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De-escalating aggression and violence in the workplace

Mark Oostergo discusses occupational violence and aggression in the workplace.

His talk covers how to handle inappropriate customer behaviour, including defining what constitutes such behaviour and how it manifests in appearance, language, and emotional responses.

Mark also discusses the significance of adopting a systems-based approach to manage the associated risks effectively and explore prevention controls to mitigate instances of inappropriate behaviour.

Practical and informative, Mark aims to equip viewers with confidence in managing and addressing inappropriate customer conduct.

Good day, everyone. I'm Chris Bombolas, your MC for today. On behalf of Workplace Health and Safety Queensland, welcome to the last of our Mental Health Week livestream sessions for 2023. I'd like to begin by respectfully acknowledging the traditional custodians of the land. We are speaking to you from today, and on which you are learning and working from today. We also pay our respects to elders past and present, and extend that respect to Aboriginal and Torres Strait Islander people watching today. Please note that this presentation includes content regarding aggression and violence in the workplace. We encourage you to draw on the self-care supports that work for you if this topic brings anything up for you, and please reach out for support if needed. The session will also be recorded, so if you need to take a break, you can catch up on the recording at a later date. In an emergency, please call OOO, or visit your local hospital emergency department. You can also call Lifeline on 13 11 14. For more information on support services available, or information on supporting stress, please visit www.qmhc.qld.gov.au forward slash emergency hyphen contact. And we'll place this in the chat box so you can link directly to it. Mental Health Week is held nationally every October to raise awareness of the importance of psychologically safe workplaces, and contributes to driving behaviour and attitudinal change to reduce stigma and discrimination of mental illness. In today's session, you'll hear from Mark Oostergo, who will discuss how to handle inappropriate customer behaviour, including what defines or what constitutes such behaviour, and how it manifests in appearance, language, and emotional responses. We will also have a panel discussion with Mark and Michelle Turton, who joins us from WorkCover Queensland. A little bit of housekeeping first up though, there'll be an opportunity to ask Mark and Michelle questions at the end of the presentation. So be sure to submit them in the chat box, and please let us know who you want to direct that question to so we can get straight into those question and answers when the presentation is finished. If you have any technical problems during the live stream, please make sure the sound on your computer is turned on, refresh your browser, and if that doesn't work, contact us via the live Q&A chat box. You can also change the size of your screen to full screen by selecting the four small arrows next to the volume bar at the bottom of your screen. It now gives me great pleasure to introduce our presenter, Mark Oostergo. Mark is a workplace psychologist and risk specialist with a broad background in the Australian Army. He was serving nearly a decade in the Australian Army as a psychology officer. This gave him the opportunity to provide individual, team and organisational psychological intervention both in Australia and overseas. During this time, Mark also had the privilege of working with Australia's elite special forces in human performance, selection, workplace mental health and resilience. He was awarded an Australian Defence Force Gold commendation for his motivational and supportive leadership in this role. Mark has also worked across industry and human factors, human performance, workplace mental health and executive leadership development. He has a passion for delivering tailored workplace interventions to promote positive mental health to create a flourishing work environment. He takes a practical and applied approach to psychology and communicates it in a way that is easily accessible. Time now to call in Mark. Thanks very much, Chris. And thank you very much to Workplace Health Safety Queensland for having me here this morning to talk to you about all things occupational violence and aggression in the workplace. I guess when I think about customer aggression, for me, being an ex-Army officer, I was often on the other side of aggression. However, it wasn't until I went into a leadership role within a health centre where I was responsible for leading a large amount of staff to support, I guess, the provision of both outpatient and inpatient care for people that I really experienced myself firsthand what occupational violence and aggression can be like in the workplace. It's nothing like when someone's health care goes wrong to see the emotional response and the challenges that people experience. And to know what that, I guess, looks like and to see the cumulative impact that I see in my work that I do, it's something that I'm so incredibly passionate about. So I'm hopeful today that we can actually start to look at, you know, what is inappropriate customer behaviour? How do we actually start to define it and distinguish it between what appropriately expressed frustration is? Thinking about what can we do from a systems-based perspective to actually address this workplace hazard and not just be reactive in nature and start to look at what are some of those really practical, functional controls that we can put in place. And then finally, you know, looking at what are some of those techniques that we might be able to use to de-escalate those situations and enhance our confidence if we do experience it in the workplace. So let's actually start off by defining what inappropriate customer behaviour is. What does it feel, look and sound like? So when we look at what it looks like across Australia at the moment, I guess what we're seeing is quite a prevalence of people reporting and experiencing inappropriate customer behaviour. These statistics are from Safe Work Australia, so they're national, and we'll cover some more Queensland in-depth trends a little bit later on in the panel discussion. But what we're seeing is that we know around two in five people are yelled at in the workplace. They experience that abuse. We know that one in five experience some more significant behaviour where there may be physical assault or being threatened in the workplace. And I guess what we're starting to see is that increase in people experiencing this. Working across industries, we're absolutely seeing an increase in reporting in finance, construction, healthcare and the like. So absolutely, it is quite prevalent out there. There's some statistics that I saw through COVID that suggested, you know, there was a 400% increase of experience of customer aggression in the retail sector. So absolutely, it is something that our customer-facing people who, you know, engage on that daily basis, experience it on a pretty regular basis. So what does it actually look like or feel like? So, I think when we look at defining it, it's important to distinguish what's the difference between appropriately expressed frustration and aggressive customer behaviour or inappropriate customer behaviour. So, I'm sure everyone can experience ringing up an organisation and being on hold for a prolonged period of time. And maybe experiencing that sense of frustration of having to be on hold. And it might be actually OK to go, you know what, that was a really long time and I'm somewhat frustrated about that process. I'd suggest that's, you know, a normal and appropriate response. What might not be is when we start to yell, threaten, abuse, discriminate, harass and those types of behaviours. Now, the behaviour can happen in person. So it might be in a retail-facing role where I might be standing face-to-face with someone. It can happen over the phone. And often we see increased intensity with the behaviour when it is over the phone because people tend to depersonalise it somewhat. But we're also seeing an increase in behaviour across social media, email, and also people using social media as a way to threaten or intimidate as well by filming people and then uploading that