Psychological Risk Management v6 - oscarkilo.org.uk · Psychological Risk Management: Introduction & Guidance Version 0.6 Page 3 of 13 Introduction This paper provides an introduction

PsychologicalRiskManagementIntroduction&Guidance

Version 0.6

Psychological Risk Management: Introduction & Guidance

Version 0.6 Page 2 of 13

CollegeofPolicingLimited

LeamingtonRoad

Ryton-on-Dunsmore

Coventry,CV83EN

Publicationdate:Winter2017

ISBNNumber:

Authors:DrIanHesketh,DrNoreenTehrani&ProfJohnHarrison

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IntroductionThispaperprovidesanintroductionandguidancetoforcesconsideringhowtoassessandmanageareas of policingwhere there is a higher level of exposure to psychological hazards known to beassociatedwithanincreasedriskofanxiety,depression,primaryandsecondarytrauma.

TheManagementofHealthandSafetyatWork (1999)Regulationsprovidesthe frameworkwithaspecificreferencetotheneedforriskassessmentandmanagement.

“Every employer shall ensure that his employees are provided with such healthsurveillanceas isappropriatehaving regard to the risks to theirhealthandsafetywhichareidentifiedbytheassessment.”

RiskManagementfallswithinthewiderRiskControlandManagementCycleinwhichorganisationsarerequiredtoundertakekeyfiveactivities:

1. Identifytherisksintheworkplace:Whathazardsexistandhowcouldthesehazardsaffectthehealthandwellbeingofemployees?

2. Find out who might be harmed and how this might occur:Whomight be exposed?Whichgroupsareparticularlyvulnerable?Howcouldtheybecomeexposed?Whichrolesortasksareparticularlyhazardous?

3. Analyse and evaluate the level of risk:What is the likelihood of an injury occurring? Whatcouldbethemagnitudeofharmcaused?Howcantheriskbemeasured?

4. Establishways to reduce the risks: Whatarethecontrolmeasures?Aretheyproportionate?Howshouldtheybeimplemented?Whowouldberesponsible?

5. Record,monitor, review and improve:How is the surveillanceprogrammeworking?Howdowe comparewith other organisations (including those outside Policing)?What canwe do toimprove?

Theapproachcoversallstagesofemployment;startingwithrecruitment,induction,deploymentandpostincidentsupport.Tobesuccessfulthereisalsoaneedforsomeinvestmentinthetrainingandeducationofofficersandstaffinhowtorecognisesymptomsofpsychologicaldistressandtoprovidetheearlyinterventionsessentialtothewellbeingofpoliceofficersandstaff.

Thepapercannotcoveralleventualities,rolesthatinvolveanexposuretohighlevelsofstressand/oroccasionalexposuretotraumaticeventsarecoveredbytheBlueLightWorkplaceWellbeingFrameworkandtheEarlyInterventionPost-Traumaproceduresadoptedbyforces.Thefollowingguidancerelatestotheriskassessmentandmanagementofhighriskroleswithinpolicing.

DrIanHesketh

CollegeofPolicing



Guidance Thisguidanceappliestoallareasofpolicingwithhighlevelsofpsychologicalhazard.Policeforcesarecommittedtopromotingthehealth,safetyandwellbeingoftheirstaffandofficersbyprovidingsuitableworkingarrangementsandenvironments.

TheCollegeofPolicingrecognisesthatsomeofficersandstaffareexposedtoahigherlevelofdistressingexperiences,materialsand/orinformationandacknowledgethatthisexposurecanaffectmentalandemotionalhealthandwellbeing.tisthedutyofeachforcetoassessthesepsychologicalhazardsandputinplacereasonablecontrolstomitigateandmanagethepsychologicalrisktoemployees.

WhilstthecoreofthisguidancecomesfromHealthandSafetylegislation,someoftheelementsaretakenfromamilitaryapproachadaptedforapolicingenvironment.

Common Q's and A’s

Q.WhatIsPsychologicalRiskManagementandWhyDoWeNeedIt?

