MENTAL HEALTH AND WORK
Olufemi Olugbile
The Nature of Work
Work is one of the most important areas in the lives of human beings. It is an area of life that everybody tends to assume they know about, but the concepts involved are notoriously difficult to grasp. Even the definitions can be ambiguous. ‘Work’ may be defined as ‘an activity, or a set of activities, engaged in for the attainment of a set of objectives, usually including some kind of remuneration’.
If the average life-span of a human being is about 70 years, it is instructive to look at how these years are spent. The first 20-25 years of life are spent in the process of preparing the individual for a career. In most societies, this involves going through a course of formal education, leading up to the attainment of certain qualifications. This may be followed by, or replaced with, a period of apprenticeship in a particular discipline or trade. This description, in broad essence, holds true, whether the subject is someone who goes to Medical School to train as a doctor, or the young man from Onitsha who is apprenticed from the age of fifteen to his ‘brother’ who sells motor spare parts at Idumota.
From this it may be said that roughly one third of the average person’s existence is spent for the primary purpose of preparing for a work-career. The next period of life, when the training is over, is spent in actually pursuing that career. The young graduate gets his first job, or the boy who was apprenticed from the age of fifteen is finally ‘settled’ by his boss, and he now has his own shop.
For the next 35 to 50 years, the story of the man’s life is the story of his career, as he moves on in the same work, or moves from work to work. Conventionally, with the passage of years, the individual advances in seniority and experience, and his income from his job increases. He does a number of other things. He gets married, he starts a family, he practises his religion. But the work is a central thread that runs through his life, connecting the different bits. It is a dominant theme. That is why one of the most crushing things that can happen to a person in modern life is to be unemployed. In every society, unemployment is one of the major causes of stress, which may precipitate or exacerbate Mental Illness.
After working through the ‘Middle Years’, (an apt description for this active, productive period), the man, approaching fifty five years, or sixty, begins to prepare for the next period – Retirement.
This is supposed to be a period when the citizen has accumulated some resources, and is traditionally supposed to sit back to rest and enjoy the balance of his life.
Psychologists and Psychiatrists have discovered that it is not so simple. When people retire and they have nothing to do, they tend to come down with physical and psychological illnesses. It is almost akin to bereavement. Many people in the modern day resolve to ‘stay active’ when they ‘retire’. In effect work remains a dominant theme in their lives, even in ‘retirement’. The primary motivation may not be financial reward, although it may remain a factor. Working helps to preserve a sense of involvement and meaning. Over the years, even social life and other areas of ‘Non-Work’ life have become inextricably interwoven with the work environment. Once work stops, it is a common experience for the individual to report that he feels he is no longer useful.
The Purpose of Work
Popular literature often gives the impression that Work is for the purpose of getting ‘3 square meals a day’. This seems to imply that if every worker is given an adequate income to live on, and every citizen, even the one that does no work gets three meals a day, everybody will live happily ever after. This is not borne out in the field. In societies where the Social Security system ensures that everybody gets an income, whether they work or not, joblessness is still associated with a relatively high incidence of mental disorder, and the work-related complaints of workers – ‘low’ or ‘high’ ‘grumbles’ (Maslow, 1968) are loud. The complaints simply shift to a ‘higher’ ground. Where the work guarantees food, the agitation is for shelter. After shelter, the worker wants to have a sense of belonging and involvement. Ultimately the goal to be attained is that elusive quantity described by Maslow – ‘Self Actualisation’.
The History of Work
Alo (Alo, O. 1991984) conducted research among a large sample of Nigerians about their work-attitudes. He found that for 67.1% of his sample, Work was the ‘Central Life Interest’ (i.e. the most important thing in their lives).
History of Work-Psychology:
Human beings have always worked. Animals work too, but their work is entirely instinctual and functional, directed at ‘drive-reduction’. A bird builds a nest instinctively, a lion kills prey to satisfy hunger.
Sigmund Freud, originator of Psychoanalysis, believed that work is unnatural, and human beings always try to do as little of it as possible.
Frederick Taylor, the pioneer of ‘Time and Motion Studies’, believed work was not about making employees happy or ‘fulfilled’, but getting them to do the maximum amount of work in the most efficient way. Their feelings really don’t matter, and they don’t need to interact with one another beyond the requirements of the work. Pay should be tied to productivity. Such thinking led to the creation of work-schemes which benefited some industries, but were very unpopular with workers.
The Human Relations Movement arose out of the ‘Hawthorne studies’ of Elton Mayo and others. They believe the feelings of workers and the relationships they form are very important in creating motivation and enhancing productivity. Work should be designed to encourage positive interactions and get people to feel good about their work-place. Workers should have imput into work-design and feel that they have a stake in the organization.
Current thinking is a variable mixture of efficiency and feeling.
The Influence of Culture
This is evident in popular myths, stories and literature e.g. the character of Okonkwo in Chinua Achebe’s ‘Things Fall Apart’ exemplifies the Igbo work-ethic.