onto different platforms. What I often see in customer-facing roles is a sense of normalisation with some of this behaviour in terms of I may have been yelled at or sworn at, but I was able to de-escalate it. And so therefore it's OK and I'm not going to report it. So I'd argue that whilst we just covered off on some of those statistics, they're not necessarily representative of the amount of inappropriate customer behaviour we see in the workplace because a lot of that lower-level behaviour is not being reported or captured. So when we start to look at industry profiles around who may be at risk, the research from Safe Work shows that there's a number out there. So absolutely our healthcare workers, whether I'm in an emergency room, a paramedic, or even in a GP clinic, we're absolutely seeing, I guess, people's increased reporting across those different domains. In education, whether that's primary, secondary, tertiary level, we're seeing an increase in reporting coming from a multitude of different avenues, including parents, for example. Our public order and safety component around our frontline workers being out there and engaging with the public on a pretty regular basis, but also in retail. So we're seeing a very diverse range of people being exposed to these types of behaviour. And when I think about it, and I think about how we've been through a lot of challenges, whether it's, you know, starting with bushfires a few years ago into a pandemic, now we're seeing a lot of financial stress and pressure. I guess what we're seeing is a lot of people under increased stress and pressure. And I often liken it to people being somewhat more walking around in their reptilian brain or their amygdala and being a little bit more reactive. Now, that might not make it OK, but it might explain what's going on. So let's actually start to look at, well, what can we do about it? How do we actually start to manage this risk? We've identified what it looks like. We've identified that absolutely it's prevalent at the moment across a range of different industries. But what can we do to support our people who may be faced with this risk on a regular basis? So when we start to look at how do we enhance that systems-based approach, there's a couple of key things that I'd like you to consider. So the first one is, do we actually understand what the risk looks like in our organisation or in the organisation that you work for? Because whilst people may experience similar types of behaviour, the risk may be quite different. There may be a greater cumulative load, so I might be exposed to it more repeatedly. There may be aspects of that risk assessment that you actually identify triggers that could potentially, I guess, lead to controls that we can put in place, whether that's the way that we're communicating with people, whether that's accessibility of information, whether that's a process that may enhance the likelihood of the behaviour occurring. It might also identify some opportunities for improvement in our physical environment, for example, and additional controls that we can put in place. I guess the next piece that is really core is our leadership commitment, and that starts at the top. And I think it's really important for senior leaders to look at this hazard and think about how do we take a zero-tolerance approach to it. Now, that can be difficult in some areas or organisations where we may be mandated to provide service, but very much looking at how do we put a consequence framework in place for our customers that we may be engaging with, who do demonstrate this behaviour on a repeated basis. Finally, I guess another core part is ensuring that we have policies and practices. And the reason why that's important is we want to create a sense of consistency in how we address this behaviour. So if I think about I might have an organisation where I have five or six retail shops, and my staff are faced with this behaviour on a pretty regular basis. Now, if I walk into one of those retail shops and that behaviour is addressed, de-escalated and not tolerated, fantastic. But if I then walk into another one of those shops and I give the person what they want with that behaviour, and that behaviour gets what they want, then that inconsistency can start to exacerbate the likelihood of that behaviour again. So having those strong policies and practices in place can be really beneficial to ensure that there's a consistent approach to how we're managing it. The data collection and management is so incredibly important. If there's one thing that you take away from today's session is that as an employee, please report when you're exposed to this behaviour, even if it's not harmful in nature. Because the more data we have, the more data-informed decisions we can make around controls. We might identify, for example, hot spots where additional controls are needed. We might identify certain procedures or controls or processes that might likely trigger a certain type of behaviour. So the more data we have around what's actually going on, the more we can look at that and identify opportunities for improvement to prevent this from occurring in the future. I guess the criticality of leadership is also important. There's a link between, I guess, this idea of strong supportive leadership and psychological capital in my employees. So what does that mean? Well, if I've got strong supportive leadership in place, I'm going to feel safer at work, I'm more likely to raise concerns, I'm more likely to be engaged in the workplace, and I'm more likely to be applying myself in the workplace as well. And what does that mean for our customer interactions? Where there's stronger psychological capital in the workplace, we're seeing more positive customer interactions. And when we have more positive customer interactions, guess what? We see a de-escalation in the amount of customer aggression that we see. So having those strong positive customer relations is incredibly important, but to do that we need strong supportive leadership to, I guess, work across the range of different things within the workplace. And so how do we start to apply some of this stuff? Well, we need, I guess, to look at how do we prepare for the hazard, how do we prevent it from occurring, but when it does occur, because we've just seen the statistics to say it's going to, how do we respond in an appropriate way? And I'd like you just to take a moment to think, in your organisation, where are you spending the majority of your time? Is it in the preparation? Is it in the prevention? Or is it in the response? And my experience to date suggests that whilst there are a lot of organisations absolutely looking at the prepare and prevent, a lot of them spend a lot of time in that response. So, the more that we can shift that upstream to look at how we assess and understand the risk and put things in place to prevent it from happening, then the better it's going to be for our employees. Now, when you look at the Queensland Code of Practice in psychosocial risk management, they have the hierarchy of controls in there. And the top of that hierarchy is this idea that we would like to eliminate the hazard. Now, absolutely, I'd love to eliminate occupational violence and aggression. But unfortunately, in a lot of organisations, we can't remove customers. So, thinking through what are some of those other strategies that we can do to support people in the workplace? And for me, it's about how do we consider those strategies across the employee lifecycle? So, what does the employee lifecycle mean? Well, it starts right at recruitment, thinking about who are we bringing into the organisation, how are we onboarding them, how are we supporting them through their employee journey, and how are we supporting them with transition, whether that's within the organisation or when they may leave the organisation? So, what does that look like? Well, we're going to jump into the prepare, prevent and respond in a little bit more depth and detail. So, let's start with the prepare piece. I guess when we're looking at that employee lifecycle, I mentioned it started with recruitment. So as an organisation where this hazard may be there, are we actually starting to think through what does that look like? Are we thinking through what are the unique psychological job demands of the role, and are we having realistic job previews in place? So thinking through how do