A.Somerolescarryadditionalvulnerabilityandhavethepotentialtointerferewithanindividual’semotionalandmentalwellbeingduetothenatureofthecontentfacedaspartoftheirday-to-dayactivities.Manyindividualshaveanin-builtabilitytodealwithacertainlevelofpsychologicalstressbutthisabilityvariesfrompersontoperson,andchangesovertimeorcircumstance,largelydependentonstressandresiliencelevels.Policyandguidancedocumentshavebeenintroducedtoraisegeneralawarenessandprovideguidanceforindividualsandmanagementalike.

Q.WhoHasResponsibilityforMonitoringPsychologicalRisk?

A.Wealldo.Asalinemanagerorpeer,thepsychologicalwelfareofthosewithwhomyouworkisparamount.PsychologicalRiskManagementhasbeenestablishedtooverseethemanagementofpsychologicalrisk,particularlyofficersandstaffthatcarryoutvulnerableroles.

Q.WhatDoINeedtoBeAwareofInAVulnerableRole?

A.Primarilyitisaboutrecognisingandunderstandingyourownresponsestopsychologicalthreatsandhowyoumanagethis.Individualsmustraiseissuesofconcernwithlinemanagementiftheyfeeltheirworkinvolvesanincreasedriskofpsychologicalhazards.Theyshouldseekadvice,andifnecessary,counsellingthroughtheiroccupationalhealthorwelfaresupportservicesiftheybecomeawareofaproblemwithinthemselves.



Q.WhatDoINeedtoBeAwareofAsALineManager?

A.Linemanagersmustseektodevelopanenvironmentthatde-stigmatisesmentalhealthandencouragesreportingofconcerns.Linemanagersmustmakeajudgementifrolesareatdangerofcausingpsychologicalrisk.Potentialexposuretopsychologicalrisksmustbeclearlystatedwithinapost’sJobSpecsandTOR’s.Withintheworkingenvironmentstaffmustadheretoclearprotocolsandlimitaccesstosensitivematerial.Linemanagersmustprovidedebriefs,impactmonitoringandsupervisionatregularintervalsasappropriate.

Q.WhatHelpIsAvailable?

A.Firstly,allshouldfamiliarisethemselveswiththeconceptofPsychologicalRiskManagement.Anindividualshouldbeabletoraiseconcernswiththeirlinemanager,peers,welfarestaff,oroccupationalhealthatanytime,andexpecttobesupported.Alistofmentalhealthtrainedstaffshouldbemadeavailabletoallstaffonarangeofmedia,suchasnewsletters,internalcommsandintranets.Regardlessofrankorposition,itiseveryone’sresponsibilitytounderstand,identifyandreportpsychologicalrisksintheworkplace.Allpersonnelshouldadheretoandpromoteaculturewherepsychologicaleffectsarenotseenasasignofweaknessorincompetenceinanycircumstance.

Risk Assessment and Management

1. Identifyingtherisks

Manypolicingactivitieswhichareknowntohaveapotentialforcausingpsychologicalharmandthereforecan be foreseen. The Health and Safety Executive have developed Management Standards whichidentifiedfivepotentialhazardswhichshouldbemonitoredandcontrolled inorganisations(HSE,2009).Thesestressrelatedhazardsinclude:thelackofcontrolandsupport,exposuretoconflictualrelationships,poorly defined roles and organisational change and can result in the workers suffering psychologicalinjuriesincludinganxietyanddepressivedisorders.

Inadditiontoworkplacestress,severalpolicingrolesareexposedtomoreextremehazardsaspartoftheirwork.Theseofficersandstaffareexposeddirectlyorindirectlytodeath,traumaanddistresswherethepossibility of psychological injury is known and is therefore foreseeable. There is a significant body ofevidencetoshowthatworkersdirectlyor indirectlyexposedtotraumaticeventsduringtheirworkhaveanincreasedriskofdevelopingpost-traumaticstressdisorder,majordepression,anxiety,alcoholordrugdependency (Breslau, 1998). These include: body handling, shootings, rape and other sexual assaults,transportationdisasters,physicalattacks,verbalthreats,harassmentandaccidents.ThelatestversionoftheAmericanPsychiatricAssociationguide topsychiatricdisorders (APA,2013)providesdescriptionsofstress related hazards which can lead to post traumatic stress disorder, acute stress disorder andadjustmentdisorder.