McClelland (McClelland, 1968) believed that you can actually determine a society that is going to be productive by analyzing the children’s stories prevalent in that society. A society’s predominant interest, according to him, could be with Achievement, or it could be with Affiliation, or it could be with Power. One of the things he did was to study the three major ethnic groups in Nigeria – the Hausas, the Ibos, and the Yoruba. His finding was that the Yoruba in particular showed ‘a high need for Achievement’ which dated back to the period before the first contact with British colonialists. Although many Nigerian scientists found certain aspects of McClelland’s theory unpalatable, his writing is being reexamined, in the light of Nigeria’s recent experience!
The Mind and the Work
Why do Nigerians work?
3 recent authorities may be examined.
Oloko (Oloko, 1965) asked 500 workers (430 Junior and 70 Senior staff) at Ewekoro Cement Factory to rate 14 ‘Motivating’ items in terms of how important they were in stimulating them to work hard. The following was how the workers rated the factors, in declining order of importance:
1. Opportunity for progress on the job (career advancement)
2. Job Security
3. Good salary/wages
4. Medical facilities
5. Working on the job you prefer
6. Pension scheme
7. Credit/Recognition for the job
8. Having good people to work with
9. Having a ‘good’ supervisor/boss
Shote (Shote, 1994) asked 107 workers of managerial rank from different establishments to rate the following 10 motivating factors in order of importance (‘factors that motivate me’)
• High wages
• Job security
• Promotion
• Good working conditions
• Interesting work
• Personal loyalty to supervisor
• Tactful discipline
• Full appreciation of work done
• Receiving help on personal matters
• Feeling of belongingness
Among his cohort, senior bank workers tended to rate ‘Good Working Conditions’ highest, followed by ‘Full appreciation of work done’, then ‘Receiving help on personal matters’, and ‘Promotion’. ‘High Wages’ was ranked 7.
Among the Senior officers of Manufacturing Organisations, ‘Job Security was rated highest, followed by ‘Good Working Conditions’, ‘Interesting Work’, ‘High Wages’ etc.
Among officials of Industrial Unions interviewed, ‘Job Security’ was rated highest, followed by ‘Good Working Conditions’, ‘High wages’, ‘Interesting Work etc.
Olugbile (Olugbile, 1997) conducted a multi-centre nation-wide questionnaire survey that involved over one thousand respondents of various categories. One item asked: ‘What is your reason for choosing/staying in your present job?’ The respondents were asked to select from a list that included the major items on Oloko’s ‘group of 14’.
The overwhelming majority picked ‘Good Prospect for career advancement’ as their major reason for preferring their present job.
To another item that asked them to list their main motivators for working hard, the majority chose ‘to improve myself’, ‘to make money’, and ‘to contribute to society’ in that order, from a list of possibilities.
With all this as background, it is now possible to look specifically at the mental health of workers.
Most discerning General Practitioners and Personnel Managers know that during periods of crisis in an organization, more people tend to report sick and visit the doctor than at other times. The complaints are often of physical symptoms such headache, pain, and ‘fever’.
Doctors who run industrial clinics tell stories of many workers who come day in day out to the clinic, complaining of symptoms for which no physical basis can be found. Such patients become a source of stress for the doctor himself after some time, because he often cannot do anything for them!
No specific type of mental illness is associated with any particular work. However some types of work are recognized as being intrinsically more stressful than others. Being a surgeon, or an Air Traffic Controller is supposed to be very stressful. The higher the level of Stress to which an individual is subjected, especially if this is sustained over a long period, the greater is the likelihood that the individual will develop a Psychological Disturbance of some sort. A recognized unit of measurement is the ‘Life Change Unit’. This scheme gives a ‘weighting’ to various common events, and postulates that if various ‘stressful’ events occur in close proximity, the individual is likely to have a breakdown of some sort. Events ‘weighted’ in this manner include ‘loss of spouse’, loss of job, and marital separation.
The disturbances that arise may range from relatively minor problems like Anxiety and Depressive disorders to major Psychotic disorders.
What are these factors in the work-place that may prove invidious to the health of the worker?
These factors could belong to the worker himself, or to the organization.
Worker:
Doing a job that one does not like or find interesting
Having a negative attitude to work generally
Importing difficulties from non-work environment into work-place (e.g. marital problems)
Drug/Alcohol Abuse
Unhealthy life style (inadequate sleep, lack of exercise etc)
Organisation:
Lack of equity/transparency in work-practices
Lack of security of tenure
Lack of relationship between effort and reward
‘Path to desired goal’ is not clearly defined
Inappropriate job placements (square pegs in round holes)
Unhealthy working environment – physical (noisy, hot or dangerous environment)
– social (strict ‘wages for labour practices with discouragement of relationships, lack of communication, lack of employee imput into decision making), lack of good health care, pension plan, recreational facilities.
Where such so-called ‘hygiene’ factors obtain, the rate of worker attrition tends to be high. There is high turn-over in terms of people leaving the job and others being hired, only to leave soon afterwards. There is high absenteeism, and there are high medical costs because of frequent illness. There is a high degree of employee dissatisfaction and frustration, and a very low level of commitment to the goals of the organization. Productivity declines, and both the worker and his employer are the ultimate sufferers.
