Insult to Injury: U.S. Workers Without Paid Sick Leave Suffer from Mental Distress

Only seven states in the United States have mandatory paid sick leave laws; yet, fifteen states have passed preemptive legislation prohibiting localities from passing sick leave. Despite this resistance, paid sick leave is starting to gain momentum as a social justice issue with important implications for health and wellness. But what are the implications for the mental well-being of Americans without paid sick leave? Little was known about their relationship until now.

Researchers from Florida Atlantic University and Cleveland State University are the first to explore the link between psychological distress and paid sick leave among U.S. workers ages 18-64. Results of their study, published in the American Journal of Orthopsychiatry, illuminate the effects of exacerbated stress on Americans without paid sick leave who are unable to care for themselves or their loved ones without fear of losing wages or their jobs.

The researchers found that workers without paid sick leave benefits reported a statistically significant higher level of psychological distress. They also are 1.45 times more likely to report that their distress symptoms interfere “a lot” with their daily life and activities compared to workers with paid sick leave. Those most vulnerable: young, Hispanic, low-income and poorly educated populations.

“Given the disproportionate access to paid sick leave based on race, ethnicity and income status, coupled with its relationship to health and mental health, paid sick leave must be viewed as a health disparity as well as a social justice issue,” said LeaAnne DeRigne, Ph.D., co-author of the study and an associate professor in the Phyllis and Harvey Sandler School of Social Work within FAU’s College for Design and Social Inquiry. “Even modest increases in psychological distress are noteworthy for both researchers and policy makers since we know that even small increases in stress can impact health.”

The study included 17,897 respondents from the National Health Interview Survey(NHIS), administered by the U.S. government since 1957 to examine a nationally representative sample of U.S. households about health and sociodemographic variables.

“For many Americans, daily life itself can be a source of stress as they struggle to manage numerous responsibilities including health related issues,” said Patricia Stoddard-Dare, Ph.D., lead author of the study and associate professor of social work at Cleveland State University. “Making matters worse, for those who lack paid sick leave, a day away from work can mean lost wages or even fear of losing one’s job. These stressors combined with other sources of stress have the potential to interfere with workplace performance and impact overall mental health.”

The researchers used the Kessler Psychological Distress Scale (K6), considered the gold standard for assessing psychological distress in population-based samples in the U.S. and internationally. With a theoretical range of 0 to 24, higher scores on the K6 represent increased psychological distress and scores above 13 are correlated with having a mental disorder of some type.

Results from the study showed that those with paid sick leave had a lower mean distress score compared to those without paid sick leave, who had significantly higher K6 scores, indicating a higher level of psychological distress. Only 1.4 percent of those with paid sick leave had a K6 score above 12 compared to 3.1 percent of the respondents without paid sick leave.

The most significant control variables indicated an increase in the expected psychological distress score among those who were younger, female, in fair or poor personal health, had at least one chronic health condition, were current smokers or did not average the recommended range of seven to nine hours of sleep per day.

Approximately 40 percent of respondents in the NHIS sample did not have paid sick leave; approximately half of the respondents were female; more than half were married or cohabitating; three-quarters indicated that their highest level of education included at least some college; and 62 percent were non-Hispanic white. The mean age was 41.2 years. Most of the respondents (79.1 percent) worked full-time and 82.7 percent had health insurance coverage. Respondents were in families with a mean size of 2.6 persons and 39.3 percent reported having children in the family. Approximately 32 percent had an annual family income of $35,000 to $50,000, and more than one quarter were below the poverty threshold.

DeRigne and Stoddard-Dare caution that even though there is concern about the potential burden on employers if paid sick leave laws are passed, it is important to be mindful of the overall situation regarding productivity loss and workplace costs associated with mental health symptoms and psychological concerns among U.S. workers. Furthermore, the personal health care consequences of delaying or forgoing needed medical care can lead to more complicated and expensive health conditions. U.S. workers with paid sick leave are more likely to take time off work and self-quarantine when necessary, without the worries of losing their job or income while also not spreading illness to others.

“Results from our research will help employers as they think about strategies to reduce psychological stress in their employees such as implementing or expanding access to paid sick days,” said Stoddard-Dare. “Clinicians also can use these findings to help their patients and clients as can legislators who are actively evaluating the value of mandating paid sick leave.”

Winning the Boss Lottery

US Secretary of Labor Thomas Perez (Left) President of Center for American Progress Neera Tandan (Right)

A couple of months ago, I attended the first ever White House Summit on Working Families in Washington, DC. While many of the President’s opponents saw the Summit as a publicity stunt or a way to cater to the democratic base, the Summit focused on several themes such as paid family medical leave, workplace flexibility, paid sick leave, and much more. Neera Tanden, President of the Center for American Progress, spoke eloquently about her experience in “Winning the Boss Lottery”. Weeks later, her speech continues to resonate with me, but this time for more personal reasons.