During this phase of the cycle each Force should examine all the roles within their organisation to identify any known hazards to the psychological health of employees. Human resources and occupational health should be alert to research and case law relating to work related psychological injury; this may involve looking at claims for compensation, stress/ trauma research and epidemiology.

2. Findoutwhomightbeharmedandhowthismightoccur

Aftertheriskassessment,thenextstageofthecontrolcycleistoidentifywhichofficersandstaffareatgreatestriskandhowtheymightbeharmed.Thereisgrowingevidencetoshowthatcertainemployeesareatmoreriskthanothers.TheManagementofHealthandSafetyatWorkRegulationsidentifyseveralcategoriesofemployeeswhorequireattentionincludingnewrecruits,newandpregnantwomen.

Research in to anxiety, depression and traumatic stress has shown awider range of vulnerability. Thisincludes:gender,personality,levelofeducation,pre-existingdisordersandearlylifeabuse.Thesefactorshavebeenshowntoincreasetheimpactofanexposuretoahazardouseventandneedtobeconsideredin recruitment, taskdesignand theprovisionof support, so it is important to identifywhich individualsmay be atmore risk, to introduce reasonable adjustments and to take account of these vulnerabilitieswhen planning and undertaking a surveillance programme (Breslau, 2009; Alexander & Klein, 2003;McFarlane,2004).

ThisphaseofthecontrolcyclerequiresForceslookathowaparticularemployeemaybecomeexposedtoa hazard. Understanding roles and how these roles are undertaken is important. Thiswould generallyrequireaninterviewwithworkerstofindouthowtheyengageinhazardoustaskstoidentifywhatmightbeinvolvedinincreasingormitigatingtherisks.Forexample,childprotectionofficer’sroleistoidentify,assessandinvestigateriskstochildren.Ifachildprotectionofficerhasachildofasimilaragetoavictimofabusethiscouldincreasestheriskofsecondarytrauma.Thisriskmaybeincreasedormitigatedbythelevelsoftraining,emotionalpreparationandsupportprovided.

3. Analyseandevaluatethelevelofrisk

Themosteffectivewaytosystematicallyanalyseandevaluatetheimpactofthepsychologicalriskwithinanorganisationisthroughpsychologicalscreening. It is importanttocheckthereliabilityandvalidityofthequestionnaireandtomakesurethatthepersonadministeringandinterpretingtheresults istrainedandcompetent inpsychometric testing. Thereareseveralquestionnairesandscreeningtools thathavebeendevelopedthatcanbeusedtohelptoanalyseandevaluatethelevelofpsychologicalriskfacedbyworkers. Researchhasbeenundertakeninclinicalandorganisationalsettingstocreatemeasureswhichassess the levels of symptoms and identify vulnerability and protective factors implicated in thedevelopmentofpsychiatricdisorders. Wilson&Keane (2004)provideagoodreviewof theassessmenttoolsandtheirreliabilityandvalidityinassessingtraumasymptoms.

An effective surveillance programme should also measure other relevant factors including personalvulnerability where gender, introversion/extroversion and neuroticism/emotional stability have beenshown to important factors (Tehrani, 2016). Several psychometric tools can be used to measurepersonality,oneoftheearliestbeingthethreefactorEPI(Eysenck&Eysenck,1975)andmorerecentlythefive factor NEO-PI (Costa & McCrae, 1992). Both personality questionnaires measure the importantextraversion/introversionandneuroticism/stabilitycontinuums.PersonalitytestscanonlybeinterpretedbyaBritishPsychologySocietyregisteredandqualifiedtestuser(BPS,2014).



