Guide to Understanding ISO 45003: Psychological Health & Safety at Work

Managing psychosocial risks has never been more important for employers

In most advanced economies, mental illness is one of (if not) the leading causes of sickness absence and long-term work incapacity.

Nearly one in five adults in the U.S. live with a mental illness, according to the National Institute of Mental Health. Almost 3 million Australians have a mental illnessⁱ. An additional 440,000 working-age people in the country care for someone affected with mental illnessⁱⁱ.

These elevated rates of mental illness spill over into the wider economy. In Australia, the annual cost of ill-health and suicide ranges from AUD 43 billion to AUD 70 billion, according to the Productivity Commission. Every year the direct cost of healthcare expenditure and other services and supports comes in at around AUD 16 billion. 

In the U.S., the American Psychiatric Association estimated the macroeconomic loss at USD 210.5 billion per year. Just a single, extra poor mental health day every month was associated with a 1.84 per cent drop in per capital real income growth, or USD 53 billion lost in total income every year from 2008 to 2014, according to a separate analysisⁱⁱⁱ.

Why? Productivity loss from absenteeism and presenteeism is one of the key culprits.

Employees with unresolved depression in the U.S. experience a 35 per cent reduction in productivity, according to the American Psychiatric Association. In Australia, the Productivity Commission estimates that employees with mental illness take an annual average of 10 to 12 days off due to psychological distress, with total costs from lost productivity ranging from AUD 12 billion to AUD 39 billion. 

The cost of ignoring psychological health and safety at work

For employers, compliance costs come into play, as well. Persons conducting a business or undertaking (PCBUs) are legally obligated to eliminate risks to the health and safety of their employees.

By statute, health encompasses physical and psychological wellbeing. As a result, employers must address a broad array of psychosocial hazards, i.e., aspects of work that have the potential to cause psychological or physical harm. Aspects of work which fall under an employer’s duty of care obligation include:

• Bullying in the workplace
• Fatigue
• Mental stress
• Overseas work
• Remote or isolated work
• Workplace change
• Workplace violence or customer aggression 

The costs of flouting this component of duty of care have been steep. In Australia, the cost of workers compensation claims related to work-related mental health conditions is about two and half times higher than that of other claims. They also involve significantly more time off work for employees. 

With COVID-19 exacerbating the trends, what can be done?

The emotional fallout from the COVID-19 crisis is also exacerbating the trend. The Household Pulse survey in the U.S. revealed sharp rises in the number of adults suffering anxiety (from 31.4 per cent to 36.9 per cent) and depressive disorders (from 24.5 per cent to 30.2 per cent)^iv.

Rates of depression rose sharply in Australia, too, from a pre-COVID-19 baseline of around 10 per cent of the population to nearly 30 per cent (27.6 per cent) in 2020^v. Anxiety also rose, from 13 per cent to 21 per cent over the same period, according to OECD data. What can employers do?

For starters, organisations need to begin investing promptly in best-practice solutions to the mental health and wellbeing crisis. But which standard to follow?

Here, international standard, ISO 45003: 2021 Occupational health and safety management – Psychological health and safety at work – Guidelines for managing psychosocial risks will help. The subsequent guide provides a primer to the newly released standard.

Introducing ISO 45003: 2021

ISO 45003 is the International Organisation for Standardisation’s first, direct foray into psychological health and safety at work. Written to help organisations already using occupational health and safety (OHS) systems based on ISO 45001: 2018 (though applicable to those that don’t), the newer standard provides simple, practical guidance on how to manage the psychosocial hazards that arise in the work environment (See more below). 

For whom is ISO 45003 useful?

The short answer is everyone. Although written to help ISO 45001-compliant organisations, ISO 45003 has practical advice for organisations of all shapes, sizes, and OHS maturity levels. 

The following roles, in particular, would benefit most from adhering to the best-practice standard: 

• Front-line managers
• HR
• CEOs & Business owners
•  Boards of directors

Besides providing guidelines for managing psychosocial risk within an OHS system based on ISO 45001, the standard also enables organisations to prevent workrelated injury and ill health (whether of employees, customers, or other stakeholders) and promote wellbeing in the workplace. 

How, exactly? The easy-to-digest standard sketches out how to develop, implement, maintain, and improve healthy and safe workplace practices, with the aim of helping business leaders identify where psychosocial risks arise and how those risks can be mitigated or eliminated.

In its primary sections, the standard highlights key areas shown to impact workers’ psychological health. As such, organisations compliant with ISO 45003 will be able to:

• Identify the conditions, circumstances, and workplace demands that have the potential to impair the psychological health and wellbeing of their workers
• Determine what changes are required to improve the working environment to improve the psychological health and wellbeing of their workers
• Manage psychosocial risk within an OHS management system

Benefits of implementing ISO 45003

• Improved worker engagement
• Enhanced productivity and higher levels of discretionary effort
• Increased innovation
• Greater organisational resilience
• Improved legal compliance

A deep dive into ISO 45003

Introductory sections stipulate the standard’s scope. That scope consists of providing guidelines for managing psychosocial risk within an OHS management system based on ISO 45001. Key terms, crucial for understanding the standard, are also defined early in the standard. Those terms include:

• Psychosocial risk. A combination of the likelihood of occurrence of exposure to work-related hazard(s) of a psychosocial nature and the severity of injury and ill-health that can be caused by these hazards.
• Wellbeing at work. The fulfilment of the physical, mental, social, and cognitive needs and expectations of a worker related to their work.

