Health promoting teams, relational work and individual strategies of how to survive in Danish psychiatric work-places

1. ”Health promoting teams, relational
work and individual strategies of how to
survive in Danish psychiatric work-
places”
Betina Dybbroe
Centre for Health Promotion Research
Roskilde University, Denmark

2. Work-related stress as one of the
big challenges for health promotion
A psycho- socialA psycho- social
approach to theapproach to the
phenomena:phenomena:
a. Psychic wear-a. Psychic wear-
out, violation ofout, violation of
the self, tothe self, to
experience beingexperience being
externallyexternally
managedmanaged
(Semmers,(Semmers,
Prætorius)Prætorius)
b.Lack ofb.Lack of
possibilities forpossibilities for
unfoldingunfolding
professionalityprofessionality
and subjectiveand subjective
meaning in workmeaning in work
(Kristensen,(Kristensen,
Olsén, AndersenOlsén, Andersen
og Buch)og Buch)

3. The psycho-social environment of
health
Traditional distinctions between
sociology, psychology and cultural
analysis should be overcome and health
promotion should be investigated
through studying individuals in relation
to others and the socio-cultural context
, as a psycho-social environment of
health that is structural and interactive
at the same time (Siegrist & Marmot
2004).

4. What is the significance of cooperation
in the work place for promoting health?
 In psychiatry- long traditions of
team work- and strong
effectivisation
 In ingeneering work- long tradition
of project work- and individual
performance measurements
 In vocational teaching- new team
discourse, individual work tradition

5. ”Well-being in teams”
 Financed by the Danish Work-
Environmental Research Fund
 1. jan.2011- 1. june 2014
 Three Universities in consortium
 Multisited- ethnographic field work,
focus-group and life history
interviews, policy analyses

6.  Work is organised through
teams of two-three, and
every professional works in
several teams with other
professions, and the whole
unit works as a team ( 25
people)
 75% or more, of work
takes place in
interrelational spaces, with
relational work with
clients, colleagues, other
institutions and
professionals-
 Work is highly time-
effective, and there is
always work ”hanging
over” the schedule
 High engagement and
meaning making in work
 Management do not have
access to most part of
work, and quality is the
responsibility of the
professionals
 There are many emotions
displayed in work, between
clients and professionals,
and between professionals
Ethnographic findings in child- and youth
psychiatry: patterns and significant observations

7. Health…
 4 out of 5 have had longer periods
of stress
 There is very low sick- leave in
general but few long term sick
leaves – stress and back problems
 Everybody likes the ”actual work”
 Even though sharing work happens
al the time, employees defend
teams

8. Dilemmas and double-bind
situations that may create stress:
Professional meaning
making and
identification with
professional ethics-
Holding on to
interprofessional work
processes and team
cooperation-
Creating quality in
working conditions in
teams
-And producing
standardised
solutions on time
-and dividing labour
to save time, not
sharing responsibility
- Performing
individually, but with
low quality

9. In team work - findings
Collaboration:
-engagement and
pride, and sharing
legitimacy
-ethical professional
meaning making and
creativity, playful
practice
- Containing and
managing each
others feelings, and
those of clients
 Sharing work-
cooperation:
 - standard
solutions and
individual doubts
 Relational cut-off
and working more
”on time”
 Individual shame
and guilt in relation
to goals

10. Healthy collaboration?
 Nurses have been especially vulnerable,
they take many work loads alone, and
doctors have a large turnover
 Psychologists are not so vulnerable, they
are the group workingmostly in close
collaboration in teams
 The treatment teams, where everything is
done in close collaboration create joy and
professional meaning

11. Hypotheses- (found also in Aronsson,Arneson
Gustavsson)
 Interacting and creating shared
work , means more professionalism
and resistance to standardised
routinisation
 Social support enhances creativity,
recognition and visibility in work
 In relational and emotional work,
working in collaboration can help
manage emotions and create
meaning