The effective use of coping skills and personal resilience factors can also be a helpful in identifyingvulnerabilitytoharm.ThereareseveralvalidandreliablemeasuresthatcanbeusedtoassessindividualresilienceincludingmeasuressuchasCOPE(Carveretal,1989)Hardiness(Bartoneetal,2008)andSenseof Coherence (Antonovsky, 1993). Some of these questionnaires can only be used by a registeredpsychologist(BPS,2014)othersaremorewidelyavailable(Brewin,2005).Resiliencetrainingsessionscanalso be an effectivemeans of improving personal resilience (Hesketh et al, 2015) and the use of self-administeredonlineawarenessinstrumentscanalsobeused,suchasi-resilience(Robertson&Cooper).

Forces may access a provider of electronic psychological screening or employ a suitably qualifiedpsychologisttoundertakethescreeningontheirbehalf(ACPO,2009).ScreeningisnormallymanagedbyOccupational Health (OH). Having undertaken surveillance screening, the OH should identify thepsychological “hotspots” where employees are experiencing above the expected levels of clinicalsymptoms.

An OH Advisor should speak to themanagers and employees to identify what might have caused theraised prevalence of symptoms, examining organisational factors including, recruitment, training,procedures,workloadandcontrolorchangesinthenature, incidenceormagnitudeofthepsychologicalhazard.

As the use of psychological surveillance increases it should become possible to benchmark withorganisationsfacingsimilarhazards.

4. Establishwaystoreducetherisks

Thecontrolcycleinvolvesthreelevelsofriskreductioninterventions:

a)primaryinterventions:involvingchangestoworkingpracticesorprocedures;

b) secondary interventions: help employees detect and manage their responses to hazards withoutattempting to eliminate or modify them. Training aimed at increasing resilience and coping skills areusefulinreducingtheimpactofpsychologicalhazardsand;

c) tertiary interventions: involving the provision of individual support to people who become ill,facilitatingareturntoworkandlearninglessonsaboutcausation(Jordanetal.2003);

Police forces should concentrate on facilitating primary interventions as these reduce risks at source.Primary interventions requiremanagement agreement and support as they typically involve changes inways of working, equipment or procedures. The use of benchmarking with other organisations canidentifygapsandopportunitiesforimprovements;thisisagoodwaytohighlightwhatmightbedonetoreducetheprimaryrisks.

Secondary interventions can involve the Force in developing educational presentations to help theemployeerecognisehowtoreducetheriskofpsychologicalharmandidentifytheearlysignsofdistress.Oneofthemoreeffectivewaysofreducingtheriskofpsychologicalill-healthisthestructuredinterviewwith employees which combines secondary and tertiary interventions. Employees identified asexperiencing difficulties in the screening should be offered a structured interview which will help toidentify the most appropriate intervention options. These options may include training to increaseresilienceorcoping,anadjustment to therole,additionalmanagementsupportor re-deploymenttoanalternative role. Employees suffering from clinical symptoms may require a referral for therapy orpsychiatrictreatment.



5. Record,monitor,reviewandimprove

Organisationsneedtomaintainrecordsofthewaythattheyarehandlingphysicalandpsychologicalriskstoemployees.Notonlyisthisimportanttothesurveillanceprocessbutitalsohelpstodemonstratethatthe organisation is meeting its legal duties. Occupational health departments should work withmanagementtoensurethatdataiscollectedandthatopportunitiesforimprovementaretaken.

Itisimportantthatariskregisterismaintainedwhichcoversanysignificantpsychologicalriskandarecordof the results from the programme of psychological surveillance. Occupational Health should providemanagement with the information on the fitness of employees to undertake their role, where theemployeeiscurrentlyunfitguidanceshouldbeprovidedonanyadjustmentsorneedforredeploymentinanalternativerole.Managementinformationshouldalsobeprovidedontheoperationofthesurveillanceprogramme,thenumbersofpeopleengagingintheprogramme,numberofrolesassessedasneedingtobe part of the surveillance programme, levels of fitness, areas of concern and opportunities forimprovement(Everton,2014)

Psychological Risk Management Procedures

Recruitment Roleswhichposeapsychologicalhazardtothewellbeingofofficersandstaffshouldbeassessedandregularlyreviewed.Applicantsshouldbemadeawareofthenatureoftherisks,therequirementthattheymayneedtoundergopre-deploymentassessments,monitoringandreviewidentified.Linemanagersshouldmakesurethathighriskrolesareassessedandthenre-assessedatleasteverytwoyearsormoreoftenwhereroleschange.