Context of the organisation

Organisations can’t successfully manage psychosocial risks without fully understanding from whence those risks arise. This isn’t always easy. The fact is that though risks might impinge on work, they don’t always stem from factors internal to the organisation.

As a result, business leaders must be aware of the full context of the organisation. The following issues are all germane to the management of psychosocial risks:

 

What then? Once fully considering the external and internal issues that can affect the achievement of the intended outcomes of the OHS management system, organisations must still attend to the needs and expectations of workers and other relevant interested parties.

Here, the standard suggests considering which of these needs and expectations are, or could become, requirements (legal or otherwise). After that, organisations should adjust the design of activities to manage psychosocial risk to suit the specific context of the workplace; tailor activities to improve the focus, reliability, validity, and effectiveness of the process to manage psychosocial risk; and determine how the assessment of psychosocial risks will be used to make effective action plans.

What other factors matter? Understanding the needs and expectations of workers is paramount. Per the standard, organisations should know that their workers (and other stakeholders) have a variety of needs and expectations that can be influenced by psychosocial risks at work. Those include:

• Financial security
• Social interaction and support
• Inclusion, recognition, rewards, and accomplishment
• Personal development and growth
• Equal opportunity and fair treatment

On the same front, the OHS management system as well as related operations and activities should be set up (or updated) to address psychosocial risk. That will mean ensuring that the OHS management system remains appropriate, effective, and relevant to the management of psychosocial risk. ISO 45001-compliant organisations will have a head start, here. All other organisations following ISO 45003 are well placed to catch up. 

Leadership and worker participation

Every major organisational initiative needs leadership commitment and worker buy-in. Managing psychosocial risk is no different. The standard anticipates this need for leadership and worker participation.

In the eponymous section, the standard focuses on the role of leadership commitment. Specifically, senior leaders are called to do the following: 

• Demonstrate leadership and commitment to managing psychosocial risk and to promoting wellbeing at work
• Identify, monitor, and be aware of its roles and responsibilities with respect to managing psychosocial risks
• Determine the resources needed and make them available in a timely and efficient manner
• Reinforce the sustainability of managing psychosocial risk by including it in strategic plans as well as existing systems, processes, and reporting structures
• Protect workers from reprisals and/or threats of reprisals for reporting incidents, hazards, risks, and opportunities
• Communicate how whistle blowers, victims, witnesses, and those who report or raise workplace psychosocial risk concerns will be protected
• Obtain and provide feedback to determine the effectiveness of managing and preventing psychosocial risk within the OHS management system, both in implementation and operation
• Empower workers and ensure they are competent to fulfil their roles and responsibilities to identify and manage psychosocial risk
• Remove barriers that can limit worker participation and aim to enhance participation
• Actively engage workers in a continual dialogue on the management of psychosocial risk
• Support and encourage workers to actively participate in the management of psychosocial risk in the workplace

Per ISO 45001, senior leadership is already responsible for the well-functioning of the OHS management system. Given this role, senior management must look to clarify roles, responsibilities, and authorities for managing psychosocial risk in the workplace.

Engaging workers is also a senior leadership responsibility. Guidelines, however, are necessary to garner meaningful participation. Which ones? Beyond the general requirements set forth in ISO 45001, ISO 45003 recommends:

• Providing opportunities for feedback by workers to help the organisation determine the effectiveness of the management of psychosocial risks
• Encouraging participation and engagement, e.g., in health and safety committees or peer-to-peer support networks if appropriate to the size and context of the organisation. 

The standard also suggests that worker outreach should be ongoing – not just in the planning stages of establishing an OHS system focused on managing psychosocial risks but throughout the lifecycle of wellbeing management, as well.

Planning

All the same, getting the planning phase right is crucial. Indeed, planning helps organisations establish appropriate objectives, determine how to achieve those objectives, and demonstrate the necessary commitment to continual improvement.

What should happen, though? The exact nature of the planning process depends on each organisation’s risk profile, the evaluation of which comes out of the hazard identification processes, where organisations uncover underlying sources of harm as well as establish, implement, and maintain processes for hazard identification that are ongoing and proactive.