we actually communicate with our prospective potential employees around what the role looks like and what some of the challenges might be, and how are we identifying potential to address those challenges? And how are we communicating in that piece around support for people if they are faced with those challenges? Then we look at that onboarding piece and thinking about how do we raise that potential to meet those challenges or those demands? Are we actually identifying our cohorts of new staff coming through and providing them coaching, upskilling? Are we onboarding them to our safety procedures? Are we actually getting them to walk the floor? Just like we would with normal health and safety. We point out, I guess, our exit pathways in case of a fire or an emergency. But do we do the same in case there's a customer regression event? Do we highlight where those safe spaces are? Do we teach them how to remove themselves safely if they do experience it in person? If we're over the phone, do we talk to them about how we might terminate a call in a safe way? So really thinking through that onboarding process to make sure that we're embedding all our processes at that stage. And then it's about how do we maintain that over time? Because it's never a set and forget thing. The more we practise something, the more we're going to be able to embed it and apply it. And we'll look at what some of those skills are a little bit later on. Then we move into our prevention piece. And if we're thinking about prevention, it might be actually taking that step back and thinking a little bit differently. Are we looking at the physical environment that we're working in? Are there objects that might become a weapon or a threat? Do we have physical controls in place, for example? Security cameras, duress alarms, safety apps, those types of aspects that may be supporting our staff? And are we onboarding them to how they work and what does that look like for them from that perspective? Are we identifying areas within a store that may have blind spots and we can't actually see people? And so there's a whole range of different security controls that we can put in place from that perspective and physical controls. I think it's also about how do we look at the psychological component of that and start to think through, actually, as a leader, am I practising my one-on-ones? Am I engaging with them? Are we ensuring that our team has clarity around what to do? Are we providing that coaching? Are we checking in with them on a regular basis to see how they're travelling? Because again, coming back to that psychological capital piece, if people might be struggling with the work that they're doing, it might actually put it at increased risk of a customer aggression event. And then we want to look at the respond component across the employer lifecycle. And thinking through, you know, if we do have an incident, what does that look like? Are we applying best practice psychological first aid, which is a World Health organisation's principles-based approach to supporting people after a critical incident? Do we have strong reporting processes in place so that we're capturing our data to then move it back upstream to identify those aspects of the work that we're doing that we may be able to change or modify?Are we thinking through, you know, how we might be able to support people with job rotation or task rotation if they've had that cumulative exposure over time? And how do we start to look at those opportunities to respond in a proactive manner and not a reactive manner? And that ability to learn from what we're doing to change the way that we work. In terms of then what are some of those skills that we might start to look at to best support, I guess, the de-escalation of inappropriate customer behaviour if we come across it on the front line. And these skills, while some are unique to an in-person environment, they can also be applied, whether I'm over the phone, on chat with someone or even via social media.And how I like to break it down is this idea around pre-incident, during-incident and post-incident. So if we think about the pre-piece, what does that actually start to look like? Well, the first part is actually building self-awareness. And that self-awareness is identifying what are my own triggers that are likely to escalate the situation more. Now, for me, for some reason, not sure where it comes from, but if someone calls me "mate" in a condescending way, there's just something about that that I automatically start to arc up. My muscles get tense and I start to recognise that response in myself. Now, everyone's going to have different triggers. We might not be able to eliminate those triggers, but by bringing awareness to them, we might be able to start to control them, for example, and start to understand how I might be able to respond, as opposed to reacting. And so that's that understanding my own triggers, but it's also about understanding the triggers to the customer that I'm serving or engaging with. So are there components of the work that we're doing, whether it's through miss expectation? So often we see a lot of customer aggression events occur because there's an expectation from a customer that doesn't align with organisational process or policy, or there's a lack of accessibility around information, so I don't actually know what that process is, so then I get frustrated with it. It might be long wait times or standing in queue for a long period of time. So how do we understand those triggers and start to look at that proactive management? And that might be as simple as queue-walking. And then looking at those static risk assessments and coming back to that environment piece, understanding the environment I'm working in, whether that's in person and that risk to self, or whether that's in a call centre environment and how I might know where to go to have that five minute break after a tough interaction. Then we look at the during incident component, and I think there's a couple of key considerations with the during incident aspect. So the first one is safety and always making sure that we maintain our safety during a customer aggression event. And that's our own safety and the safety of those around us. I think the second is that it's never linear. It's going to go up and down and all over the place. We might be de-escalating someone and then something triggers and it goes back up again. So whilst we'd like to look at it in a nice linear motion, that's not always the case. So how do we actually start to look at some of those capabilities? So the first one is situational awareness. Am I actually recognising what's around me? Am I aware where my exit pathways are? Is there a table that I could potentially use as a barrier? Do I know where the door is? And am I close to the door as opposed to having the person between me and the door? So how do we build in that situational awareness when we are working in that in-person environment? And then we look at that dynamic risk assessment. So very different to our static risk assessment. The dynamic risk assessment is one where we're continuously thinking around what those risks or hazards might be to me in this particular situation. And then we look at how we might diffuse the behaviour or de-escalate it. And that might be through skills like acknowledgement of what the person's going through, that active listening piece to truly understand and listen with curiosity around what might be there or what the challenges might be for the employee, or sorry, for the customer. But it's also that piece around potentially being assertive. So if we're unable to de-escalate that behaviour, calling it out and making those needs-based requests and asking people to stop in a safe way. And I guess that dynamic risk assessment might also then mean that we may need to exit the situation or end it as well. And I think from a post-incident perspective is coming back to how do we ensure that we're reporting the behaviour when it does occur and how are we supporting ourselves and others around us? Are we applying those psychological first aid principles around promoting self-efficacy, hope, and really building people's ability to, I guess, leverage on those pieces? And I think it's also that opportunity to reflect on what we did and how we might do things differently and build that operational knowledge of those different components. So what does this