Recruitmentmaterialsshouldclearlyindicatethoseroleswhichhavebeenidentifiedasinvolvingahigherlevel of psychological risk. Where there is to be pre-employment screening and/or regularmandatoryscreeningthisshouldbeclearlydescribed.

Anypsychologicalscreeningtoolsincludingquestionnairesneedtobereliableandvalidandpsychologicalinterviewsorassessmentsshouldonlybecarriedoutbyqualifiedpractitioners.

During Appointment Linemanagersshouldconductregularone-to-oneswithofficersandstafftoproactivelymonitorthevolumeandnatureoftheirexposuretopsychologicalhazards.Thisshouldalsotakeaccountofanyindividualvulnerabilitieswhichmayaffectresilience.Thismayincludeanypersonalissuessuchasthebirthofachild,abereavementorillness.Wherenecessarythelinemanagermaymakeanadjustmenttotheworkoriftheyneedmoreinformationorsupportrefertheindividualto



OccupationalHealth.Regularresiliencebuildingsessionswhereteamscansharetheirapproachestodealingwithpsychologicalhazardsascanindividualorgroupdebriefingofparticularlydistressingorviolentincidents.Linemanagersshouldpromoteinternalandexternalsupportnetworksthatareavailabletoofficersandstaff.(EGHSEstressmanagementcompetencies)WherenecessaryreferralsshouldbemadetoOccupationalHealthforapsychologicalassessmentandreferralforadditionalsupport.

Onetoonesessionsshouldatleastfourtimesayear.Theyshouldalsotakeplacefollowinganyabsenceorwheretheteammember’scircumstanceschange.Resiliencecanbecomedepletedwithtimewiththeneedforconsiderationbeinggiventointroducingjobrotationandtenureforparticularlydemandingroles.

AfterCareLinemanagementshouldofferaccesstoadvice,andreviewthewellbeingofallstaffleavingthosepostswhichareassessedasputtingstaffatriskofpsychologicalhazards.Whereanindividualhasbeenfoundtohavebecomesensitisedtoaparticularkindoftraumatichazardcareshouldbetakentoensurethatfuturedeploymentsdonotposeariskofreactivatingatraumaresponse.Whereanofficerorstaffmemberleavesahigh-riskroleandawelfareconcernremainsthereshouldbeareferraltoOccupationalHealthsoanassessmentoftheneedforcontinuingsupportcanbeundertaken.

The impact of a traumatic exposure can be long term. Trauma responses can be re-triggered by anyreminderoftheoriginaltraumaticevent.Thiscanaffecttheremainderoftheofficer’sworkinglifeandina small number of cases can involve serious psychiatric difficulties which make it impossible for theindividualtocontinueworkinginpolicing.

SupportandSupportServicesLinemanagerandpeersupportisimportantinpreventingthedevelopmentofpsychologicaltraumaresponses.Teamattitudesthatrecognisetheneedtoshareconcernsandtoprovidepeersupportwillhelptobuildresilience.Apositiveleaderwhoprovidesrecognition,positiveengagement,cleardirectionandopennessfortheteamwillprovideanatmospherewherethereisanenhancedlevelofresilience(Cunha,Cunha&Rigo,2009).Individualsshouldbeabletoraiseconcernsandbesupportedforanypsychologicalissuesbytheirlinemanager.

Thereshouldalsobeeasyaccesstooccupationalhealth,welfareandpeersupportersorambassadorswithoutfearofbeingstigmatised.OccupationalHealth’sroleistoassessfitnessforworkandtoadviselinemanagersonrehabilitationandtheneedforworkrelatedadjustments.Whenrequiredoccupationalhealthpractitionercanmakeappropriatereferralstootherhealthcareprofessionals,includinggeneralpractitioners,psychologistsandpsychiatrists.