The weekend I left for the Summit, my sister suffered a stroke which has left her paralyzed on the right side, and I am thankful for the ability to work predominately online which allows me the flexibility to be there for my family when needed. Fortunately, my brother-in-law works at Stuken, a wonderful company, which has never penalized their family for having life changing events throughout his years of employment. Again needing time off of work after dealing with an illness of his own, I asked him if he was concerned about losing his job, and he replied, “not at all”. While staying at the hospital with my sister, a delivery guy walked in with a big bouquet of flowers, and the card read, “Wishing you well from the Stuken Family”.

How many of you are confident that your job would not be in jeopardy if you suffered a life changing event such as a taking care of an elderly parent, chronically ill child, cancer diagnosis, a stroke, car accident, workplace accident or other serious illness? Would a life changing event derail your fast track to promotion, encourage your boss to identify ways to relieve you from your position, or will you have to choose between saving your job, unemployment, or not being there for your family?

Not everyone can work for a company like Stuken, but supervisors, bosses, and policy makers within a company have the ability to craft a workplace culture to support their employees whether they are experiencing a life changing event or not. Having a great boss shouldn’t carry the same odds as winning the Powerball, but when you hit the jackpot, you definitely know when you have landed yourself a great boss and a good company to work for.

I hit the boss lottery once, and I am going to share with you why I stayed with a company for 10 years despite outgrowing the position five years earlier.

A great boss and company….

1. Measures Progress and not Process

This is the first step where a lot of supervisors and bosses go wrong. Those who obsess about the steps you make to complete the job versus having the skills to develop measurable outcomes and ways to monitor progress tend to stifle creativity and ingenuity in their employees. A great leader surrounds him/herself with employees who excel in areas they are weak, and their ability to see the bigger picture in order to accomplish the mission and goals of the team is what makes them an excellent leader.

Bosses who fail at being good leaders are insecure in their own ability and will often perceive a great employee as a threat instead of an asset. As a result of having leeway in how I handled my investigations, I was able to identify a security flaw their current computer system was not programmed to look for which saved the company a fortune in future losses.

2. Understands Quid Pro Quo (This for That)

A great boss doesn’t treat their employees as a resource to siphon off in order to make themselves look good. They invest in your development as an employee. My boss use to say, “When you shine, I shine”, and this was the philosophy in which she ran her department which had zero turnover. A position did not open up until after my sixth year, but it was only because someone retired. During this time, I was given access to training and a security clearance higher than most supervisors above me. My base pay was meager, but my bonuses often exceeded my base pay. For every loss I prevented, prosecuted or recovered, the company paid me a percentage in a bonus because they understood the cost benefits analysis of having motivated investigators. Most importantly, it made me feel like a valued member of the team.

Another area bosses fail is when they utilize a quota system to measure an employee’s performance to determine whether the employee will keep their job or not. Quota performance metrics will drive employees to meet the minimums because their pay will be the same no matter the input, in addition, quota systems increase liability, risk-taking, and stress for the employee and the company.

Today, many employers treat employees as if they should be grateful to have a job which ultimately is terrible for their bottom line. If a company would reinvest into an employee discount, benefits, or bonus plan instead of increasing their acceptable losses, productivity would go up while losses would go down. Believe me, as evident in my former job investigating employees, employees will find a way to offset the bad behavior of their boss/employer.

3. Knows Workplace Flexibility Is A Necessity

My boss, as well as her boss, were both outcomes driven in how they assessed employee performance. As long as the job was done within ethical boundaries, they didn’t stress how we got it done. When it came to needing time off, scheduling, leaving earlier, or dealing with a family crisis, the ability to take care of our family was given equal importance to getting the job done. From the time I started until they both retired, we were given the ability to set our own schedules by letting them know what days and hours we would work.

Having bosses that were invested in me as an employee as well as the well-being of my family inspired loyalty and trust. The workplace culture they cultivated inspired employee performance to go through the roof in all departments. As a result, they received lots of awards and accolades. We received lots of catered dinners, company cookouts while we worked, and my department got taken out for steak dinners a lot because we minimized the loss portion from the Profit and Loss Statement. After they retired and the workplace culture changed, employee turnover, profit losses, and employee theft also increased.

What I learned…

Mentorship and workplace culture can have a profound effect on work output and productivity. As a result of the millennial generation, more and more companies are beginning to implement workplace strategies to retain and inspire their workforce with flexible work culture, wellness, and corporate responsibility programs. Maybe you don’t have the power to change your company’s entire culture but as a manager, what can you do to change the work culture of your department to help enhance productivity?