look like for an employee over the lifespan? So I think part of it is absolutely looking at that induction and making sure that we have those baseline knowledge transfer there for people as they come into their roles. And then looking at how we build that out and build on that both before, during, and post-incident, and looking at how we map that across the lifespan. So I'm really keen to receive your feedback today on the information that I've provided. Was it useful? Was it beneficial? For me, there's a couple of key takeaways. So I think the first one is that absolutely, you know, is that acknowledgement that it is prevalent. We are seeing an increase in inappropriate customer behaviour, in customer aggression, and in those different forms. I think what we're seeing is a lot of organisations spending time in responding to those incidents, as opposed to taking those steps to be preventative and proactive in nature, and really taking that systems-based approach and having those building blocks in place to address this hazard. Now, for me, Gold and Endstate would be working as an industry to start to address these things and having that consistency across multiple workplaces. So it doesn't matter where I go, I'm going to have that same experience and that same zero tolerance. I think it's also then looking at how do we ensure our people a good fit for role and have that opportunity to raise that potential to really manage that customer aggression, whether that's before incident, during incident, or post-incident. So hopefully you have gotten something out of that. I recognise that it is a high-level introduction, but hopefully there's some principles there that you can start to think about around how you might apply to either your workplace as a leader or to your practice as an employee, and really keen to look at how we might unpack some of your questions in more depth and detail in the panel discussion. So thank you very much. - Well, Mark, Mark's presentation obviously finished, and if you do have any questions for Mark, please put them into the Q&A in the chat box. That would be fantastic. We're about to be joined in a panel discussion by Michelle Turton. But as I say, if you do have any questions for Mark, we'll get to those questions as soon as we can at the end of our session. Moving on to a panel discussion now. As I said, I'd like to welcome in Michelle Turton from WorkCover Queensland, who is going to join Mark and myself for a panel discussion. Michelle is the Manager of Mental Injury at WorkCover. She has a background in psychology and has worked in a range of operational and leadership roles across various departments within WorkCover Queensland. In her current position, she leads the planning and delivery of the Mental Health and Injury Claims Strategy, providing technical expertise and coaching for claims teams and offering guidance and mentoring for leaders to support capability and promote mental health literacy. Welcome, Michelle. Thanks for joining us. Thank you for having me. It's great to be here. No worries.We are obviously talking about work-related violence, and for you, Michelle, first up, mental health claims continue to rise. Can you share any insights you may be aware of in terms of claims and specifically regarding violence in the workplace and what trends you have been seeing? Absolutely. It's a great question to kick off with. What we're seeing at WorkCover Queensland, perhaps not any surprise, is that growth in mental injury claims. And I should distinguish the growth between both primary mental injury claims and secondary mental injury claims, and I can talk a little bit about that. But primary mental injury claims probably take up about 6% of all of our statutory claims, but they consume about 12% of the costs associated with those. We know that mental injury claims have... They take...They have longer. We offer poorer outcomes compared to claims for physical injuries. People are off work for longer. They're accessing more treatment as part of their recovery. And from that first stage of the claim, they can take sometimes up to three or four times long of a WorkCover to actually decide liability on those claims. They're very complex. They're very multi-layered. There's many players usually involved in that claim ecosystem when something has happened at work that has brought on a mental injury, brought for a worker as well. We also know that some of the drivers for these claims are multi-factorial as well. So there can be aggression in the workplace or it can be occupational violence. We know from... So in 2021, the provisions were entered into the workers' compensation legislation for first responders. There's presumptive provisions for first responders who experience trauma and PTSD. So certainly we see those are drivers for the increase in claims. But we're all also part of this societal movement around increasing awareness and reducing stigma around mental health. And any publication or news or media release you might see from the likes of Black Dog or Beyond Blue or Dear Mind is all about help-seeking behaviour. And perhaps that wasn't as prominent for people before. And people are more willing to talk about mental health, but they are struggling. And when that relates to employment or their job, then they're more likely to perhaps lodge a claim and seek support and treatment or have time off work as part of that recovery. So there's lots of the trends we're seeing. I suppose I mentioned earlier about secondary mental injuries and I always like to touch on that as well. So we're probably all really familiar with primary mental injuries. Something traumatic may have happened in the workplace, whether it be a first responder who's been assaulted or perhaps it was a journey claim, it was a traumatic incident. But secondary mental injuries are something that can come. And we most commonly see these from musculoskeletal injuries. So someone might be recovering perhaps in an estimated way from a musculoskeletal injury, but perhaps because of the nature of the injury or the impact it has on their lifestyle or on their identity or their ability to access normality in their life, hobbies and how they can go with their family. The sense of that pull or that inability to cope or really struggle can set in for people. And so we're seeing that as a real trend as well, that secondary mental injury that comes as a result of coping with the recovery from a physical injury. And interestingly, too, one of the larger trends we're seeing in our data across WorkCover is those particular claims that have secondary mental injury as part of them. Their conversion to common war, which I think we'll talk about a bit later, is quite high. So the pain and suffering that people are seeking compensation for after a statutory claim closes is really an increasing trend as well. Industries or types of work in particular that seem to have higher rates of violence and aggression. Absolutely. So perhaps also not surprised is that we see that across government and we see that across government because that's where a lot of our first responder agencies are. So our Queensland Police, our ambulance services, our firing rescue, corrective services, child and youth justice. So workers who are exposed to trauma, responding to time sensitive types of occupations where they're facing the public, but there might be time sensitive in the nature. And I think Mark made a good observation about this earlier, that that engagement with public or what people are perceiving is the best care or treatment they can have in an urgent situation, can really see that those escalations become even more heightened than what you might expect. So certainly across government, we see that as our predominant trend. And then after that, we certainly see it in the transport industry, in retail and accommodation as well. But most of the highest proportion of that customer aggression we see is across those government agencies. OK, thanks for that. Thank you for joining us as Alicia has done. And Alicia is asking you, Mark, is there any evidence on whether zero tolerance statements or positive acceptable behaviour statements work better in practice? Yeah, it's a great question, Chris. And thanks to Alicia for putting that one up there. So when we're talking about those statements, just to clarify for everyone listening in, it's often if you think about signage, right, when you walk