Lorraine. "Beware of mental health gurus," warns Denis Renaud, director of ALSMT 54.
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You're better known as "occupational medicine," but it's actually the Lorraine Association for Workplace Health (ALSMT). What is your role? Can employees contact you at any time and anonymously?
"Any employee can request, without speaking to their employer, to see their occupational physician outside of the periodic visit, which can be every five years for simple monitoring, three years for specific monitoring, pregnant women, disabilities, etc., and twice two years for enhanced monitoring, for those who have a job with particular risks. You have an obligation to display, in all companies, the contact details of the occupational health service and the occupational physician. The employee must have it available."
So, generally, when he calls you, it's for a mental health issue?
"As a first step, generally, yes. Mental health is a balance between different factors. Physical, psychological, emotional, social, spiritual, possibly, and economic factors. However, work is a factor of social inclusion and self-esteem. When faced with a risky work situation, the employee asks to see their occupational physician to share their fears and concerns: the psychological problems they may encounter, pressure, stress management, etc. In the context of management, we have many situations involving complicated hierarchical positions that leave the employee feeling confused."
What can you do about these psychosocial risks?
"The occupational physician can, first, engage in dialogue with the employer. After a consultation, as with any doctor, the employee can request action or not. The request for consultation can also come from the employer. In fact, the occupational physician is the missing link in the relationship between the employer and the employee. It is often the physician who reestablishes the employer-employee relationship when it is broken."
Mental health at work: “Listen, I can’t take it anymore, I’m going to kill him!”
So, for good mental health at work, what is needed, what is the message to managers?
"So, it's true that this is a somewhat general discourse, a little difficult to understand, but we must imagine mental health as a construction game. From the moment you start removing a brick, there is an imbalance. So, we must ask ourselves the question: when you remove this brick, is it temporary or not? Will you be able to compensate for it and preserve the balance? And then, perhaps, we must also tell ourselves that it is not necessarily the company's fault. We can also, without interfering in private life, advise the employee who we feel is in human difficulty to go see the occupational physician because he can open the dialogue, do things. You ask him to call the occupational physician, it is the occupational physician who will do it. The manager is required to maintain a normal relationship. He cannot go beyond that. You do not have the right to be intrusive."
What kind of explosive situations do you face and how do you handle them?
"Typically, it's the call that says, 'Listen, I can't take it anymore, I'm going to kill him!' First, there's stress management. We're going to relieve the pressure. Tell us what's going on... If you really have a problem, you leave your office, you go for a walk, you come back... In these cases, we'll find you an appointment quickly. We always leave room for emergencies."
You denounce the "gurus" of workplace well-being. Who are they?
"I'm targeting mutual insurance companies. They do a lot of harm. They make people believe that a teleconsultation, a phone call, or a collective awareness-raising intervention is enough to make the world wonderful. Let them do their job as mutual insurance companies. Our role is prevention. We have people trained for that. A mutual insurance company isn't going to go into a company to tour it and assess the risks. So, it's going to come and copy a model, a general awareness-raising campaign in the company. What does that bring? Reality, effectiveness, efficiency, they're not there. They're in a local approach with people who travel and know how to adapt their messages and recommendations. We have a strength born of multidisciplinarity. And it's free. So, I say to companies: before giving in to the sirens, before spending €1 on external advice, call us."
Do you have coercive power?
"We provide opinions and advice. The employer is not required to follow them. However, they must justify their actions, and in the event of an inspection, they are liable. You must understand that we are acting under the employer's delegation of responsibility. It is the employer who is responsible for the safety of their employees. They delegate this responsibility to us. We have a basic offer, but, in return, they remain the decision-maker. So, they can very well refuse a proposed workstation adjustment, for example. Afterwards, if there is a workplace accident, they may be held liable if they did not take into account the advice given to them. On the other hand, when we issue an opinion of unfitness for an employee, they are obliged to follow it. They can then contest it in court."
Coming back to mental health, are you seeing a surge in “burnout”?
“We have to be careful about what we say about “burnout.” It’s one aspect of a very broad mental health imbalance. We cover a lot of things under this term. In mental health imbalance, there are people who suffer from mental illness, but who can work without any problems. It’s often a completely invisible disability. And then, you have people who can suffer from depression. Depression isn’t necessarily “burnout.” It can be multifactorial. And there, there’s a mental health imbalance. The main development in occupational health is that we now have a vision of primary and global prevention. That is to say, we take the individual as a whole. We don’t divide them into time slots. We don’t say: occupational health is from 7 a.m. to 6 p.m..”
So the “imbalance” is to be sought beyond the professional environment?
"At our level, we're going to try to provide keys to understanding when the imbalance occurs. Let's take the example of family caregivers. You have someone who always arrives at work late, tired. What you don't know is that they get up at 5 a.m. to take care of a relative. By the time they get to their desk, they've already put in three hours of work. So, you don't necessarily have this information because caregivers don't declare themselves. And yet, it will have a direct impact on the employee's mental health. This notion of distinguishing between the expected skill, the given skill, the skill that may be exceptional, and the skill that may be inferior—that's a manager's job. They must know how to deal with all of that. Mental health balance is also the manager's ability to find a point of balance. What we can say to employers is, listen to your employees."
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