Women Concerns as Social Workers in the Workplace

On June 17th, 2014, Social Work Helper Magazine co-hosted a Virtual Town Hall with National Association of Social Workers (NASW -NC) by simultaneously conducting a Live Twitter Chat and Facebook Forum to identify concerns of women as social workers in the workplace. The town hall was held in preparation for the upcoming White House Summit on Working Families on June 23rd, 2014. Participants were asked to host local events in order to help identify priorities for the summit, and  As Editor-in-Chief of Social Work Helper Magazine, I will be in attendance at the Summit with President Obama.

working_families_summit_social_inviteAs a female dominated profession, approximately 80 percent of social workers are women, yet men overwhelming hold key leadership, administrative, and executive positions. The virtual town hall explored issues such as gender pay equity, sick leave, maternity leave, promotion/retention, workplace discrimination, and workplace safety. 

The key issues arriving from the live twitter chat were pay equity and the need for national unionization comparable to teachers, nursing, and law enforcement. The Facebook Forum most active discussions were workplace safety and the ability to use sick leave for self-care when needed. However, the consensus from both platforms is that no one felt safe reporting issues of with pay equity, sick leave, maternity leave, promotion/retention or workplace safety.  Dr. Michael Wright a professor at Tennessee State University who participated in the live Twitter chat stated, “When your job is what stands between you and homelessness, you don’t rock the boat”.

One woman made a profound statement in which I hid her comment from public view to help prevent any retaliation whether real or perceived. She expressed concern about hoping her comment does not hurt her job, but she also expressed the need to share with people who may understand.

As a woman who was out in the field with another woman three weeks ago when I was assaulted by a client with a brick in the head, I’m really tired of having safety training on fire extinguishers (which there are none in my building and it’s been evacuated due to fire twice in six months), but none on what I could have done differently when faced with a psychotic child with a brick. I love my job, but don’t feel I can turn a blind eye this time. Something needs to change. #workplacesafety

Law enforcement officers which is a male dominated profession requires at minimum a high school diploma and are often paid higher than an entry level Master of Social Work graduate working in the public sector of a female dominated profession. Despite both jobs being classified as hazardous by local, state, and federal agencies, social workers are often denied comparable overtime, time off, and other benefits given to law enforcement officers. When social workers witness or experience trauma or fatalities, there is no mandatory counseling or fitness for duty assessment to ensure the social worker is emotionally prepared for duty.

Social workers have  been denied the additional workplace safety protections given to law enforcement officers despite both law enforcement and social workers operating under statutory authority and hazardous conditions in the public sector. Some agencies do not even provide social workers with an agency vehicle or cell phone, and social workers are often required to utilize personal assets in order to perform job duties. Social workers are not given any self-defense, no radios, have no weapons, no backup, are often alone, and have no communications center to call for help to know someone is coming.

According to a 2007 Hill Briefing on Social Work Safety Issues,

A disturbing trend of violence against social workers and other human service professionals was mentioned in a letter sent to legislators by the bill’s sponsors. In April 2005, a woman in Texas fired a shotgun at two social workers visiting her home. In March 2006, The New York Times reported that Sally Blackwell, a social worker, was found dead in a field just outside of Austin, Texas. Throughout the investigation, her family said that threats were a daily part of Sally’s life as a social worker investigating accusations of child abuse and neglect with the power to remove children from their homes.

Two surveys conducted by the National Association of Social Workers in the last few years have found that job-related violence and the threat of such violence are common. In a 2002 survey, among 800 social workers, 19 percent had been victims of violence, and 63 percent had been threatened. In a 2006 national study of the licensed social work labor force, 44% of 5,000 respondents said that they face personal safety issues in their primary employment practice.

The current bill, H.R. 2165, would establish a grant program to provide for safety measures such as GPS equipment, self-defense training, conflict prevention, facility safety and more. It would also help with educational resources and materials to train staff on safety and awareness measures. The bill calls for Congress to authorize $5 million per year for the next five years and require states to provide 50 percent matching funds.  Read Full Briefing

Unfortunately, this bill and many others to address the debt of becoming a social worker do not go anywhere in Congress. Social Workers are often under a mountain of student loan debt in order to provide services to those within the margins. The unfortunate part is that many social workers and  social work students working in mandatory unpaid internships are living in the margins along with their clients. Many are having to rely on public assistance and programs in order to make ends meet and take care of their families.

Last year in New Orleans, a social worker named Ashley Qualls was murdered on her way home. Social Work Helper did a story on Ashley Qualls’ death when A&E First 48 Hours aired an episode with the detectives who continue to look for those responsible for her death.

Tulane School of Social Work graduate, Ashley Qualls, was working at a substance abuse treatment center when she was gunned down while walking home from work. Although Ashley was from South Carolina, she moved her family to New Orleans believing they would have more opportunity in a larger city. Each day, she rode public transportation to work, but at night she was forced to walk the 3.5 miles home because public transportation had stopped running. Read Full Article

It is my hope that events such as the White House Summit for working families will begin to acknowledge the specific challenges women working as social workers face in the workplace in order to serve others and take care of their own families. To view the storify of the Virtual Town Hall, you can visit this link.

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