into your local Bunnings, you might or Woolworths or Coles or whatever the case might be, you might see that signage up there saying we do not accept or we have a zero tolerance to abusive, rude, etc. Now, the evidence behind it around actually eliminating the behaviour is pretty low, but where I've seen it have positive impact is that demonstration of support to employees. So it gives them something to leverage back to and point towards. And it's that demonstration of executive commitment as well to that zero tolerance approach. So reinforcing that component to their employees, whether it's necessarily going to stop someone from being rude or aggressive, that that evidence isn't quite there yet. OK, can you share some insights into how inappropriate customer behaviour manifests in appearance, language and emotional responses among employees and what other types of violence and aggression might someone see in a work context? Yeah, so that's a really great question. So when we think about the response, I think it's, you know, thinking about it at a couple of different levels. So the first one might be that individual response and recognising that there might be that immediate acute reaction after a significant incident. And that could be that that flight, fight, freeze response kicking in, right? So, you know, the adrenaline pumping through, you know, potential, you know, shaking a whole range of different emotional responses. It could be being quite physically visibly upset, distracted, disoriented and that quite acute reaction. I think it's also the recognition, though, that there can be some chronic reactions as well over time. So to that cumulative exposure or repeated exposure to occupational violence and aggression. And again, that might be through some of those behaviour changes. So I might become more withdrawn. I might not be, you know, putting the same effort into my appearance. So those types of things. So that change in baseline behaviour. And from a workplace context, it might be things like decreased productivity or I'm not necessarily as engaged as I once was. I'm maybe not as interacting with the customers in the same way. I could be absent more. So we can start to see those responses vary depending on the situation right from that acute, immediate reaction where where intervention might be required to some or more of those chronic ones. We're getting plenty of questions. And if you do have a question, don't forget to use the chat box. Get to us. Let us know whether it's for Mark or for Michelle. Mark, we talk about balance, right? And fair play, perhaps. And one of the questions is, how can organisations strike a balance between ensuring employee safety, which is paramount, obviously, and providing good customer service, especially when dealing with difficult customers? Yeah, so great question. And I think the more we invest in our customer service, the more and in our people, the more likely we are to see, you know, that customer aggression come through in our interactions. There's absolutely that link linkage there and relationship between strong customer, you know, interactions and the amount of customer aggression we might see. Now, there's always going to be people that we find a little bit more challenging to deal with than others. And I think for me, it's about how do we how do we try to dig beneath the service and understand what's actually going on and listen with curiosity so that we can try and meet those needs where possible, but recognising that at no point should we be putting our employees or ourselves at risk in doing so. Mark, there's lots of questions about call centres. Lachlan asks for employees on first contact phone inquiries that might be high intensity. What sort of de-prefing interventions are most effective? And vice versa. How do we this is for me to just as a follow on to that, how do we how do we a person may not be aggressive, but frustrated when they first start the phone call and then get frustrated and then become more than just frustrated, particularly when there's a language barrier or a message is lost in translation. How can we descale that? How can we take the emotion out of it and make it like a professional phone call? Yeah, so I think there's a couple of things in there, Chris. So the first one around, I guess, you know, being in that contact centre environment and responding to, you know, distressing calls. I think that for me, that first line of defence is our leadership support. So there's been a really strong evidence base around having strong supportive leadership in place and minimising psychological injury. And really, you know, having that proactive engagement and empathy from our leaders. Again, in a call centre environment, the other really good protective factor is strong team cohesion. And I think the challenge in call centre environments is often there is low job control or autonomy. So I might not necessarily have much decision making around when I'm doing my work or what I'm doing. Often we see high core occupancy. So I'm on the phone a lot. And, you know, so really and we can't really change that work too much. So it's about how do we enhance some of those other supports? And for me, that's that team cohesion, morale and our leadership support. Now, in terms of I guess that that other piece there around the, you know, that appropriately expressed frustration, I think it's about taking the time to listen and trying to understand. And I think often what we see is absolutely that miscommunication and that can escalate things. I think a lot of people, you know, if you think about call centre environments, you know, I is this is a hypothesis in a bit of world, according to Mark. But I think, you know, often people, if they're able to solve it themselves, most of the time they will. Right. So I might be ringing a call centre because I've got a problem with a service, a product, I can't figure out how to do something. And so thinking about actually, can we start to look at that piece up front and how we might start to change some of that as well and the accessibility of information and all those different pieces. Now, we know that recounting incidents immediately can be traumatic. How do we be trauma informed? Yep. Great question. So if we're thinking about being trauma informed, there's a couple of key principles. So the first one is recognising, I think that everyone, you know, comes, you know, is taking that person centred approach and recognising that everyone has had their own experiences in life. And so when we're talking about trauma informed, what we're thinking about is how do we minimise the risk of re-traumatisation? So what we want to do is ensure that we're giving people that safe space to explore. We're thinking through the questions and how we might start to frame them differently around, you know, tell me what you feel comfortable with, as opposed to just tell me what happened. I think it's also about looking at our processes and procedures around giving people that time to, you know, engage those proactive coping mechanisms after a difficult call or interaction. And also looking at our operational processes as well and how they may potentially exacerbate or minimise that risk for re-traumatisation. I.e. have you got someone who can take over for 10 minutes or whatever, half an hour, hour, whatever the time takes for that person to, you know, to regather their thoughts. Which can be a really tough situation when you're in a high-pressure call environment. But, you know, recognising that our people come first and if we invest in our people, then we're more likely to see better interactions and customer service. Michelle, one for you. The managing the risk of psychological hazards at work code of practice was released earlier this year. Can you talk us through how this supports workplaces to create a mentally healthy workplace?  