That being said, all organisations will need to account for the following during the planning process:

• The needs and expectations of specific groups of workers
• The needs of specific workplaces or sets of operations or work tasks
• The results of the assessment of psychosocial risks
• The implementation of actions designed to eliminate psychosocial hazards and reduce the associated risks
• The evaluation of those actions and their outcomes
• The management of the process by reviewing and updating it to meet changing needs, recognising good practice
• How to actively involve workers through consultation and participation

While best-practice plans are a must have, only dedicated resources can help organisations achieve the objectives set out in those plans. Per ISO 45003, organisations should plan to allocate resources with the following criteria in mind:

 

Final operational sections

The detailed section on planning leads up to the final operational sections. Here, organisations learn not only how to implement internationally recognised practices for managing psychosocial risks in the workplace but how to measure their effectiveness, as well. The latter helps, of course, to ensure constant improvement and militate against ineffective measures.

What stands out is the need to combine multiple levels of intervention. Specifically, the standard calls for three levels of intervention (i.e., primary, secondary, and tertiary).

They are:

1. Primary.
   Organisational level controls to prevent or reduce harmful effects and promote wellbeing at work.
2. Secondary.
   Increasing resources that assist workers to deal with psychosocial risks by raising awareness and understanding through effective training and other appropriate measures.
3. Tertiary.
   Reducing the harmful effects of exposure to psychosocial hazards by implementing rehabilitation programmes and taking other corrective and supportive actions.

When it comes to measuring how these interventions perform, the standard prescribes establishing and implementing systematic approaches to monitoring and measuring activities related to managing psychosocial risk and the performance of the OHS management system. Besides being developed in consultation with workers, the qualitative and quantitative measurement mechanisms should:

• Determine the extent to which the policy is complied with and objectives are met
• Provide data on activities related to psychological health and safety in the workplace, recognising the need for confidentiality of personal information
• Determine if the processes for psychosocial hazard identification and assessment of risk are in place and controls are operating effectively
• Provide the basis for decisions about improvements related to health, safety, and wellbeing at work
• Determine the extent to which the organisation has fulfilled legal requirements and other requirements
• Provide information on the OHS management system’s performance in managing psychosocial risks

The role of digital technology in complying with ISO 45003

Now, what about the start-up costs (both direct and indirect) of complying with ISO 45003? Clearly, organisations can’t afford to belabour the process of implementing best practices in managing psychological health and safety at work, especially now in the face of an acute mental health (and compliance) crisis.

Here, certain digital technologies can help businesses, with functionality tailored to complying expeditiously with ISO 45001 and ISO 45003 (as well as related standard ISO 9001 and ISO 14001). Beyond that, dedicated wellbeing management functionality within those platforms can help organisations (1) respond to mental health and wellbeing events, (2) implement and track proactive initiatives to support their personnel, as well as (3) better understand the opportunities for mental health and wellbeing improvement.

What capabilities in particular? Organisations will:

• Gain situational awareness of current events impacting on personnel through live weather, Twitter, and pandemic feeds
• Broadcast communications to distributed personnel in seconds using email, SMS, or voice
• Conduct welfare checks at scale enabling personnel to respond via email, SMS, or voice
• Triage response to events
• Push surveys to personnel to understand how they are coping before, during, and after events
• Launch initiatives with templates that take the heavy lifting out of creation and implementation
• Customise initiatives based on current events or unique organisational requirements
• Schedule periodic working from home ergonomic assessments for distributed staff
• Enable personnel to request mental health and wellbeing support
• Direct personnel to support programs and bestpractice content
• Securely store personnel information in a single solution or import from your HR Software

Finally, the COVID-19 crisis has turbocharged an already explosive mental health and wellbeing crisis. We are only now beginning to experience the fallout in lost productivity and engagement.

And as safety regulators move to catch up to advances in the psychological health and wellbeing space, the mentally resilient workforces of today will only lengthen their competitive (compliance) advantage over their less developed peers. 

Don’t stay on the wrong side of the divide. Instead, invest in wellbeing management strategies and easy-to-use technologies, such as Noggin for Mental Health and Wellbeing, to comply with ISO 45003, promote mental health resilience, reduce compliance and injury risk, as well as boost productivity, engagement, and morale. 

Citations

i. Edie-Louise Diemar, HRM: Employers’ role in addressing Australia’s $220 billion mental health issue. Available at https://www.hrmonline.com.au/mental-health/productivity commission-employers-role/#:~:text=The%20report%20estimates%202.8%20 million,estimated%20%2417%20billion%20a%20year.

ii. Ibid.

iii. Penn State, Science Daily: Poor mental health days may cost the economy billions of dollars. Available at https://www.sciencedaily.com/releases/2018/07/180730120359.htm.

iv. Heather R. Johnson, Psychiatry Advisor: Anxiety and Depression Increases During COVID-19 Highest Among Young Adults. Available at https://www.psychiatryadvisor.com/home/topics/anxiety/the-number-of-adults-with-symptoms-of-anxiety-or-depression-increased-during-covid-19/.

v. OECD, OECD Policy Response to Coronavirus (COVID-19): Tackling the mental health impact of the COVID-19 crisis: An integrated, whole-of-society approach. Available athttps://www.oecd.org/coronavirus/policy-responses/tackling-the-mental-health-impact-of-the-covid-19-crisis-an-integratedwhole-of-society-response-0ccafa0b/.