirement preparation.

Can social firms contribute to alleviating the economic burden of psychiatric disabilities for the public healthcare system?

In a number of countries, unemployment rates for people with psychiatric disabilities are much higher than in the general population. On the one hand, the expenses for mental health reach 3.5% of the total public health and social services budget in Québec. On the other hand, social firms (SFs) receive government subsidies. The objective was to compare public healthcare expenses for people with psychiatric disabilities who work in SFs with those associated with people with a similar condition who are looking for a job in the competitive labour market. This study followed a retrospective comparative design and considered two groups, namely: 122 employees working in SFs and 64 individuals participating in a supported employment program as job-seekers. Two complementary datasets were used: a self-report questionnaire and public healthcare databases. The cost analysis was performed from the perspective of the public healthcare system and included outpatient visit fees to physicians, outpatient visits to health professionals other than physicians in public healthcare centres, inpatient expenses due to hospitalisations, emergency room visits and amounts reimbursed to patients for medication. Regression analyses using generalised linear models with a gamma distribution and log link were used. Our results revealed that when controlling for sociodemographic variables (gender, age, marital status, education, physical disability), global health (EuroQol EQ-5D-5L), the severity of psychiatric symptoms (18-item Brief Symptom Inventory) and self-declared primary mental health diagnosis, annual healthcare costs paid by the public insurance system were between $1,924 and $3,912 lower for people working in SFs than for the comparison group. An explanatory hypothesis is that working in SFs could act as a substitute for medical treatments such as outpatient visits and medication use. There might be a form of compensation between supporting SFs and financing the public healthcare system, which provides valuable insights for public decision-making.

Coping With Negative Stereotypes Toward Older Workers: Organizational and Work-Related Outcomes.

The current study aims to test a moderated-mediation model in which occupational self-efficacy determines the indirect effect of negative stereotypes about older workers in the organization both on psychological engagement in the work domain and on attitudes toward development opportunities through identification with the company. The survey involved 1,501 Italian subjects aged over 50 who were employed by a major large-scale retailer. Consistently with the Social Identity Theory and the Social Exchange Theory, results showed that the perception of negative stereotypes about older workers in the organization is associated with low identification with the company and, subsequently, with poor psychological engagement in the work domain and with attitudes indicating very little interest in development opportunities. In addition, this association was found to be stronger in older workers with higher and medium levels of occupational self-efficacy. These findings suggest that organizations should discourage the dissemination of negative stereotypes about older workers in the workplace because they may lead to older workers' disengagement from the work domain and their loss of interest in development opportunities.

Work productivity of people with a psychiatric disability working in social firms.

BACKGROUND: Several factors impact work productivity in employees with a psychiatric condition. OBJECTIVE: In the context of social firms (SFs) the goal of this study is to test a theoretical model to predict work productivity across time, while considering worker and workplace factors. METHODS: 222 people with a psychiatric disability employed in SFs were enrolled in a longitudinal study (6 month follow up) and completed the baseline battery of questionnaires on health (severity of symptoms), individual (self-esteem as a worker) and organizational factors (organizational constraints and supervisory support), and their work productivity (also measured at follow-up). Path analysis was used to test the hypothetical model, assessing individual and organizational factors in the context of social firms that could facilitate or hamper work productivity in the immediate term (T1), as well as the stability of work productivity in the middle/long term (T2 or 6 month follow up). RESULTS: Work productivity of people with a psychiatric disability was affected negatively by severity of the symptoms, organizational constraints, and positively by self- esteem as a worker at T1. The stability of work productivity was significant across time (T2). Supervisor support was only related to work productivity at 6 month follow-up. CONCLUSIONS: The results highlight the importance of the supportive workplaces for people with mental disorders that SFs provide, and the stability of work productivity across time. Supervisor support seems to have a delayed impact on work productivity. In future studies, researchers could determine how individual and organizational variables influence job tenure of employees with a psychiatric disability.