Yes, absolutely. Thank you. And Mark spoke quite eloquently about this earlier, so it probably is an extension of that. But it's a really great framework. It's really clear for employees to understand. And that's not a new requirement. It really is legislation or health and safety regulations that had already been in place. But the code provides a practical guide for employers to implement their obligations and their duty as a as a PCBU. And I suppose in essence, what the code takes employers through is those steps around identifying what the risks are in your workplace. How can you assess what those are and how they're impacting your workforce? What are the controls you might be able to put in place to mitigate those, but also continuously review those controls, reviewing the effectiveness of those controls and overlaying those for risk that risk management process are these concepts of ongoing consultation and management commitment, because that top down focus is really what's needed to ensure that cultural change actually takes place and that the controls that are in place are actually being effective. They do talk about the different levels of control. So, you know, eliminating, reducing, minimizing, substituting controls, as to Mark spoke earlier, sometimes you can't eliminate them. But what are the best strategies you can to achieve controls that are actually going to reduce harm to your workforce? And one of the best ways to do that is to have consultation ongoing with your workforce. Workplace Health and Safety also often talk about a really good analogy around a dirty fishbowl. So it's image of a dirty fishbowl. And in that fishbowl, there are two fish. It's one that's mentally well and one that's mentally unwell. And then they basically explain that what you need to do is to clean that fishbowl, that environment, look at the design of the environment, the relationships in that environment, so that both of those fish become well, because staying in an environment that's not mentally healthy for your workforce will make both of those fish unwell. The one that was unwell and the one will become unwell. So it really is that design of the environment and thinking about the relationships about how people work together. You know, it might be plant-based equipment. It might be the environment that they work in on different sites. So really thinking about that whole environmental approach to managing what those risks look like, all those hazards look like, and then being able to support your workforce to be able to address and control them. Also, Workplace Health and Safety have some great tools to start that process. They've got the People at Work Survey and they've got the Mentally Healthy Workplaces Toolkit, and they're also just these guides that employers can use to guide them through this process. They know that the outcomes and what they're achieving is actually meaningful and it's also sustainable. Thanks, Michelle. And I guess this question probably leads on from what Michelle has just spoken about. Mark, have you got any tips on how to build a culture and accountability at all levels within a workplace? And Wendy says she's witnessed aggression against another colleague, but the behaviours were not addressed at leader level. So advice for influencing leaders and going all the way to the top. Yeah, it's a great question and a tough one as well. And I think it's quite challenging as an employee when you might not necessarily have that sense of control or influence in the organisation to be addressing some of these harmful behaviours. I think when we look at internal interactions, it's that difference between being a bystander and an upstander. And how do we encourage people at all levels in the organisation to be an upstander? But to do that, we need to give people the capability and the confidence to do it, because it's a challenging conversation to have with someone to say that, actually, you know what, this behaviour isn't acceptable and we're not going to tolerate it, especially if it's a peer or if it's a senior person. So part of that culture then is also ensuring that we have the appropriate escalation pathways to make, you know, I can report it safely and without fear of repercussions. So whether that's through to HR or whistle-blower and those types of aspects. But it has to come up from the top. The behaviour needs to be role modelled and it needs to be called out for that systemic change. And do these need to be confidential so that, you know, word doesn't spread across the organisation? Yeah, absolutely. Confidential reporting pathways is important so that, you know, it is managed in a way that will protect privacy. Alicia asks, can you give an example of systemic preventative interventions controls other than physical controls? For example, what can an organisation do to ensure the customer is less likely to be aggressive or reactive in the first place? Yeah, look, I can I think it's I can give a couple of examples and I think it's very dependent on industry. So and the nature of the work that we're doing. So, for example, working with a finance institution, looking at what were some of the main triggers. And one of the main triggers was this idea of actually withdrawing my money and not having my ID. So there's a certain limit. And what they found was that actually, you know, people wanted to withdraw slightly over that limit. They didn't have their ID. They were being turned around, turned away. And that led to increased customer aggression events. By increasing that limit, we were actually able to reduce the amount of customer aggression events to within. So protecting our people's safety by taking on a little bit more risk from that perspective. Another example is looking at some human factors components around the information that was being presented to the customer. And actually, when we were looking at the notification component, one of those key aspects of the notification of people requiring ID to do something was so small that people were missing it. So by the time they're getting to the shop front, they wanted to use their pick something up and they couldn't because they didn't have their ID. So looking at actually how we communicating and making it more obvious for people that they needed those components to actually Or educate them before they get to that shop front. Absolutely. Yeah. So there's lots of different things. And I think if we if we look at that risk assessment component and actually start to identify it and the more data we have, then the more data informed we can be around some of those systemic level controls. Okay. Back to you, Michelle. How can organisations collaborate with WorkCover Queensland to best support workplaces with employees in the process of recovering from mental injuries? Oh, good question. And the key word there, I would say is about partnerships. So WorkCover really do want to partner with employers because they're a key part of that ecosystem to ensure a successful and a sustainable return to work for someone who's recovering from a mental injury or mental ill health, but also engaging in their treatment. And the best way to do that is collaboration with us. So within our claims teams, we have our customer advisors who are there to talk to employers, explain the steps about a process, but also talk to them about what best practice engagement is. It's interesting in all of my time at WorkCover how sometimes not all employees can undervalue the importance of communication. Sometimes I think, look, I'm concerned that I might reach out to my employee who's unwell, and I might trigger them, or that my communication might be unwelcome, or they don't want to hear from me. And I suppose to try to unpack that with either your consultants or your HR team, or even with us to really understand what is the risk that that's there. And perhaps you can put that on the table with that injured worker and talk freely. It's important that the person who's reaching out to those workers during that climate recovery is someone that's meaningful to them. So perhaps that direct line manager or supervisor who they had in the workplace. So engaging with those people and making sure that they feel confident and probably to Mark's point earlier, making sure we're giving out those leaders the capability to lean into those mental health conversations. They feel comfortable and capable of having them as well. And then return to work as part of treatment is really important. So encouraging or working with WorkCover to explore what suitable duties might look like in the workplace. Perhaps we can engage together workplace rehabilitation consultants or return to work specialists who might be able to identify what light duties are. And we get the buy-in and the approval from the doctor to perhaps trial what those light duties are. But getting people back in the door can just be that first important step to supporting their recovery and actually helping