NRSICON’15

Workplace Bullying

Prathap Tharyan MD, MRCPsych

Professor of Psychiatry

Christian Medical College, Vellore, Tamil Nadu, India

NRSICON’15

Bullying and Harassment

• Bullying:

• “persistent, offensive, abusive, intimidating, malicious or

insulting behaviour, abuse of power or unfair penal

sanctions, which makes the recipient feel upset, threatened,

humiliated or vulnerable, which undermines their self-

confidence and which may cause them to suffer stress” [Lyons R, Tivey H, Ball C. Bullying at work: how to tackle it. A guide for MSF representatives

and members. London: MSF, 1995]

• Defined in terms of its effect on the recipient not the intention of the

bully.

• There must be a negative effect on the victim

• Persistent

• Need not only be face to face

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Harassment

• “Unwanted conduct related to a relevant protected

characteristic, which has the purpose or effect of violating

an individual’s dignity or creating an intimidating, hostile,

degrading, humiliating or offensive environment for that

individual.”

• The relevant protected characteristics are age, disability, gender

reassignment, race, religion or belief, sex and sexual orientation

[Equality Act 2010 , UK]

• Sexual harassment:

• Any gesture, behaviour, words or advances that are sexual in

nature

[Vishaka guidelines, Supreme Court of India]

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Discrimination

• Discrimination occurs when someone is treated less

favourably than others because they have a particular

characteristic or belong to a particular group of people.

• For example, it would be discriminatory not to hire or

promote a woman because she is pregnant or may become

pregnant.

• It is possible for a person to be bullied, sexually harassed and

discriminated against at the same time

• Workplace conflict

• Differences of opinion and disagreements are generally not

considered to be workplace bullying.

• Conflict that is not managed may escalate to the point where it

meets the definition of workplace bullying.

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Types of bullying in the workplace

• Threat to professional status • belittling opinion, public professional humiliation, accusation of lack of effort;

• Threat to personal standing • name calling, insults, teasing;

• Isolation • preventing access to opportunities such as training, withholding information;

• Overwork • undue pressure to produce work, impossible deadlines, unnecessary disruptions;

• De-stabilization • failure to give credit when due, meaningless tasks, removal of responsibility,

shifting of goal posts.

Rayner C, Hoel H. A summary review of literature relating to workplace bullying. J

Comm Appl Soc Psychol 1997;7:18191.

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Direction of effect

• Downward

• Superior to junior

• Lateral

• Colleagues

• Upward

• Junior to superior

• Workplace bullying can also be directed at or

perpetrated by other people at the workplace

such as clients, patients, students, customers and

members of the public.

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What is not considered bullying or harassment

• Examples of reasonable management action include but are

not limited to:

• setting reasonable performance goals, standards and deadlines

• rostering and allocating working hours where the requirements are

reasonable

• transferring a worker for operational reasons

• deciding not to select a worker for promotion where a reasonable

process is followed

• informing a worker about unsatisfactory work performance in an

honest, fair and constructive way

• informing a worker about inappropriate behaviour in an objective and

confidential way

• implementing organisational changes or restructuring

• taking disciplinary action, including suspension or terminating

employment

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How common is workplace bullying

Results:

• 1100 employees returned questionnaires –a response rate of 70%.

• 421 (38%) employees reported experiencing one or more types of

bullying in the previous year.

• 460 (42%) had witnessed the bullying of others.

• When bullying occurred it was most likely to be by a manager.

• Two thirds of the victims of bullying had tried to take action when the

bullying occurred, but most were dissatisfied with the outcome.

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How common is workplace bullying

• Overall, 220 of the 594 junior doctors (37%) identified themselves as

having been bullied in the past year, though 486 (84%) had in fact

experienced one or more of the bullying behaviours described on the

bullying scale

• 407 (69%) had witnessed the bullying of others.

• Black and Asian doctors were more likely to report being bullied than

white doctors (78 (45%) v 139 (34%); relative risk 1.59 (95% confidence

interval 1.11 to 2.28)

• Women were more likely to report being bullied than men (43% (126)

v 32% (92); relative risk 1.61 (1.14 to 2.26)

• Reports of bullying did not vary by job grade or age.

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Mental Health Consequences

• The cross-sectional data (65 effect sizes, N = 115.783) showed positive

associations between workplace bullying and symptoms of depression (r =

.28, 95% CI = .23–.34), anxiety (r = .34, 95% CI = .29–.40) and stress-

related psychological complaints (r = .37, 95% CI = .30–.44).

• Pooling the literature that investigated longitudinal relationships (26 effect

sizes, N = 54.450) showed that workplace bullying was related to mental

health complaints over time (r = 0.21, 95% CI = 0.13–0.21).

• Baseline mental health problems were associated with subsequent

exposure to workplace bullying (r = 0.18, 95% CI = 0.10–0.27; 11 effect

sizes, N = 27.028).