A Comparison of Healthcare Use and Costs for Workers with Psychiatric Disabilities Employed in Social Enterprises Versus Those Who Are Not Employed and Seeking Work.

Because of work's contribution to recovery, governments have moved to improve employment rates of people with severe mental disorders (SMDs). Social enterprises (SEs) have been identified as a means to achieve employment. In Ontario, Canada, the Ministry of Health and Long-Term Care (MOHLTC) have provided SEs government subsidies. Public funding arrangements create a potential trade-off for governments that must decide how to distribute constrained budgets to meet a variety of public needs. In Ontario, the government is potentially faced with choosing between supporting employment versus healthcare services. This study addresses the question, are there significant differences in service use and costs from the MOHLTC's perspective for people with SMDs working in SEs versus those who are not working and looking for work? Our results indicate there is a significant difference in healthcare use between the two groups suggesting there could be less healthcare use associated with SE employment.

Reducing perceived stigma: Work integration of people with severe mental disorders in Italian social enterprise.

OBJECTIVE: People with mental illnesses face stigma that hinders their full integration into society. Work is a major determinant of social inclusion, however, people with mental disorders have fewer opportunities to work. Emerging evidence suggests that social enterprises help disadvantaged people with their work integration process. The purpose of this study is to enhance our understanding about how perceptions of stigma can be decreased for people with mental disorders throughout their work experience in a social enterprise. METHOD: Using a longitudinal study design, 310 individuals with mental disorders employed in Italian social enterprises completed a battery of questionnaires on individual (e.g., severity of symptoms; occupational self-efficacy) and environmental (e.g., social support; organizational constraints) variables. Of the 223 individuals potentially eligible at the 12-month follow up, 139 completed a battery of questionnaires on social and working skills, perceived work productivity and perceived stigma. Path analyses were used to test a model delineating how people with mental disorders working in social enterprises improve social and work outcomes (i.e., motivation, skills and productivity), and reduce the perception of being stigmatized. RESULTS: Working in a social enterprise enhances working social skills, which leads to a perception of higher productivity and, consequently, the perception of being discriminated against and stigmatized is reduced. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Social enterprise provides a context in which people with mental disorders reach a sense of work-related and social competence. This sense of competence helps them to reduce perceived stigma, which is a crucial step toward social inclusion. (PsycINFO Database Record

A serial mediation model of workplace social support on work productivity: the role of self-stigma and job tenure self-efficacy in people with severe mental disorders.

PURPOSE: Compared to groups with other disabilities, people with a severe mental illness face the greatest stigma and barriers to employment opportunities. This study contributes to the understanding of the relationship between workplace social support and work productivity in people with severe mental illness working in Social Enterprises by taking into account the mediating role of self-stigma and job tenure self-efficacy. METHOD: A total of 170 individuals with a severe mental disorder employed in a Social Enterprise filled out questionnaires assessing personal and work-related variables at Phase-1 (baseline) and Phase-2 (6-month follow-up). Process modeling was used to test for serial mediation. RESULTS: In the Social Enterprise workplace, social support yields better perceptions of work productivity through lower levels of internalized stigma and higher confidence in facing job-related problems. When testing serial multiple mediations, the specific indirect effect of high workplace social support on work productivity through both low internalized stigma and high job tenure self-efficacy was significant with a point estimate of 1.01 (95% CI = 0.42, 2.28). CONCLUSIONS: Continued work in this area can provide guidance for organizations in the open labor market addressing the challenges posed by the work integration of people with severe mental illness. Implications for Rehabilitation: Work integration of people with severe mental disorders is difficult because of limited access to supportive and nondiscriminatory workplaces. Social enterprise represents an effective model for supporting people with severe mental disorders to integrate the labor market. In the social enterprise workplace, social support yields better perceptions of work productivity through lower levels of internalized stigma and higher confidence in facing job-related problems.

The affect heuristic in occupational safety.