that conditioning of getting them back to work. We know from the data that people being isolated at home isn't healthy for them. And we know that they'll be accessing treatment. But a real complement to treatment is normalising their lifestyle, continuing to talk to their employer and WorkCover being able to work with the employer to help them step through that return to work process. And we do that, as I say, that entire ecosystem of support. And that's where we see the best types of outcomes. The other tip I would approach that's really important for employees is the readiness of the workforce for when that person returns. So perhaps that worker who's recovering from mental injury has been off work for an extended period of time. And whilst they might be recovering positively and keen to return to work, there's lots of fear and uncertainty for them about returning to the workplace. What might my colleagues think? They might already have pre-ideas about what the culture of my workplace or that particular site was like. So how can an employer, through good communication, and we can do that in a three-way conversation, how can we all lay those fears for the injured worker? How can we perhaps even learn from what has happened to that injured worker to maybe raise the awareness around mental health and talking about wellbeing holistically in the workplace? So that transition when people come back to the workplace is a really smooth and also a sustainable one. That's what we want with, you know, in a claims environment. We want return to work and recovery outcomes to be sustainable. We don't want it to be a case of someone's good that day and then we forget their ongoing or the aftercare once a claim may close or a person may be signed off from that doctor. So also encourage employers to think about what they can learn from these types of claims. And WorkCover can give them data about what their trends look like and what's happening in the workplace that can really feed that type of insight for employers as well. And Michelle, while you're on a roll, can you discuss some considerations from a common law perspective? Common law always comes up, thank you, because it seems to be this mystical beast for employees that I don't know what happens, you know, behind that curtain. And I suppose very practically there are some concepts, firstly, that aren't common law related, but I will share that are really relevant for employees in this space.No matter the nature of the claim or the injury or the relationship broke down or perhaps if the relationship thrived hopefully as part of that recovery or return to work process. But good record keeping for employees is really important. And having them point in time is very good. If we're thinking about, you know, a common law claim which comes on after that statutory phase can be years down the track. So having point in time records is important. I would reiterate my point around contact and communication. At a common law stage, having had an ongoing dialogue and relationship invested in with my employer if I was off work can really be positively impactful at that common law stage. And there was also changes to our legislation a couple of years ago that introduced essentially the concept that employer, if you say sorry to a worker for what happened for them, that is not an admission of liability. Because what we learned from employers and their experience of going through the common law process over time was that they felt that saying sorry was an admission of liability. And actually what we learned from workers was sometimes just hearing sorry or I understand or I regret what happened can make all the difference to someone's experience. So there are some key concepts in terms of what's I often think of what's in the employers control. So that's in the employers control. They can control those things. The other concepts around common law, which are good concepts for employers to be aware of, are things like foreseeability. So at a common law stage, we know in a statutory claim there's no fault, but at a common law phase fault does come into play. So at a common law stage, plaintiffs and panel solicitors will be looking at was it foreseeable that that instance of customer aggression could have happened? And really to try to understand that concept. And for an employer to turn their mind to, well, what do I understand? Do I understand that my workplace is inherently risky or is it not? Or is there some element of risk and what am I doing to mitigate that risk? Again, we come back to that conversation around the psychosocial hazard code of practice. We also encourage them to think about reasonable person. So what would a reasonable person expect in this circumstance if they might be exposed to risk in the workplace and how might they respond and what are the mitigating strategies that I would expect an employer to have in place? And also there's the concept around breach of duty. So essentially has an employer breached their duty to keep someone safe in their workplace? I like to convey those points because that is really what contributes to that heads of damage, the cost of a common law claim. And just knowing those concepts at the very beginning, perhaps of a claim or even from a preventative approach can really inform employees and help them think of what's in my circle of control? What are my knowns? What are my unknowns? And how can I proactively address them? Because not only doing that, does it obviously keep their workforce safe, but it helps them with their claims experience as well. Thank you. Let's go to Mark and Janice would like to know if you find the way staff interact with clients is a big trigger in aggressive behaviour and in cases where employees face repeated instances of inappropriate customer behaviour, what strategies can these organisations employ to provide adequate support and prevent burnout or trauma? Great question. So Janice, absolutely, there is research that suggests the quality of the customer interaction can be a risk factor for aggressive customer behaviour. So where we might have lower quality customer interactions, we're more likely to see aggressive customer behaviour. So absolutely, there's that interaction and relationship there. So what does that actually mean? Well, are we investing in upskilling our people to have good quality customer interactions? And do we know what that looks like? And are we engaging with our customers? Are we actually asking them what good looks like as well? Often when we're talking about the code of practice, we're talking about consultation with our employees and it's absolutely vital and critical. But when we're talking about this particular hazard, are we actually engaging with our customers and getting that feedback as well around what some of those other triggers might be and the challenges that they face interacting with us as a provider? I think then the next piece around that repeated exposure and how can we protect or prevent or put mitigating strategies in place. I think there's a couple of things to think about. So the first one is work design and where we know that there might be job roles with cumulative exposure. Can we reimagine how work is done or can we think about things like task rotation or job rotation, giving people the time in the day to go and do something different where they might not necessarily be exposed to that behaviour? I think the other thing that's critical is how do we enhance support for those people in those roles? And so that might be ensuring that our leaders have the capability and confidence to be having those regular checking conversations, that we have escalation pathways in place for when people might be experiencing compromised mental health and wellbeing. Are we intervening early and are we putting all those systems in place to support the worker? This next question is for both of you. So you've got the floor at the moment, Mark. So I'll let you go first and Michelle, if you can respond as well. If a worker has experienced violence or aggression, what steps would you encourage them to take to raise this, especially for young workers who are most vulnerable in organisations who may not have been exposed to this before, particularly if the aggressor is their direct manager or supervisor, they're not quite sure how to deal with this because this is the first time this has happened to them. Violence and aggression