Though these assumptions stand to reason and are generally accepted in the circles of Work Psychology circles, defining the quantitative relationships between these factors constitutes a fertile area for future research by Psychiatrists, Psychologists and Sociologists.
Towards Attaining Good Mental Health For Nigerian Workers
‘Outside’ factors
Some of the factors that cause Mental Health problems for the worker are ‘imported’ from the non-work sphere into the work space. Some of these factors actually operate in society at large, and their solutions lie beyond the power of the employer. One of the most devastating strike actions in Nigeria’s history was one undertaken by PENGASSAN, the umbrella group of workers in the petroleum industry during the military era to protest what was essentially a political problem. The strike went on for a long time, virtually paralyzing the nation’s industry. The employers were powerless, the workers were under stress, and everyone suffered. A certain amount of societal harmony and equity, and provision of infrastructure and political stability along with a stable economy would reduce the day to day stress the worker is under, and improve his mental health.
Factors In The Work Place
Physical:
Organisations need to make the work place as ‘Worker-friendly’ as possible. The Nigerian work-place must be neat, and meet internationally acceptable standards in terms of lighting, noise, vibration, heat, and other criteria. Contrary to general public perception, the Nigerian worker himself generally rates his work-place as being neat, safe and conducive to his health (Olugbile, 1997). A lot of improvements can be carried out in factories and offices which will further enhance the health of the worker, and improve the environment in which he spends his work-life.
Social
The social milieu of work should be conducive for workers. There must be effective communication across all strata of staff. Workers must be allowed to have an input into decision-making, and their suggestions for improvement must be actively considered. The criteria for rewards such as pay increase, bonuses and promotion must be clearly set out and adhered to. Factors such as favouritism and nepotism must be played down, and a clearly defined merit system instituted. There must be security of tenure. ‘Casual’ labour leads to casual work and a poor and frustrated worker, who is likely not to be in the best of psychological health.
Individual Life-style
Workers themselves must learn the need to live a life-style that will be conducive to their mental health. Good and adequate sleep is essential. It is desirable to sleep between 6-8 hours every 24 hours. It is necessary to eat a balanced diet. Regular exercise and relaxation are important.
A good network of relationships both within and outside the work-place tend to enhance mental health and reduce the likelihood of illness.
Change of Job
Anyone who is engaged in work he cannot bring himself to enjoy or which he feels is not right for him, which does not match his competence or his interest is best advised to look for another job instead of waiting around for retirement which he may not live to see as a result of illness.
Management of existing illness
Even with adherence to the preventive measures outlined previously, some workers will still develop mental disorder. Afterall one in a hundred people will suffer from Schizophrenia at some point in their lives. Up to 25% of workers will have some symptoms of mental disturbance (mostly of the relatively minor varieties) at some point in their lives.
For those who develop such mental disturbances, there must be a Health Care system that is able to provide adequately for their needs. Mental illness is a special category of illness that requires special provision. Often the sick person needs to see not just a General Practitioner, but a Specialist, and this attracts additional costs. The medicines used in the treatment of mental illnesses, especially the newer drugs are relatively expensive, and the worker is unable to afford them on his own. On the other hand companies themselves complain they cannot afford the high medical bills. For this reason, many companies find a way to get rid of the mentally ill worker as soon as they discover the nature of his illness. The advent of Health Insurance will hopefully bring some relief in this area.
There is also the problem of Stigma which is often attached to mental disorder of any sort in Nigerian society. This leads people to hide their symptoms and to hide the fact that they are receiving treatment. It also keeps many people who can benefit from treatment from seeking such treatment, for fear of being stigmatized and ostracized by fellow workers. The generality of Nigerian workers will benefit from educational programmes which will help to demystify and de-demonise mental illness.
The Prospects for the Mentally Ill of staying on the job
Most mental illnesses, when effectively treated are compatible with full return to work, although accommodation must be made for such incidental problems as side-effects of medication such as drowsiness which may impair ability to operate sensitive machines. Again these are problems that must be tackled openly for the good of all.
If workers and employers are able to begin from this point to understand and address the crucial issue of Mental Health in an enlightened and open manner, the gain will be a more productive workplace, and ultimately a more prosperous society.
References:
Maslow, A (1968) Towards a Psychology of Being. Brooklyn
Alo, O. (1984) Understanding Work Attitudes and Behaviour – A Study of Work and Non-Work Spheres Of Life (PhD Thesis, Obafemi Awolowo University, Ile Ife)
McClelland, J.(1968) The Achieving Nation. London
Oloko, O (1965) The Muddywater Studies. Labour And Development In Nigeria. Lagos
Shote, G.A. (1994) Psychology In Industrial Development. Labour And Development In Nigeria. Lagos
Olugbile, F. (1997) Nigeria At Work – A Survey Of The Psychology of Work Among Nigerians. Malthouse, Lagos.