BACKGROUND: The affect heuristic is a rule of thumb according to which, in the process of making a judgment or decision, people use affect as a cue. If a stimulus elicits positive affect then risks associated to that stimulus are viewed as low and benefits as high; conversely, if the stimulus elicits negative affect, then risks are perceived as high and benefits as low. OBJECTIVES: The basic tenet of this study is that affect heuristic guides worker's judgment and decision making in a risk situation. The more the worker likes her/his organization the less she/he will perceive the risks as high. METHOD: A sample of 115 employers and 65 employees working in small family agricultural businesses completed a questionnaire measuring perceived safety costs, psychological safety climate, affective commitment and safety compliance. RESULTS: A multi-sample structural analysis supported the thesis that safety compliance can be explained through an affect-based heuristic reasoning, but only for employers. CONCLUSIONS: Positive affective commitment towards their family business reduced employers' compliance with safety procedures by increasing the perceived cost of implementing them.

The relation between overcommitment and burnout: does it depend on employee job satisfaction?

Using the Conservation of Resources (COR) theory as a framework, we hypothesized a maladaptive role played by overcommitment in the escalation of burnout. We further specified our model by testing an interaction effect of job satisfaction. By using a longitudinal design, we proposed a moderated mediational model in which burnout at Time 1 (T1) increases overcommitment, which in turn leads to more burnout one month later. We further expected to find a moderating role of job satisfaction in the link between overcommitment and burnout at Time 2 (T2). A group of 86 white-collar workers in personnel services in Italy (longitudinal response rate = 77.48%) participated in our study. The findings supported our hypotheses even when controlling for gender and role stressors. In particular, by using bootstrapping procedures to test mediation, we found evidence that employees reporting burnout tend to develop a maladaptive coping style, i.e., overcommitment, which in turn increases burnout over time. This relation was particularly strong for dissatisfied employees. These results highlight the importance of overcommitment for burnout escalation, as well as of job satisfaction, since it may mitigate, at least in the short term, the effect of such dysfunctional strategies.

Why did Italians protest against Berlusconi's sexist behaviour? The role of sexist beliefs and emotional reactions in explaining women and men's pathways to protest.

By taking advantage of the Italian protest in 2009 in reaction to the behaviour of then Prime Minister Berlusconi, in this research, we investigated the role of sexist beliefs (i.e., hostile sexism, complementary gender differentiation, protective paternalism, and heterosexual intimacy) and group-based emotional reactions (i.e., anger, humiliation, and sadness) to women's and men's action mobilization against public forms of sexism. The findings of this study suggest that women and men engaged in this protest for different reasons. Women mobilized to express their anger at Berlusconi's sexist behaviour, an emotion related to the condemnation of hostile sexist views and benevolent sexist beliefs about heterosexual intimacy. In contrast, the strength of men's participation in the protest was affected by humiliation, an emotion related to the condemnation of hostile sexist beliefs and support for complementary gender differentiation. This emotional path suggests that men likely protested to restore their reputations. These findings underline the role of sexist beliefs and group-based emotions in transforming the condemnation of a sexist event into action mobilization against sexism for both women and men.

Individual and environmental factors related to job satisfaction in people with severe mental illness employed in social enterprises.

OBJECTIVE: The purpose of this study was to enhance understanding of the impact of individual and environmental variables on job satisfaction among people with severe mental illness employed in social enterprises. PARTICIPANTS: A total of 248 individuals with severe mental illness employed by social enterprises agreed to take part in the study. METHODS: We used logistic regression to analyse job satisfaction. A model with job satisfaction as the dependent variable, and both individual (occupational self-efficacy and severity of symptoms perceived) and environmental (workplace) factors (provision of workplace accommodations, social support from co-workers, organizational constraints) as well as external factors (family support) as predictors, was tested on the entire sample. RESULTS: All findings across the study suggest a significant positive impact of both individual and environmental factors on job satisfaction. People with higher occupational self-efficacy who were provided with workplace accommodations and received greater social support were more likely to experience greater job satisfaction. CONCLUSIONS: These results suggest that certain features of social enterprises, such as workplace accommodations, are important in promoting job satisfaction in people with severe mental illness. Further studies are warranted to expand knowledge of the workplace features that support employees with severe mental illness in their work integration process.