isn't always physical or immediately apparent. You know, it might be an afterthought and you go, oh my God, you know, and you think, well, how do I deal with this now? Yeah, I think, I think, wow, it's a complex question, right? And there's a multitude of things to think through. So I think the first one is making sure that you're looking after yourself and you're leaning on your own support, I guess, pathways or mechanisms. So whether that's, you know, engaging with family, friends and the like to get that immediate support in the organisation, it, you know, depending on the size of the organisation, that support might be through the Employee Assistance Program or similar for that kind of confidential service or that confidential counselling service. I think the other component is, you know, depending on the size of the organisation, whether there's a HR team, another leader, or a whistleblower scheme or some sort of confidential reporting that you can engage in to raise that in the workplace so that it can be addressed. And I'll leave Michelle to talk about some of the other external options that they might be able to leverage if those pathways don't exist. Over to you, Michelle. Thank you. Yeah, that's quite comprehensive, Mark. And I suppose the point of difference within the claims scheme is perhaps even talking to a doctor. So a little bit outlier, looking after yourself first, perhaps asking the EAP. There might be a trusted person in the workplace. So, you know, for some industries, you have mates, connectors and construction as an example, you might have a peer support network to get that immediate help and make sure that your wellbeing is in check. And of course, from a claim perspective, talking to your doctor and checking your signs of well or unwell and perhaps unpacking the scenario with the doctor and really checking in again, I suppose, with that HR or a trusted leader concept to understand your options for lodging a claim. And certainly anyone can do that and work cover steps you through that process.There might be information in your orientation when you began at the place of employment or that something's familiar to you through the HR professionals that you connect with. But certainly going through that claim process is something you can do and work cover will step you through that. All we require is you can complete an application form online or over the telephone with work cover. And we just require that during that determination phase that you do have a medical certificate from your doctor. That perhaps outlines what was causative to your lodging, your claim and what happened in the workplace and what perhaps are the symptoms that you're experiencing. And then work cover, engage in that process from there. Obviously, as an insurer, we need to check in with you and ensure that you can access the support you need. In the last legislative provisions that were changed a couple of years ago, where workers lodge a mental injury claim. During that determination period where we haven't even decided liability and we're going through those steps, you can actually access early psychological support. So which is pretty much includes anything except inpatient hospitalisation. It might be extended consultations with your doctor or it could be you accessing a counsellor, a psychologist, a rehab counsellor, a social worker in mental health, whatever that looks like. And work cover will come those costs during that determination phase. So that can really support people with that early access to treatment and recovery while you're going through a process that might be somewhat unfamiliar. All right, time on the wing. Let's move to our last question and I'll direct it to you. But Michelle, if you want to make a comment after Mark's responded, that's fine. Can you talk about some of the other methods in which perpetrators may use what might be more subtle or harder to define? It's all a bit grey and it may not strike the victim immediately like a head on, but at a later time they might think, well, yeah. It's a great question. I think if we broaden it from occupational violence to that inappropriate customer behaviour piece. So I think often when we look at that component, we start to think about people yelling, swearing, spitting, threatening, vists, banging things, throwing furniture and that kind of stuff. And it's really obvious behaviour to pick up on. But sometimes when we think about why this behaviour is occurring, it's to intimidate or to exert power to get what I want. And so sometimes it can be as simple as actually dropping the tone of my voice and speaking in a very firm and direct manner in a way that's inappropriate. I think when we broaden that definition of inappropriate behaviour, actually seeing other forms of discrimination and harassment from customers as well. And so that might be sexual or otherwise in nature and it quite be quite covert. So it's not as overt in nature. It could be a gentle touch, a suggestion or all those types of things. So absolutely, there's those types of behaviours. I think the other one that we often fail to capture in this is often it's about threats to other people. But sometimes it can be threats to self as well. So whether that's threats of self-harm or suicide and recognising that whilst a different scenario can absolutely have a similar impact on our workforce. So thinking through some of those other behaviours that might form into how we manage that in the workplace. Michelle, anything to add? So I think again, I think they're quite comprehensive. I suppose Mark's talking to external customers and I suppose sometimes that we do see a lot is within the one business is the internal customers. So and that can again take the form of perhaps very subtle bullying, gaslighting. It might be in a minority group being excluded from events. So that can be quite subtle as well, something that people don't notice until there's a pattern of behaviour as well. But that can certainly help. So sorry, certainly occur in the workplace as well as things that can be threats and things like that can happen verbally. But things that can actually be an undertone in writing can be forms of aggression as well. I just want to ask one question without notice, and this comes from a personal point of view that I'm allowed out there kind of guy that uses hand gestures and has quite a booming voice. Can that be deemed, if I'm not careful, to someone who is soft in nature and is a bit gentler, my actions, because I speak so voluminously, be seen as aggression if it continues, particularly if they've said something to you that says, oh, I'm a bit overwhelmed or I feel a bit intimidated? I think we all have to be mindful of our behaviours and how we're impacting others. And so whilst there might not be any malintent there or maliciousness, sometimes it can be perceived that way. And so I think it's important to have that self-awareness and check in with how other people being influenced or impacted by what I'm doing and listen to what they've got to say. Absolutely. Thank you very much both for joining us today. Really appreciate your time. And thank you for those who have joined us. We hope you've learned some valuable takeaways to help protect the psychological health of workers in your workplace. As we wrap up the event today, can I ask you to scan the QR code that will pop up on your screen? There it is. To complete our short and anonymous survey, your feedback is really important to help us evaluate the program and obviously inform planning for future events. Check out the website, worksafe.qld.gov.au for other events and to access the recordings from all of the live streamed events that we've hosted during this Mental Health Week for 2023. For more information on support services available, please visit the sites that are up on your screen. These sites are invaluable. And should you need them, please take advantage. There are links and websites and phone numbers there. And you can go back and have a look at those if you don't have time to look at them at the moment and go through them. Well, that brings us to our conclusion on behalf of Workplace Health and Safety Queensland. Thanks for joining us for this special Mental Health Week presentation. Our thanks to Mark and Michelle for joining us. Enjoy the rest of your day, as always. Work safe, home safe, key message as always, but particularly during Safe Work Month.