AspartoftheRiskManagementProcessPoliceForcesshouldmonitorandreviewthescreeningresultsandtoencourageregulardiscussions,monitoringandreflectivepracticeascontrolmeasures.



Roles and Responsibilities

Asalinemanagerorpeer,thepsychologicalwelfareofthosewithwhomyouworkisparamount.Regardlessofrankorpositionwithinaforce,itiseveryone’sresponsibilitytounderstand,identifyandreportpsychologicalrisksintheworkplace.Allofficersandstaffshouldadheretoandpromoteaculturewherepsychologicaleffectsarenotseenasasignofweaknessorincompetence.

Someroleswithinforceshavethepotentialtointerferewithanindividual’semotionalandmentalwellbeingduetothenatureofthecontentfacedaspartoftheirday-to-dayactivities.Althoughnotexhaustive,thesepsychologicalstressorsmayresultfromviewingoneormanydisturbingimagesandreports,readingaccountsofviolentactions,anddealingwithday-to-dayexposuretoconflictsandcrisis.

TherolesandresponsibilitiesofindividualsinvolvedinPsychologicalRiskManagementshouldbedetailedinaforcepolicydocument.

Senior Management Responsibilities • Developingandintroducingpoliciesandproceduresforassessingandmanagingpsychologicalrisk• Providingadequateresourcetoeffectivelymanagepsychologicalrisk• Rolemodellingbehavioursandvalues-basedpromotionalassessments• Documentsupportservicesinplaceforindividuals,peersandlinemanagersare,ormaybe

affectedbypsychologicalhazardswhichcancausepsychiatricconditions.• Fosteranorganisationalculturewhereofficersandstaffcanapproachappropriatelytrained

individualsandlinemanagersinconfidencethatthiswillnotbeseenasasignofweaknessorincompetence.

• A‘termsofreference’(TOR)forPsychologicalRiskManagementshouldbeagreedandreviewedregularly.

Line Management Responsibilities • Identifyingandassessinghighriskroles• Managingworkloadsanddemands• Supportingteammembers• Monitortheimpactofrolesposingapsychologicalhazard• Referringtroubledteammembersforextrasupport• Providingapositiveleadershipmodel

The Federation/Union Responsibilities • Identifyingconcernstomanagement• Supportingresiliencebuildingprogrammes



Human Resources Responsibilities • Ensuringpre-employmentproceduresarecarriedout• Facilitatingmovestolowerriskroleswhenrequired• SupportingLineManagement• FacilitatediscussionbetweenLineManagementandOccupationalHealthregardingthenatureof

rolesandthepotentialexposuretoanypsychologicalhazardspriortoanyrecruiting• Ensuringthatthelevelofpsychologicalhazardisclearlystatedwithinrolespecificationsand

requirements.• Alertapplicantstothemandatoryscreening,assessmentsanddebriefingthatarerequiredforthe

durationofthepost.

Occupational Health Responsibilities • SupportingLinemanagerbyassessinganindividual’ssuitabilityforahigh-riskrole• Adviselinemanagementonthewellbeingofofficersandstaffonleavingpoststhatareassessed

havingincreasedriskofpsychologicalhazards.• Providingassessmentsforofficersandstaffwhoremainawelfareconcernafterleavingahigh-risk

role• Providingmanagementinformationontheimpactoftheworkonteamsandsections• Organisationalhealthchecksandstrategichealthcareadvice

Welfare/Ambassadors Responsibility • Supportthewellbeingofofficersandstaffinpostandonleavingposts/• Actasasignpostforotherservices• Providepeersupporttocolleagues

Employees Responsibilities • Protecttheirownhealthandwellbeingandtospeaktotheirteamleaderwhentheyare

experiencingdifficulties• Engageinanywellbeingtrainingorsupportactivities• Noticewhenacolleagueisnotcopingandtooffersupport



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