Evaluation of the fear-avoidance model with health care workers experiencing acute/subacute pain.

Studies in the literature do not show clear evidence supporting the relationship between pain and depressive symptoms in individuals experiencing acute/subacute pain compared to those experiencing chronic pain. However, more information is needed about which variables act as mediators in the pain-depression relationship in people having acute/subacute pain, before pain becomes chronic. Our objectives were to test the suitability of the fear-avoidance model in a sample of 110 health care workers experiencing acute/subacute pain using path analyses, to improve the model as needed, and to examine a model involving both pain catastrophizing and pain self-efficacy with work status as a final outcome. Overall, the results indicated that adjustments to the fear-avoidance model were required for people experiencing acute/subacute pain, in which fear-avoidance beliefs and depressive symptoms were concurrent rather than sequential. The catastrophizing concept was most closely associated with depressive symptoms, while pain self-efficacy was directly associated with fear-avoidance beliefs and indirectly to work outcomes. Assessing and modifying pain self-efficacy in acute/subacute pain patients is important for interventions aiming to decrease fear-avoidance and improve work outcomes.

Working plans of people with mental disorders employed in Italian social enterprises.

OBJECTIVE: Social Enterprises (SEn) are innovative companies that help disadvantaged people (e.g., individuals with mental disorders) with the work integration process. This study explores the working plan patterns of people with mental disorders employed in SEn. METHODS: A cross-sectional design was adopted. One hundred and forty individuals with mental disorders employed in 19 Italian SEn filled out a battery of questionnaires. RESULTS: We identified three patterns of working plans: Cluster 1 (n = 39, 30%) showed a stronger intention to work in a competitive labor market; Cluster 2 (n = 16, 12.3%) showed a stronger intention to stop working; Cluster 3 (n = 75, 57.7%) showed a stronger intention to continue working at a SEn. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Most of the sample had a pattern of intentions to keep working, thereby demonstrating the effectiveness of the SEn approach to work integration. Future studies should explore the approach further. Indeed, these results seem important for implications for practice, suggesting that people with mental disorders inside SEn can improve their level of interpersonal skills and reinforce their vocational identity, and ultimately increase their chances of employment in the regular labor market.

Job acquisition for people with severe mental illness enrolled in supported employment programs: a theoretically grounded empirical study.

INTRODUCTION: The main purpose of this study was to test a conceptual model based on the theory of planned behaviour (TPB) to explain competitive job acquisition of people with severe mental disorders enrolled in supported employment programs. METHODS: Using a sample of 281 people with severe mental disorders participating in a prospective study design, the authors examined the contribution of the TPB in a model including clinical (e.g., severity of symptoms), psychosocial (e.g., self-esteem) and work related variables (e.g., length of time absent from the workplace) as predictors of job acquisition. Path analyses were used to test two conceptual models: (1) the model of job acquisition for people with mental illness adapted from the TPB, and (2) the extended TPB including clinical, psychosocial, and work related variables recognized in the literature as significant determinants of competitive employment. RESULTS: Findings revealed that both models presented good fit indices. In total, individual factors predicted 26% of the variance in job search behaviours (behavioural actions). However, client characteristics explained only 8% of variance in work outcomes, suggesting that environmental variables (e.g., stigma towards mental disorders) play an important role in predicting job acquisition. About 56% (N = 157) of our sample obtained competitive employment. CONCLUSION: Results suggest that employment specialists can be guided in their interventions by the concepts found in the extended model of work integration since most of these are modifiable, such as perceived barriers to employment, self-efficacy, and self-esteem.