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Impacts of workplace bullying

• Workplace bullying can be harmful to the person

experiencing it and to those who witness it.

• The effects will vary depending on individual

characteristics as well as the specific situation and may

include one or more of the following:

• distress, anxiety, panic attacks or sleep disturbance

• physical illness for example muscular tension, headaches and

digestive problems

• reduced work performance

• loss of self-esteem and feelings of isolation

• deteriorating relationships with colleagues, family and friends

• depression

• thoughts of suicide.

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Impacts of workplace bullying

• Workplace bullying can also have a negative impact on

the work environment, damage the reputation of a

business and can lead to:

• high staff turnover and associated recruitment and training costs

• low morale and motivation

• increased absenteeism

• lost productivity

• disruption to work when complex complaints are being

investigated

• costly workers’ compensation claims or legal action

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Impacts of workplace bullying

• Staff who had been bullied had

• significantly lower levels of job satisfaction (mean 10.5

(SD 2.7) v 12.2 (2.3), P < 0.001)

• higher levels of job induced stress (mean 22.5 (SD

6.1) v 16.9 (5.8), P < 0.001),

• depression (8% (33) v 1% (7), P < 0.001),

• anxiety (30% (125) v 9% (60), P < 0.001),

• and intention to leave the job (8.5 (2.9) v 7.0 (2.7), P

< 0.001).

• Support at work seemed to protect people from some

of the damaging effects of bullying.

BMJ 1999;318:228–32

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Contributory factors

• Organizational environment

• leadership styles – autocratic behaviour that is strict and directive and

does not allow workers to be involved in decision making

• behaviour where little or no guidance is provided to workers or

responsibilities are inappropriately and informally delegated to

subordinates

• Lack of guidelines

• Lack of feedback

• Work related stressors

• high job demands, limited job control, organisational change, role

conflict and ambiguity, job insecurity, an acceptance of unreasonable

workplace behaviours or lack of behavioural standards, unreasonable

expectations of clients or customers

• Type of job

• Prior mental health

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Contributory factors

• Systems of work

• lack of resources, lack of training, poorly designed rostering,

unreasonable performance measures or timeframes

• Work relationships

• poor communication, low levels of support or work group hostility

• Workforce characteristics

• casual workers

• young workers

• new workers

• apprentices/trainees

• injured workers and workers on return to work plans

• piece workers

• workers in a minority group because of ethnicity, religion, disability,

gender or sexual preferences.

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Dealing with bullying

• Is the behaviour bullying or not?

• Does the situation warrant measures to minimise the

risk of ongoing harm?.

• Do I have a clear understanding of the issues?

• Do I need additional information or assistance?

• Can the matter be safely resolved between the parties

or at a team level?

• Should the matter be progressed to an investigation?

Depending on the severity or complexity

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Management

• Duties of different employees and employer

• Early identification of unreasonable behaviour and

situations likely to increase the risk of workplace

bullying

• Implementing control measures to manage the

risks, and

• Monitoring and reviewing the effectiveness of the

control measures

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Controlling risks

• Implement a workplace bullying policy

• a stand-alone policy or incorporated into a broader code of conduct

or work health and safety policy.

• developed in consultation with workers and should include:

• a statement that the organisation is committed to preventing

workplace bullying as part of providing a safe and healthy work

environment

• the standard of behaviour expected from workers and others in the

workplace

• how and where to report incidents of unreasonable behaviour

• the process for responding to reports

• the consequences for not complying with the policy

• the process for managing vexatious reports.

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Controlling risks

• Design safe systems

• Clearly define jobs and seek regular feedback from workers about

their role and responsibilities.

• Provide workers with the resources, information and training they

need to carry out their tasks safely and effectively.

• Review and monitor workloads and staffing levels.

• Develop and maintain effective communication throughout

workplace change including restructuring or downsizing.

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Controlling risks

• Workplace environment

• Promote positive leadership styles by providing training for managers

and supervisors on: communicating effectively and engaging workers

in decision-making

• providing constructive feedback both formally and informally

• effectively managing workloads

• people and performance management.

• Mentor and support new and poor performing managers and

workers.

• Facilitate teamwork and co-operation.

• Ensure supervisors act in a timely manner on unreasonable

behaviour they see or become aware of.

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Controlling risks

• Dealing with external parties

• Where there is a risk of workplace bullying by other people,

for example clients, patients:

• communicate the expected standard of behaviour through a code of

conduct or in contracts and agreements

• empower workers to refuse or suspend service if other people fail

to comply with the expected standard of behaviour

• provide support to workers who are exposed to unreasonable

behaviour

• implement control measures to eliminate or minimise the risk of

workplace violence

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Controlling risks

• Encourage reporting of events

• Disseminate polices

• Use events as learning points

• Training : Induction training for workers should include

information on:

• the standards of behaviour expected in the workplace including the

use of social media if relevant

• how workplace bullying should be reported and how such reports

are managed

• where to go for more information and assistance